Osgood-Schlatter Disease

Osgood-Schlatter disease is described as osteo-chondrosis of the tuberosity of the tibia (also known as the shinbone). With this condition, there is pain about 2 to 3 in (5 to 7.5 cm) below the kneecap, where a tendon inserts into a bony protrusion called the tibia tubercle. In about 25% of cases, the pain can also exist on both sides of this area.

First described in 1891, Osgood-Schlatter disease is named for Robert Bayley Osgood and Carl B. Schlatter. Since the condition tends to disappear with age without treatment, Osgood-Schlatter disease is more correctly considered to be a symptom.

Whether described as a condition or disease, and even though it usually persists for only a few years at most, the hallmark knee pain is disruptive and painful for adolescents.

Rapidly growing active boys and girls between 11 and 15 years of age are most commonly affected. Boys are approximately three times more susceptible than girls. This may reflect the past tendency of adolescent boys to participate more in physical activities than girls. However, those times have changed. With girls increasingly being part of the game, rather than being on the sidelines, the incidence of Osgood-Schlatter disease in adolescent girls may well rise.

The pain can arise from a single event such as a blow to the knee. More often, however, the pain arises from the repeated flexing of the knee against a quadriceps muscle that has become abnormally tight due to rapid body growth during adolescence. This strain aggravates the tibial area. So, typically, Osgood-Schlatter disease is an overuse injury.

For some sufferers, the pain is mild and periodic and occurs after athletic activity. For others, the pain can be severe and constant. Usually, only one knee is affected, although for a small percentage of people, both knees become painful.

When pain is mild, it is possible to continue with sports activities by following some or all of the treatments. However, severe pain can cause an athlete to stop engaging in sports entirely until the problem is resolved.

Because flexing of the knee aggravates the injury, adolescents who are involved in certain athletic activities are especially prone. Sports that involve a lot of knee motion, jumping, and rapid side-to-side movement, such as soccer, gymnastics, basketball, figure skating, and distance running, can lead to Osgood-Schlatter disease.

Swelling of the area below the kneecap and pain that is accentuated when the area is gently pressed are diagnostic hallmarks of Osgood-Schlatter disease. Once a diagnosis is made, treatment can involve curtailing athletic activity, applying heat before the activity to increase circulation, applying ice after activity to help prevent inflammation, taking regular doses of an anti-inflammatory such as ibuprofen, and even wrapping the knee to restrict movement. Some or all of the treatments are continued until there is little or no discomfort or pain following exercise. This may require several months.

Stretches that strengthen the bone, tendon, and cartilage in the knees can help lessen the chances of a reoccurrence of pain. One exercise involves stretching the quadriceps (the muscles in front of the thigh) by grasping a foot with the hand on the same side of the body and pulling the foot up until the heel touches the buttock. This can be done standing up or lying stomach-down on the floor. The stretch is held for about 30 seconds.

Another useful stretch focuses on the hamstring, the muscle located in the back of the thigh. For this stretch, a person sits with one leg straight out in front and the other leg is bent so that the sole of the foot touches the other leg. Leaning forward and keeping the extended leg straight produces stretching in the back of the thigh. The stretch is held for about 30 seconds.

Other stretches can be done as well. It is advisable to consult with a physician or a physiotherapist before starting a stretching program. With their guidance, a diligent stretching routine can help get an athlete back into action.

The symptoms of Osgood-Schlatter disease can persist for several years. However, most typically, symptoms disappear within 12 to 14 months, soon after the end of the growth spurt experienced by many adolescents (generally around the age of 14 for girls and 16 for boys).

SEE ALSO Bone mineralization patterns; Bone, ligaments, tendons; Osteoporosis; Recurrent stress fractures.