Physiotherapy for Osgood Schlatter's Disease
WHAT IS OSGOOD SCHLATTER'S DISEASE?
Osgood Schlatter's disease is a quite common and painful knee condition that commonly affects adolescents, especially those that play a lot of sport.
Osgood Schlatter's disease is a bit of an odd name, but it's not really a disease like you might think of with a fever or actual illness. You can't catch it from anyone, and you definitely can't pass it on!
It's actually a condition that happens mostly to kids and teenagers, especially those who are really active and play sports or do a lot of running.
WHAT ARE THE SYMPTOMS OF OSGOOD SCHLATTER'S DISEASE?
Osgood-Schlatter's disease, also referred to as osteochondrosis or apophysitis of the tibial tubercle, is a condition that primarily affects adolescents during their growth spurts.
It's most common in individuals who participate in sports and activities that involve frequent running, jumping, and rapid changes in direction.
The main site of involvement is the growth plate at the top of the shinbone (tibia), right where the patellar tendon attaches. This is the small (and sometimes) large bump below the knee cap.
It is thought that during a child’s growth spurt the bone grows quicker than the muscles and tendon and this causes the quadriceps tendon to pull at the attachment site of the tibia which causes pain.
Pain is typically worse with repeated knee straightening, especially with sports such as running and jumping.
HOW IS OSGOOD SCHLATTER'S DIAGNOSED BY A PHYSIOTHERAPIST IN MELBOURNE?
Diagnosis of Osgood Schlatter's disease is carried out by thorough examination.
A local physiotherapist who is skilled at diagnosing Osgood Schlatter's disease will check for full range of motion of the knee, determine if swelling is present and go through full muscle testing of the lower limb.
A main feature of Osgood Schlatter's disease is pain and swelling at the tibial tuberosity, which is the bump of bone just below the knee cap, at the other end of the patellar tendon.
DO YOU NEED A SCAN TO CHECK FOR OSGOOD SCHLATTER'S DISEASE?
In the vast majority of cases, you won't need to have a scan to help you diagnose and recover from Osgood Schlatter's disease.
If there has been a traumatic episode that has contributed to your child's knee pain, then an Xray or MRI may be ordered, or if the problem has been there for a longer than usual period of time, a scan to clear for other injuries may be required.
The story behind the injury and the history of how it occurred is usually sufficient to determine the need for scanning. When in doubt and progress is slow from Osgood Schlatter's Disease, the team at Melbourne Sports Physiotherapy can arrange a scan for your knee pain.
WHAT IS ACTUALLY OCCURING IN YOUR KNEE WITH OSGOOD SCHLATTER'S DISEASE?
This is what is currently viewed to be the main process with Osgood Schlatter's disease.
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Growth Plate Stress: During periods of rapid growth, the bones, muscles, and tendons may not grow at the same rate. This can create tension and stress where the patellar tendon attaches to the tibial tubercle, which is the bony bump just below the kneecap.
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Microtrauma and Inflammation: The repeated stress on the growth plate can lead to small microtraumas or tiny tears in the tendon and the surrounding tissue. This triggers an inflammatory response as the body tries to heal the area.
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Bone Growth and Bump Formation: As the body tries to heal, new bone may form at the site where the tendon attaches to the tibial tubercle. Over time, this can result in the formation of a bony bump or prominence. This bump can be felt just below the kneecap and might be tender to touch.
HOW DO WE TREAT OSGOOD SCHLATTER's DISEASE? Physio for Osgood Schlatters Disease.
Osgood Schlatter's Disease is known as a self-limiting knee condition, meaning that it will settle over time.
There is not a great deal of evidence that absolute rest accelerates the healing process, so it is important to get information from your physiotherapist to determine how to best manage this condition.
The key to managing this condition is to monitor, gauge and refine your child's training volume and loads, and the specific activities within their training sessions.
The team at Melbourne Sports Physiotherapy can provide specific physio for Osgood Schlatter's disease to relieve knee pain and symptoms via managed training programs.
Treatment options are tailored to the individual and may include advice involving cryotherapy, strengthening and stretching, soft tissue work, correction of biomechanics and controlling symptoms through load management.
The most important aspect is looking in detail at the person's training program and altering to minimise aggressive tendon loading activities.
Taping can be utilised for specific individuals, though is not effective for a long term strategy, nor does it work for everyone.
CAN ADULTS GET OSGOOD SCHLATTER'S DISEASE?
Not really!
If we think about the fact that this condition is an irritation where the tendon joins an immature and still growing growth plate, once your growth plate has finished growing, you can't really get Osgood's anymore.
The growth plate usually heals over around 14 to 18 years of age for most people, some can be a bit longer.
People that have had severe Osgood Schlatter's can have a more prominent bump of bone just below their knee, which is effectively bony scar tissue, though this won't cause problems for their activity, only sometimes with kneeling.
If you're an adult that has been diagnosed with Osgood Schlatter's, you need to be querying the diagnosis, as it is extremely unlikely that this is the case.
It is most likely that you are suffering from a patellar tendinopathy, and should be assessed by a physiotherapist skilled in knee management and diagnosis.
If you are suffering from Osgood Schlatter's disease, please contact Melbourne Sports Physiotherapy to arrange an assessment from one of our experienced sports physiotherapists. We look forward to helping you soon!
In the meantime, be sure to check out our FREE Ultimate Knee Pain Handbook!