Osgood-Schlatter’s disease (OSD) is a common injury affecting 1 in 10 people aged 9-15.  It is commonly seen in active adolescents, especially jumping athletes. It is known as a growth plate injury of the top of the shin bone (tibial tuberosity) which may be vulnerable to repetitive and high stress before maturation.

Osgood-Schlatter’s is characterised by:
• A swelling or bump at the top of the shin bone (tibial tuberosity)
• Pain around the area which is highly linked to increasing levels of activity
• Symptoms experienced around periods of rapid growth

Previously, the condition has been thought to be self-resolving (12-18 months) and without lasting implications as it was thought the closure of the growth plate results in the reduced symptoms. However, contemporary evidence would suggest that this may not be the case.

A recent research trial (Holden & Rathleff 2018) reports that up to 60% of participants aged 10-14 still report symptoms 4-years post diagnosis. A significant portion of these children were also unable to participate at the same level of activity prior to symptoms, with the sequelae being a reduced quality of life, diminished sports-function (strength and power) and increased body fat percentage.

We need to abandon the ‘wait and see approach’ and instead adopt a proactive approach. Physiotherapy can help by:
• Initially off-loading the front of the knee with tape or a brace for short-term pain relief
• Address impairments in strength and function (seen even years after the resolution of pain)
• Implement contemporary adolescent strength and conditioning principles to improve biomechanics and load absorption
• Building muscles around the knee and other parts of the body (trunk and hip) to help with long-term pain resolution
• A graduated activity modification approach (refer to activity ladder below), followed by a staged pathway back to sport participation

Education, exercise and activity modification are key for the adolescent to better manage their pain (example above). Osgood-Schlatter’s may not be the self-limiting condition we once thought!

By Kevin Doan, Sports Physiotherapist