knee pain in children

Children's knee pain/Osgood Schlatter ‍

What is Osgood Schlatter?‍

Osgood schlatter is a common knee overload injury that can occur during growth. In our practice, we see this most in boys between the ages of 10 and 15 or girls between 8 and 13 years old, who like to exercise.

An enlarged and/or continuous pull of the knee tendon to the attachment on the lower leg, just below the kneecap, can cause local inflammation.

We often see that in the early stages, it is still possible to exercise pain-free, but that pain occurs in the front of the knee after exercise. This is almost always accompanied by a thickening at the attachment of the knee tendon to the lower leg and local heat. Children mainly complain about pain when climbing stairs, cycling, starting running/sprinting, deep bends and sitting on the knee (s).

Because the children are still growing, the bone (the growth plate) to which the knee tendon attaches is still mainly provided with cartilage tissue, which is fully hardened into bone in older people. This cartilage is softer and can irritate due to the tensile force of the tendon.

Osgood schlatter disappears automatically when the growth plate is fully grown and 'cured', but the symptoms are almost always gone before that time and last an average of about 6 months. Of course, this also depends partly on the right approach and early diagnosis and guidance. In the past ‍

Diagnosis and advice‍

For a correct diagnosis, it is sufficient to consult a general practitioner or physiotherapist. Based on a brief physical examination and the pattern of complaints, the diagnosis can quickly be made. Sometimes we use ultrasound to support the diagnosis and it also gives us the opportunity to objectively see the recovery.‍

Can Osgood schlatter be prevented? 

Because we mainly see (actively) exercising children in our practice with this injury, advice might be not to let a growing child exercise. And in the past, it was often assumed that there should be no sport for an entire season. But that is of course nonsense and definitely does not fit our vision “exercise makes you better!”. In fact, it appears to be better to keep moving and exercising, but in a good rest-training relationship, on the advice of a physiotherapist.

It is important to recognize the symptoms early so that an adapted program can be quickly created so that the child can continue to enjoy exercising. We regularly provide information to the trainers of the sports clubs that we supervise about the physical resilience of the growing child and let the children measure their height a few times a year. Is there a growth spurt? Then we can adjust the training load in time. This seems to be a simple but successful way to prevent worse pain symptoms.

In addition, during training/competitions, it is important that the tension on the upper leg and thus on the tendon attachment to the growth plate of the lower leg is kept as small as possible.

Has a child had Osgood schlatter, but is it still growing? Then pay extra attention when building up the (sports) load and, in particular, build strength and explosiveness (such as sprinting) slowly. It is also important that there is a healthy ratio between rest and the number of training moments.

‍Treatment‍

To a large extent, the treatment consists mainly of preventing pain and the above advice. But if there is pain in the front of the knee, we recommend:

1. to prevent relative calm and provocative loads. This differs per child and per sport and is therefore really customized.
2. cool regularly with ice, especially when there is pain. Then the knee often also feels warm, a bit thicker, and cooling often provides immediate relief.
3. stretching the thigh muscles to reduce the tension of the knee tendon on the growth plate
4. a personal training/practice schedule. Every body is different and, especially when you are a growing child, there can be major individual differences, provoking or maintaining a complaint. One child will have to work on the running technique while another child may be advised to adjust footwear and possibly put supportive insoles in the shoe.

Although Osgood Schlatter is therefore a common disorder among children and the pain symptoms are almost always similar, it remains important to draw up a customized treatment or prevention plan for each child. This way, you prevent the complaints from persisting for an unnecessarily long time.

Do you have any questions, or do you want an appointment? We'd love to help you out!