Osgood Schlatter and other osteochondrosis

Osgood-Schlatter Disease is a common cause of knee pain among young children and adolescents who are growing. In children, some growth plates serve as attachment sites for tendons, the strong tissues that connect muscles to bones. A bony bump called the tibial tubercle covers the growth plate at the end of the tibia (shin). The group of muscles in the front of the thigh (called the quadriceps) attaches to the tibial tubercle. When a child is active, the quadriceps muscles pull on the patellar tendon which, in turn, pulls on the tibial tubercle. Pain occurs due to irritation around the growth plate where the patella tendon attaches. OSD usually affects children during their growth spurt periods, especially so if they are active in sports.

What are the symptoms of OSD?

Children will usually present with pain and swelling just below the knee joint. The tibial tuberosity is usually tender to touch and, in some cases, may be prominent. The pain will usually worsen with kicking, running, jumping, walking up stairs or hills and squatting. Severe pain may also lead to your child limping. The condition can affect one of both knees.

How can a physiotherapist help?

A physiotherapist can help by:

• Pain management
  • Pain management is essential in the initial phases of rehabilitation
  • This may be done through taping, soft tissue release of tight muscles, prescribing supports or education on icing and managing training loads
• Prescribing specific stretching and strengthening exercises
  • Stretching exercises will be prescribed to reduce the pull on the patellar tendon. The stretches prescribed will help improve flexibility and reduce pain
  • Strengthening exercises are also essential to gradually reload the tendon. In the initial period of rest, muscles around the knee can become weaker. A carefully crafted exercise program respecting pain levels will be prescribed by the physiotherapist to assist your child’s return to activities
• Advice on activity limitation
  • Most of the time some relative rest from sport or activities is required. In some cases, a short period of total rest may be required if pain is severe. This is important as there can be potential long-term problems if the condition is not treated properly. In some cases, if the pain is ignored and your child continues to play through it, the condition can get worse and become difficult to treat
• Balance and Coordination exercises
  • Balance and knee control exercises may also be included in the rehabilitation programme to ensure safe return to activities

If you have any questions on OSD and its treatment, please contact us. Our physiotherapists will be able to help your child with managing their condition.