Overview
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Osgood-Schlatter disease is a painful enlargement of the bump of the shin bone (tibia) just below the knee. This bump is called the tibial tuberosity. The tendon from the kneecap (patella) inserts here. OsgoodSchlatter disease is most often seen in children between the ages of 10 and 15 and usually appears during a period of rapid growth.
Anatomy
Types
Symptoms
Your child will complain of a painful bump below the kneecap. The parents or child may notice a bony enlargement at the top of the shin bone. The pain will sometimes come and go and usually is gone by the time your child has stopped growing. Sometimes young adults can have pain in the area of the bump. Your child will always have a bump even after the pain has gone away.
Diagnosis & Treatment
Diagnosis
Your child's health care provider will do a physical examination of the knee and review your child's symptoms. X-rays show an enlarged tibial tuberosity. An x-ray may also show irregular or loose bony fragments from the tibial tuberosity.
Treatment
Your child may need to rest or do activities that do not cause knee pain. Ice packs should be applied to the knee for 20 to 30 minutes every 3 to 4 hours for 2 to 3 days or until the pain goes away. If the knee is swollen, it should be elevated by placing a pillow under it. Your child's health care provider may prescribe a special padded brace. He or she may prescribe an anti inflammatory medication and may recommend exercises.
Outcomes
Common Injuries
Age Recommendations
Reducing Risk
Application & Aftercare
Managing the Cast
Cast Removal
How does it occur?
Osgood-Schlatter disease is caused by overuse of the knee in normal childhood and sporting activities. It is possible that muscles are too tight in the front of the thigh, the back of the thigh, or in the calf.
Return to Sport
The goal of rehabilitation is to return your child to his or her sport or activity as soon as is safely possible. If your child returns too soon the injury may worsen, which could lead to longer healing times.
Everyone recovers from injury at a different rate. Return to his or her sport or activity will be determined by how soon your child's knee recovers, not by how many days or weeks it has been since the injury occurred. In general, the longer your child has symptoms before starting treatment, the longer it will take to get better.
Your child may safely return to his or her sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:
- Your child's tibial tuberosity is no longer tender.
- The injured knee can be fully straightened and bent without pain.
- The knee and leg have regained normal strength compared to the uninjured knee and leg.
- Your child is able to jog straight ahead without limping.
- Your child is able to sprint straight ahead without limping.
- Your child is able to do 45-degree cuts.
- Your child is able to do 90-degree cuts.
- Your child is able to do 20-yard figure-of-eight runs.
- Your child is able to do 10-yard figure-of-eight runs.
- Your child is able to jump on both legs without pain and jump on the injured leg without pain.
Prevention
Osgood-Schlatter disease may be difficult to prevent. The most important thing to do is to have your child limit activity as soon as he or she notices the painful bump on the top of the shin bone. Proper warm-up and stretching exercises of the thigh, hamstring, and calf muscles may help prevent Osgood-Schlatter disease.
Home Exercises
1. Hamstring Stretch
Lie on your back and bring affected leg towards your chest.Grab the back of your thigh and try to extend your leg. Hold this position for 30to 60 seconds, feeling a stretch in the back of your thigh. Repeat three times.You may also try this with a towel around your foot if it is more comfortable.
2. Quadriceps Stretch
Stand sideways to a wall, about an arm’s length away from the wall, with your injured leg towards the outside.Facing straight ahead, keep the hand nearest the wall against the wall for support. With your other hand, grasp the ankle of your injured leg and pull your heel up toward your buttocks. Do not arch or twist your back. Hold this position for 30 seconds. Repeat three times.
This may also be done while laying on the opposite side and grasping the ankle of the affected leg. Do not arch or twist your back. Hold this position for 30 seconds. Repeat three times
3. Straight Leg Raise
Sit on the floor with the injured leg straight and the other leg bent, foot flat on the floor. Pull the toes of your injured leg toward you as far as you can, while pressing the back of your knee down and tightening the muscles on the top of your thigh.Raise your leg six to eight inches off the floor and hold for 5seconds. Slowly lower it back to the floor.Complete 3 sets of 10.
4. Abduction
Lie on your uninjured side and place leaning on the elbow of your uninjured side and using the arm of the injured side in front of you to stabilize your body. Slowly with the injured leg up, hold for 5 seconds then lower slowly. Be sure to keep your hips steady and don’t roll forwards or backwards. Complete 3sets of 10.
Lie on your injured side with your top leg bent and flat foot placed in front of the injured leg, which is kept straight. Raise your injured leg as far as you can comfortably and hold it there for 5 seconds. Keep your hips still while you are lifting your leg. Hold this position for 5 seconds, and then slowly lower your leg.Complete 3 sets of 10
5. Extension
Lie on your stomach. Raise your injured leg as far as you can comfortably and hold it there for 5 seconds. Keep your hips still while you are lifting your leg. Hold this position for 5 seconds, and then slowly lower your leg.Complete 3 sets of 10.
6. Bridge with Abduction and Resistance (AkaBanded Bridges)
Start by lying supine (on your back) with your knees bent to 90degrees and your feet flat on the floor. Place the tied resistance band just above your knees. Bring your feet and knees apart to hip/shoulder width. You should feel the band trying to bring your knees back together.Keeping tension on the band, press into your heels and lift your hips off the table as high as you can into a bridge position. Hold at the top for 3-5 seconds and slowly lower to the starting position. Do not allow the space between your knees to decrease throughout the movement. Repeat for 3 sets of 10 repetitions.
7. Clamshells
Lie on your side with your kneesslightly bent, keeping your legs and anklestogether. Open and close your knees like a clamby lifting your top knee up until its parallel withyour hip. Keep your feet together throughout theexercise, move slowly and controlled as ifsomeone is pushing against your knee while youare pressing it up. Complete 3 sets of 10.
