Diagnosis: Osgood Schlatter Disease (OSD)
What is OSD?
Osgood Schlatter Disease (OSD) is a condition commonly seen in growing children and teenagers causing swelling and pain around the top of the shinbone, due to repeated pulling of the patella ligament1.
Signs of OSD
OSD usually causes pain over the front of the knee joint during sports or exercise. Some of the common signs include
- Pain in one or both knees1
- Pain when straightening the knee joint or squatting1
- Pain on running or walking up and down
- The bump at the top of the shin bone becomes soft and swollen2
- Tightening of the quadriceps muscles at the front of the thigh2 Stopping activity and rest usually relieves pain
How is OSD Diagnosed?
Taking to a physiotherapist about what brings on pain and where it is, can help to diagnose OSD. The physiotherapist may also confirm the diagnosis with the following2:
- Feeling the top of the shin bone for pain and swelling
- Straightening the knee from a bent position to see if this causes pain
- Ely’s test: here, lying on your back the physiotherapist will bend the knee towards the bottom to see if there is any pain, tightness or tingling in the muscles at the front of the thigh
In some cases, where the injury may be more severe an X-‐ray is needed to see if there are any large fractures on the top of the shin1.
What Causes OSD?
OSD is more common in active growing children, especially during a growth, than adults. This is because unlike adults, in children, the bones in the leg and thigh have not completely developed and there are areas that are still growing, which are much softer3. During repeated activity, such as sports the muscles around the knee pull on these growing areas and over time if the child continues to play it can cause stress over this area and lead to small hairline fractures forming in the shin, from where the ligament has pulled3. This causes the pain and swelling seen in the shin and around the knee joint.
How is OSD treated?
Physiotherapists can help manage OSD using a variety of methods that are very effective, but it usually goes away when the bones stop growing (between 14-‐18 years). Rest is key for pain relief, so in mild cases the child may need to restrict the activities that cause the pain2. They may be able to continue their activities as long as the pain is mild and not increasing. If symptoms flare up during activity a short break is required to rest the knee.
In some cases the physiotherapist may recommend shock-‐absorbent insoles to decreases stress on the knee2. Taping is another common tool used to protect the knee; here the tape is placed around the knee to take the stress of the tendon therefore reducing pain3.
The muscles around the knee will need to be addressed to control or manage the symptoms during the course of the OSD. The physiotherapist will prescribe and help teach exercises and stretches to help with muscle control and lengthening the muscles around the knee in order to help with recovery3.
Shanam Nisha
Student Physiotherapist
References
- http://physioworks.com.au/injuries-conditions-1/osgood-schlatters-disease
- http://www.physio-‐com/Osgood-‐Schlatter’s_Disease
- https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/osgood-‐ schlatter-‐syndrome
