Osgood Schlatters ‘disease’ is a painful condition which typically affects youths between the ages of 10 and 15 years, and is one of the primary reasons why a child of this age may be brought to a physiotherapist, often for the first time.
The title ‘disease’ is an unfortunate one, as the condition is simply a biomechanical and inflammatory one in which the patellar tendon pulls and irritates the bone cells at the attachment to the front of the shin bone (tibia), just below the knee joint itself. Typically, it starts as an achy discomfort, and the child continues to play sport until eventually it becomes self-limiting and the youngster usually reports that he/she is ‘not able to play, as it hurts too much’.
Bones actively grow in length until we are 18-20 years of age. Muscles and tendons however, which attach to our bones, do not actually ‘grow’ in the same manner – they simply get longer as they stretch as the bones they attach to are growing. For this reason, the muscles and tendons can effectively be ‘too short’ for a while, and during this period they exert a traction force on the site where they attach – and produce anterior knee pain.
It is common for Osgood Schlatters disease to occur in very active and sporty individuals, particularly those involved in jumping and sprinting sports. It can also be seen in less active individuals at a less involved level of sport also.
Typically at physiotherapy presentation, a youngster will point to the site of most pain as being at the very top of their shin bone, but often the entire knee can feel sore and stiff to them, especially in the morning time. They find it difficult to describe how long the problem has been there, as it starts quite insidiously and gradually. On examination, we will often find that the region around the knee cap and upper tibia is tender to touch, and the child’s quadriceps, hamstrings and calf muscles are quite shortened in length, in keeping with a recent growth spurt.
Minimising the Risk
In elite sports academies, young (asymptomatic) athletes have their height measured and recorded on a regular basis, and when a growth spurt is observed, the physiotherapy staff will liase with the coaching staff to modify the young athlete’s activities in order to reduce the stress and load onto these vulnerable sites eg anterior knee or heel until the patient has had some time to increase soft tissue and muscle flexibility to a desirable level.
This is a simple strategy which can be transferred into the care of young athletes of all levels, and can be easily undertaken at home by parents. This strategy is particularly helpful when a youth’s knee pain has settled down and resolved, and they are returning to full involvement again.
Physiotherapy for Osgood Schlatters Disease – High success rates and happy faces.
At Physiofusion, we understand that Osgood Schlatters disease may bring a young person to physiotherapy for the first time, and often both the child and the parents are concerned about the appearance of the characteristic ‘bump’, or the fact that the child may have developed a limp which is not improving with rest, or that they are missing out on key periods of the school or club sports season.
We approach the care of these young people with gentle discretion, using a gentle approach to allow the child give us consent to conduct our examination, and lead them through a programme of suitable exercises. We like to show parents what they can do at home by way of massage, ice etc to help their child and reduce time at physiotherapy, and we liase with school or club sports coaches to educate all involved in the care of the young person – from letters requesting permission for the child to wear runners at school, to providing guidelines for a suitable warmup for their age group.
To make an appointment with one of our physiotherapists, please call us on 01 6077104.
*Please note that all children under the age of 16 should be accompanied by a parent or legal guardian who will be requested to remain in the treatment room for the duration of the session.
We have a Child GDPR policy, which is available on our website www.physiofusion.ie.