What it is, how it happens, and how physical therapy can help
Osgood-Schlatter disease is one of the most common causes of knee pain in active children and teens—especially during growth spurts. If your child plays sports that involve running, jumping, or quick changes in direction (like soccer, basketball, or volleyball), there’s a good chance they’ll experience some level of knee discomfort. But when that discomfort becomes focused just below the kneecap and worsens with activity, it could point to Osgood-Schlatter disease.
This condition involves irritation and swelling at the tibial tuberosity, the bony bump just beneath the kneecap where the patellar tendon attaches. It affects the growth plate in this area, making it vulnerable to overuse, especially during periods of rapid skeletal development.
What causes Osgood-Schlatter disease?
The primary culprit is excessive tension on the patellar tendon—the strong band of tissue connecting the kneecap to the shinbone. This tension increases when a child’s quadriceps (front thigh muscles) contract during movement, pulling on the tendon and, in turn, the tibial tuberosity.
Several factors can amplify this tension:
- Repetitive motion from sports
- Sudden growth spurts that create muscle imbalances
- Poor alignment in the legs (like knock-knees or flat feet)
- Tight muscles, particularly the quadriceps and hamstrings
Together, these factors make the area more susceptible to microtrauma, inflammation, and pain. And while it’s not typically serious, untreated symptoms can limit activity and cause long-term discomfort.
Recognizing the symptoms
Pain is typically located just below the kneecap and may worsen during:
- Running or sprinting
- Jumping or squatting
- Kneeling or climbing stairs
You may also notice:
- Swelling around the tibial tuberosity
- A visible bump or tenderness to the touch
- Muscle tightness in the legs
Some children only experience pain during intense activity, while others may feel it during regular walking or even at rest.
How is it diagnosed?
Because multiple conditions can cause knee pain in growing children, it’s important to get a proper evaluation. A physician—often a pediatric sports medicine specialist—will assess your child’s posture, range of motion, and activity history. Imaging may be used to confirm the diagnosis or rule out other concerns.
The role of physical therapy in treating Osgood-Schlatter
Physical therapy is one of the most effective, non-invasive ways to treat Osgood-Schlatter disease—especially when symptoms persist or affect athletic performance. Our approach focuses on reducing irritation, improving movement mechanics, and addressing the underlying imbalances that contribute to stress on the knee.
Here’s how physical therapy helps:
- Pain and inflammation management
Therapists use treatments such as ice, heat, electrical stimulation, and soft tissue work to reduce swelling and ease discomfort. - Targeted flexibility and mobility exercises
Stretching tight muscle groups—like the hamstrings, quadriceps, hip flexors, and calves—helps reduce tension on the knee. This also improves how the muscles work together during movement. - Strength training and stabilization
Strengthening the hips, glutes, and core helps support the lower body and offload stress from the knees. Specific exercises also improve lower leg and foot mechanics. - Posture and alignment correction
Therapists assess for and address postural imbalances or leg alignment issues. In some cases, custom orthotics may be recommended to support flat feet or knock-knees and promote better knee tracking. - Balance and proprioception work
Balance training helps athletes stay aware of their body position during activity, improving coordination and preventing re-injury. - Sport-specific movement training
Once pain is under control, therapy progresses to sport-specific drills that promote better form, movement efficiency, and knee safety during play.
Can dry needling help?
Yes—dry needling may be used as part of treatment to help reduce tightness in overactive muscle groups, particularly the quadriceps and surrounding tissues. By targeting trigger points, dry needling can help relieve muscle tension, reduce pain, and improve flexibility—all of which can be beneficial in managing the mechanical strain that contributes to Osgood-Schlatter symptoms.
What to expect from treatment
Most kids recover well with consistent therapy and activity modification. Your child may need to temporarily reduce training frequency or take short breaks from competition. Kneepads may be recommended for high-contact sports to protect the irritated area.
Recovery timelines vary, but with the right support, most athletes return to full participation without limitations.
