Osgood Schlatter Disease

What is an Osgood Schlatter Disease

Osgood Schlatter Disease is an inflammation of the tibial tubercle, which is an area below your kneecap (patella). The inflammation causes pain and tenderness in this area.

It is most often seen in children and adolescents during the time of growth spurts. The muscles and cord-like structures that attach muscle to bone (tendons) tighten as the bones become longer.

Osgood Schlatter disease is a common cause of knee pain in adolescence (11 to 14 years old) that is thought to result from repetitive traction through the patellar tendon onto the developing tibial tubercle.

This traction can lead to partial avulsion through the ossification center and heterotopic bone formation.

This puts strain on areas of tendon attachment. Osgood Schlatter Disease is associated with physical activity that involves running and jumping.

What are the causes?

Osgood Schlatter Disease is caused by a strain on areas of tendon attachment during activity.

It occurs when the muscles and tendons that attach muscle to the tibial tubercle are becoming longer.

Who are at risk?

You may be at increased risk for Osgood Schlatter disease if:

  • You are physically active and participate in sports or activities that involve running and jumping.
  • You are experiencing puberty and growth spurts, especially between the ages of 8 and 15 years.

What are the symptoms?

The most common symptom is pain that occurs during activity. Other symptoms include:

  • A lump or swelling below one or both of your kneecaps.
  • Tenderness or tightness of the muscles above one or both of your knees.

How is this diagnosed?

Osgood Schlatter Disease may be diagnosed by:

  • Symptoms and medical history.
  • Physical exam.
  • X-ray.

Although the diagnosis may be made clinically, radiographs may aid in the exclusion of other etiologies of knee pain.

Lateral radiographs may reveal irregular ossification of the proximal tibial tubercle, calcification and thickening of the patellar tendon, and soft tissue swelling.

How is this treated?

Osgood Schlatter disease can improve in time with simple treatment and less physical activity. Surgery is rarely needed. Treatment may include:

  • Medicines, such as NSAIDs.
  • Resting the affected knee or knees.
  • Physical therapy and stretching exercises.
  • Wearing a knee strap (patellar tendon strap). The strap may help to lessen the strain on the tendon.

Follow these instructions at home:

Managing pain, stiffness, and swelling

  • If directed, put ice on the injured knee or knees:
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times a day.

Activity

  • Rest as instructed by your health care provider.
  • Limit your physical activities until the pain goes away. Choose activities that do not cause pain or discomfort.
  • Do stretching exercises for your legs as directed, especially for the large muscles in the front and back of your thighs.
  • Wear the knee strap as told by your health care provider.

General instructions

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you have:

  • Increasing pain or swelling in the knee area.
  • Trouble walking or difficulty with normal activity.
  • A fever.
  • New or worsening symptoms.

Summary

  • Osgood Schlatter disease is an inflammation of the tibial tubercle, which is an area below your kneecap (patella).
  • The inflammation causes pain and tenderness in the area below your kneecap. It is most often seen in children and adolescents during the time of growth spurts.
  • The most common symptom is pain that occurs during activity.
  • This condition is treated with rest, pain medicine, and physical therapy. Wearing a knee strap may help.
  • Follow your health care provider’s instructions about what activities to avoid, how to apply ice, and when to contact your health care provider.

Osgood Schlatter Disease Rehabilitation

Ask your health care provider which exercises are safe for you. Do exercises exactly as told by your health care provider and adjust them as directed. It is normal to feel mild stretching, pulling, tightness, or discomfort as you do these exercises, but you should stop right away if you feel sudden pain or your pain gets worse. Do not begin these exercises until told by your health care provider.

Stretching and range of motion exercises

These exercises warm up your muscles and joints and improve the movement and flexibility of your knee. These exercises also help to relieve pain, numbness, and tingling.

Exercise A: Quadriceps, prone

  1. Lie on your abdomen on a firm surface, such as a bed or padded floor.
  2. Bend your __________ knee and hold your ankle. If you cannot reach your ankle or pant leg, loop a belt around your foot and grab the belt instead.
  3. Gently pull your heel toward your buttocks. Your knee should not slide out to the side. You should feel a stretch in the front of your __________ thigh and knee.
  4. Hold this position for __________ seconds.

Repeat __________ times. Complete this stretch __________ times a day.

Exercise B: Standing lunge (hip flexors)

  1. Stand with the foot of your injured leg 2–3 ft (0.6–1 m) in front of your other foot.
  2. Keeping good posture with your head over your shoulders, tuck your tailbone underneath you. Slowly shift your weight toward your front leg until you feel a stretch in the front of your back hip and thigh. It is okay if your back heel comes off the floor.
  3. Hold this position for __________ seconds.

Repeat __________ times. Complete this stretch __________ times a day.

Exercise C: Hamstring, doorway

  1. Lie on your back in front of a doorway with your __________ leg resting on the wall and your other leg flat on the floor in the doorway. There should be a slight bend in your __________ knee.
  2. Straighten your __________ knee. You should feel a stretch behind your __________ knee or thigh. If you do not feel that stretch, scoot your bottom closer to the door.
  3. Hold this position for __________ seconds.

Repeat __________ times. Complete this stretch __________ times a day.

Strengthening exercises

These exercises build strength and endurance in your knee. Endurance is the ability to use your muscles for a long time, even after they get tired.

Exercise D: Straight leg raises (hip flexors and quadriceps)

  1. Lie on your back with your __________ leg extended and your other knee bent.
  2. Tense the muscles in the front of your __________ thigh. You should see your kneecap slide up or see your muscle bulge just above the knee, or both.
  3. Keeping these muscles tight, raise your __________ leg to the height of your __________ knee. Do not let your moving leg bend.
  4. Hold this position for __________ seconds.
  5. Keep the muscles tense as you lower your leg.
  6. Relax your muscles slowly and completely.

Repeat __________ times. Complete this exercise __________ times a day.

Exercise E: Straight leg raises (hip abductors)

  1. Lie on your side with your __________ leg in the top position. Lie so your head, shoulder, knee, and hip line up. You may bend your bottom knee to help you keep your balance.
  2. Roll your hips slightly forward so your hips are stacked directly over each other and your __________ knee is facing forward.
  3. Leading with your heel, lift your top leg 4–6 inches (10–15 cm). You should feel the muscles in your outer hip lifting.
    1. Do not let your foot drift forward.
    1. Do not let your knee roll toward the ceiling.
  4. Hold this position for __________ seconds.
  5. Slowly return to the starting position.
  6. Let your muscles relax completely after each repetition.

Repeat __________ times. Complete this exercise __________ times a day.

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