Osgood Schlatter’s – Knee Pain in Children
Osgood Schlatter’s is pain felt on the bony bump below the knee joint.
This pain happens when the muscle at the front of the leg gets pulled too tight at the point where it connects to the shin bone. This area is called the tibial tuberosity and feels like a bony bump just below the knee.
The straining of the muscle can be caused by activity and exercise, or a growth spurt.
If your child is limping and develops any of the following signs you should urgently call 111 who will triage if your child needs urgent care:
- Sudden onset pain in their hip, thigh or knee
- Unable to put any weight on their leg to stand or walk
- The leg has changed shape or is pointing at an odd angle
- Generally unwell with a high temperature, feeling hot and shivery
- Severe pain in the lower part of their tummy
- Symptoms are getting worse
Your child may also need to see a doctor urgently if they have fallen or twisted their knee and:
- Their knee is immediately swollen
- Their knee has locked (they are unable to move it at all) and
- They are unable to put any weight on their leg to stand or walk
If this happens, you should urgently call 111 who will triage if your child needs urgent care.
Symptoms and Diagnosis
How is it managed?
Exercises
Symptoms and Diagnosis
The symptoms are:
- Pain and swelling on the bony part at the top of the shin bone (the tibial tuberosity), underneath the knee joint
- The tibial tuberosity can be sore when it is touched or when your child kneels
- Pain at the front of the knee and the top of your child’s shin when taking part in sport
Symptoms usually appear around puberty (9-14 years) when children are having a growth spurt or as a result of changing activity levels. Usually only one knee is painful but both can be affected.
The diagnosis is often clear from the typical symptoms. No x-rays or scans are necessary.
How is it managed?
The following things may help improve the pain your child is experiencing in their knee:
Reduce pain
- Take painkillers (as advised by a doctor or pharmacist)
- Use an ice pack (follow the instructions on the pack). It can be helpful to use ice before and after any activities that make the pain worse. If you need to, take a break half way through an activity to use ice and settle your pain
Improve tissue flexibility and length
It is important to make sure the tissues around the knee are flexible. This should help reduce the pain. Check out the next tab for suitable exercises that will help stretch the tissue.
Modify activity
Pacing your activities is a really important factor in managing the pain.
It’s important to keep moving but also to be aware of the pain and know when to stop to prevent the pain getting too intense.
Try to help your child think of their pain on a scale of 0 to 10. Level 0 means you have no pain, level 10 is the worst pain you can imagine. Using this scale helps us decide when to carry on and when to stop by using a traffic light
Red level pain would be levels 7-10. This is too high. Your child should stop their activity and let the pain settle.
Amber level would be levels 4-6. This is acceptable. Your child can carry on with the activity but they may need to think about stopping to rest soon.
‘Green’ pain levels would be levels 0-3. This is the safe zone and means you can carry on your activity.
Have a think about how much activity your child does in a week. Activity is really important to keep strong and healthy, but don’t over-train. We recommend having one or two days off each week to rest or participate in other activities. It is also important to take 2-3 months away from a specific sport during the year. Find out more on our page, ‘Preventing Sport Injuries’.
We also recommend making sure you are participating in a variety of activities rather than one particular sport to prevent overuse injuries and burnout.
Exercises
If any of these exercises increase your pain, seek further advice from your physiotherapist. It is important to complete these exercises at least 3 times a day.It is also important to complete these exercises before and after any activities which bring on your knee pain.
Standing Quad Stretch
Stand with your feet together. Bend the knee of the leg to be stretched, use your hand to bring your heel to your bottom. Make sure to stand tall, tuck your bottom in and make sure your knees are level. Hold this stretch for 30 seconds, then release the leg and repeat 3 more times.
Prone Quad Stretch
Lie on your tummy. Bend the knee of the leg to be stretched, hold your foot with your hand and pull your heel towards your bottom. If you can’t reach your foot, wrap a towel around the ankle, hold the towel with your hand and use this to bring the heel towards your bottom. Make sure your hips do not come off the floor, your may need someone to help you keep your hips flat on the floor. Hold this stretch for 30 seconds, then release the leg and repeat 3 more times.
Hip flexor stretch
Come in to a half kneeling position, with the back leg being the leg to be stretched. Lean in to your front leg, making sure you keep your body upright. You should feel the stretch across the front of your hip of the back leg. Hold this stretch for 30 seconds, then release the stretch and repeat 3 more times.
If you have any questions about this information please call Dolphin Physiotherapy Outpatients on 029 218 47577.
If you do not have an appointment arranged with physio and symptoms continue or are not improving gradually, then a child’s parent or legal guardian can self-refer by phoning 02921 836 908.
Noah’s Ark Children’s Hospital of Wales
Heath Park
Cardiff
CF14 4XW
