Osgood Schlatter’s Disease | Knee Pain Physiotherapy East Fremantle
Osgood Schlatter’s Disease is a common cause of knee pain in adolescents going through a growth spurt. It is highly common in active adolescents who partake in sports that involve frequent jumping and landing movements and involve forceful quadriceps contractions.
The symptoms of this condition are as follows:
- Knee pain experienced below the kneecap, at the insertion of the patella tendon into the tibia.
- Occasionally swelling, or a protuberance at this tibial tubercle may be present.
- Pain is often made worse by running and jumping movements – e.g. it is highly common in basketball players, netball players, volleyball players etc.
- It can become highly painful to kneel on the knee or place increased pressure through this tibial tubercle.
This condition generally affects boys aged 11-15, and girls aged 8-13 years. It occurs more commonly in boys. It is highly common in adolescents who are involved with basketball, netball, volleyball, athletics and dance.
Pathophysiology of Osgood Schlatter’s Disease
Osgood Schlatter’s Disease occurs for the following reasons:
- During adolescence, our bone structure is weaker and less mature in order to allow growth. As such, it is unable to withstand high forces as occurs during running, jumping and other high velocity movements which can result in pain and inflammation around the tibial tubercle. In severe cases, this can even cause micro-fractures and avulsion fractures at this site.
- During our growth spurt, the femur can develop at a rate that exceeds increase in the increase in extensibility of our quadriceps muscles. This results in increased tensile force which can create pain and inflammation at the tibial tubercle.
Management of Osgood Schlatters
The knee pain caused by Osgood Schlatter’s disease is largely self-limiting, in that, the adolescent athlete is simply limited by their pain tolerance during sport and activity. Furthermore, these symptoms generally self-resolve when the adolescent growth spurt is completed, at around age 14 for girls and 16 for boys. However, it is important to ensure that symptoms remain at the mild end of the spectrum to prevent fractures from occurring at the site of the tibial tubercle and to avoid damage at the growth plate.
Your physiotherapist can assist in rehabilitation of this condition by:
- Reducing tension to the quadriceps muscles, thereby reducing tensile load onto the tibial tubercle. Consistency using a foam roller is hugely important to reduce this muscle tension.
- Restoring any muscle imbalances. For example, if an adolescent athlete is largely quadriceps dominant with their jumping and squatting movements, this means they place more strain through the quadriceps muscles and therefore through the patellar tendon into the tibial tubercle. In contrast, a hip dominant pattern places greater load through the gluteal and hamstring muscles. An adolescent may adopt a quadriceps pattern of movement due to weakness through their hamstrings and gluteal muscles, and as such strengthening the hamstrings and posterior chain can even out this load distribution and thereby alleviate pain.
Furthermore, an infrapatellar knee strap can reduce load whilst playing sport. These straps function by absorbing some the force that would otherwise be applied to the tibial tubercle. This should be applied to the patellar tendon, above the site of pain.
Acute episodes of pain can be controlled through applying ice, anti-inflammatory medications and rest.
If you are experiencing this type of pain, https://movephysiotherapy.com.au. can provide you with a comprehensive assessment which will not only diagnose your pain, but also identify the contributing factors, and provide you with an individualised treatment program.