Q. My thirteen year old daughter plays field hockey and soccer. This year she developed painful bumps on the front of her knees several inches below the knee cap on the upper shin area. She is able to play but is sore for several days afterward. My friends say it’s just “growing pains”. What should I do?

A. There really is no such thing as “growing pains”. It should not hurt to grow! However, during the growth spurt years active teenagers can develop a variety of problems around the knee. Some are more serious and others just more of a nuisance.
Your daughter’s problem sounds like Osgood Schlatter Condition which is an overuse injury of the tibial tubercle. It is a relatively minor stress fracture or stress reaction. The tibial tubercle is a vulnerable area that serves as the attachment site of the infrapatellar tendon or ligament. This attaches the large strong front thigh muscle (quadriceps) and knee cap to the upper shin and is prone to overload.

Treatment is usually conservative and involves cutting back activities but not necessarily stopping sports completely. The use of ice over the bumps is helpful as well as knee sleeves and aggressive preventive stretching should be done, especially the hamstrings. A good supportive sneaker is also important.  It is important to get a proper diagnosis with an orthopaedic surgeon or sports medicine specialist who can also outline some other preventive measures for you. Young athletes with Osgood Schlatter condition can usually remain active unless it is more severe. Occasionally this happens where there is significant swelling and a limp, and in those instances a layoff from sports is prudent.