Osgood-Schlatter’s

What is it?

Osgood-Schlatter’s disease refers to an injury to the bone growth plate in the shin bone (tibia) below the kneecap, which occurs in younger athletes. It is more a condition than a disease.

How does it happen?

The large muscles on the front of the thigh (quadriceps) attaches to the shin bone via the patellar tendon. The function of this tendon is to transmit forces produced by the thigh muscle to the shin to support and move the knee joint. In children, the portion of the shin bone into which the patellar tendon inserts is separated from the bulk of the shin bone by a growth plate. This growth plate enables bone growth to occur. However, it also represents a site of weakness in the bone. Forcible and repeated contraction of the thigh muscle can injure the growth plate. This commonly occurs in sports which involve running and jumping and occurs during a period of rapid growth. During rapid growth, the thigh muscle and patellar tendon become tighter as the bones grow. This leads to increased pulling of the thigh muscle and patellar tendon on the shin bone and growth plate.

How does it feel?

Pain felt where the patellar tendon attaches to the shin bone in people with Osgood-Schlatter’s disease. The painful site is just below the kneecap in the bony bump on the front of the shin, called the tibial tuberosity. Pain is felt most commonly during activity or exercise. The tibial tuberosity may also be tender to touch and swollen.

What should you do?

If your child has pain below the kneecap and you think it may be Osgood-Schlatter’s disease, you should consult a sports physiotherapist for assistance. In the meantime, you should limit their participation in their chosen sport/s as pain dictates. To help with their pain and to control any swelling you can apply ice. Ideally, this should consist of crushed ice wrapped in a moist towel applied just below the kneecap for 15-20 minutes, every 1-2 hours.

What shouldn’t you do?

If you think your child has Osgood-Schlatter’s disease, you should not encourage them to exercise and exercise through the pain. This may make their injury worse, prolonging their recovery.

Could there be any long-term effects?

Osgood-Schlatter’s disease does not produce any long-term effects as long as it is properly managed. It is a self-limiting condition which settles when growth ceases and the tibial tuberosity fuses with the rest of the shin bone. This may take anywhere from six months to two years to resolve. Osgood-Schlatter’s will not interfere with your child’s growth and the only remnants may be an enlarged tibial tuberosity.

Management

The assistance of a sports physiotherapist is important in the treatment of Osgood-Schlatter’s disease. Initially, they can assist in diagnosing the injury and the extent of the damage. From this, they will be able to determine an appropriate management plan. This may involve an initial period of rest or activity modification, regular icing, soft tissue treatment such as massage and stretching, treatments to assist in relieving pain, and the progression through a series of specific strengthening exercises. In addition, the sports physiotherapist will be able to advise you and your child on an appropriate time for return to exercise and sport.

Brukner & Khan (2012) Clinical Sports Medicine.