Adolescent Knee Pain and What You Need to Know

If your child has ever come to you after dancing/gymnastics/football/netball/rugby with this familiar statement, only to then go and play again the next day, then this blog post is for you!

Dubai, UAE- Trust me when I tell you that knee pain as a sporty child is no fun, and not just for the child. My poor parents thought they were well past sleepless nights when I started waking up with knee pain after a school, netball and swimming filled day, crying because my knees ached and I couldn’t get back to sleep. I’d been to the Doctors, tests were done to rule out anything scary and they were told ‘it’s growing pains’ and would settle once I stopped growing. I’d sit with cold towels wrapped around my knees because it was the only thing that worked, and someone would sit with me until I could sleep and be put back to bed. The Doctor was right, it did go away when I stopped growing, but when you’re 10 years old, that’s not reassuring when you’re aware you can grow until you’re 16-18! And that’s soooo OLD!

Osgood Schlatters’ (OGS) is common in children aged between 10-15 years old and 30% more common in boys. It’s normally associated with high impact sports such as netball, football, rugby, athletics and is often significantly more common in children who do some form of impact sport everyday. The disorder itself is thought to be because of excessive force from the quadriceps (muscles at the front of the thigh) pulling the kneecap upwards when we run and jump, causing multiple tiny stress injuries to the attachment with the bone. Overtime, these small injuries build up and result in a hard lump on the front of the knee. It is the process of the build up of those small injuries that cause pain and inflammation at the front of the knee during exercise, and the bony lump is the body’s repair mechanism which occurs during rest periods.

Dubai has such a plethora of sporting activities and we’re lucky to have them all at our fingertips for children. It encourages social interaction, healthy lifestyle, an element of competition and reduces the risk of other childhood co-morbidities that are well documented in the media, such as obesity and depression. However, OGS does not only affect sporty children, it may also result from a sudden change of activity, for example changing schools and suddenly having to climb stairs everyday. But what happens when this starts to impact on their health, what can we do?

Previously, the knees would have been casted and full rest advised. However, now we’re a little less strict. Physio advice following full assessment may include moderation of activities, finding somewhere during the week that encourages time off and try to establish a baseline your child can work at without pain before we gradually re-introduce the frequency and avoid flaring up the symptoms. We’ll also rule out anything sinister from other joints and refer to the doctors with anything we feel needs further investigation. At home, you can use ice wrapped in a towel on the knees following sports, but be sure to only ice for 10 minutes. Frostbite is not a good look! Simple over the counter pain relief can be used as per instructions and stretches for the quadriceps and hamstrings can be useful when done regularly.

OGS is associated with growth spurts and impact exercise, it causes microtrauma at the knee and is nothing to fear. Apart from some modifications to the sporting schedule initially, it is perfectly fine to continue a normal school (sorry kids!) and social (sorry taxi mums/dads!) life. A Physiotherapist can certainly assess and tailor a rehab programme to ensure you don’t miss too much of the season, and while most outdoor based sports wind down during the summer period and rest is easier to factor into the week, maybe this is the ideal time to contact a Physiotherapist and do just that.

OGS does not only affect sporty children, it may also result from a sudden change of activity, for example changing schools and suddenly having to climb stairs everyday
Jennifer Rath, Physiotherapist