The Bee’s Knees:
Common Childhood Knee Injuries and Their Treatment
By Dr. Fred Cushner

Beth Israel’s Insall Scott Kelly
Institute for Orthopaedics

Now, in addition to all the other concerns that teachers and parents have about children, there is another cause for worry: one of the populations increasingly suffering knee ailments
is children, due largely to their growing participation in sports like basketball, soccer and hockey.

Overuse injuries are the most common. These include bursitis, tendinitis, or sprains and strains. All occur with repetitive activities or repeated or prolonged pressure on the knee. Stair climbing, bicycle riding, jogging, or jumping are activities that can all lead to irritation or inflammation.

One of the most common knee overuse ailments for children, seen usually more prominently among boy athletes aged 11-15, but now increasingly seen in girls, and at earlier ages, is Osgood-Schlatter disease.

Osgood-Schlatter disease occurs during a child’s rapid growth years. Since girls begin developing earlier, Osgood-Schlatter begins in active girls between the ages of 8 and 13. The problem consists of an inflammation at the top of the shinbone where the patellar tendon attaches to a bony prominence.

Symptoms of Osgood-Schlatter disease include:

-Pain and tenderness in front of the knee

-Mild swelling just below the kneecap

-A bump at the bottom of the knee or top of the shin

Osgood-Schlatter disease can be exacerbated by activities such as running or gymnastics. However, Osgood-Schlatter disease usually goes away with time. Only rarely does it persist beyond the growing stage.

Home treatment focuses on preventing symptoms and using first-aid to reduce pain when symptoms occur. For treatment, remember the acronym “RICE”: Rest, Icing the area for 20 minutes three times per day, Compressing the area with a bandage and Elevating the leg. Decreased activity is also suggested. If the child ignores or plays through the pain, the disease can worsen. Surgery is only considered as a last resort.

With attention and care, we can make sure that overuse injuries in children are avoided, and that children do not grow up to become part of this startling statistic: 4.1 million adults seek medical attention for knee problems each year.#

Dr. Fred D. Cushner has been an ankle and knee specialist at Beth Israel’s Insall Scott Kelly Institute for Orthopaedics in New York City since 1995.