Image credit: James Heilman, MD
Osgood what?
While the name is a bit of a mouthful, and may feel foreign to pronounce, Osgood Schlatter’s (OZ-good SHLAW-ters) disease is a common cause of knee pain in adolescents.
Image credit: Musculuskeletal Key
Anatomy
The knee joint is made up of 3 bones, the femur (thigh bone), tibia (shin bone) and patella (kneecap).
At the front of the thigh, we have the quadriceps muscle group, which converges and encapsulates the patella, and forms the patella tendon, which then attaches to the tibial tuberosity. The tibial tuberosity is the bump located just under the knee at the front of the lower leg, along the growth plate of the tibia.
Image credit: Beantown Physio
Pathology
Osgood is a disease known as osteochondrosis or traction apophysitis.
It is primarily an overuse injury, that is caused by the constant traction, and pulling, of the quadriceps tendon, on the shin bone.
The tibial tuberosity is a part of the growth plate of the tibia, and repeated microtrauma, and traction at the tubercle cause microvascular tears, fractures, and inflammation, experienced as swelling, pain and tenderness.
Repeated trauma generally occurs in adolescents who have had recent growth spurts, and are highly active;
A sudden growth spurt can result in a inequality between bone growth, and the ability for the muscle-tendon to stretch sufficiently to maintain previous flexibility, leading to increased traction at the tendon.
High levels of activity can act as in a similar mechanism to a repetitive strain injury, overloading the tendon and its insertion onto the tibia.
Who is most at risk
The main risk factors are:
Age - Boys ages 12 to 14 and girls ages 10 to 13 (linked with puberty/ major growth spurts)
Sex - Male
Activity - Sports that involve running, jumping and rapid changes in direction
Flexibility - Preexisting tightness in quadriceps muscle group
Diagnosis
Diagnosis is determined from a thorough history and physical assessment by your allied health practitioner.
We generally do not require radiological imaging unless it is a severe presentation, where an avulsion fracture is suspected.
A common presentation of Osgood’s includes:
Pain when touching the tibial tuberosity
Pain at the tibial tuberosity that intensifies with, and after, physical activity
Increase in size of bony protuberance at the tibial tuberosity
Static activation of the quadriceps muscle is painful
Prognosis
Prognosis for this condition is very good, as it is self-limiting. With the right management and treatment, the pain can resolve in as little as a month's time, and generally, will completely dissipate within 2 years, when the growth plates fully fuse.
Treatment:
Once diagnosed with Osgood Schlatter’s, treatment and management of the condition will revolve around relative rest and activity modification. While complete rest does not provide for a quicker resolution of the condition, it does help with pain management.
In addition to activity modification, the use of ice, taping and anti-inflammatories are usual for pain relief.
Hamstring and quadricep stretching and strengthening are also beneficial.
Overall, Osgood is a manageable condition, that occurs commonly among adolescents.
Knee(d) to know more? If you would like further information regarding Osgood Schlatter’s Disease, or to talk to one of our knowledgeable osteopaths, please contact us on (02) 6680 7447 or book an appointment online at www.retrainhealth.com
Retrain Health is based in the Northern Rivers, NSW. From our Byron Bay and Ballina clinics, our team provides a range of quality healthcare services and products.
Retrain Health offers osteopathy, remedial massage, strength and conditioning, and PT sessions, with qualified practitioners.
If you are interested in finding out more information, or would like to book an appointment, please contact the clinic by phone (02) 6680 7447, send us an email or click here to book an appointment online.