What is it?
Osgood-Schlatter disease is a common cause of anterior knee pain in an adolescent/skeletally immature populations.
It is typically experienced between the ages of 8-15 years.
Essentially, it is an irritation of the growth plate at the Tibial Tuberosity where the Patella Tendon inserts into the front of the shin.
Pain is typically felt at the top of the shin/front of the knee lower than the knee cap and will be tender to press on.
It is common in physically active children, particularly those participating in running and jumping sports such as basketball, netball and football.
The growth plate hardens into solid bone at around 10-12 years old in females and 12-14 in males at which point the symptoms will resolve.
Diagnosis
Tell-tale findings in patients with Osgood-Schlatter Disease include:
- Tenderness when pressing on Tibial Tuberosity (bony lump on front of the shin)
- Painful with movements that load the Patella Tendon/Tibial Tuberosity such as squatting, jumping, running and extending the knee.
Management
Education
- Understanding the activities and movements which will put extra strain on the tendon/growth plate
- Understanding the expected timeframes for resolution
- Understanding how to manage symptoms
Load management
- See ‘Pain Diary’ section below
Pain relief
- Over the counter medication such as Paracetemol
- Non-Steroidal Anti-Inflammatory Medication (NSAIDs) such as Nurofen, Voltaren etc.
- Ice
Symptom management
- Manual therapy including massage
- Taping or bracing including consideration of Patella Tendon taping or strap/brace
Improve strength
- Individually tailored exercises to improve lower body muscle strength
- In particular targeting the quadriceps muscles at the front of the thigh
Improve flexibility
- Mobility and stretching exercises to improved flexibility in the muscles around the knee
- In particular targeting the quadriceps muscles at the front of the thigh
Pain Diary
Osgood-Schlatter Disease is a self limiting condition which will resolve in time. Unfortunately, we don’t always know exactly when the growth plate will ossify and harden so we don’t know exactly when the symptoms will resolve.
Given that this condition is experienced between 8-15 years of age, most patients with Osgood-Schlatter Disease will want to remain active and continue playing sport.
This is encouraged, as long as they are coping with their current loads.
A great way to monitor load is by using a Pain Diary.
Essentially, if we see pain ratings increasing/getting worse and performance rating decreasing/getting worse that would tell us that they are not coping with their current loads and may need to reduce the frequency, duration or intensity of playing and training for their chosen sport.
Summary
Osgood-Schlatter Disease is mostly a self-limiting source of anterior knee pain in active, adolescents between the ages of 8-15 years.
It is caused by irritation of the growth plate at the front of the shin where the Patella Tendon attaches.
Load management and symptom monitoring are important first line treatments.
Physiotherapy can be effective for managing symptoms.
This condition should resolve by approximately ages 10-12 in females and 12-14 in males when the growth plate ossifies and hardens into solid bone.
References
Corbi, F., Matas, S., Álvarez-Herms, J., Sitko, S., Baiget, E., Reverter-Masia, J., & López-Laval, I. (2022). Osgood-Schlatter Disease: Appearance, Diagnosis and Treatment: A Narrative Review. Healthcare (Basel, Switzerland), 10(6), 1011. https://doi.org/10.3390/healthcare10061011