Is your child suffering from knee pain? It could be Osgood-Schlatter Disease!

Does your child complain of knee pain? Does he/she complain that the pain gets worse when playing, running, or jumping? If so, it could be due to a condition called Osgood -Schlatter Disease. Don't worry, let's talk about it in more detail.

What exactly is this Osgood-Schlatter condition?

Simply put, Osgood-Schlatter is a condition that occurs in the growth plate , which is located just below the knee, on the top of the shinbone. Now you may be wondering what this growth plate is. Think about it, when we are young, our limbs grow longer and taller. This is a special place that helps the bones grow. This is a part near the end of a bone, made of a substance similar to cartilage . This part is where the most growth of the bone occurs. However, this growth plate is a little weaker than other parts of the bone, so it can easily be damaged. This Osgood-Schlatter condition usually gets better once the child stops growing, and it rarely causes long-term problems.

Who gets this more often?

Osgood-Schlatter disease is most common in children between the ages of 9 and 16. Boys are more likely to develop it, but girls can also develop it, especially if they play sports. The main reason for this is that children grow very quickly during this time, called a "growth spurt." Also, children who are active, run, and jump, especially those who play sports such as soccer, basketball, volleyball, gymnastics, long jump, and high jump, are more likely to develop this condition. This is because these sports put a lot of pressure on the knees.

Why is this happening? What are the reasons?

Okay, now let's see why this happens. When your child runs, jumps, or bends their knees , a large muscle in the thigh above the knee (we call it the ``Quadriceps`` muscle) is activated. This muscle passes through the kneecap and is attached to the top of the patella, the growth plate we talked about earlier, by a strong tendon. We call this tendon the ``Patellar Tendon``.

So, when a child is constantly running or jumping, this ``Quadriceps`` muscle contracts and pulls on the growth plate through that tendon. When this kind of pulling is repeated, that sensitive growth plate gradually starts to get injured and swollen. That is what causes a small swelling or lump to form in that area.

Especially during a child's growth spurt, the bones grow rapidly, but the muscles and tendons may not grow at the same rate. Then the tendons become tighter and put more pressure on the growth plate. That's why Osgood-Schlatter disease is more common during this time.

Does your child have these characteristics?

How do you know for sure if your child has Osgood-Schlatter disease? Here are some symptoms to watch out for:

• Pain below the knee, above the kneecap: To be precise, this pain occurs in a place that feels like a small lump when touched with your hand, just below the kneecap. Sometimes this lump can be slightly larger and visible.
• Swelling and tenderness in the area: If you touch the lump, you may notice that the child is in pain.
• Pain increases with activity: This pain increases significantly when running, jumping, climbing stairs, climbing mountains, or kneeling. The pain may persist even after you finish playing.
• Sometimes limping: If the pain is severe, the child may walk with a limp, especially during or after play.
• Occurrence in one or both knees: This condition can affect only one knee, or it can occur in both knees at the same time. Usually, about 20-30% of children develop it in both knees.
• Gradual increase in pain: This is not something that happens all at once. Usually, the pain increases gradually, over a period of weeks or months.

Imagine, your son Chamath is on the school cricket team. When he comes home after practice, he always says, "Mom, my knee hurts," especially when he touches the area below the knee. After a while, you see that it's a little swollen. It hurts the most when he runs and fields. That's what happens in this case.

How does a doctor recognize this?

When you take your child to a doctor, the doctor will first ask you and your child about the pain, how often it occurs, what activities your child engages in, and whether there has been any previous knee injury.

The doctor will then examine the child's knee. They will feel the painful area, look for swelling, and watch how the knee bends and straightens, as well as how the child walks. Sometimes the child may even be asked to do things like jump or sit on their knees to see if the pain is still there.

Most of the time, the doctor can diagnose Osgood-Schlatter disease based on these symptoms and an examination. An X-ray is usually not necessary. However, if the doctor suspects another serious condition, such as a fracture, infection, or tumor, or if the symptoms are unusual, an X-ray may be ordered.

What are the treatments for this? Things you can do at home

The good news is that Osgood-Schlatter disease can be completely cured with time . Once the child stops growing and the growth plate becomes a strong bone, the pain will go away on its own. But until then, there are some things we can do to manage the pain and provide comfort to the child.

The most important thing is patience. This is not something that will heal in a day or two. The pain may subside over several months, maybe even a year or two.

Here are things you can do:

• Rest and activity restriction: This is the most important thing. You need to temporarily remove your child from any activity that causes pain. This means stopping running, jumping, and other activities that put pressure on the knees. Allowing them to play through the pain will only make things worse. You need to make your child understand that this is only temporary. Once the pain subsides, you can gradually start playing again.
• Ice: Apply ice to the area of ​​pain and swelling for 15-20 minutes several times a day. Do not apply ice directly to the skin, wrap it in a cloth. It is especially good to apply ice immediately after playing.
• Painkillers: A general painkiller like `( Paracetamol )` can be given on the advice of a doctor. Sometimes the doctor may also recommend an anti-inflammatory like `(Ibuprofen). Do not give any medicine without the doctor's advice.
• Stretching and strengthening exercises: Stretching and strengthening exercises for the quadriceps and hamstrings can help a lot. These increase the flexibility of the muscles and reduce the pressure on the tendons. However, these should be done when there is no pain. It is best to see a physiotherapist and learn the appropriate exercises for this.
• Knee support/strap: Some children find that a special strap or support worn under the knee helps reduce pain. This helps take some of the pressure off the patellar tendon and reduces the impact on the growth plate. Ask your doctor about this.
• Be patient: As mentioned earlier, this takes time. Pain may flare up here and there for months, maybe even a year or two, especially if activity increases. The most important thing is to be patient and wait for your child to grow.

Can this be prevented from happening again?

It's difficult to completely prevent Osgood-Schlatter disease, as it's related to a child's development. However, there are some things you can do to help manage the pain and reduce the frequency of flare-ups:

• Warm-up before playing and cool-down after playing: This is very important. You need to prepare your muscles and tendons for the activity. Set aside at least 5-10 minutes for this.
• Regular Stretching: Stretching the muscles in the front of the thigh (`(Quadriceps)`) and the back of the thigh (`(Hamstrings)`) regularly is essential. This increases the flexibility of the muscles and reduces the pressure on the tendons.
• Gradually increase your training: It's not a good idea to suddenly increase the amount of training or the intensity. You should increase it gradually and systematically. It's best not to increase your training time or intensity by more than 10% per week.
• Proper footwear: It is important to wear good quality, athletic shoes that help reduce stress on the knees while playing sports. Avoid wearing worn-out shoes.
• Listen to your body: If you feel pain, don't ignore it and continue playing. Pain is a signal from your body, you need to listen to it and rest. The saying "No pain, no gain" doesn't apply in this situation.

Is it something to be afraid of? When should I see a doctor?

Many parents are afraid of this, thinking, "Oh, my child's knee is seriously injured." But Osgood-Schlatter is not a serious, long-term condition. As mentioned earlier, it usually gets better on its own once the child is fully developed. In most cases, there is no permanent damage. Maybe that little lump under the kneecap will stay for a while, but it's not painful, it's just a cosmetic issue.

However, in cases like these, you should definitely see a doctor:

• If the pain is very severe, if the child cannot bear it, if he cannot perform normal activities.
• If the pain does not subside after two to three weeks of home treatments (rest, ice) or if it gets worse.
• If the child walks with a clear limp and cannot bear weight on the knee.
• If the swelling is excessive, the knee is red, and there is warmth (these may be signs of infection).
• If the pain is present at night, that is, if the pain occurs even when the child is resting, if the pain is severe enough to wake the child from sleep.
• If you have knee pain along with other symptoms such as fever, body aches, and weight loss.

At times like this, it's important to see a doctor to determine exactly whether it's Osgood-Schlatter or some other condition.

Take-Home Message

Okay, so I hope you now have a better understanding of the Osgood-Schlatter Disease condition we talked about.

Finally, the most important things to remember are these:

• Osgood-Schlatter is a knee pain condition that affects growing, active children .
• This is caused by pressure and minor injuries to the growth plate, located above the tibia, below the knee.
• The main symptoms are pain below the knee, swelling, and pain that increases with activity.
• Rest, ice, and avoidance of activities that cause pain are the main treatments. Physiotherapy is also very important.
• This condition is not serious and will improve on its own as the child grows.
• However, if the pain is severe, does not subside, or if there are other unusual symptoms , definitely see a doctor.

So, if your child also has these symptoms, don't panic, give him the necessary rest, and seek advice from a doctor before dealing with this situation. The most important thing is to make the child understand this and be patient.