As Winter sport is just beginning to recommence, it's a good time to discuss Osgood-Schlatter's Syndrome, and there will be an inevitable increase in cases as AFL, Soccer, and Basketball all begin. Below we have provided some basic information on this common source of knee pain for young athletes.
What is Osgood-Schlatter Syndrome?
Schlatter, otherwise known as Tibial Tubercal Apophysitis, 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 main muscle that extends the knee which 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). As a result of this tightness through the quadricep, there is an increased amount of force through the tibial tuberosity which can lead to inflammation and pain. High impact sports which involve a lot of running or jumping often exacerbate this pain due to the forces associated which place further stress on the quadricep and the knee.
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 some inflammation at the site of pain and often a bony lump which itself is sore to touch. 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. The bone has simply adapted to the forces it was exposed to and is now thicker in this area.
treatment is available and how long is recovery?
There is a fairly large range in recovery time, and this can be influenced by mutliple factors. Osgood-Schlatter's can be present from a few weeks to a few years. Things such as the severity of the inflammation/pain, the amount of growth that has occured recently, whether it affects one or both knees, and the sporting demends of the individual all can play a role in how long the condition persists for. The good news is that Osgood-Schlatter's is that it's self-limiting, meaning that even if it is stubborn and persistant, it will eventually resolve by itself over time even if nothing is done to help.
If you want to reduce your recovery time and keep playing/get back to playing sport sooner, that's where physiotherapy can make a big difference. Performing the correct strength exercises and/or stretches can help reduce the tension through the quadricep, and hence reduce the amount of force at the front of the knee. It's important that the intensity/type of exercise is prescribed based on the individual, as not everyone who experiences Osgood-Schlatter's will have the same amount of pain/limitation.
Looking at managing the overall volume of sport/exercise is also an important factor to consider, and this too can be discussed with your Physiotherapist. Working together, a plan can be formulated to allow the continuation of sport in some capacity while avoiding aggravating the knee too much.