What is Osgood Schlatter Disease? Osgood Schlatter disease, also known as apophysitis of the tibial tubercle, is characterized by inflammation of the growth plate just below the knee. The tibial tubercle is a prominence just below the kneecap; it is an attachment site for the patellar tendon. The growth plate can become painfully enlarged. It is most often seen in children between the ages of 10-15 and usually appears during a period of rapid growth. How does it occur? Osgood Schlatter disease results form stress or injury to the tibial tubercle growth plate, which is still developing during adolescence. The growth plate is an area of relative weakness and injury to it occurs due to repeated stress of vigorous exercise in an adolescent. Signs and symptoms include: a slightly swollen, warm, and tender bump below the knee along the shin and pain with activity including sporting activities that include jumping, deep knee bends, or weight lifting. What risks are involved? Risks include: Overzealous conditioning routines, such as running, jumping, or jogging Obesity Boys between the ages of 11-18 Rapid skeletal growth Poor physical conditioning (strength and flexibility) How is it diagnosed? The patient should be evaluated by a physician for examination and review of symptoms. Your doctor may request an x-ray following examination. X-rays usually show an enlarged tibial tuberosity. An x-ray may also show irregular or loose bony fragments from the tibial tuberosity. How is it treated? The patient may need to rest or only perform activities that do not cause pain. Initial treatment consists of anti-inflammatory medications and ice to relieve pain and inflammation, stretching and strengthening exercises (especially the hamstrings and quadriceps), and modification of activity. Specific activities that should be avoided include: kneeling, jumping, squatting, stair climbing, and running. Mild cases can be treated with a home exercise program. Moderate to severe cases will require occasional immobilization (for approximately 6-8 weeks) and a referral to a physical therapist or athletic trainer for further evaluation and treatment. Surgery is generally not necessary unless conservative treatment has failed or after skeletal maturity of the ossical remains painful. Are there Preventive Measures? Osgood Schlatter disease may be difficult to prevent. It is important to recognize signs early, such as a painful bump along the shin, so you can limit your child’s activity and schedule an evaluation by a physician. Other helpful preventive measures include: Lose weight or maintain ideal body weight Appropriately warm up and stretch before practice or competition especially the thigh, hamstrings, and calf musculature Maintain appropriate conditioning: Muscle strength Flexibility and endurance Cardiovascular fitness Exercise moderately, avoiding extremes Use proper technique When can my child return to his or her sport or activity? Like any injury, 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 permanent damage. Everyone recovers from injury at a different rate. Return to a 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. A trained professional including a physician or physical therapist will indicate the appropriate time the child is released back to participation with out the risk of further injury.
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