Osgood-Schlatters Disease

This morning I was working on this Osgood-Schlatters Disease article for you.

The idea came from an interview that I had heard a few weeks back.

The interview was with Ryan Kesler who is an ice hockey player for the Vancouver Canucks.

Since my ice hockey team is the Vancouver Canucks, I have seen him in the last few years become a very good ice hockey player.

He almost did not make to the National Hockey League (NHL) because he had an injury when he was a kid that could have ended it all.

He had Osgood-Schlatters Disease and if it was not for his father and his internal push to overcome his injury, his career in the NHL may never have happened.

The things that helped him overcome his Osgood-Schlatters Disease was his mindset which was determination, hard work and a never give up attitude that he could overcome his injury, plus a good exercise rehabilitation program.

Lets chat about Osgood-Schlatters Disease and an Exercise Program for it.

What Is Osgood-Schlatters Disease?

 

Osgood-Schlatters Disease (OSD) is a condition found in active adolescents that are going through a growth spurt where they have pain and tenderness at the patella tendon where it connects with the lower leg.  There ends up being traction (stress) of the muscle-tendon unit at tibial tuberosity which leads to pain.

Symptoms of the condition come and go and can take months to years to resolve fully.

About 90% of people overcome the injury with rest, ice, activity modification and exercise rehabilitation. Often times it resolves after the closure of the tibial growth plate.

Other Names for Osgood-Schlatters Disease:

  • Tibial Aponphysitis.
  • Morbus Osgood-Schlatter
  • Rugby knee

It is classified as a knee extensor mechanism problem (knee straightening out).

Often times medical professionals will classify Osgood-Schlatters as anterior knee pain.

Other injuries that fall into the anterior knee pain classification are:

The physical signs of Osgood-Schlatters are tenderness, warmth or swelling at the tibial tuberosity.

Key Structures Involved in Osgood-Schlatters Disease

Structures involved in Osgood-Schlatters Disease:

  1. Quadriceps Femoris
  2. Patellar (Quadriceps) tendon
  3. Patella
  4. Muscle-Tendon unit
  5. Tibial Tuberosity
  6. Tibia

Who Gets Osgood-Schlatters Disease?

 

It is most often seen in teenage boys and young men. The age range in boys is 12 to 15 and if it is seen in girls, their age range tends to be 8 or 12 years. Most times it is seen after the boy or girl has had a growth spurt and the symptoms gradually come on.

New research has come out showing that athletes with limited dorsiflexion could be at great risk for OSD. It is thought that a decrease in dorsiflexion in the ankle leads to compensation in the leg with increased knee flexion, tibial inversion and foot pronation during the stance phase of running. These three compensations may lead to greater stress placed on the patellar tendon which could lead to OSD.

What Can Cause Osgood-Schlatters Disease?

 

  • Rapid growth and physical activity
  • Athletes with poor ankle dorsiflexion

What Makes Osgood-Schlatters Disease Worse?

 

  • squatting
  • running
  • walking up or down stairs
  • cycling
  • forceful contractions of the quadriceps muscle
  • jumping (basketball, volleyball)
  • kneeling
  • hurdling
  • repetitive hard landings place
  • anything that puts excessive stress on the insertion of the patellar tendon

How is Osgood-Schlatters Disease Diagnosed?

 

  • Physical exam by a qualified health care professional
  • Radiographic imaging (x-ray)
  • Ultrasonography or Magnetic Resonance Imaging (MRI) will show changes in the distal part of the patellar tendon at the tibial tuberosity

What can You Do to Overcome Osgood-Schlatters Disease?

 

  • Modify activities
  • Ice
  • Decrease inflammation with over the counter or prescribed medication
  • Infrapatellar strap
  • Stretching
  • Strengthening
  • Often resolves after growth spurt is done
  • 10% to 12% of patients may need surgery

In one study (Kujala 1985), athletes had on average 3.2 months of training and 7.3 months of some activity modifications.

Osgood-Schlatters Exercise Rehabilitation Program

Now lets head into an exercise program that can help.

Stretching for Osgood-Schlatters Disease

 

  • Prone quadriceps stretching
  • Hamstring stretching
  • Calf stretching
  • Soleus stretching

Strengthening Exercises for Osgood-Schlatters Disease

 

  • Single leg raises
  • Prone hip extension
  • Side-lying clam exercise

Mobility for Osgood-Schlatters Disease

 

  • Ankle mobilization

Where to Get More Information on Osgood-Schlatters Disease

I know you might want to dig deeper into things.  Here are the resources that I used to put the article together.

Antich T J., Brewster C E (1985). Osgood-Schlatter disease: review of literatur and physical therapy management. J Orthop Sports Phys Ther 1985;7(1):5-10.

Bloom OJ, Mackler L, Barbee J. (2004). Clinical inquiries. What is the best treatment for Osgood-Schlatter disease? J Fam Pract. 2004 Feb;53(2):153-6.

Calmbach WL, Hutchens M. (2003). Evaluation of patients presenting with knee pain: Part II. Differential diagnosis. Am Fam Physician. 2003 Sep 1;68(5):917-22.

Czyrny Z. (2010). Osgood-Schlatter disease in ultrasound diagnostics–a pictorial essay. Med Ultrason. 2010 Dec;12(4):323-35.

Gholve PA, Scher DM, Khakharia S, Widmann RF, Green DW. (2007). Osgood Schlatter syndrome. Curr Opin Pediatr. 2007 Feb;19(1):44-50.

Hirano A, Fukubayashi T, Ishii T, Ochiai N. (2002). Magnetic resonance imaging of Osgood-Schlatter disease: the course of the disease. Skeletal Radiol. 2002 Jun;31(6):334-42. Epub 2002 Apr 24.

Kujala UM, Kvist M, Heinonen O. (1995). Osgood-Schlatter’s disease in adolescent athletes. Retrospective study of incidence and duration. Am J Sports Med 1985;13:236–241.

Vreju F, Ciurea P, Rosu A. (2010). Osgood-Schlatter disease–ultrasonographic diagnostic. Med Ultrason. 2010 Dec;12(4):336-9.

Saxena A, Kim W. (2003). Ankle dorsiflexion in adolescent athletes. J Am Podiatr Med Assoc. 2003 Jul-Aug;93(4):312-4.

That is it.

I hope you enjoyed the article.  It was a lot of fun to put together.

Let me know if you would like me to put more together.

Take care.

Rick Kaselj, MS