Osgood-Schlatters occurs as a boney inflamation at the front of the knee where the quadriceps muscle attaches to the growth plate of the tibia. Repeated contraction of the quadriceps muscle pulls on the growth plate and sets up an inflamation.
The condition is extremely common in adolescents at the time of a growth spurt or with increased training or the addition of extra activity eg between seasons when the athelete is finishing off summer season comp and they are training for the winter comp or at cross country time when cross country training is added to their regular sporting commitments.
It is usually associated with sports with a high level of physical activity, especially a sport involving running and jumping like basketball, netball, little athletics or gymnastics. Playing sport at a high level, an overlap of seasons, a growth spurt or increased training intensities can all precipitate or exacerbate the condition.
Pre-teens and young teens – generally between 11 and 14 years of age are often affected because their bones are growing very fast at this age which leads to tightness in the soft tissue structures around the knees for a period of time. Back in the old days this was referred to as growing pains.
Here’s what’s going on anatomically:
Uneven length or strength between hamstrings and quads, pronated feet or lots of activity all result in forces being applied to the tibial tuberosity. This pulling leads to inflammation, swelling and extra bone being laid down in the area – this is the bump that is painful to touch.
Any activity can bring on Osgood Schlatters however it’s more common in activities which involve a lot of jumping and cutting like basketball, netball, soccer, volleyball and gymnastics.
The good news is that you can treat the pain and the condition generally goes away by itself in 1-2 years. The knee might feel uncomfortable during this time with episodic bursts of pain and discomfort. Your physiotherapist will be able to help you to settle these outbursts of pain and give you management strategies to reduce the recurrence and severity of pain. What we generally suggest is active rest which means that you can be as active as the condition allows you. If the pain gets too much, you need to reduce your level of activity for a period to allow the inflammation to settle and you can then resume activity as you are able.
Your physio can check your gait (the way you walk), knee cap angle and position, muscle length and flexibility, foot position and training schedule to work out ways of reducing your pain during your growth spurt.
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