CONDITION

Osgood-Schlatter

Why the Front of the Knee Hurts and How We Treat It

Dr. Austin Van Poole
Written by Dr. Austin Van Poole, DC
Active Rehab Chiropractor
4 min read

Is your child complaining of pain just below the kneecap during sports?

Or are you dealing with persistent knee pain when squatting, running, or jumping?

Front-of-knee pain is one of the most common issues we see in active families.

In younger athletes, this is often Osgood-Schlatter disease. In teens and adults, it’s usually jumper’s knee (patellar tendinopathy).

At Radius Physical + Sports Rehab, we don’t just treat the painful knee. We identify the movement and loading problems that caused it, so you or your athlete can stay active without recurring pain.

What Is Osgood-Schlatter Disease?

Osgood-Schlatter is a growth-related condition that affects active kids and adolescents, especially during growth spurts.

It occurs at the tibial tuberosity — the bump just below the kneecap where the patellar tendon attaches.

Common symptoms

  • Pain just below the kneecap
  • Swelling or a prominent bump at the top of the shin
  • Pain with running, jumping, squatting, or kneeling
  • Tenderness to touch

The good news: it’s common, manageable, and rarely dangerous — but proper load management is key.

What Is Jumper’s Knee (Patellar Tendinopathy)?

In older athletes and active adults, similar pain usually involves the patellar tendon itself.

This occurs when:

  • Training volume exceeds tendon capacity
  • Repetitive loading causes micro-irritation
  • The tendon loses its ability to tolerate force

Common in:

  • Basketball and volleyball athletes
  • Soccer players
  • Runners
  • CrossFit and gym athletes
  • Anyone doing frequent squats, lunges, or plyometrics

Why Front-of-Knee Pain Happens

At Radius, we often describe the knee as the “middle child” of the lower body.

It takes extra stress when:

The Hip (Big Sibling) Isn’t Doing Its Job

Weak or poorly controlled glutes increase load on the knee during:

  • Landing
  • Cutting
  • Squatting
  • Running

The Ankle (Little Sibling) Doesn’t Move Well

  • Limited ankle mobility changes mechanics:

  • Heel lifts early

  • Knee collapses inward

  • Quadriceps and patellar tendon absorb more stress

In most cases, the knee is the victim, not the root cause.

How Long Does Recovery Take?

Osgood-Schlatter (kids)

  • Symptoms may fluctuate during growth spurts
  • Most improve over several months
  • Many athletes continue modified sports safely

Patellar Tendinopathy (teens/adults)

  • Early stage: 4–6 weeks
  • Moderate: 6–12 weeks
  • Chronic: 3+ months

Tendons respond best to progressive loading, not complete rest.

Best Practices for Recovery

Modify Activity — Don’t Shut It Down

We help athletes:

  • Reduce jumping volume
  • Adjust intensity
  • Stay active without flaring symptoms

Progressive Tendon Loading

Treatment includes:

  • Isometric strengthening
  • Slow, heavy resistance training
  • Gradual return to plyometrics

Fix the Movement System

We address:

  • Hip strength and control
  • Ankle mobility
  • Squat and landing mechanics

How We Treat Knee Pain at Radius Physical + Sports Rehab

Hands-On Treatment

  • Quadriceps and surrounding tissue work

  • Patellar tendon irritation management

  • Soft tissue mobility

Joint Mobilization

  • Ankle dorsiflexion

  • Hip mobility

  • Knee and patellar mechanics when needed

Strength Progression

Phase 1: Isometric quad and glute activation Phase 2: Split squats, step-downs, heavy resistance Phase 3: Jump training and sport-specific return

Our goal isn’t just pain relief, it’s strong, confident movement under load.

For chronic patellar tendinopathy that hasn’t responded to conservative care, shockwave therapy can be the right next step.

When Should You Schedule an Evaluation?

Consider an evaluation if:

  • Your child’s knee pain lasts longer than 1–2 weeks
  • Pain limits sports participation
  • A bump develops below the kneecap
  • Squatting or jumping consistently hurts
  • You want to prevent long-term tendon problems

Early treatment helps athletes stay in their season and avoid chronic issues.

Don’t Just “Wait for Them to Grow Out of It”

Many families hear: “They’ll grow out of it.”

Many adults think: “It’s just tight quads.”

Ignoring persistent tendon pain can lead to:

  • Chronic irritation
  • Reduced performance
  • Compensations and future injuries
  • Longer recovery later
Dr. Austin Van Poole
About the author
Dr. Austin Van Poole, DC
Active Rehab Chiropractor

Dr. Austin Van Poole is a compassionate and results-driven chiropractor based in Nevada City, California, focused on musculoskeletal rehabilitation, soft tissue therapy, and active care for injury recovery and performance enhancement. Known for his empathetic approach and dedication to patient-centered care, Dr. Van Poole is passionate about helping individuals reduce pain, regain function, and reclaim the active lives they love. Whether treating acute injuries, chronic pain, or sports-related conditions, he delivers personalized care plans focused on movement optimization and long-term wellness.

More from Dr. Austin Van Poole →

Frequently Asked Questions

Common questions about Osgood-Schlatter disease.

What is Osgood-Schlatter disease and what causes it?

Osgood-Schlatter disease is a common cause of knee pain in growing children and adolescents, also called traction apophysitis of the tibial tubercle. It develops where the patellar tendon attaches to a growth area at the top of the shinbone. During growth spurts, repeated pulling from the quadriceps and patellar tendon, especially in running and jumping sports, irritates that area and produces pain, tenderness, and swelling just below the kneecap.

What age does Osgood-Schlatter affect, and who is most at risk?

Osgood-Schlatter usually appears during the adolescent growth spurt, roughly ages 8 to 13 in girls and 10 to 15 in boys, and it is more common in boys. The main risk factors are rapid skeletal growth and repetitive running and jumping, so it is frequently seen in young athletes in sports such as basketball, soccer, gymnastics, and volleyball. Both knees are affected in about 20% to 30% of cases.

How long does Osgood-Schlatter last, and does it go away on its own?

Osgood-Schlatter is self-limiting, which means it tends to resolve on its own. Symptoms often settle over a period of months but can come and go during growth spurts, and the condition usually clears once a child finishes growing, around age 14 in girls and 16 in boys. In some cases symptoms last longer, up to about two years, until the growth area at the top of the shin fully matures.

Will the bump below the knee go away?

The knee pain from Osgood-Schlatter almost always stops once a child has finished growing, but the bony bump at the top of the shin can remain permanently. A leftover bump is usually painless and harmless, and surgery to remove it is rarely needed. If the bump stays tender into adulthood, padding it during kneeling or direct pressure can help.

Can my child keep playing sports with Osgood-Schlatter?

In many cases children with Osgood-Schlatter can keep playing sports, guided by their pain. The condition is self-limiting, and while rest has not been shown to speed healing, easing off aggravating activities does reduce pain. A common approach is to let a child stay active as long as the pain settles with rest and does not limit how they move, and to cut back on jumping and high-impact load when symptoms flare.

How is Osgood-Schlatter treated?

Treatment for Osgood-Schlatter focuses on easing pain and managing load rather than curing it, since it resolves with time. Common measures include relative rest and activity modification guided by pain, icing after activity, and stretching and strengthening the thigh muscles, especially the quadriceps and hamstrings. A protective pad can shield the bump from direct contact. If pain does not settle with these steps, formal physical therapy may be recommended.

When should we see a clinician about my child's knee pain?

It is worth having a child's knee evaluated if the pain is getting worse, if they are limping, or if symptoms are severe or are not improving. A clinician can confirm the diagnosis, which is usually based on history and a physical examination rather than imaging, and rule out other problems such as a fracture. X-rays are not normally needed for Osgood-Schlatter unless the presentation is severe or unusual.

Sources

The information on this website is general education about musculoskeletal and movement-related conditions. It is not medical advice or a diagnosis, and it cannot tell you what is causing your symptoms. Reading it is not a substitute for an in-person evaluation, and booking a visit does not confirm that your condition is right for our care until a provider has examined you. This information cannot identify every condition, and some urgent problems can feel like musculoskeletal pain. If your symptoms are severe or getting worse, or you are unsure how urgent they are, contact your physician, call 911, or go to the nearest emergency room. When in doubt, seek emergency care.

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