Understanding the Causes of Teen Knee Pain
Introduction
If your teenager is suddenly limping off the soccer field or complaining of sharp pain just below their kneecap, they could be suffering from Osgood-Schlatter’s disease. Osgood … what? Let me explain what exactly this odd sounding “disease” is and what triggers Osgood-Schlatter disease?
This common condition affects 10-20% active children and adolescents, often catching parents and young athletes off guard. The pain and swelling just below the knee can seem to appear out of nowhere, often interfering with sports and physical activity.
As a physical therapist with a decade of experience treating youth sports injuries, I’ve seen how frustrating and confusing Osgood-Schlatter disease can be for families. This particular issue strikes close to home as I suffered from this during my junior high basketball season. In this article, we’ll explore what really causes it, what to avoid, and what you can do to support recovery and performance.
The Science + Anatomy Behind Osgood-Schlatter Disease
Osgood-Schlatter disease is an overuse injury that primarily affects adolescents during periods of rapid growth. It occurs at the tibial tuberosity—the bump just below the kneecap—where the patella (knee cap) tendon attaches to the shinbone.
During growth spurts, the bones often grow faster than the muscles and tendons can keep up with, causing tension and strain on growth plates. In physically active kids, repetitive activities like jumping, running, and squatting can overstress the patellar tendon. This repeated pulling on the still-developing tibial tuberosity leads to inflammation, pain, and even visible swelling or a bony bump.
A study published in the British Journal of Sports Medicine highlights that adolescent athletes involved in sports requiring running and jumping are at increased risk, especially between ages 10–15. Boys are slightly more affected than girls, though the gender gap is narrowing as more girls participate in high-impact sports.
Key factors that trigger Osgood-Schlatter disease:
- Rapid growth spurts
- High-volume or high-impact sports (e.g., soccer, basketball, track)
- Poor recovery or inadequate strength in surrounding muscles
- Tight quadriceps or hamstrings increasing pull on the knee
Common Mistakes and Misconceptions
“It’s just growing pains—play through it.”
One of the most damaging myths is that kids should just “tough it out.” While some discomfort during growth is common, persistent or worsening pain just below the kneecap shouldn’t be brushed off. Playing through the pain can lead to prolonged inflammation, longer recovery time, and even chronic knee issues into adulthood.
“Rest is the only solution.”
While rest may be necessary during flare-ups, total inactivity can weaken muscles and disrupt long-term healing. A tailored rehab plan involving mobility, strength, and movement education is essential. The key isn’t just stopping activity—it’s modifying and gradually reloading the knee in a smart, progressive way.
What to Avoid (and What to Do Instead)
Understanding what triggers Osgood-Schlatter disease also means knowing what movements and exercises can aggravate symptoms—and what alternatives support healing.
Activities and Movements to Avoid (at least temporarily):
- Deep lunges and deep squats: These increase compression at the knee and tension on the tibial tuberosity.
- High-impact plyometrics (jumping, bounding drills): These place repeated, explosive loads on the patellar tendon.
- Heavy leg extensions: (Knee kickout motion) The isolated load on the quadriceps can increase stress directly on the tibial tuberosity.
- Kneeling activities: Pressure on the tibial tuberosity can be painful and delay healing.
- Uncontrolled sports movements: Quick cutting, sprinting, or aggressive deceleration can flare symptoms if reintroduced too early.
Smart Modifications and Exercises That Support Recovery:
- Foam Rolling: This can be a more effective way to reduce the muscle tension along the quad, hamstrings and calf muscles without placing extra stress on the tibial tuberosity.
- Isometric exercises (e.g., wall sits, quad sets): These help maintain strength of the quads and glutes while reducing pain without irritating the area.
- Modified squats: Limit depth and control range of motion; focus on technique and muscle control.
- Glute bridges and hip thrusts: These activate your powerful back side muscle, your glutes! These muscles often go underused in youth athletes.
- Core work: A stable core reduces compensation at the knee and improves control in your entire body.
- Balance training (single-leg stands, wobble board drills): Enhances control of your joints and understanding how your body moves in a coordinated way.
- Gradual progression to jumping and landing: Once pain is well-managed, introducing soft landings and controlled deceleration helps retrain athletic movements to return to sport safely. Ensure these should not be the focus until the athlete has better mobility, strength, and control of their body.
At our clinic, we design age-appropriate rehab plans that build confidence while reducing pain—because the goal isn’t just to recover, but to return stronger and smarter.
Conclusion: There’s Hope and a Plan
If you’re dealing with a child or teen affected by Osgood-Schlatter disease, know this: it’s common, manageable, and temporary with the right guidance. Understanding what triggers Osgood-Schlatter disease is the first step toward preventing long-term complications and keeping your young athlete healthy and confident.
At our clinic, we specialize in adolescent injury recovery and performance. If your child is struggling with knee pain or has been diagnosed with Osgood-Schlatter disease, we’re here to help.
Book an evaluation / Injury screen today and let’s get them moving better—not just today, but for years to come.
