Knee

What It Is

Osgood Schlatter disease causes a painful lump just below the kneecap in children and adolescents who are going through the growth spurts of puberty (American Academy of Orthopaedic Surgeons, n.d.; Cleveland Clinic, 2024). The condition often occurs in those who take part in sports that involve running, jumping and changing direction quickly, such as soccer, figure skating, ballet and basketball.

The condition is more common in boys than girls (Vaishya et al., 2016), and it is more common in young people who play sport. One review estimated that roughly 1 in 10 sporty teenagers are affected (Corbi et al., 2022). It usually affects children aged around 11 to 14 (Cleveland Clinic, 2024), and girls tend to be affected at a younger age than boys because they go through puberty earlier (Corbi et al., 2022). Once the child stops growing, the symptoms usually go away (American Academy of Orthopaedic Surgeons, n.d.).

The quadriceps muscles at the front of the thigh pull on the patellar tendon, which in turn pulls on the tibial tubercle, a bony bump at the top of the shinbone that covers a growth plate (an area of growing cartilage). In some children this repeated pulling (traction) irritates the growth plate, which causes pain and swelling, and the bump can become very pronounced (American Academy of Orthopaedic Surgeons, n.d.).

One theory is that the quadriceps muscles are unable to lengthen at the same pace as the bones grow, which increases the pull on the tendon where it attaches to the shinbone (Corbi et al., 2022). The children who most commonly suffer are the ones who do regular sport, several times per week.

Children will complain of pain under their kneecap, especially while running, jumping or kneeling (Cleveland Clinic, 2024).

Osgood Schlatter Disease Anatomy

The knee is one of the biggest and most complex joints in the body. It is formed where the thigh bone (femur) meets the shinbone (tibia), with the kneecap (patella) at the front (American Academy of Orthopaedic Surgeons, n.d.). Tendons connect the leg muscles to the knee bones to enable the knee joint to move. Ligaments join the knee bones together and give the knee stability.

The main culprit in Osgood-Schlatter's is the quadriceps muscle. This is a group of four muscles at the front of the thigh. The muscle blends into and around the kneecap and then attaches via a strong tendon to the tibial tubercle on the shinbone. This tendon is known as the patellar tendon (sometimes called the ligamentum patellae). When a child is active, the pull of this tendon on the growth plate under the tibial tubercle can irritate it and make the bump larger (American Academy of Orthopaedic Surgeons, n.d.).

Not a diagnosis — for more information, contact me or another trusted healthcare provider.

Treatment

Self-Care & Treatment

How to Treat Osgood Schlatter Disease

Stretches for the muscles at the front and back of the thigh (quadriceps and hamstrings) may help relieve pain, along with strengthening exercises (American Academy of Orthopaedic Surgeons, n.d.). I can explain why the problem is happening and how to manage it, and guide your child through a stretching and strengthening programme. See the My Approach tab for how I work.

1. Reduce Sports that Cause Pain

Running and jumping sports should in the first instance be reduced. Do these sports less often and have rest days between sports if possible. Just reducing the frequency of sports may be enough to reduce the pain and pressure on the knee. But if this is not enough, come and see me.

2. Medication

The American Academy of Orthopaedic Surgeons (n.d.) says that over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can reduce pain and swelling in Osgood-Schlatter disease. But most parents will want to avoid using medication with their children if possible.

(This medicine information comes from the American Academy of Orthopaedic Surgeons (OrthoInfo), not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.)

Tips

Allow the joint to rest. Limit the amount of time spent on activities that can aggravate the condition, such as jumping, running and kneeling (Cleveland Clinic, 2024).
Ice the affected knee to help ease swelling and pain. Use a cold pack wrapped in a thin towel for up to 20 minutes at a time, several times a day, especially after activity. Never put ice directly on the skin (American Academy of Orthopaedic Surgeons, n.d.).
Stretching the quads (the muscles along the front of the thigh) and the hamstrings can help relieve pain (American Academy of Orthopaedic Surgeons, n.d.).
Whenever your child takes part in sport, a protective pad over the affected knee can help where irritation might occur (Vaishya et al., 2016).
Suggesting that your child switches to activities that do not involve running or jumping, such as swimming or cycling, until the symptoms are better might be helpful (Corbi et al., 2022).
Children usually grow out of the condition, although the bump below the knee may remain (American Academy of Orthopaedic Surgeons, n.d.).

Treatment

My Approach

Osgood Schlatter disease happens when the thigh muscles pull hard on a growth area just below the kneecap that isn't ready for that much strain yet. Most children grow out of it. My aim is to settle the pain, help your child stay as active as they comfortably can, and keep their legs flexible and strong while they grow.

I start by assessing how your child's knees, hips and ankles move, the flexibility of their thigh and calf muscles, their strength, and how they run, jump and land. I also ask about their sports and weekly schedule. Parents are welcome to sit in, with their child's agreement.

Calming It Down

Explaining what's going on, so your child understands why the knee hurts and that it usually settles as they grow
Adjusting how often and how hard they train, with rest days between sports, rather than stopping everything
Gentle hands-on work for the thigh, hamstring and calf muscles, keeping pressure off the sore bump below the knee
Warm or cool applications in the clinic, and I'll show you how to use ice safely at home

Building Up

Stretches for the muscles at the front and back of the thigh, and the calves
Strengthening for the thighs and hips, starting with pain-free holds and building gradually, with light, well-supervised loads suited to their age
Swapping some running and jumping for swimming or cycling while it's sore
A gradual return to full training and matches as the pain settles

I'll show you how to help your child with their home stretches and exercises, and which signs mean we should ease off. If the pain keeps getting worse despite cutting back, or your child can't put weight on the leg, see your family doctor or nurse practitioner.

What to Expect

Typical Course

Typical course: Most children come once or twice a week for the first couple of weeks, then weekly, with a reassessment at about 4 to 6 weeks, then less often as you manage more at home. Flare-ups usually ease within a few weeks of adjusting training, and the symptoms usually go away once your child stops growing, although the bump below the knee may remain.

What I Focus On

Explaining the Problem

Training Load Changes

Gentle Thigh Release

Stretching & Strength

Gradual Return to Sport

Sources

References

American Academy of Orthopaedic Surgeons (OrthoInfo) (n.d.) Osgood-Schlatter Disease (Knee Pain). Available at: https://orthoinfo.aaos.org/en/diseases--conditions/osgood-schlatter-disease-knee-pain/ (Accessed: 7 October 2026).
Cleveland Clinic (2024) Osgood-Schlatter Disease: Symptoms & Treatment. Available at: https://my.clevelandclinic.org/health/diseases/21171-osgood-schlatter-disease (Accessed: 7 October 2026).
Corbi, F. et al. (2022) 'Osgood-Schlatter Disease: Appearance, Diagnosis and Treatment: A Narrative Review', Healthcare (Basel), 10(6), p. 1011. doi: 10.3390/healthcare10061011
Vaishya, R. et al. (2016) 'Apophysitis of the Tibial Tuberosity (Osgood-Schlatter Disease): A Review', Cureus, 8(9), p. e780. doi: 10.7759/cureus.780

Massage therapy · Kitchener–WaterlooOsgood Schlatter Disease

What It Is

Osgood Schlatter Disease Anatomy

Self-Care & Treatment

How to Treat Osgood Schlatter Disease

1. Reduce Sports that Cause Pain

2. Medication

Tips

My Approach

Calming It Down

Building Up

Typical Course

References

Related Conditions

Book a session

Massage therapy · Kitchener–WaterlooOsgood Schlatter Disease

What It Is

Osgood Schlatter Disease Anatomy

Self-Care & Treatment

How to Treat Osgood Schlatter Disease

1. Reduce Sports that Cause Pain

2. Medication

Tips

My Approach

Calming It Down

Building Up

Typical Course

References

Related Conditions

Anterior Cruciate Ligament (ACL) Injuries

Chondromalacia Patella

Fat Pad Impingement

Iliotibial Band Friction Syndrome

Book a session