Osgood-Schlatter Disease: A Physiotherapist’s Perspective
- Caryn von Fintel
- May 12
- 3 min read
Osgood-Schlatter Disease (OSD) is a common cause of knee pain in growing adolescents, particularly those involved in sports that require frequent running, jumping, or rapid changes in direction. As a physiotherapist, understanding the biomechanics, symptoms, and rehabilitation strategies is essential in helping young athletes manage this condition effectively.
What is Osgood-Schlatter Disease?
OSD is an overuse injury that affects the tibial tuberosity—the bony prominence just below the kneecap where the patellar tendon attaches. It occurs due to repetitive traction forces exerted by the quadriceps muscle on the immature growth plate of the tibial tuberosity. This leads to inflammation, pain, and in some cases, a visible lump in the affected area.
Who is at Risk?
OSD typically affects adolescents aged 10 to 15 years, with boys historically diagnosed more often than girls. However, with increased female participation in sports, the prevalence in girls has risen. Young athletes involved in soccer, basketball, gymnastics, and ballet are particularly susceptible due to the repetitive stress placed on the knee joint.
Symptoms of OSD
Pain and tenderness over the tibial tuberosity
Swelling in the lower knee area
Increased discomfort with activities such as running, jumping, squatting, or kneeling
Pain that improves with rest but worsens with activity
A bony prominence at the tibial tuberosity in chronic cases
Physiotherapy Management of OSD
Effective management of Osgood-Schlatter Disease involves a combination of symptom relief, load management, and strength training to reduce strain on the knee while maintaining overall function.
1. Load Management
Encourage activity modification rather than complete rest. Total inactivity can lead to deconditioning.
Reduce high-impact activities (e.g., jumping, sprinting) during painful flare-ups.
Implement a gradual return to sport when symptoms subside.
2. Pain Relief Strategies
Ice therapy: Applying ice to the tibial tuberosity for 10–15 minutes after activity can reduce pain and inflammation.
Taping or patellar straps: These can help offload stress on the tibial tuberosity.
Non-steroidal anti-inflammatory drugs (NSAIDs) may be used under medical guidance.
3. Stretching and Mobility Exercises
Quadriceps Stretch: Lengthening the quadriceps can reduce the pulling force on the tibial tuberosity.
Hamstring and Calf Stretches: Tight posterior chain muscles can increase stress on the knee, so improving flexibility is crucial.
4. Strengthening Exercises
Eccentric Quadriceps Strengthening: Controlled lowering movements (e.g., step-down exercises) improve quadriceps control while reducing excessive loading on the knee.
Gluteal and Core Strengthening: Strong gluteal and core muscles help optimise lower limb biomechanics and reduce stress on the knee.
Closed Kinetic Chain Exercises: Squats and lunges performed with proper technique can aid in gradual strength development without excessive strain.
5. Education and Long-Term Management
Teach athletes and parents about the self-limiting nature of OSD—symptoms often subside once skeletal maturity is reached.
Encourage proper warm-up and cooldown routines before and after exercise.
Monitor for biomechanical imbalances that may predispose the athlete to other injuries.
When to Seek Further Medical Advice
In most cases, OSD improves with conservative management. However, referral to a specialist may be necessary if:
Pain persists despite physiotherapy interventions.
There is significant swelling, redness, or signs of infection.
The adolescent experiences locking or instability in the knee joint.
Conclusion
Osgood-Schlatter Disease can be a frustrating condition for young athletes, but with appropriate physiotherapy intervention, most can continue participating in sports with minimal disruption. By addressing load management, implementing targeted exercises, and educating patients and caregivers, physiotherapists play a crucial role in ensuring a smooth recovery and preventing future complications.
If you or your child is experiencing knee pain, consult a physiotherapist for a tailored management plan to keep them active and pain-free!
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