PT Tip of the Month Archive

What is Osgood Schlatter Disease?

Kids playing basketballOsgood-Schlatter disease is a condition that affects children and adolescents who are undergoing rapid growth spurts. It is manifested by a pain below the kneecap at the bump where the patellar tendon attaches, called the tibial tuberosity. It is most commonly seen in children who participate in sports that involve running, jumping (as in volleyball, ballet, gymnastics, and figure skating), and lateral movements (as in football, soccer, and basketball).

 

 

Symptoms

Knee anatomyTenderness to palpation, pain, and swelling at the tibial tuberosity are the most commonly reported symptoms. This pain generally worsens with running and jumping activities or with ascending stairs. Depending on the level of pain, the child or adolescent may have a noticeable limp. Pain can be reproduced with resisted knee extension. Resolution of pain usually happens with rest. Because the patellar tendon connects the quadriceps muscle to the tibial tuberosity, this muscle is often tight and is indicative of the pain the child or adolescent experiences as the muscle is repeatedly lengthened and shortened during activity. It is generally seen in just one knee, but can develop in both simultaneously. The degree of pain varies from individual to individual and can last from weeks to months. Pain may be recurrent and usually resolves completely once the adolescent stops growing.

Causes

Repeated stress (as in running and jumping) can cause the quadriceps tendon to pull on the tibial tuberosity and thereby stress the underlying growth plate of the bone. Stress on the growth plate can cause it to become swollen and painful. In some instances, the body responds by attempting to grow new bone in that area, which may be felt upon palpation.

Risk Factors

As stated earlier, Osgood-Schlatter disease is seen in adolescents who participate in running and jumping sports and undergoing a concurrent growth spurt. Boys are more commonly affected by Osgood-Schlatter disease, however the incidence in girls has increased drastically as more and more girls are becoming involved in sports at an earlier age. Most recent incidence reports indicate that 1 in 5 adolescents are affected by this condition. Typically, Osgood-Schlatter disease is seen in boys aged 12-15 years old and girls aged 8-12.

Diagnostics and Testing

X-rays, ultrasound, and MRI are the most commonly used imaging to confirm Osgood-Schlatter disease, with clinicians looking for abnormality at the tibial tuberosity or avulsion of the patellar tendon at the tibia. Often times, risk factors combined with patient presentation are usually sufficient in assisting the clinician in determining whether or not the adolescent is experiencing Osgood-Schlatter disease.

Prognosis and Treatment

Knee x-rayThe prognosis of Osgood-Schlatter disease is very good, with about 80-90% of cases responding well with conservative treatment such as physical therapy. Icing and anti-inflammatory medications are often prescribed early on to control pain and localized swelling. Physical therapy treatment may include stretching of tight lower extremity muscles, such as the quadriceps or hamstrings, which will reduce the tension on the tibial tuberosity as the knee bends and straightens. Strengthening exercises of the hip and thigh musculature is often prescribed to add stability to the knee joint, which is important in single-leg and dynamic activities. External supports, such as a patellar strap, may also be recommended. Your physical therapist may also suggest cross-training activities to decrease the inflammatory cycle and allow for symptoms to subside. If you think you are experiencing signs and symptoms of Osgood-Schlatter disease and would like to be scheduled for a physical therapy evaluation, please contact 617-232-PAIN (7246) for our Brookline office and 617-325-PAIN (7246) for our West Roxbury office.

References

  1. Gholve PA, Scher DM, Khakharia S, Widmann RF, Green DW. Osgood Schlatter syndrome. Curr Opin Pediatr. 2007;19:44-50.
  2. Vreju F, Ciurea P, Rosu A. Osgood-Schlatter disease – ultrasonographic diagnostic. Med Ultrason. 2010;12:336-339.
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