Osgood-Schlatter disease is a traction apophysitis at the level of the tibial tubercle due to repetitive strain on the tibial tuberosity. The repetitive strain is from the strong pull of the quadriceps muscle produced during sporting activities. The tibial tuberosity avulsion may occur in the pre ossification phase or the ossified phase of the secondary ossification center. Once the bone or cartilage is pulled away it continues to grow, ossify and enlarge. The intervening area may become fibrous, creating a separate persistent ossicle or may show complete bony union with some enlargement of the tibial tuberosity. It occurs more often in boys. These traction apophysitis are probably one of the most encountered overuse injuries in children and adolescents.
It is a tibial tuberosity apophysitis, which is the medical name for inflamed bone at the site of the tibial tuberosity growth plate, in children.
Osgood Schlatter’s disease is an inflammation of the bone at the top of the tibia (shin bone), where the tendon from the patella (kneecap) attaches. It is an overuse knee injury rather than a traumatic injury. While Osgood Schlatter’s disease is a relatively uncommon, it is a quite debilitating knee injury that occurs in young active children/adolescents.
What are the Symptoms of Osgood-Schlatter’s Disease?
Osgood Schlatter’s disease presents in growing boys and girls as:
- Local pain, swelling, and tenderness over the tibial tuberosity at the attachment of the patellar tendon.
- Pain is experienced during exercise (e.g., running, jumping) or with a direct contact, such as in kneeling.
- Stairs, squatting and kneeling may be painful.
- Quadriceps weakness can be present in chronic cases.
- Bilateral symptoms occur in 20-30% of cases.
- The apophysis may be enlarged in later stages, which looks like a lump that is tender in its active phase.
Who Suffers Osgood Schlatter’s Disease?
Osgood Schlatter’s disease usually strikes adolescents who are active during their growth spurts, which is the two year period where they grow most rapidly. Osgood-Schlatter’s Disease is most common in boys but can affect either gender if the children are active. Tight thigh muscles also predispose you to Osgood Schlatter’s disease.
The most prevalent groups are Boys: ages 11-15 years – Girls: ages 8-13 years.
Activities involving repetitive, strong quadriceps contractions, such as in jumping, running, volleyball, basketball, soccer, gymnastics, dance, netball and ice skating are most at risk.
Physiotherapy assessment and treatment is a proven benefit for Osgood Schlatter’s disease sufferers. About 90% of patients respond well to non-operative physiotherapy treatment, but symptoms may come and go for 12-24 months before complete resolution.
One of the common reasons for developing Osgood Schlatter’s disease is excessively tight quadriceps muscles, ITB, hamstrings, hip flexors and calf muscles. Your physiotherapist will prescribe specific stretches for you if they assess that you are tight in these muscle groups.
Massage and foam rollers are beneficial especially in the early phase when stretches create pain.