I’d like to talk to you about Osgood Schlatter’s syndrome beginning with the primary problem. It’s not what you think.
If you Google knee pain for kids you’ll get an explanation like “pain in the front of the knee characterised in late childhood as the patellar tendon inserts into the bony prominence (tibial tuberosity)”.
And that sounds about right but…
But there’s more to it one layer deeper.
THINK ABOUT IT LIKE THIS –
- Kids grow in height by the long bones lengthening at each end called your ‘growth plates’ or epiphyseal plate
- For girls aged 10-12 and boys 11-13 this time in their childhood is where a massive growth spurt may occur (you often see kids suddenly shoot up in height around Year 5 to Year 7!)
- Here’s the key point – the muscles DO NOT grow at the same pace as the bones are elongating
- The result? A pulling force on where the muscle anchor on the bone causing that bony protrusion
Think about your own experience.
I remember in Year 7, I was running around nonstop.
I too suffered from Osgood-Schlatters syndrome and it hampered my running for almost 1-2 years!
You see load and particular overload becomes the issue.
Growing kids are working against their biology as their bodies are changing and evolving PLUS they are very busy loading up their joints with physical activity.
So if you can picture this rope pulling forcefully on a bony anchor, something has to give way.
Due to the plasticity of the growing bone it can almost bulge and protrude out in an almost abnormal bump!
With all this gloomy inevitable information where’s the good news?
Here are my key recommendations –
Manage how busy the growing child is and the commitments they have in an average week.
Once I asked a parent how many rest days her 12yo son had.
He played cricket, basketball and athletics and he trained every night, played 2 games on the weekend and even did extra running sessions for fitness!
Consider reducing the training sessions throughout the week and I recommend 3 x heavy running days per week (training and games included).
Yes this is a muscle and bone problem.
Which of the two do you have control over?
So get it stronger!
Which one should you focus on? I have found good gluteal, hamstring, quad and calf strengthening will do a lot in reducing the mechanical load onto the knee.
A happier knee!
3. LOW IMPACT
Despite strengthening work and managing the child’s activity levels you’re still struggling.
It’d suggest low impact exercise like swimming, bike riding, rowing and activation work (see Aarvi’s blog posts) to reduce the stress on the knee.
If you’ve exhausted all your conservative measures this may be a good time to seek more help from a sports physician and I would be more than happy to organise a referral letter for you if I was managing your child.
I hope this post helps with understanding this common kids knee injury!