Osgood Schlatter Disease

What is Osgood Schlatter Disease?
Osgood Schlatter Disease is swelling and pain within the patella ligament at the tibial tuberosity (the top part of the leg bone), underneath the kneecap. Osgood Schlatter Disease can vary in severity depending on multiple factors and pain can last from weeks to months, in one or both knees. It affects growing children and adolescents and is most common between the ages of 10-16 years. Implementation of management strategies appropriate to each individual can significantly reduce symptoms and expedite recovery times.



What are the symptoms of Osgood Schlatter Disease?
People who experience Osgood Schlatter Disease will report pain below the knee cap and can often feel a bump or lump where the pain is most intense.

People that have Osgood Schlatter Disease will report pain with activities such as running, jumping and particularly with rising motions such as getting up from the ground or climbing stairs.

During onset, pain is often mild and people will often continue on with activity, although they may be experiencing pain. Once established, the pain can be severe and prevent people from bending the knee with confidence, limiting the ability to walk, run and jump.



How is Osgood Schlatter Disease diagnosed?
It is common for medical professionals to use imaging such as plain film X ray for diagnosis, however booking appointments for and obtaining images can be time consuming and thus delay effective long term treatment. A good therapist who has experience working with Osgood Schlatters Disease can diagnose and begin treatment during the first session of treatment, without the need for x-rays or further imaging.

What causes Osgood Schlatter Disease?
Osgood Schlatter Disease is caused by repetitive forces applied to the growing bone (tibia) and an inflammatory reaction within the area at the top part of the tibia (leg bone).

Who gets Osgood Schlatter Disease?
Athletic young people are most at risk of development of Osgood Schlatter Disease.

Activities that involve repetition of higher impact movements such as running and jumping increase the likelihood of development of the problem. Given this it is most likely to affect pole vaulters, long jumpers and bowlers (cricket).

What are the treatment options of Osgood Schlatter Disease?
Historical treatment of Osgood Schlatter Disease
Complete activity avoidance was a common treatment strategy in the past and it worked, providing people refrained from activity for extended periods of time. Today, some people can experience recurring incidence of Osgood Schlatter Disease with a return to activity if this type of management plan is still being used.


Short term management of Osgood Schlatter Disease is targeted at reducing the pain and improving function.

 

This can include:

  • Reducing the amount of provocative activities such as walking, running, playing sports etc. 
  • Wearing lace up, cushioning shoes to refrain from excessive load being transferred up the leg to the tibia, leading to pain
  • Using ice packs to reduce the swelling and pain
  • Taking anti-inflammatory medication to reduce the swelling and pain
  • In some cases, using crutches can be useful 

Successful long term management of Osgood Schlatter Disease can be different for different people.

Historically, complete activity avoidance was regularly recommended, in some cases for many years. Thankfully practitioners are more understanding about psychological and social health and will now provide a thorough assessment to understand the multiple influencing factors that may have caused the problem.

A successful long term management plan will address the underlying cause of the problem and may include: 

  • Load/ activity management 
  • Footwear advice/ consideration 
  • Strength and conditioning exercises (to make the body stronger and prevent recurrence of injury) 
  • Orthotic therapy to influence biomechanics and gait (the particular way the foot is being loaded)

These management strategies will be applied over many weeks, months to provide comfort and a full resolution of the problem.

Written by:

Ryan Michell,

Physiotherapist
Proactive Health & Movement

 

Daniel Monteleone,
Podiatrist, Strength and Conditioning Coach,
Proactive Health & Movement

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