Does your child's knees hurt all the time? It could be Osgood-Schlatter Disease!

Does your child love to play sports? Is he or she eager to run and jump? If your child complains of knee pain, especially below the kneecap, it could be due to Osgood-Schlatter Disease. The name sounds a bit scary, doesn't it? But it's really nothing to be afraid of. Let's talk about it simply.

What is Osgood-Schlatter Disease?

Simply put, Osgood-Schlatter disease is a swelling and inflammation of the growth plate, located at the top of the shinbone, just below the knee in children. Think about it, our children's bones grow as they grow. Near the ends of these bones, there are special areas made of soft cartilage. That's what we call growth plates. These growth plates are the main contributors to a child's height and bone length. They are a little weaker than normal bones, so they can be easily damaged.

Osgood-Schlatter disease is a condition in which the tendons (particularly the patellar tendon, which connects to the quadriceps muscle in the front of the thigh) that attach to the growth plate at the top of the shin bone (known medically as the tibial tuberosity) below the knee become inflamed. This can feel like a small lump.

The important thing is that this condition usually completely resolves as the child grows older and rarely causes major long-term problems.

What are the symptoms of this? How do you recognize it?

If your child has Osgood-Schlatter disease, he or she may say things like:

• Pain below the knee: This is the main symptom. The pain occurs just below the kneecap, at the top of the kneecap.
• Swelling: The area of ​​pain may be slightly swollen. Sometimes it may feel like a small lump that can be caught in the hand.
• Tenderness: If you touch or press on the lump, it will hurt the baby.
• Pain increases with activity: Pain increases with activities that put weight on the knee, such as running, jumping, climbing stairs, or hiking. It may hurt for a while after you finish playing.
• Possibly limping: If the pain is very severe, the child may also limp a little when walking.
• In one or both knees: This condition can occur in just one knee or in both knees.

Imagine your daughter or son is on the school netball team, or playing cricket. When they come home from training, they say, "Mom/Dad, my knee hurts." When you look at it, it looks a little swollen under the knee. If you put your hand on it, they say, "Ouch!". They say it hurts the most when they run and play. If you've had an experience like this, it's very likely that it's Osgood-Schlatter.

Why is this happening? What are the reasons?

The main reason for this is the rapid growth spurts that children go through. During this time, children's bones grow very quickly. But sometimes the muscles and tendons don't grow at the same rate.

The large muscle group at the front of the thigh (the ``Quadriceps`` muscle) passes through the kneecap and is attached to the growth plate (``Tibial Tuberosity``) on the top of the shin bone by a tendon (``Patellar Tendon``). When the child runs, jumps, or bends the knee, this ``Quadriceps`` muscle contracts. Then, a pull is created on the growth plate through that tendon.

As a child's bones grow rapidly, these muscles and tendons become relatively tight. Then, when the knee is subjected to repetitive stress, such as during sports, the tension on that growth plate increases, causing it to become compressed, swollen, and painful.

In particular:

• Basketball
• Volleyball
• Soccer
• Gymnastics
• Athletics such as long jump and high jump

This condition is common in children who play sports.

Who is most likely to develop this condition? (Risk factors)

Osgood-Schlatter disease is most commonly seen in:

• During periods of rapid growth: Boys grow faster between the ages of 10-15, and girls between the ages of 8-13. That's when it's most likely to develop.
• Active, sporty children: Children who play sports that involve running, jumping, and changing directions quickly are especially at risk.
• For boys: Although this condition is more common in boys than girls, the gap is narrowing as girls are now also getting involved in sports.

How does a doctor recognize this?

In most cases, a doctor can tell if this is Osgood-Schlatter disease by listening to your child's symptoms and examining them.

The doctor does things like this:

• Ask the child about the pain, how long it has been there, and when it gets worse.
• They feel the lumpy area under the knee, press it, and see if there is any pain or swelling.
• They ask the child to run, jump, or kneel to see if it hurts.
• Checks the tightness of the thigh muscles (Quadriceps, Hamstrings).

An X-ray is usually not necessary. However, your doctor may order an X-ray only if they suspect a more serious condition (such as a broken bone, an infection, or, rarely, a tumor). So don't worry if they say they don't need an X-ray.

What are the treatments? What should we do?

The good news is that Osgood-Schlatter disease often does not require specific, extensive treatment. The main goal is to reduce pain and swelling and provide comfort to the child.

Here are some things you can do:

1. Rest and Activity Modification:

• This is the most important thing . You need to reduce or stop the child's sports or activities that increase the pain for a while. You don't need to stay in bed completely, but you need to stay away from the things that cause the pain for a while.
• Once the pain subsides, you can gradually resume activities. However, it is not a good idea to put on heavy weights all at once.

2. Ice Application:

• Apply ice to the area of ​​pain and swelling for 15-20 minutes, 3-4 times a day. Do not apply the ice directly to the skin, but wrap it in a cloth. It is also a good idea to apply ice after you have finished playing.

3. Pain Relievers:

• If the pain is unbearable, you can ask your doctor or pharmacist to give you a painkiller like Paracetamol or Ibuprofen. But it is not a good idea to give these continuously. Only give them as your doctor tells you.

4. Stretching and Strengthening Exercises:

• It is very important to do stretching exercises for the quadriceps and hamstrings. When these muscles become more flexible, the pressure on the growth plate decreases.
• You can also do strengthening exercises to strengthen these muscles.
• It is best to seek the help of a physiotherapist to learn exactly how to do these exercises.

5. Protective Straps or Pads:

• Sometimes, using a special strap or knee pad worn under the knee, over the patellar tendon, can help reduce pain. These help reduce the pressure on the growth plate during sports.

6. Sometimes temporary immobilization (Immobilization - Rare):

• Very rarely, if the pain is very severe, a doctor may recommend using crutches or putting a plaster of Paris (cast) on the leg. However, this is not necessary in most cases.

Remember, the key to these treatments is to listen to your child's body. If pain occurs, stop the activity. Don't force yourself to do anything in pain.

How long will it take for this to heal?

This varies from person to person. The pain can last from a few weeks to a few months. For some children, the pain may subside after a few days and then recur when they resume activities.

The important thing is that this pain may come and go until the child's growth plate has completely turned into bone and stopped growing (usually around 14-18 years of age). But the bony bump may still be there. It is usually not a problem and does not hurt.

Could this cause long-term problems?

Most of the time, Osgood-Schlatter disease does not cause long-term problems. It usually goes away completely as the child grows older.

However, the bony prominence under the kneecap may persist in some adults. It is usually painless and does not interfere with activities.

Very rarely (this is very rare), a small piece of that growth plate can not heal properly and cause pain in adulthood. If that happens, you may need to have a minor surgery. However, this is very rare, so don't worry too much about it.

Can this be prevented?

Although it cannot be completely prevented, you can do the following to reduce your risk:

• Warm-up and cool-down properly: It is important to warm up before starting any sport and to cool down after the sport.
• Regular Stretching: Regular stretching of the muscles , especially the front of the thigh (`(Quadriceps)`) and the back of the thigh (`(Hamstrings)`), can help maintain their flexibility.
• Gradually increase your training: Don't suddenly increase the intensity or duration of your training. Increase it gradually.
• Appropriate footwear: It is important to wear footwear that is appropriate for the sport and comfortable for the feet.
• Avoid overtraining: Also make sure your child gets enough rest.

When should I see a doctor?

In cases like these, you should definitely see a doctor:

• If the pain is so severe that the child cannot bear it.
• If the pain does not subside after home treatments (icing, rest).
• If the pain makes it difficult for the child to do daily tasks or go to school.
• If there is severe swelling, redness, or warmth in the knee (these may be signs of infection).
• If the child has a fever.
• Find out exactly if this is really Osgood-Schlatter, or if it's some other problem.

Finally, things to remember (Take-Home Message)

Osgood-Schlatter disease is a temporary condition that is common in active, growing children. Although the name may sound scary, it is not a serious condition.

• This is related to the child's development.
• The main thing is to control pain and swelling.
• Rest, ice, and exercise are the main treatments.
• Most of the time, this completely resolves once the child's growth stops.
• Long-term problems rarely occur.

So, if your child has these symptoms, don't panic and consult a doctor for advice. Give your child the support and encouragement they need. In no time, your child will start playing again!

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