Last month I was seeing a young student athlete who uses sports therapy sessions as part of his recovery plan for running. As I was working on his legs, I placed my hand under his knee which seemed to spark a pain sensation. When I asked what was wrong my patient explained to me that he has had a painful knee from Osgood Schlatter's Disease for a few years. I found that a negative experience with a doctor in the past has led him to believe there was nothing that could be done. This prompted me to write an article on Osgood Schlatter's Disease with my own thoughts throughout my own practice as well as looking at evidence-based literature. There is in fact a lot that can be done to manage this condition properly without loosing fitness and I hope my readers find this article helpful.
What is Osgood Schlatter's Disease?
Osgood Schlatter's Disease (OSD) is not as scary as it sounds and is much more of an overuse injury than an actual disease. Although, I am not too sure the late Robert Osgood or Carl Schlatter (the surgeons that first discovered OSD) would be very happy with any name-change. OSD is regarded as a traction apophysitis (an inflammation below the knee occurring from repetitive pulling). This pulling below the knee happens as a result of the quadricep muscles being overused and concentrically loaded (shortened and tightened). The area where the pain is felt is at the tibial tuberosity (that bump just below your knee cap). This pulling mechanism happens often when running and is even harsher on harder surfaces.
Osgood Schlatter's Disease (OSD) is not as scary as it sounds and is much more of an overuse injury than an actual disease. Although, I am not too sure the late Robert Osgood or Carl Schlatter (the surgeons that first discovered OSD) would be very happy with any name-change. OSD is regarded as a traction apophysitis (an inflammation below the knee occurring from repetitive pulling). This pulling below the knee happens as a result of the quadricep muscles being overused and concentrically loaded (shortened and tightened). The area where the pain is felt is at the tibial tuberosity (that bump just below your knee cap). This pulling mechanism happens often when running and is even harsher on harder surfaces.
Who does OSD affect?
OSD has been found most commonly in children and teenagers. This is because children and teenagers have growth zones on the tibia and femur bones as well as a bunch of cartilage tissue at that bony bump just under the knee. These zones are very important and essential for proper growth however, there is one major problem which causes the pain. The bony and cartilaginous areas grow at a much faster rate than the tendons and muscles. This is the reason behind the pulling. The quadricep muscle contracts many hundreds of times when running and this translates a huge amount of stress and subsequently, pain to the tibial tuberosity. The forces can cause microavulsions at the knee where the cartilage tissue is pulled away from the tibia or in some cases bigger avulsion fractures.
OSD has been found most commonly in children and teenagers. This is because children and teenagers have growth zones on the tibia and femur bones as well as a bunch of cartilage tissue at that bony bump just under the knee. These zones are very important and essential for proper growth however, there is one major problem which causes the pain. The bony and cartilaginous areas grow at a much faster rate than the tendons and muscles. This is the reason behind the pulling. The quadricep muscle contracts many hundreds of times when running and this translates a huge amount of stress and subsequently, pain to the tibial tuberosity. The forces can cause microavulsions at the knee where the cartilage tissue is pulled away from the tibia or in some cases bigger avulsion fractures.
Signs and Symptoms:
General ache/ pain at the tibial tuberosity.
Pain upon touching the tibial tuberosity.
Pain at tibial tuberosity which worsens with general physical activity.
Increased pain at the tibial tuberosity with squatting, stairs and jumping.
Increased size or swelling at the tibial tuberosity.
General ache/ pain at the tibial tuberosity.
Pain upon touching the tibial tuberosity.
Pain at tibial tuberosity which worsens with general physical activity.
Increased pain at the tibial tuberosity with squatting, stairs and jumping.
Increased size or swelling at the tibial tuberosity.
| Don't do nothing:
| Sports Therapy: At the clinic we assess and treat OSD to a high standard with the following:
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Thanks for following!
Murray Collier
Murray Collier
This article was written in an evidence-based style using the following resources:
Baltaci, G., Ozer, H. and Tunay, V. (2003) ‘Rehabilitation of avulsion fracture of the tibial tuberosity following Osgood-Schlatter disease’, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA., 12(2), pp. 115–8.
Blankstein, A., Cohen, I., Heim, M., Diamant, L., Salai, M., Chechick, A. and Ganel, A. (2001) ‘Ultrasonography as a diagnostic modality in Osgood-Schlatter disease. A clinical study and review of the literature’, Archives of orthopaedic and trauma surgery., 121(9), pp. 536–9.
Çakmak S , Tekin L, Akarsu S. Long-term outcome of Osgood-Schlatter disease: not always favorable. Rheumatology International January 2014, Volume 34, Issue 1, pp 135-136.
Gholve, P., Scher, D., Khakharia, S., Widmann, R. and Green, D. (2007) ‘Osgood Schlatter syndrome’, Current opinion in pediatrics., 19(1), pp. 44–50.
Kaya, D., Toprak, U., Baltaci, G., Yosmaoglu, B. and Ozer, H. (2012) ‘Long-term functional and sonographic outcomes in Osgood-Schlatter disease’, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA., 21(5), pp. 1131–9.
Baltaci, G., Ozer, H. and Tunay, V. (2003) ‘Rehabilitation of avulsion fracture of the tibial tuberosity following Osgood-Schlatter disease’, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA., 12(2), pp. 115–8.
Blankstein, A., Cohen, I., Heim, M., Diamant, L., Salai, M., Chechick, A. and Ganel, A. (2001) ‘Ultrasonography as a diagnostic modality in Osgood-Schlatter disease. A clinical study and review of the literature’, Archives of orthopaedic and trauma surgery., 121(9), pp. 536–9.
Çakmak S , Tekin L, Akarsu S. Long-term outcome of Osgood-Schlatter disease: not always favorable. Rheumatology International January 2014, Volume 34, Issue 1, pp 135-136.
Gholve, P., Scher, D., Khakharia, S., Widmann, R. and Green, D. (2007) ‘Osgood Schlatter syndrome’, Current opinion in pediatrics., 19(1), pp. 44–50.
Kaya, D., Toprak, U., Baltaci, G., Yosmaoglu, B. and Ozer, H. (2012) ‘Long-term functional and sonographic outcomes in Osgood-Schlatter disease’, Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA., 21(5), pp. 1131–9.
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