What is Osgood-Schlatter’s Disease?
While the name may sound daunting, Osgood-Schlatter’s Disease isn’t life-threatening nor a life-long condition. The disease is caused by increased amounts of strain where the ligament of the patella (kneecap,) meets the top of the tibia (shinbone). The ligament which connects the kneecap to the tibia is exposed to high tractional forces through the powerful quadriceps tendon during times of high activity loads. At this junction there is a growth plate in young athletes which is the weak link in the musculoskeletal chain and suffers from the repeat tractional forces. In children and especially growing teens who engage in very active athletic lifestyles irritation of this growth plate called “tibial tuberosity apophysitis” is very common. Osgood-Schlatter’s Disease (OSD) is a specific form of tractional apophysitis (also found on this blog,) characterized by its location on the body and most-notably the sports or activities affiliated with it.
What specific activity types are likely to cause Osgood-Schlatter’s Disease?
Sports which demand a lot of running, cutting, and jumping are most likely to increase the risk of a patient developing OSD, especially during puberty. Thus many cross-country, track and field, soccer, and basketball players will develop OSD, and find continuing through the inflammatory periods of OSD to be difficult. Patients are still encouraged to continue playing their sport and treating the tenderness and soreness as noted below. Patients in contact sports (soccer, football, basketball, wrestling,) with OSD will most likely encounter issues with direct collisions or contact with other players, a mat, or a ball, as the tops of the patient’s shins can become exquisitely tender to direct impact. Avoidance of direct impact is best to avoid such pain, however the patient isn’t at any known increased risk of injury to the knee or leg during the inflammatory or painful period of OSD.
What are the classic symptoms of Osgood-Schlatter’s Disease?
Patients with Osgood-schlatter’s disease can report exquisite tenderness to the patellar ligament and tibia (shinbone) junction where the growth plate is, and may also note redness, swelling, and/or stiffness of the top of the shinbone swelling, redness, stiffness of the joint, exquisite tenderness to impact/touch below the kneecaps. Some patients may endorse a noticeable bump below the knee cap (at the top of the shinbone,) which was not previously there. This bump is reactive process occurring at the growth plate due to the increased stress at that site caused by vigorous activity. While the pain, swelling, and redness of OSD is not chronic or life-long, patients who develop this bump during the acute stages of OSD may notice it’s presence continues for many years after developing. Luckily this prominence does not cause or continue to cause any functional impairment of the joint, nor does it continue to be as sensitive as when it first appeared.
How long will Osgood-Schlatter’s Produce symptoms?
Luckily Osgood-Schlatter’s will typically last no more than a few months if treated properly, however some patients may have lingering periods of pain or aggravation following especially active periods. Patients may also have increased sensitivity to the top of their shins, which also decreases and goes away with time.
How do we treat Osgood-Schlatter’s Disease?
Acute pain and tenderness can be treated with NSAIDs (such as ibuprofen,) alternating Ice and Heat, and avoidance of aggravating activities that produce recurrent tractional forces at that growth plate. Most patients are able to play their sport or complete activities in spite of the inflammation caused by OSD as long as they do not have high stage disease. Patients who are unable to continue playing due to discomfort will require at least 4-6 weeks off of their sports with aggressive physical therapy with a therapist trained in young athletes. Proper physical therapy and rehabilitation for OSD includes focus on hamstring and quadriceps flexibility, core strength, pelvic stability, bio mechanics, and proper gait patterning.
By Mo Mortazavi MD and Kyle McKeown