Private osgood-schlatter and sever's clinic in London, same-day paediatrics.

Which is which

• Osgood-Schlatter — pain and a tender bony lump just below the kneecap, where the patellar tendon attaches. Typically boys 12–15, girls 10–13. Worse with running, jumping, kneeling and stairs.
• Sever's disease — pain at the back or underside of the heel, worse during and after sport, often with a limp at the end of a game. Typically ages 8–14. Squeezing the sides of the heel reproduces it.
• Both are commoner during growth spurts, in children playing multiple sports, and on hard surfaces.

Load management, not rest

Complete rest settles the pain and it returns within a fortnight of going back, because nothing has changed. What works is reducing load enough to bring pain to a tolerable level, then rebuilding gradually while strengthening.

1. Use a pain scale. Pain up to about 3 or 4 out of 10 during activity, settling within 24 hours, is acceptable. Above that, reduce.
2. Cut volume, not everything. Drop from four sessions to two, shorten them, avoid the highest-impact elements — sprinting, jumping, hills.
3. Strengthen. Quadriceps and calf work respectively, done consistently. This is the part that changes the outcome.
4. Stretch the quadriceps, hamstrings and calves daily — tightness during a growth spurt is a major contributor.
5. Rebuild gradually over weeks once pain settles, adding one element at a time.

What else helps

How long

Symptoms typically fluctuate over several months to two years, settling once the growth plate closes at the end of the growth spurt. In Osgood-Schlatter, a painless bony lump below the knee usually remains permanently — harmless, but it can be uncomfortable to kneel on. Neither condition causes arthritis or long-term damage.