Osgood-Schlatter Disease

Osgood-Schlatter disease causes pain in the front of the knee. It is commonly seen in boys and girls between the ages of 9-16.  It features a painful lump just below the knee, this is because of inflammation of the patellar ligament at the tibial tuberosity. The pain usually occurs during physical activity such as running, jumping, squatting and going up and down stairs.

Around 75% of cases affect boys and occurs in up to 20% of sporty children compared to 4% of a group of all activity levels. In a quarter of cases, both knees are affected and it is more likely to occur around periods of rapid growth. As the condition is due to irritation and damage of the growth plate, it can only occur while the growth plate is present, up to the age of 16 years approximately.

Mechanical factors play a big role in Osgood–Schlatter’s disease. When the feet are in ‘perfect’ alignment, the quadriceps muscles, patella tendon, patella and tibial tuberosity are all in a line.  Any force created by using the thigh muscles transmits to the tuberosity in a direct, front-on direction.  A pronated foot will increase the quadriceps angle in a similar way that a knock kneed position would. The change in the angle of pull can leave the trochanter more vulnerable from an angled pulling force.

Ignoring symptoms or adopting a ‘no pain, no gain’ attitude is likely to cause further damage and prolong recovery in patients with Osgood Schlatters disease. Immediate, appropriate treatment in patients with this condition is essential to ensure a speedy recovery.

Some of the factors which may contribute to the development of Osgood Schlatters disease include:

A sudden increase in training or sporting activityInappropriate trainingRecent growth spurtsInappropriate footwearMuscle tightness or weakness (particularly the quadriceps)Joint stiffnessPoor lower limb biomechanicsPoor foot posture

Treatment techniques the Podiatrist may use include:

RICE (Rest, Ice, Compression, and Elevation)Orthotics-The Podiatrist may discuss the use of foot orthotics as part of a treatment plan. This is especially important if there are biomechanical factors that exacerbate the tension on the patella tendon. This will help support the foot and reduce the effect of biomechanical abnormalities such as an excessively pronated foot.Stretching—Advice on stretching the quadriceps & hamstrings.Recommence sport in a month or soTraining changes—depending on your activities the podiatrist may recommend modifications to a training regime. Return to activity should be supervised by a qualified person such as a podiatrist or experienced adolescent coach.

The success rate of treatment is largely dictated by patient compliance.

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