Osgood Schlatter Syndrome Explained
Are you age 8 – 15 and suffering from pain on that bony part beneath your knee cap? You may be suffering from Osgood-Schlatter Syndrome.
Who does it affect?
– Males and females, generally aged 8 – 15 (going through puberty and/or recent growth spurt).
– Those who participate in high impact sports that put higher loads on the patella tendon (jumping sports) or sports involving repetitive knee extension (such as kicking) (1, 2)
What does it feel like?
– Pain on the bony part underneath your knee (tibial tuberosity)
– The pain can be after sport, during sport, or can be constant depending on the severity
– The bony part of your knee will be tender to touch
– Straightening your knee against resistance will be painful (3)
Why does it happen?
The tibial tuberosity is an apophysis. As a child, that part of bone is made of cartilage (soft and pliable) and as you grow it ossifies (becomes bone which is hard). During adolescence and this stage of growth, the cartilaginous tibial tuberosity changes to a more bony structure and then needs to fuse with the tibia.
During this stage, the area where the tibial tuberosity is fusing to the tibia does not withstand tensile forces well, hence why it becomes irritated when repetitive movements and forces are pulling on it. During a growth spurt, bone length growth is faster than the muscle lengthening hence causing tight quadriceps and increasing the tensile force on the apophysis further.
Does it go away?
As you read above, Osgood-Schlatter Syndrome is due to the growth plate not yet being fused, hence when the growth plate fuses it is expected that the pain will go away. This time range varies for people and generally can be 1-2 years (1).
What can we do?
Generally a sport loving adolescent is not going to wait for their growth plates to close before they return to sport so there are some things that can be done to help get back on the field faster
– Soft tissue release to relieve tension from the quadriceps
– Brace/tape to take the pressure off the tibial tuberosity
– Home exercise program based on stretching tight muscles – Check out this quadricep/hip flexor stretch HERE
– Activity modification – rest from training or sport for a short period and then gradual return to sport
– Running screening – to see if there are lower limb deficits contributing to overload of the tibial tuberosity
– Gait/running re-education (get some ideas here from Brad’s book “You Can Run Pain Free”)
– Clinical Pilates – a good option while the adolescent is off sport to maintain strength without overloading the tibial tuberosity. Click HERE for information on Clinical Pilates.
– Referral to sports doctor or orthopaedic specialist if required
Osgood-Schlatter Syndrome is a frustrating injury that is common among young sports people. Despite being an age related injury, there are things you can do and please feel free to contact us if you have any questions about anything written above.
Emily Georgopoulos
POGO Associate Physiotherapist
Useful Resources
Information on Pilates Fitness Pilates Click HERE Clinical Pilate Click HERE
You Can Run Pain Free Click HERE
Hip-Flexor Quad Stretch Click HERE
References:
(1) Gholve PA, Scher DM, Khakharia S, Widmann RF, Green DW. Osgood Schlatter
syndrome.Curr Opin Pediatr. 2007;19(1):44-50.
(2) Wall EJ. Osgood-Schlatter disease: practical treatment for a self-limiting condition. Phys
Sportsmed. 1998;26(3):29-34.
(3) Weiler R, Ingram M, Wolman R. 10-minute consultation: Osgood-Schlatter disease. BMJ.
2011;343.
