What is it?
Osgood-Schlatters Disease is a condition that develops during adolescence. It is a common cause of pain and inflammation at the bony prominence below the knee cap (Tibial tuberosity) where the patellar ligament/tendon attaches. This is usually a result from micro trauma of the patellar tendon fibres at the side of attachment onto the tibial tuberosity. However, pain/inflammation can also be caused by pulling (avulsion) of cartilage and/or bone during adolescence as this is when the tibial tuberosity is weak.
What does it feel like?
The pain and swelling is of gradual onset being mild and alternating at the tibial tuberosity and becomes aggravated with running and jumping activities and also through direct pressure such as kneeling. Rest and avoiding aggravating activities relieve the pain. In the acute aggravated phase, however, pain may be severe and continuous.
Osgood-Schlatters Disease is more prevalent in highly active adolescent individuals with males having a 30% higher incidence rate than females. The average age of onset of symptoms is 13 years of age, or commonly observed during the periods of significant growth spurts.
What causes it?
There are several factors that may increase an individual from developing Osgood-Schlatters Disease. These include: regular practice of sports; and overuse of the quadriceps tendon in activities such as jumping, squatting and running. One explanation for this disease to develop during adolescence is as a child grows, bones grow faster than tendons leading to tight/shortened tendons. The quadriceps tendon attachment is already large compared to it attachment, therefore along with the shortened and tight tendons when it contracts it produces a significant amount of tension leading to the mirco-trauma and possibly avulsion.
Positive signs that assist in diagnosing the condition include: tenderness and pain on palpation of the tibial tuberosity with localised swelling; observable prominent bump in the area; pain with straightening the knee against resistance; shortened/tight quadriceps, hamstrings or calves; and pain on stretching the quadriceps (particularly the rectus femoris).
What can I do about it?
Conservative (non-surgical) management is the best option for treatment and reduce the symptoms. A stretching exercise program should be commenced to target shortened muscles found in assessment, particularly the hamstrings and quadriceps– this will decrease the tension placed on the tibial tuberosity. Appropriate decrease in activity will assist in decreasing pain and inflammation. After aggravating activities, applying an ice pack to the area will be useful for swelling and inflammation. If continuing to do aggravating activities, a patellar strap can ease symptoms by decreasing force through the tendon. Strengthening quadriceps muscles is also recommended.
Things you can start to do to relieve symptoms
Relative rest – resting from aggravating activities will help to relieve your symptoms. This puts less stress on the tendons, allowing the area to be less irritated.
Ice – when knee feels aggravated after activities, wrap an ice pack with a towel then place it on your knee for approximately 10 mins. This is can help with any irritation/inflammation in the area and decrease pain and swelling. Allow to rest for approximately 2 hours then cycle through again with the ice pack if needed. Stop applying ice if more irritation occurs due to the cold.
Quadriceps stretch – Have some support on the side, stand on one leg and grab your foot that is off the ground backwards towards your bottom, allowing your knee to bend. Hold static stretch for 30 secs and repeat 4 more times. Only slight stretching discomfort should be felt.