Understanding cause of knee pain among adolescent children

Is your growing child (10 – 16 years) complaining of knee pain especially after vigorous activity or even mild activity? They have no history of a fall or trauma to the knee. Well they could be suffering from a knee condition called Osgood schlatter disease (OSD).

This condition affects both girls and boys alike. However, girls aged 10-12 years may suffer from OSD earlier than boys (13 – 14 years) because girls experience puberty earlier than boys. The child will complain of:

• Knee pain and tenderness at the lower front part of the knee
• Swelling at the lower front part of the knee
• Tight muscles in the front or back of the thigh
• Increased discomfort with activity.

The symptoms, however, may vary from child to child, while others complain of mild pain with certain activities others have constant and debilitating pain.

Osgood Schlatter disease is a common cause of knee pain in growing adolescents. It is swelling of the area just below the knee where the tendon from the kneecap attaches to the shinbone as shown in the diagram.

Osgood-Schlatter disease most often occurs during growth spurts (rapid rise in height and weight) where kids are vulnerable because their bones, muscles, and tendons are growing quickly and not always at the same time. With exercise, differences in size and strength between the muscle groups place unusual stress at the top of the shinbone.

Children who participate in physical activities such as sports that involve; running, jumping and swift changes of direction e.g. soccer, basketball, figure skating and ballet — are at an increased risk for this condition.

However, less active adolescents may also experience this problem. In most cases both knees have the symptoms although one knee may be worse than the other.

The good news is that OSD is far less scaring than the name sounds. It usually goes away when the teenagers’ bones stop growing (15 – 18 years). However during that stage the following will help manage the pain and discomfort.

1. Apply heat 15 minutes before an activity or apply ice 20 minutes after an activity.

2. Use knee support to help rest the knee joint. Also shock absorbent insoles (shoe pads) aid in easing stress to the knee.

3. Stretching exercises for the front and back of the thigh help relieve pain and prevent recurrence.

If the symptoms persist see a physiotherapist for further treatment.

Ms Kungu is a physiotherapist at C&P Health Centre in Karen, Nairobi.

4. Rest the knee/ limit activities that cause pain. During a flare up a short break from sports will be necessary.

5. Crutches. In severe cases the child may be temporarily issued with elbow crutches to take weight off and enable the knee to rest.

Parents find it a cruel irony that the most active kids are most likely to get OSD and they are also the ones least likely to rest the affected area.

If the symptoms still persist you need to seek the attention of a physiotherapist for further evaluation and management.