Osgood-Schlatter Syndrome Explained...

What is Osgood Schlatter Syndrome?

Osgood-Schlatter Syndrome is a common cause of knee pain in children associated with growth spurts. The condition is more common in boys than girls presenting in boys at about 12 to 15 years of age and girls at about 10 to 12 years old. It is an overuse condition linked with an imbalance between long bone growth in the legs and muscle length and strength of the quadriceps and hamstrings muscles. This imbalance causes a tractioning or pulling at the patella tendon insertion on the tibia (tibial tuberosity-see diagram).

Diagnosis

Accurate diagnosis of this presentation is critical to ensure correct management. A Physiotherapist or Sports Doctor can diagnose the condition in clinic by taking a thorough history that considers growth and loading activities in conjunction with a thorough examination. An X-Ray may be needed to confirm diagnosis in some cases. Patients usually present with a gradual onset of pain locally at the tibial tuberosity. This is often relieved by rest and aggravated by exercise, especially sports involving running and jumping.

How long will it last?

This condition will often resolve at the end of the growth spurt. The patient may be left with a raised bony prominence at the tibial tuberosity. Up to 10% of patients continue to experience persistent symptoms into adulthood, despite conservative measures.

Management

In most instances sporting activity may not have to stop completely. A reduction in activity may be sufficient to control the pain. A graded reduction in exercise duration, frequency and intensity over a limited period can be enough to resolve or tolerate pain. When pain is tolerable, it is possible to consider gradual increases in exercise levels again by pain symptoms. Your Sports Doctor can guide appropriate use of pain relief medications such as Paracetamol and non-steroidal anti- inflammatories. Ice application (10–15 minutes, up to three times a day, including after exercise) to the tibial tuberosity can be used for pain management. Physiotherapy can be helpful for stretching, strengthening and addressing muscle imbalances. Attention to the quadriceps, hamstrings, gluteals, calf muscles and iliotibial band is helpful in addition to taping techniques.

Leisa Stringer, APA Sports & Musculoskeletal Physiotherapist