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  • Rachel Johns

Knee Pain in Children?

An explanation of ‘Osgood-Schlatter Lesion’ and how to address it.

Knee pain, especially anteriorly, is a common complaint of the younger athletic population.

Many girls and boys in their early adolescent years may suffer from pain just below their knees, particularly if they are highly active and participate in regular sport. If this is the case, they may be experiencing symptoms of Osgood-Schlatter Lesion (OSL) which is an osteochondritis (inflammation) that occurs at the growth plate of the tibial tuberosity.

OSL usually occurs in girls aged 10 – 12 years, and boys 13 – 15 years as they undergo significant growth spurts but is generally more common in boys. Combining a rapid growth spurt with high levels of sport stresses the area where the patella tendon attaches to the tibia (tibial tuberosity). Repetitive, forceful extension of the knee causes rapid contraction of the quadriceps muscles and pulls on the patella tendon, which in turn pulls on the tibial tuberosity, resulting in inflammation and pain that is aggravated by activity.

Typical aggravating sports include basketball, netball, gymnastics, dancing and football where there is high levels of repetitive impact through running and jumping. OSL is a self-limiting condition, meaning it will eventually settle with time but may occasionally limit a young athletes performance.

The tibial tuberosity is often tender and swollen and tension may be felt in the quadricep muscles. It can be detected on X-Ray, however this is often unnecessary as a Physiotherapist can accurately diagnosis OSL based on a thorough history and clinical assessment.

Conservative Physiotherapy management has proven to be highly beneficial in settling symptoms of OSL. Your Physiotherapist will guide you on modifying activities to allow the knees to rest and heal while still remaining active. It is generally ok for young athletes to play sport as long as their pain is well managed, hence it is not always necessary to restrict participation. If you’re unsure, use pain as your guide! Applying ice to the area for 10 – 15 minutes may also help to reduce pain and swelling. Your Physiotherapist will work to reduce tension in muscles surrounding the knee, apply tape to offload the patellar tendon where required, and provide strength and conditioning exercises to manage symptoms and assist return to sport.

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