06/08/2023
Knee pain in kids?
Could it be Osgood-Schlatter Disease (OSD)?
OSD is a common cause of anterior knee pain in the skeletally immature athletic population, typically active kids keen on their sports. Clinically, it presents as atraumatic, insidious anterior knee pain, with tenderness at the patellar tendon insertion site at the tibial tuberosity. The condition occurs secondary to repetitive extensor mechanism stress activities such as jumping and sprinting, as well as during sporting activities like Basketball, Volleyball, Sprinters, Gymnastic, Football.
Overall treatment and management includes symptomatic treatment with ice and non steroidal anti-inflammatory meds (NSAIDs), activity modification and relative rest from aggravating activities, and lower extremities stretching regimen to alter underlying predisposing biomechanics factors.
OSD usually develops during the stage of bone maturation (10-12 yrs in girls and 12-14 yrs in boys), although there are always outliers to this. The underlying etiology can be attributed to the repeated traction over the tubercle leading to microvascular tears, fracture, and inflammation which then presents as swelling, pain and tenderness.
OSD is essentially an overuse injury that mostly appears in active, adolescent patients. The repetitive strain and microtrauma results in irritation and in severe cases partial avulsion of the tibial tubercle apophysis. Rarely trauma may lead to a full avulsion fracture. Predisposing factors include poor flexibility of quadriceps and hamstrings or other evidence of extensor mechanism misalignment.
The prognosis is excellent. The condition is generally self limiting and most patents will recover in a couple of months. Sometimes pain can persists for a couple of years of symptoms are left untreated.
The pain usually subsides with the cessation of growth at the tibial tubercle.
Ice application after activity will help to reduce the anterior knee pain.
Limiting the sports activity, for 6-8 weeks is advisable. If the hockey season is die to break this could be an ideal time to recover.
Gentle stretching of the quads and hamstrings along with strengthening will help reduce pain. The taping techniques Ive shown you today will help to decrease patellar loading.
Laser therapy can be used in children. It's safe and effective in the management of pain and to enhance healing properties.