Given that junior winter sport is well and truly back into the swing of things, we have seen a recent rise in the number of cases of Osgood Schlatter's disease presenting to our rooms. In This week's edition of #whatiswednesday physio Laurence Schubert provides some basic education about the condition.
What is it?
Osgood Schlatter's (OS) is a painful knee condition that primarily affects adolescents aged 9-16. During puberty our bodies experience large amounts of bone growth and as a result, the muscles have not yet caught up in length. This leads to an increased tension in certain muscles such as the quadriceps. The quadriceps is the main muscle that extends the knee, and is located at the front of the thigh. This muscle attaches to a bony point just below your knee cap (tibial tuberosity). During adolescent years, the bones have not fully fused and have sites of softened bone (epiphysis). At the quadriceps insertion point, this landmark is not fully developed until adulthood. This is why you experience pain in that area.
What are the symptoms?
The most common symptom is pain just below the kneecap (approximately 2cm below). This pain will be experienced during impact and high intensity activities such as running, jumping and kicking. The adolescent may even experience pain going up and down stairs, walking, squatting and kneeling. There will be pain and inflammation at the site of pain and often a bony lump. After intense exercise, there may be increased pain and difficulty walking.
Will the bony lump ever go away?
Your bony lump may decrease slightly in size as the injury resolves but it is unlikely that it will ever go away completely. However, this DOES NOT mean you will be in pain for the rest of your life. You may have a lump there but this does not mean you are injured.
What treatment is available and how long is recovery?
The great news is that targeted physiotherapy treatment has shown to be extremely effective in reducing pain and getting patients back to sport. Using the Strickland protocol, if followed correctly there is a high chance of return to sport within one month. This protocol includes specific massage and stretching techniques, as well as guidance on what exercise you should be doing. Pain can be present for much longer than one month but the earlier the condition is diagnosed the quicker the recovery. It is important to see your physiotherapist, as this condition can masquerade as other issues. If the condition is left untreated, your pain may be present for up to 2 years or until growth has ceased.