Growing Pains: Osgood –Schlatter and Sever’s Diseases

seversWe’ve all heard about it or heard our children complain of it. Some of us might have even felt it when we were young. Growing pains. That aching discomfort that radiates from your bones.

No one doubts the condition’s existence, but there comes a point when those aches and pains of youth are little more serious. It tends to happen among tweens and teens who are either highly active or spend a lot of time on their feet.

The good news is it usually isn’t serious. And the even better news is by putting a name to these growing pains, your children can get the help they need to ease their discomfort.

What is Osgood-Schlatter Disease and Sever’s Disease?

There are some aches and pains associated with growth that go beyond the normal nuisance of pain from growing bones. Depending on where the pain is, your child could be suffering from something a little more serious including Osgood-Schlatter Disease or Sever’s Disease.

Osgood-Schlatter Disease is an inflammation of the growth plate on the top and front of the shin bone often associated with growth spurts in adolescents. It often results in an overgrowth of the boney projection just below the knee cap where the patellar tendon attaches (the tibial tuberosity) and is a common cause of knee pain in growing tweens and teens.

Sever’s Disease (also referred to as calcaneal apophysitis) is an inflammation of the growth plate, but instead of the shin and knee, Sever’s affects the heels of children entering early puberty. In Sever’s Disease, the bone affected is the calcaneus, or heel bone, where the Achilles tendon attaches. It’s a lot like Osgood-Schlatter, but in the foot.

Causes and Symptoms

Both Osgood-Schlatter and Sever’s can be considered overuse injuries. They are most common during periods of rapid growth in children ranging in age from 8-14. Boys experience these conditions more often than girls, likely because boys tend to have bigger growth spurts.

In each case, the bone is basically growing faster than the tendons and muscles can lengthen. And that can be painful. Osgood-Schlatter Disease is most common in athletes who participate in sports that involve running, jumping and cutting. Sever’s Disease is more likely to occur in the non-athlete, maybe a young teen who has particularly flat or arched feet and spends a lot of time standing.

If your middle schooler has pain and swelling in front of the knee and he hasn’t banged it in recent days, he could have Osgood-Schlatter Disease. Initially, pain occurs with athletic activity such as running and jumping. As it progresses, a teen may have pain with walking, climbing stairs, kneeling and squatting. Similarly, kids with Sever’s Disease will initially have pain with more athletic activities. As Sever’s Disease progresses, a child may complain of pain with standing, walking, wearing shoes (due to rubbing) and sometimes first thing in the morning. With Sever’s be on the lookout for a lump at the bottom of the Achilles tendon near the heel from extra bone as a result of increased stress to the area.

What Does Treatment Involve?

kneesThe good news is treatment for both conditions can be as easy as rest from sports activities and placing ice on the affected area. Patients with Sever’s Disease frequently benefit from the use of orthotics (think Dr. Scholl’s) to improve the alignment of the foot and lessen any pulling on the Achilles tendon.

Once the inflammation subsides, a physical therapist can prescribe specific exercises to address strength and flexibility limitations. Taping, bracing, or orthotics can be applied to improve joint mechanics. And a therapist can provide hands-on care to improve the mobility of the joints in your child’s knee and ankle.

You may be treated by a physical therapist directly without a referral. However, if the pain is the direct result of a specific injury or the child is unable to bear weight, you may need to see a physician for x-rays to rule out a fracture.

Assuming all is well – and your child follows the prescribed exercises and stretches – tweens and teens dealing with either disease should be back up and running in several months, if not weeks. The key is for adolescents to take their time and gradually return to sports and other activities.

It’s possible to avoid a recurrence of the symptoms by monitoring growth patterns. During periods of rapid growth, teens should maintain flexibility of their legs and parents should monitor their sports activities.

Because both are conditions that occur gradually, it is difficult to prevent an occurrence altogether. Just remember that growing pains can hurt, but there is help out there to make your child more comfortable.

Article written by Diana Brooks, PT, DPT