Osgood Schlatter Disease

A 13 year old female presented to the office with bilateral (both) knee pain. She stated the pain was worse when running but better on rest. The pain started during field hockey season and has persisted for months. She denied any trauma or injury. Exam was remarkable for tenderness right below both knee caps. Radiograph findings were consistent with Osgood Schlatter Disease.

Osgood Schlatter disease is a benign condition that causes pain, tenderness, and/or swelling below the knee cap, over the shin bone (tibia). It is typically seen in active teenagers eleven to fifteen years of age (during the growth spurt years) with a male to female ratio of 3:1. The pain is caused by stress on the patellar tendon that attaches to the quadriceps at the front of the thigh to the tibial tuberosity. The repeated stress from running, jumping, gymnastics, dancing, etc, causes inflammation and possible avulsion fractures at the site which leads to the pain and a bony lump. The pain is typically worse during activity.

The signs and symptoms include:
1. Pain on the upper shin, below the knee cap...can be intense!
2. Swelling at the site
3. Tender bony lump
4. Tight quadriceps


Osgood-Schlatter disease affects about 20 percent of adolescents who participate in sports. The sports include soccer, football, basketball, ballet, gymnastics, volleyball, field hockey, lacrosse, etc...

Diagnosis is made by history, physical, and x-rays.

Treatment includes:
RICE
R = Rest the knee from the painful activity.
I = Ice the affected area for 20 minutes, 3 times a day.
C = Compress the painful area with an elastic bandage.
E = Elevate the leg.

Anti-inflammatories (Motrin, Advil) also will help with the pain.

Physical therapy is utilized to strengthen the quadriceps and hamstrings. Some examples include straight leg raises, quad contractions, and leg curls.

The pain may last for several weeks to several months. Physical activity may have to be restricted depending on the severity of the pain.

With adequate time, treatment, and rest, Osgood Schlatter disease should resolve. Rarely does OSD occur after the growth spurt years due to the strengthening of the patellar tendon.

For more information, contact your primary physician.