Osgood-Schlatter Disease- Symptoms, Treatment and Prevention

Definition

Osgood-Schlatter Disease is a condition that happens when a tendon in the knee (the patellar tendon) pulls against the top of the shinbone. This causes pain in the knee and the upper shin. Tendons are bands of tissue that connect muscles to bones. The patellar tendon pulls on an area of the shinbone where new bone is forming, called the growth plate. The pulling causes pain and inflammation (swelling and irritation). A hard bump may also grow right below the knee as the growth plate hardens. People with Osgood-Schlatter disease usually get better with rest, over-the-counter pain medication and time. Osgood-Schlatter disease is sometimes referred to as growing pains or jumper’s knee.

Epidemiology

Osgood-Schlatter disease is one of the common causes of knee pain in active adolescents who play sports. The common age for boys is between 12 and 15 years and for girls, between 8 and 12 years. Knee pain is common in athletes. Both knees are affected in up to 30% of people with the condition. It is more common in boys than in girls. It is seen in children who participate in sports such as football, basketball, gymnastics and volleyball.

Risk factors

The main risk factors for Osgood-Schlatter disease are:

Age: Osgood-Schlatter disease occurs during puberty’s growth spurts. Age ranges differ by sex because girls enter puberty earlier than do boys. Osgood-Schlatter disease typically occurs in boys ages 12 to 14 and girls ages 10 to 13.

Sex: Osgood-Schlatter disease is more common in boys, but the gender gap is narrowing as more girls become involved with sports.

Sports: The condition happens most often with sports that involve running, jumping and swift changes in direction.

Flexibility: Tightness in the quadriceps muscles can increase the pull of the kneecap’s tendon on the growth plate at the top of the shinbone.

Osgood-Schlatter Disease causes

Some of the causes of Osgood-Schlatter syndrome may include:

Growth spurt- The condition tends to affect adolescent children. Affected boys are often aged about 13 to 14 years, while affected girls are often aged 10 to11 years.

Exercise- Active children, particularly those engaged in athletics and sports, are at increased risk.

Gender- Boys are more susceptible than girls, but perhaps this is because boys typically play more vigorous sports.

Injury- Around half of all children with the condition report a prior knee injury.

Symptoms of Osgood-Schlatter Disease

Common symptoms of Osgood-Schlatter disease include:

• Knee or leg pain
• Swelling, tenderness, or increased warmth under the knee and over the shinbone
• Pain that gets worse with exercise or high-impact activities, such as running
• Limping after physical activity

The severity of these symptoms often varies from person to person. Some individuals experience only mild pain during certain activities. Others experience constant, debilitating pain that makes it difficult to do any physical activity. The discomfort can last from a few weeks to several years. The symptoms typically go away once the growth spurt of adolescence is finished.

Complications            

Potential complications of Osgood-Schlatter disease include:

• A permanent, painless bump on the knee. It may still be tender when kneeling;
• Bone fragments (called ossicles) developing in the patellar tendon leading to persistent pain, and;
• Genu recurvatum, a condition in which the knee overextends. This occurs when the growth of the shinbone (tibia) is affected and the front part of the bone stops growing prematurely, changing the position of the knee.

Rarely, symptoms may continue to be troublesome after the bone stops growing. Surgery is not commonly recommended, but may be performed to:

• Remove bone fragments from the patellar tendon, or;
• Remove some of the tissue of the enlarged tibial tuberosity.

Diagnosis and test

X-Rays may be utilized to better visualize the musculotendenous junction in severe cases or if an avulsion is suspected.

The diagnosis is based on typical clinical findings.

• Radiographic examinations of both knees should always be performed, in both the anterior-posterior and lateral projections, to rule out the possibility of tumors, fractures, ruptures or infections. The lateral radiograph generally shows the characteristic picture of prominent tibial tubercle with irregularly ossific nucleus, or free bony fragment proximal to the tubercle. Imaging is also useful to exclude tuberosity epiphysiolysis or tumors.
• Sonographic examination can also be used. The ultrasound can be directed to demonstrate the appearance of the cartilage and bony surface, the patellar tendon, soft-tissue swelling anterior to the tibial tuberosity, and fragmentation of the tibial tuberosity.

Examination

A diagnosis can be made through a thorough history and examination. Tenderness to palpation over the tibial tuberosity that worsens with weight-bearing squat or jumping is fairly indicative of this disease.

• Physical examination reveals pain during palpation of the tibial tubercle.
• Resisted extension of the knee from 90° flexed position will usually reproduce pain, but resisted straight leg raised test is usually painless.
• Ely’s test, which proves excessive tightness of the quadriceps femoris muscle, is positive in all cases.

Osgood-Schlatter Disease treatment

Do you have Osgood-Schlatter disease as an adult? If so, check out the different treatment methods below, which help both children and adults!

Resting and Icing Your Knee

• Resting the knee, elevating it, and icing can all help drain any excess swelling and inflammation, which can help alleviate the pain. If you experience pain during a physical activity, you should take a break from that activity.

• Follow the R.I.C.E. (Rest, Ice, Compression, Elevation) treatment plan to eliminate irritation and manage pain associated with Osgood-Schlatter disease. Rest is probably the most important thing you can do to treat Osgood-Schlatter disease.
• If necessary, cut back on weight-bearing activities and put a cold compress on your knee to help bring the inflammation down. Do this about 3 times each day for 10 to 15 minutes each time. A bag of frozen vegetables or BraceAbility’s cold compression knee brace works great.

Osgood Schlatter Disease Surgery

In extreme cases, surgery may be used to get rid of Osgood-Schlatter disease in adults with recurrent symptoms. The primary purpose of surgery is to remove the bone fragments that are causing irritation on your tendon. By removing the bone fragments, you should be able to function fully without pain from Osgood-Schlatter disease.

Osgood Schlatter Disease Brace

• A knee brace is extremely helpful if you are unable to refrain from pain-producing activities and could benefit from some extra stability. Thankfully, BraceAbility has a number of knee supports to help manage Osgood-Schlatter disease, including braces, straps, and knee sleeves for adults and children.
• Wearing a brace can help you get back to playing soccer, basketball, running, skating, or climbing stairs without pain.

Physiotherapy

• A physiotherapist can recommend stretching and strengthening exercises for your child. They can also show you how to strap or bandage the knee to reduce pain.
• Stretching of the thigh muscles (quadriceps and hamstrings) can be helpful because having tight quadriceps can increase the pulling force on the growth plate in the tibia.

Prevention of Osgood-Schlatter Disease

You might not be able to prevent Osgood-Schlatter disease, but you may be able to lower your risk of getting it.

A few tips on how to prevent your risk of Osgood-Schlatter disease include:

• Modifying your activities
• Stretching your leg muscles
• Performing regular lower body strengthening exercises
• Weight loss to acquire a proper body mass index for age and height
• Warm up and stretching before partaking in physical activity
• Warming the area with a hot compress or shower may improve stretching
• Maintaining appropriate flexibility, endurance, and muscle strength
• Avoidance of open kinetic leg extensions (such as extending the knee in the sitting position against resistance)