What is Osgood-Schlatter Disease?

Osgood-Schlatter Disease (OSD) is a common cause of anterior knee pain in the skeletally immature athletic population. Clinically, The condition manifests clinically as an insidious, atraumatic anterior knee pain, with tenderness at the site where the patellar tendon inserts at the tibial tuberosity.

The condition occurs secondary to repetitive extensor mechanism stress activities such as jumping and sprinting, as well as during sporting activities like Basketball, Volleyball, Sprinters, gymnastics, Football.

Causes of Osgood-Schlatter Disease:

  • Osgood-Schlatter Disease is an overuse injury that mostly appears inactive, in adolescent patients.
  • Repetitive activities like jumping and sprinting.
  • The repetitive strain and microtrauma.
  • poor flexibility of quadriceps and hamstrings.

Sign & Symptoms of Osgood-Schlatter Disease:

  • Painful palpation of the tibial tuberosity.
  • An increase in tibial tuberosity pain while exercising or playing sports.
  • There is sometimes an increased bony protuberance at the tibial tuberosity.
  • tightness of Quadriceps.
  • Resisted isometrics exercises of the Quadricep muscle is painful.

Physiotherapy Management:

Pain relief

  • Cryotherapy such as Ice packs, or Cryo air therapy.
  • A gentle stretch to quadriceps and hamstring muscle, along with.
  • strengthening of the Vastus Medialis Oblique muscle.

Patellar Taping/ McConnel tapping or using the brace

  • Tapping the kneecap or knee can guide the tissues into better alignment, relieving some pressure on the painful area at the tibial tuberosity.

Use of therapeutic modalities

  • Extracorporeal Shock Wave Therapy,
  • Combo therapy.

Once the initial pain and inflammation have calmed down, the physiotherapist will focus on improving the flexibility, strength, and alignment around the knee joint and the entire lower extremity.

Stretching Exercises

  • Stretches for the front and back of the thigh (quadriceps, hamstring,  hip flexors, and calf muscles, and iliotibial band).
  • Static stretching (static stretches focus more on gaining overall flexibility).
  • Dynamic stretching (dynamic stretches are used to prepare the tissues for activity).

Foam rolling & Soft tissue massage

  • Foam rolling & Massage is used in the early phase when stretches create pain.

Strengthening exercises

  • Strengthening of gluteal, quadriceps, hamstring, and gastrocnemius muscles.
  • Isometric exercises, such as isometric leg extensions.
  • eccentric exercises
  •  leg raises, squats.

Proprioceptive, or Balance Training

  • The muscles and joints cannot be utilized efficiently without adequate proprioception, which increases the risk of sustaining another injury.
  • Proprioception can be improved by simple exercises such as standing on a wobbly surface or mini-squatting on a soft mat.

Gait training

Functional training

  • Functional training includes exercises that improve patient's daily living function as well as athletic function for their respective sports. for example:
  • Agility training.
  • Plyometric exercises.
  • Sports-specific drills.

Lifestyle modification

  • Wear shock-absorbing customized insoles in the shoes.
  • For 15 minutes before sports, place a heating pad or warm wash cloth on the knee.
  • For 15 minutes after the activity put ice on the knee (with a towel between the ice and the skin).
  • Stretch before and after sports.