Knee pain in children

Posted by Brendan Hill G.S.R on Wednesday, August 6, 2014

I have had a 14 and 15 year old male into the clinic in the last few weeks with knee pain that turned out to be Osgood-Schlatter disease. Disease makes it sound worse than it is. This condition that occurs in girls of about 10-12 yrs and boys of about 13-15 yrs, although these ages may vary. Osgood-Schlatter usually occurs in adolescents who are undergoing a growth spurt and are involved in a high level of physical activity, especially in sports involving running and jumping. The condition usually occurs in one knee but at can occur in both. Pain is usually felt around the tibial tuberosity, which is a bony point just 1-2 cm below the knee cap where the quad muscles attach to. It can be regarded as an over use injury as repeated contraction of the quad muscles may place excessive stress on the growth plate at the tibial tuberosity. A growth plate is a layer of cartilage near the end of a bone where most of the bone's growth occurs. It is weaker and more vulnerable to injury than the rest of the bone. 

Other symptoms include;
• pain that worsens with exercise
• relief from pain with rest
• swelling or tenderness around the tibial tuberosity 
• limping after exercise
• tightness of the muscles surrounding the knee (the hamstring, quads and calf muscles)

While there is no evidence to show that rest accelerates the healing process it has been shown that reduction in activity will lead to a reduction in pain. If the adolescent plays for several teams it may be advisable to reduce the number that they play for. Pain should be the main guide as to the amount of activity that they take part in. 

Ice the sore area after activity for 15-20 mins. Soft tissue message on the calfs, hamstrings and in particular the quads should help relieve symptoms. A stretching program should be implemented to increase the muscles length. Taping the area may help. The biomechanics of the foot may need to be examined to see are the adding to the problem. 

Ultimately Osgood-Schlatters in a self limiting condition, which generally resolves when a teenager achieves skeletal maturity, so symptoms can last for up to 12-24 months. It has been suggested that greater than 90% of patients respond well to the conservative management techniques that I mentioned above

Brendan Hill G.S.R.
Ennis Injury Clinic

Tags: osgood schlatters 

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