Osgood Schlatter disease is painful inflammation that affects kids and teens where their kneecap (patella) connects to their shin bone (tibia). Healthcare providers also sometimes call Osgood-Schlatter disease growing pains.

During the growth spurts of adolescence, certain muscles and tendons grow quickly and not always at the same rate. With physical activity, differences in the size and strength of the quadriceps muscle can put more stress on the growth plate near the top of the shinbone. The growth plate is weaker and more prone to injury than other parts of the bone. As a result, it can become irritated during physical stress and overuse. The irritation can result in a painful lump below the kneecap.

It’s especially common in kids going through a growth spurt. A growth spurt can make lots of parts of a child’s body more sensitive to stress and strain, including their:

• Muscles.
• Bones.
• Ligaments.
• Tendons.

This rapid growth is normal and healthy, but it can make these tissues more likely to be irritated by repeated, everyday stress. If a child uses their knees a lot (like playing the same sport often), overuse can irritate their joints. This irritation may cause pain and swelling.

Causes of Osgood Schlatter disease

Osgood Schlatter disease is a type of repetitive strain injury. As the name suggests, repetitive strain injuries are caused by doing the same motion or activity repeatedly until it starts to hurt the body. Doing lots of intense physical activity (especially the same kinds of motions often) can put lots of pressure on child’s knees (overuse).

Osgood Schlatter disease happens when kids overuse their patellar tendon — the tendon that connects their kneecap to the shin bone. A child’s quad muscle in their thigh squeezes (contracts) to move their knee. Specifically, the quad pulls at the top of their patellar tendon. The tendon attaches their kneecap to their shin bone at a small, bony bump called the tibial tubercle.

The tibial tubercle covers the growth plate at the top of child’s shinbone. Kids and teens have a special section of bone called a growth plate at the ends of some of their longer bones. The growth plate is exactly what it sounds like — a special area that helps bones grow longer and develop into the correct size and shape. Growth plates harden into solid bone when a child has finished growing.

Activities like running, jumping, climbing or training for a sport can all cause Osgood-Schlatter disease. This extra stress and overuse cause swelling and irritation that spreads into their growth plate, which causes the pain and tenderness in child’s knee.

The most common symptoms of Osgood Schlatter disease include:

• Knee pain (especially just below your child’s kneecap at the top of their shin).
• Swelling (inflammation).
• A feeling of tenderness (especially to touch), pain get worse with exercise or movement.
• Tight muscles in child’s legs (usually the quadriceps muscles in their thighs).
• A hard, painful bump on or just below child’s kneecap.

Osgood-Schlatter pain usually builds up and gets worse over time, but it can happen suddenly. Patient/child might have pain in one or both knees. The pain will usually get worse during and after physical activities.

Risk factors

Any child can experience Osgood Schlatter disease, but kids between the ages of 11 and 14 are more likely to. That’s because that age range is usually when kids experience the most growth spurts.

Playing sports that require kids to run and jump a lot can increase their risk, including:

• Basketball.
• Volleyball.
• Soccer.
• Football.

A doctor will diagnose Osgood Schlatter disease with a physical exam. Examine your patient’s knee and the area around it. Ask your patient, when he/she first noticed symptoms like pain or tenderness, and if they play sports or do any physical activities that might have caused their symptoms.

At physical examination lightly press on the front of child’s knee. If that spot is tender or painful, there’s a good chance the child has Osgood-Schlatter disease. Ask your child patients to do some movements with their knee, including:

• Walking.
• Jumping.
• Kneeling.

These motions might hurt, but there’s no risk they can injure or damage child’s knee. Child should feel safe to say when or if anything hurts too much to do, or if they don’t feel comfortable.

Usually, a good doctor does not need any imaging tests to diagnose Osgood Schlatter disease, but it will be better to take a knee X-ray to take pictures of patient’s knee, growth plate and the bones around them.

Osgood Schlatter disease usually resolves on its own once a growth spurt ends. Until then, treatment is focused on relieving symptoms, such as knee pain and swelling. Treatment typically involves:

• Icing the affected area two to four times a day, or after doing physical activity.
• Taking over-the-counter pain relievers, such as ibuprofen or acetaminophen.
• Resting the knee or reducing physical activity.
• Wrapping the knee or wearing a knee brace.
• Stretching.
• Physical therapy/physiotherapy.

Some children may be able to participate in low-impact activities, such as swimming or biking, as they recover. Others may need to stop participating in certain sports for several months, so their bodies have time to heal properly. In rare cases, children with the disease may experience chronic pain or ongoing swelling.

According to allopathy, most children with Osgood Schlatter disease only need at-home treatments, including:

• Rest: Child should avoid the sport or activity that caused the irritation in their knee. A doctor should suggest how long child should avoid playing sports. It might only be a few weeks but may be a month or more.
• Icing: Put ice or a cold pack on child’s affected knee for 10 to 15 minutes at a time a few times a day. Wrap the cold packs in a thin towel to avoid putting them directly on child’s skin. Patient can also massage an ice cube on the painful area. Rub the ice in a circular motion on knee for three to five minutes for even faster pain relief.
• NSAIDs: Over the counter (OTC) medication like diclofenac, ibuprofen or naproxen relieves pain and reduces swelling. Don’t NSAIDs to a child for more than 10 days in a row.
• Physical therapy: Stretching their quad muscles can help relieve tension on child’s patellar tendon. Physiotherapist should advise stretches and some exercises to strengthen the muscles around their affected knee to support it better.

Homeopathic treatment for Osgood Schlater disease

In my (Dr. Qaisar Ahmed) opinion, any disease needs its treatment, every disease should be treated to avoid further and/or from future diseases/problems.

In Homeopathy there are many medicines for bones, cartilage and for ligaments diseases and malfunctioning, very few of them are:

Rhus Toxicodendron

Pains – tearing pains relieved by motion. Rheumatic pains, mucous membrane affections. Affects fibrous tissue markedly-joints, tendons, sheaths-aponeurosis. Knee pain – stiffness and soreness, tenderness, paralyzed sensation, and even stitches, sprains, wrenches, etc. Post-operative complications. Ailments from strains, overlifting, getting wet while perspiring. Septic conditions. Hot, painful swelling of joints. Pains tearing in tendons, ligaments, and fasciae.

Bryonia Alba

Knee pain – knees stiff and painful. Hot swelling of feet. Joints red, swollen, hot, with stitches and tearing; worse on least movement. Every spot is painful on pressure. Constant motion of left arm and leg. all the joints and joint membranes are swollen and affected. The pain experienced is unbearable and increases with motion. The inflamed joints become red and swollen.

China Officianalis

Pains in limbs and joints, sprained. Knee pain. Sensation as of a string around limb. Joints swollen; very sensitive, with dread or open air. Debility, trembling, with numb sensation. Weariness of joints; worse, mornings and when sitting.

Ledum Palustre

Ledum Paul is a best choice for arthritis and gout. Knee pain – acute, tearing pains in the joints; weakness of the limbs and numbness and coldness of the surface; Pain going from below upwards; Pain in small joints; Nodes form in them, and the pains travel up the limbs. The pains are made worse from warmth. The effusion into the joints is scanty and it soon hardens and forms the nodes.

Arnica Montana

Back pain arising from injury, from falls blows – of both recent and remote origin; sore, bruised pain in the back, lameness in the back. Knee pain – extreme sensitivity which makes it impossible to walk.

Caulophyllum Thalictroides

This is an effective medicine for rheumatoid arthritis. It is used when small joints are affected more, compared to the larger joints in the limbs. Arthritis of fingers. The pain keeps on changing positions all the time within a small span of time. Severe drawing, erratic pain and stiffness in small joints, fingers, toes, ankles, etc. Aching in wrists. Cutting pains on closing hands. Erratic pains changing place every few minutes. Gradually shifting pains.

Abrotanum

Limbs – Inability to move. Marasmus of lower extremities, Soreness and lameness; worse mornings. Chilblains itch, frostbitten limbs. Gout in wrists and ankles. Inflammatory rheumatism before swelling begins; metastatic rheumatism, metastasis of rheumatism from joints to heart; to spine etc.

Berberis Vulgaris

pains in the arms, Pains in the shoulder, Cramps like pains, acute pains radiate to the hand and to the fingers – Aching, digging, violent pains in the back of the hand, with sensation of heaviness. Urticarial spot on the back of the hand. Small warts in the fleshy part of the hand, under the thumb. Sensation in the extremity of the finger, as if caused by subcutaneous ulceration. Flat wart on the finger. Redness of the hands, with itching.

Neuralgic pain under nails; tender to touch, paralysis in the knees while walking, Stitches between metatarsal bones, burning pains in the toes.

Calcarea Carbonica

It is an important medicine for Osteoarthritis especially of knee joints. There is mild swelling and pain in the deeper portion of the joint, pain generally worse in cold damp weather.

Like Rhus tox in Calcarea carb the pain is also aggravated when getting up from a sitting position and also by walking. Best for fatty and obese constitutionally and tendency to catch cold easily – patients.

Kalium Carbonicum

Kali Carb is very effective in knee pain, lower back pain etc. The pain – get worse on walking patient have to stop and take some rest before starting to walk again. There is a desire to lie down for relief from back pain. Stiffness or excessive weakness in the back, back pain during menses or after a miscarriage.

Rhododendron

Rheumatic pains which wander from joint to joint with swelling. Knee Pain. Enlargement of joints not due to gouty deposits but – Arthritic nodes.

Cimicifuga

When there are spasms in the large muscle groups. Body feels sore and bruised all over, jerking and twitching of the muscles. The spine feels sensitive, and there is pain especially in the back, neck and shoulders.

Kalmia Latifolia

Kalmia have wandering pains, and it is especially useful in pains affecting the chest i.e. the cost chondral articulation. It has also tearing pain in legs, without swelling; neuralgic type of pain. The pain from the chest portion shoots down into the stomach and abdomen (could be cardiac pain). Sometimes the pain from chest traverse downwards in arm. Knee pain. Numbness.

Hypericum Perforatum

Hypericum Perforatum is most significant medicine for coccyx pain (coccydynia) arising from a fall over the coccyx. Knee Pain.

Colchicum Autumnale

Great remedy for gout. Knee Pain. The typical case calling for colchicum is where the swelling is red or pale, with extreme tenderness to touch, a tendency to shift about from joint to joint, and pains worse on the slightest motion. The smaller joints, fingers, toes, wrist and ankles, are affected; the pains are very violent, patient cannot bear to have the parts touched or to have anyone near him, worse towards evening, a red big toe joint – Inflamed

If the general symptoms of great prostration of the muscular system and abdominal bloating be present colchicum is the remedy.

Cobaltum

Cobaltum should be advised where pain in the back is worse in the sitting position. The pain radiates from the lower back down the legs and feet. Weakness in the legs, Walking may relieve the back pain. Knee Pain.

Phosphorus

Prolonged sitting leads to back pain, knee pain. Weakness in the back may also be felt. Burning sensation in the spine is another feature that may attend. Irritates, inflamed and degenerates mucous membranes. Ascending sensory and motor paralysis from ends of fingers and toes. Stitching pain. Post-diphtheritic paralysis, with formication of hands and feet. Joints suddenly give way.

Causticum

Back pain which has soreness, weakness and stiffness in the muscles that is worse from over exertion. Knee Pain.

The muscles in the legs feel contracted, tight and sore, with restlessness at night. The forearms are weak, even though they are also stiff. These patients feel better in a warm bed or warm shower.

Abrotanum

Limbs – Inability to move. Marasmus of lower extremities, Soreness and lameness; Knee Pain. Chilblains itch, frostbitten limbs. Gout in wrists and ankles. Inflammatory rheumatism before swelling begins; metastatic rheumatism, metastasis of rheumatism from joints to heart; to spine etc.

Berberis Vulgaris

Knee Pain, pains in the arms, pains in the shoulder, Cramps like pains, acute pains radiate to the hand and to the fingers – Aching, digging, violent pains in the back of the hand, with sensation of heaviness. Urticarial spot on the back of the hand. Small warts in the fleshy part of the hand, under the thumb. Sensation in the extremity of the finger, as if caused by subcutaneous ulceration. Flat wart on the finger. Redness of the hands, with itching.

Neuralgic pain under nails; tender to touch, paralysis in the knees while walking, Stitches between metatarsal bones, burning pains in the toes.

Helleborus Niger

Automatic motion of one arm and leg. Limbs heavy and painful. Stretching of limbs. Thumb drawn into palm. Vesicular eruption between fingers and toes.

Antimonium Crudum

Twitching of muscles. Jerks in arms. Arthritic pain in fingers. Nails brittle; grow out of shape. Horny warts on hands and soles. Weakness and shaking of hands in writing followed by offensive flatulence. Feet very tender; covered with large horny places. Inflamed corns. Pain in heels.

Arnica Montana 

Gout. Great fear of being touched or approached. Pain in back and limbs, as if bruised or beaten. Sprained and dislocated feeling. Soreness after overexertion. Everything on which he lies seems too hard. Deathly coldness of forearm. Cannot walk erect, on account of bruised pain in pelvic region. Rheumatism begins low down and works up.

Stellaria Media

Rheumatoid pains in different parts of the body. Sharp pain in small of back, over kidneys, in gluteal region, extending down thigh. Pain in shoulders and arms. Synovitis. Bruised feeling. Rheumatic pains in calves of legs.

Actaea Spicata 

Tearing pains in loins. Rheumatic pains in small joints, wrist, fingers, ankles, toes. Swelling of joints from slight fatigue. Wrist swollen, red, worse any motion. Paralytic weakness in the hands. Lame feeling in arms. Pain in knee. Sudden lassitude after talking or eating.

Sanguinaria Canadensis

Rheumatism of right shoulder left hip-joint and nape of neck. Burning in soles and palms. Rheumatic pains in places least covered by flesh; not in joints soles of feet burn. Right-side neuritis; better touching the part.

Pulsatilla

Drawing, tensive pain in thighs and legs, with restlessness, sleeplessness and chilliness. Pain in limbs, shifting rapidly; tensive pain, letting up with a snap. Numbness around elbow. Hip-joint painful. Knees swollen, with tearing, drawing pains. Boring pain in heels toward evening; suffering worse from letting the affected limb hang down. Veins in forearms and hands swollen. Feet red, inflamed, swollen. Legs feel heavy and weary.

You might not always be able to prevent Osgood Schlatter disease, especially if your child is an athlete. But the best way to prevent it is to make sure your child has a balanced and good organic diet, he/she takes natural milk and dairy products regularly, eat enough meat/mutton daily; avoid artificial sweetener and/or sugar and take care if he/she is safe when they’re physically active. During sports or other physical activities, they should:

• Wear the right protective equipment.
• Never “play through the pain” if their knee hurts during or after physical activity.
• Give their body time to rest and recover after intense activity.
• Stretch and warm up before playing sports or working out.
• Cool down and stretch after physical activity.

Kids and teens with Osgood Schlatter disease almost always recover with no lasting health effects. It doesn’t cause any permanent damage to their bones or knee joint. Children grow out of the condition as their growth plates harden into adult bone and they strengthen and stretch the muscles around their knees.

Your doctor will tell you how long your child should avoid playing or training. Don’t let your child resume playing sports before your doctor says it’s safe, even if they start to feel better. Their knee needs time to heal. Returning to sports or physical activities too soon can make the pain come back.