Osgood-Schlatter Disease

Osgood-Schlatter disease is an overuse injury that occurs in the knee area of growing adolescents. This disease is caused by inflammation of the tendon below the kneecap (patellar tendon) where it attaches to the tibial tuberosity on the shinbone (tibia), a result of the constant pulling of the patellar tendon on the area below the knee where the tendon attaches. Young adolescents who participate in sports such as soccer, gymnastics, basketball, and distance running are at risk for Osgood-Schlatter. Symptoms of Osgood-Schlatter disease include pain and tenderness below the knee, along with swelling around the knee. Sometimes the inflamed tendon may pull a tiny piece of the bone away from the tibia.

Diagnosis

Osgood-Schlatter disease can be diagnosed based on typical symptoms and physical examination findings. X-ray testing may be performed to rule out other lesions.

Treatment

The goal of treatment is to control knee pain and limit activities that could aggravate the condition. Treatment can include:

• Rest, ice, compression, elevation
• Anti-inflammatory medications such as Ibuprofen
• Elastic wrap or a neoprene sleeve around the knee
• Restricted activity
• Stretching and flexibility exercises for the thigh and leg muscles

Prevention

Osgood-Schlatter disease can be difficult to prevent. Activity modification and regular stretching and strengthening exercises provide the best preventive measures against this disease.

Rehabilitation

• Standing calf stretch: Facing a wall, put your hands against the wall at about eye level. Keep the injured leg back, the uninjured leg forward, and the heel of your injured leg on the floor. Turn your injured foot slightly inward (as if you were pigeon-toed) as you slowly lean into the wall until you feel a stretch in the back of your calf. Hold for 15 to 30 seconds. Repeat three times.
• Hamstring stretch on wall: Lie on your back with your buttocks close to a doorway, and extend your legs straight out in front of you along the floor. Raise the injured leg and rest it against the wall next to the doorframe. Your other leg should extend through the doorway. You should feel a stretch in the back of your thigh. Hold this position for 15 to 30 seconds. Repeat three times.
• Quadriceps stretch: Stand an arm's length away from the wall, facing straight ahead. Brace yourself by keeping the hand on the uninjured side against the wall. With your other hand, grasp the ankle of the injured leg and pull your heel toward your buttocks. Don't arch or twist your back, and keep your knees together. Hold this stretch for 15 to 30 seconds. Repeat three times.
• Quad sets: Sit with legs extended and fully contract the muscles of the front thighs. Hold contractions for 10 seconds. Repeat 10 times for three sets.
• Straight leg raises (hip flexion): Lie with one leg extended and the other bent at the knee. Lift the entire leg from the hip so that the heel is about five inches above the floor. Hold this position for five to 10 seconds and then slowly lower the leg. Repeat 10 times for three sets.
• Backward leg raise (hip extension): Lie on stomach with legs straight. Lift one leg as high as possible and hold for five to 10 seconds, then slowly lower the leg. Repeat 10 times for three sets.
• Hip abduction: Lie on side of uninjured leg, so that the injured leg is on top of the uninjured leg. Lift the injured leg at the hip away from the body. Lift the leg as high as possible and hold for five to 10 seconds, then slowly lower the leg. Repeat 10 times for three sets.
• Hip adduction: Lie on side of injured leg, with uninjured leg bent at the knee and foot flat on the floor. Lift the injured leg at the hip toward the other leg. Hold for five to 10 seconds, then slowly lower the leg. Repeat 10 times for three sets.