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Osgood Schlatter affects children in their teens

Osgood Schlatter – a disease or injury?

Osgood Schlatter, also known as “growing pains”, is a common inflammatory injury and cause of knee pain in the younger athlete. This article will help inform you about the injury and assist in management thereof.

How does Osgood Schlatter injury/disease occur?

Boys and girls go through growth spurts at various stages in their lives, boys being later than girls. The bones of children and adolescents are not completely fused allowing them to still grow. A growth plate is a piece of cartilage that is located near the ends of bones and is often a source for a tendon insertion. The quadriceps muscle in the knee inserts via a tendon into the bony protuberance called the tibial tubercle.

Osgood Schlatter disease/injuryAs the muscles, tendons and bones are growing swiftly and unequally, it can result in a traction force on the bony area known as the growth plate. Repetitive pulling of the quadriceps muscle on the growth plate can then result in injury. This then leads to inflammation and pain just below the knee where the tendon from the kneecap attaches to the shinbone.

What are the signs & symptoms?

  1. Inflammation, swelling and warmth just below the knee
  2. Knee pain and tenderness
  3. Stiff muscles in the front and back of the knee (Quadriceps and Hamstrings)
  4. Pain brought on by (intensified) physical activity (running, jumping, stairs etc)
  5. A hard bump felt under the knee that is sensitive to touch

How is the diagnosis made for Osgood Schlatter?Osgood Schlatter bony protuberance in teens' knee area

  • Mainly by physical examination and report of signs and symptoms.
  • A firm bump is felt over the tibial tubercle which is sensitive to touch.
  • It is painful to straighten the knee against resistance.
  • This condition is NOT commonly diagnosed via X-ray, but should the patient’s condition be different to normal, then a diagnosis can be concluded using an X-ray.

Osgood Schlatter avulsion fracture seen by X-rayPrevention and Treatment:

The extent of the treatment varies between individuals and focuses on:

  • Education about this condition
  • A modification in activities
  • Treatment to reduce the pain and swelling
  • Rest and physiotherapy.

Some individuals may need to rest for a few months, depending on the severity of the pain. The use of anti-inflammatory medication can assist in the initial management of pain.

What can the Physiotherapist do for me?

Osgood Schlatter pain treatment by strapping⇒ Assist with pain and swelling
⇒ Education about Osgood Schlatter
⇒ Provide input on how to modify physical activities and training
⇒ Giving the patient some strengthening and stretching exercises
⇒ Strapping the knee area
⇒ Recommending orthoses (Crutches, patella band/brace)
⇒ Demonstrate how ice can be used to manage pain

What is the prognosis?

As soon as maturity is reached in the young person, the growth plate will seal and become solid bone, thereby limiting the disease. The adolescent growth spurt usually ends in boys at age 16 and in girls at age 14. Complications can occur whereby the tendon pulls at the bone so much that is results in an avulsion fracture. Surgery is rarely recommended for Osgood Schlatter.

This article was submitted by Rikki Malherbe who practises at the Paulshof branch of Lamberti Physiotherapy. If you wish to discuss this condition with her or you have a query, make contact via our handy appointment form.

References:
Clinical Sports Medicine 5th Edition – Brukner and Khan
www.orthoInfo.org
The Juvenile Athlete – SPT (2016)

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