My teenager has pain below the kneecap. Is it jumper's knee or Osgood-Schlatter?

Same tendon, different weak points

The patellar tendon connects the kneecap to the shin. In children and young teenagers, the weakest link is not the tendon but the growth areas at either end. Repeated pulling from running and jumping irritates these growth areas. Once growth plates close in late adolescence, the tendon itself becomes the part that suffers, and jumper's knee becomes the more likely diagnosis.

How they compare

• Osgood-Schlatter disease: pain and often a tender, enlarging bump at the bony point just below the knee on the shin; typically ages around 10 to 15 during growth spurts
• Sinding-Larsen-Johansson syndrome: pain at the lower tip of the kneecap; typically a little younger, around 10 to 13
• Patellar tendinopathy: pain in the tendon just below the kneecap; more common in older teenagers and adults who jump a lot
• All three: worse with running, jumping, kneeling and stairs, and better with rest

How they are managed

Osgood-Schlatter and Sinding-Larsen-Johansson usually settle as growth slows. Treatment focuses on adjusting sport volume, ice after activity, quadriceps and hip strengthening, and kneeling pads. Jumper's knee needs the specific progressive tendon-loading programme used in adults. In all three, children can usually keep playing at a level that keeps pain mild.

When to see a specialist in Doha

Arrange an assessment if pain is severe, present at night or at rest, affects only one side with swelling, or follows a fall or a pop, or if your child is limping. These need examination, and sometimes an X-ray, to exclude a fracture, tendon avulsion or other causes. At Aman Hospital, Dr. Pablo Gelber examines young athletes, explains the diagnosis to the family and works with their coach on a sensible plan.