Osgood–Schlatter Disease: Common Knee Pain in Active Teens

Cogent Rehab Blog

Folarin Babatunde PT PhD MScSEM MScPT BScPT

January 16, 2026

If your child or teenager in is active in sports and has started complaining of pain just below the knee—especially during or after running, jumping, or kicking—Osgood–Schlatter disease may be the cause. This condition is very common in growing adolescents and, although painful, is not considered a dangerous condition and does not usually cause long-term knee damage when managed properly.

At Cogent Physical Rehabilitation Center in Burlington, we regularly assess and treat young athletes with knee pain related to growth and training load. In this article, we will explain Osgood–Schlatter disease is, why it happens, and how physiotherapy can help your child stay active while protecting their knee.

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What Is Osgood–Schlatter Disease?

Osgood–Schlatter disease (OSD) is an overuse-related knee condition that affects children and adolescents during growth spurts. It occurs where the patellar tendon attaches to the tibial tuberosity—the bony bump just below the kneecap.

The exact cause of OSD is unclear. It may be as a result of repeated microtrauma of the tibial tuberosity or tight quadriceps mucles. Another common opinion is that during periods of rapid growth, bones lengthen faster than muscles and tendons can adapt. Repeated pulling of the patellar tendon—especially during sports that involve running, jumping, or kicking—can irritate this growth area, leading to pain and swelling.

Despite the name, OSD is not a disease in the traditional sense. It is a temporary growth-related condition that usually settles as growth slows.

Osgood-Schlatter disease causes pain at the tibial tuberosity — the bony bump where the patellar tendon attaches to the tibia.

Who Is Most Affected?

Osgood–Schlatter disease most commonly affects both boys and girls and symptoms can occur in one or both knees:

• Adolescents aged 8-15 years. OSD most frequently occurs between the ages of 8 and 13 years in girls, and between 10 and 15 years in boys

• Youth going through a rapid growth spurt

• Active teens involved in soccer, basketball, volleyball track and field, hockey and martial arts

• Young athletes training multiple times per week or year-round

• Single sport female athletes may have a four-times-higher risk of developing OSD than multi-sport athletes.

Common Symptoms Parents and Teens Notice

Common symptoms experienced in individuals with OSD includes:

• Pain just below the kneecap

• Swelling or a visible bump on the shin

• Pain that worsens with running, jumping, squatting and kicking

• Tenderness when kneeling

• Pain that improves with rest but returns with activity

• Tight muscles in the front or back of the thigh

• Pain when descending stairs

• Pain after prolonged periods of sitting with the knee immobile

• Pain while leaning

  
  

Usually, symptoms often build gradually and may worsen toward the end of practices or games, or later that evening.

Is Osgood Schlatter Disease Serious and Should We Be Worried?

You can be reassured that Osgood–Schlatter disease is benign and self-limiting. It does not damage the knee joint and rarely causes long-term problems. However, pushing through pain or ignoring your symptoms can lead to the following issues:

• Prolong recovery

• Increase pain severity

• Limit sports participation

• Create frustration for both athletes and parents

Early physiotherapy guidance can significantly reduce symptoms and help young athletes stay active safely.

How Physiotherapy Helps Osgood–Schlatter Disease

Physiotherapy focuses on load management, movement control, and muscle balance, not just rest.

At Cogent Rehab in Burlington, treatment may include:

Education Components

• Factors contributing to OSD

• Risk of OSD

• Rationale for treatment

• Increase/decrease physical activity based on symptom response

Activity Modification

• Adjusting training volume and intensity

• Modifying drills rather than stopping sport completely

• Teaching when pain is acceptable vs. when to stop

Flexibility Training

• Stretching tight quadriceps, hamstrings, and calves

• Reducing excessive tension through the patellar tendon

Strengthening

• Hip and core strengthening to reduce stress on the knee

• Gradual quadriceps strengthening within pain limits

• Improving landing, running, and squatting mechanics

Return-to-Sport Guidance

• Step-by-step progression back to activity

• Avoiding unnecessary time away from sport

• Preventing symptom flare-ups during future growth spurts

Sample Physiotherapy Treatment Plan

This step-by-step approach allows young athletes to stay active, protect their knee during growth, and return to sport with confidence.

Early Phase (Weeks 1–4) Goal: Settle pain & protect the knee	Later Phase (Weeks 5–12) Goal: Build strength & return to sport
Understand the condition Learn why knee pain happens during growth spurts and why pain does not mean damage.	Build confidence with movement Understand how to progress exercises and activity safely without flaring pain.
Adjust activity load Reduce or modify painful activities (not total rest). Training volume may be temporarily reduced.	Gradually increase activity Slowly add back running, jumping, and sport-specific drills as pain allows.
Pain-monitoring approach Learn how to judge when activity is “okay” vs. “too much.”	Continue pain monitoring Use symptoms to guide progression, not fear or complete avoidance.
Start gentle strengthening Simple exercises for thighs, hips, and core that do not aggravate knee pain.	Progress strengthening More challenging leg and hip exercises to better tolerate sport demands.
Daily routine focus Short, consistent home exercises and clear expectations.	Return-to-sport planning Gradual return to full training and competition when symptoms are stable.

Key Message for Parents and Athletes

• Pain does not mean damage

• Complete rest is usually not required

• Progress is guided by symptoms, not timelines

• Most teens improve as growth slows, especially with the right guidance

Can My Child Keep Playing Sports?

In many cases, a child with osgood schlatter disease can keep playing sports but with modifications.

Physiotherapists often use a pain-monitoring approach, allowing activity that:

• Causes mild discomfort during activity

• Does not significantly worsen symptoms afterward

• Settles back to baseline within 24 hours

This approach helps maintain fitness, confidence, and mental well-being while protecting the knee.

When to Seek Physiotherapy in Burlington

Consider booking a physiotherapy assessment if:

• The knee pain lasts longer than 2–3 weeks

• Pain is significantly limiting sports or school activities

• The knee swelling or tenderness is increasing

• Your child is in a rapid growth phase

• You want guidance on safe participation in sports

Early assessment often shortens recovery time and reduces frustration.

Book a Physiotherapy Assessment in Burlington

Worried About Your Child’s Knee Pain?

If your child’s knee pain is lingering, affecting sports participation, or becoming a source of frustration, you don’t have to navigate this alone.

A physiotherapy assessment at Cogent Rehab can help:

• Confirm whether the pain is related to growth (such as Osgood–Schlatter disease)

• Identify training or movement factors that may be overloading the knee

• Provide clear guidance on what activities are safe to continue

• Reduce pain while helping your child stay active and confident

Early, evidence-based guidance often means less pain, less time away from sport, and fewer flare-ups during growth spurts.

Book a physiotherapy assessment today to get clear answers and a practical plan tailored to your child’s needs.

Book An Assessment For Your Child Today

Supporting Your Teen Through Growth-Related Knee Pain

Osgood–Schlatter disease can be frustrating, especially for motivated young athletes. With reassurance, education, and structured rehabilitation, most teens return to full activity without long-term problems, even if symptoms come and go during growth.

Sources

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2. Gawel E, Zwierzchowska A. Therapeutic interventions in Osgood-Schlatter disease: a case report. Med (Baltimore). 2021;17:e28257

3. Rathleff MS, Winiarski L, Krommes K, Graven-Nielsen T, Holmich P, Olesen JL, Holden S, Thorborg K. Activity modification and knee strengthening for osgood-schlatter disease: a prospective cohort study. Ortho J Sports Med. 2020;8:23259671209111076

4. Krommes K, Thorborg K, Clausen MB, Rathleff MS, Olesen JL, Kallemose T, Holmich P. Self-management including exercise, education, and activity modification compared to usual care for adolescents with osgood-schlatter (the SOGOOD trial): protocol of a randpmized controlled superiotiy trial. BMC Sports Sci, Med Rehab. 2024;16:89.

5. Smith JM, Varacallo MA. Osgood-Schlatter Disease. [Updated 2023 Aug 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.

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7. Cleveland Clinic. Osgood-Schlatter disease [Internet]. Cleveland (OH): Cleveland Clinic. Assessed December 18, 2025.