Conditions / Children & Adolescents
Osgood-Schlatter Disease
Knee pain just below the kneecap in a growing young athlete is often Osgood-Schlatter. It's common, manageable, and rarely requires stopping sport altogether — with the right plan, most young athletes can stay active throughout.
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Osgood-Schlatter disease is an apophysitis of the tibial tuberosity — the bony bump just below the kneecap where the patella tendon attaches. During periods of rapid growth, the tibial tuberosity growth plate is vulnerable to the repeated tensile pull of the quadriceps through the patella tendon, causing pain, swelling and sometimes a visible bony prominence at the attachment site.
It is one of the most common causes of knee pain in adolescent athletes, affecting boys aged 10–15 and girls aged 8–13 — corresponding to peak growth spurts in each sex. It is not a disease in the traditional sense but a growth-related overuse condition that almost always resolves once skeletal maturity is reached. With appropriate management, most young athletes can continue participating in sport throughout.
Rapid Growth
During growth spurts, bones lengthen faster than muscles and tendons, increasing the tensile stress the patella tendon exerts on the still-developing tibial apophysis.
High Training Volume
Sports involving repetitive jumping, running and squatting — football, basketball, gymnastics, athletics — generate high quadriceps loads and are strongly associated with OSD.
Quadriceps Tightness
Tight quadriceps — common during growth spurts — increase the resting tension in the patella tendon, raising baseline stress at the tibial tuberosity.
Foot & Lower Limb Mechanics
Overpronation and altered lower limb alignment increase the load transmitted through the patella tendon to the tibial tuberosity during activity.
Pain and tenderness at the tibial tuberosity — the bony bump just below the kneecap
Swelling and sometimes a visible bony prominence at the attachment site
Pain that worsens with running, jumping, squatting and kneeling
Limping or reduced activity during or after sport
Can affect one or both knees — bilateral in around 25–50% of cases
Tight quadriceps and hamstrings are commonly associated
The goal is to keep the young athlete as active as possible while managing pain and protecting the growth plate. Complete rest from sport is rarely necessary or helpful — a structured load management plan is far more effective and much better for the athlete's wellbeing and development.
01
Apply ice to the tibial tuberosity after sport — 10–15 minutes wrapped in a cloth
02
Perform daily quadriceps and hip flexor stretches — especially during growth spurts
03
Wear supportive footwear with adequate cushioning for sport
04
Reduce training load during flares — modify rather than stop completely where possible
If your child has knee pain below the kneecap that is limiting sport or causing a limp, an assessment is recommended. Early management keeps young athletes active and prevents the habit of avoiding sport during a critical developmental period.
Osgood-Schlatter almost always resolves fully once growth is complete. With appropriate management in the meantime, most athletes can continue participating — they do not need to stop sport entirely.
Does my child need to stop playing sport?
Not usually. Complete rest is rarely necessary and can be counterproductive — it removes the positive effects of physical activity during an important developmental period. A structured load modification plan is far more effective and allows most young athletes to continue participating.
Will it go away on its own?
Yes — Osgood-Schlatter almost always resolves once skeletal maturity is reached and the growth plate closes, typically between ages 14–18. The bony prominence may remain permanently but is usually painless. Management in the meantime focuses on keeping your child active and comfortable.
Can it affect both knees?
Yes — bilateral Osgood-Schlatter occurs in around 25–50% of cases. When both knees are affected, load management and strengthening are even more important as total training volume needs to be considered carefully.
Is the bony lump permanent?
A bony prominence at the tibial tuberosity can remain after symptoms resolve — this is a normal structural change and is usually entirely painless in adulthood. It does not cause long-term functional problems.
Is your child struggling with knee pain?
We'll assess their biomechanics, build a plan to manage symptoms, and keep them active throughout their growth period.
