Osgood Schlatter Disease: Symptoms, Causes, Treatment

osgood-schlatter-disease-symptoms-causes-treatment

What is Osgood Schlatter Disease

Osgood Schlatter Disease or OSD is characterised by pain just below the kneecap, where the patellar tendon inserts into the shin bone (tibia). This is the growth centre (apophysis) located at the bony prominence called the tibial tuberosity.

Osgood Schlatter Disease appears in 10% of adolescents. Of those affected, 30% have symptoms in both knees. Osgood Schlatter Disease usually occurs during peak growth periods - in females aged around 8-14 years and males aged 10-15 years. The number of adolescents who develop Osgood Schlatter Disease is higher in those who participate in sport.

what-is-osgood-schlatter-disease
what-is-osgood-schlatter-disease

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Symptoms of Osgood Schlatter Disease

There are a number of symptoms related to  Osgood Schlatter Disease, which include:

  • Swelling at the tibial tuberosity (the bony prominence at the top of the shin
  • A more prominent bony bump on the tibial tuberosity
  • Pain in one or both knees
  • Redness and inflammation of the skin over the tibial tuberosity
  • Pain when straightening the knee, especially against resistance
  • Pain performing a full squat
  • Pain during running or playing sport
  • Pain going up and down stairs
  • Pain that settles with rest
  • Reduced strength and muscle bulk in the quadriceps (muscles in the front of the thigh)
symptoms-of-osgood-schlatter-disease
symptoms-of-osgood-schlatter-disease

Causes of Osgood Schlatter Disease

Growth centres in children are their 'weak link'. The growth centres are still cartilaginous and haven't fused into bone yet. In adults where these centres are now fused into strong bone, injury is more likely to occur in the tendon. Osgood Schlatter Disease is then like the patellar tendinopathy for children, but high loads from the quadriceps muscle (front of the thigh) pulling on the tendon will cause pain in the growth centre, rather than the tendon. 

Researchers have found that Osgood Schlatter Disease may develop from repeated high forces at the tibial tuberosity, created by strong contraction of the quadriceps muscle.  This is why Oscgood Schlatter Disease in more common in very active children or adolescents, particularly those involved in sports that include running, kicking, jumping and landing.

Some research has also found quadriceps tightness can contribute to Osgood Schlatter Disease.

During periods of rapid growth, the long bones, such as the femur (thigh bone) and tibia (shin bone) grow more rapidly than the muscles can adapt. Teenagers often go through periods of poor flexibility, where their muscles are essentially too short for their bones (until they catch up). This can then contribute to the tugging at tendon insertions - where the tight muscles join onto the bones.

During these periods, co-ordination can also reduce, due to the tight muscles and getting used to moving their changing bodies. Reduced co-ordination may result in more falls and reduced control around the hip and knee. This may also contribute to the pain.

causes-of-osgood-schlatter-disease
causes-of-osgood-schlatter-disease

Quick Tip: How do you know if your child is in a growth spurt?

The feet grow first, so if you're suddenly needing to buy new shoes, they are in a growth spurt!

 

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Treatment Options for Osgood Schlatter Disease

Osgood Schlatter Disease is typically self-limiting (goes away in time) and almost always resolves once the adolescent has stopped growing. Pain can continue after the bones have stopped growing in some rare cases.

Adolescents that have experienced Osgood Schlatter Disease may not entirely recover their full joint functionality. This can be treated with the help of a physiotherapist to reduce symptoms and speed up the recovery process with treatments including strengthening and gentle stretching exercises.

How we can help you

Our physiotherapists can assess your child's knee pain to determine if they have Osgood Schlatter Disease. They will take into account the load their body is under with the level of physical activity that they do.

A home exercise program will be developed to help progress the strength of the muscles that support your knee, but also the control of the whole lower limb. Working on co-ordination around the pelvis, hip, knee and foot can help reduce excessive and irritating forces occuring at the knee.

Working on co-ordination, control and balance can also be really helpful in improving performance in competitive young athletes.

Gentle active muscle lengthening exercises can help gradually improve flexibility without causing further irritation at the insertion into the bone. Some massage of the tight muscles may help to relieve some tension, while we work on other longer-term strategies.

Taping to redistribute load around the bony tibial tuberosity can provide relief for some, so it's something we can trial to see if it is effective as a short term pain-reducing strategy for your child.

Treatment approach, including exercises and advice will be tailored to your child and their specific sports or other needs.

how-our-physios-can-help-with-osgood-schlatter-disease
how-our-physios-can-help-with-osgood-schlatter-disease

Is knee pain making it hard to move normally, or do things you or your child love, like dancing or playing sport? Visit us at PhysioTec, and let one of our physios provide an assessment and a personalised program to help you or your child get on-top of that pain, and back to those favourite activities!

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Rhianna Tunks - Physio at Physiotec, Tarragindi, Brisbane

Author

This blog was written by Rhianna Tunks, one of our Dance physiotherapists and our Group Exercise & Pilates instructor. Rhianna's love of movement and exercise, is also of broad benefit for anyone with musculoskeletal pain or injury. You can read more about Rhianna here.

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Knee pain can have a large impact on your life, limiting your movement, and keeping you away from doing the things you love. At PhysioTec, our experienced physios can assess you and provide you with a personalised program to help you get on-top of your knee pain, and back to doing the things you love!

If you would like to book with one of our experienced Brisbane Physios, please call, email or book online below:

Phone: (07) 3342 4284

Email: reception@physiotec.com.au

References:

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  2. Ohtaka M, Hiramoto I, Minagawa H, Matsuzaki M, Kodama H. Screening of the maturity status of the tibial tuberosity by ultrasonography in higher elementary school grade schoolchildren. IJERP. 2019;16(12):2138. https://www.mdpi.com/1660-4601/16/12/2138
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  4. Pan T, Mun F, Martinazzi B, King TS, Petfield JL, Hennrikus WL. The Posterior Tibial Slope and Insall-Salvati index in Operative and Nonoperative Adolescent Athletes with Osgood-Schlatter Disease. Arthrosc Orthop Sports Med. 2022; 142:3903-3907. https://link.springer.com/article/10.1007/s00402-021-04314-z
  5. Schultz M, Tol JL, Veltman L, Kaaden van der L, Reurink G. Osgood-Schlatter Disease in youth elite football: minimal time-loss and no association with clinical and ultrasonographic factors. Phys. Ther. Sport. 2022;55:98-105. https://www.sciencedirect.com/science/article/pii/S1466853X22000402?via%3Dihub
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