Conditions & Treatments - Osgood-Schlatter Disease / Syndrome

Osgood-Schlatter (OS) disease or syndrome is a form of patellar tendonitis that commonly occurs in pre/adolescents (1). It is most commonly experienced in children between the ages of 8-15 years old (10-15 years old for boys & 8-13 years old for girls) with boys being three times more likely to develop this condition than girls (1, 2). It results from traction or pulling by fibers of the patellar tendon on the tibial tuberosity where a growth plate is located during repetitive quadriceps contraction (2). This stress from the traction can result in apophysitis (inflammation of a projection of bone) of the immature tibial tubercle (1, 2).

Symptoms of Osgood-Schlatter Disease / Syndrome
Onset of OS is usually gradual and patients who suffer from OS often complain of a constant ache which is localized at the region of the tibial tubercle (1, 2, 3). The tubercle is often tender to the touch and can become enlarged as well (3). Activities such as running, squatting, negotiating stairs and jumping which forcefully stresses the patellar tendon insertion upon the tibial tubercle can exacerbate the patient’s condition. Rest will often result in some relief from the symptoms (1, 2, 3).

Physical Therapy Findings in Patients’ with OS
Often times patients who present with OS will display significant tightness at the quadriceps, hamstring, iliotibial band and calf muscles (1, 2, 3). Tightness in these areas can result in added stresses or pull to the tibial tubercle with participation in the above mentioned activities (1). Weakness of the quadriceps muscle and pain with active knee extension and resisted knee flexion are common findings in patients’ with OS as well (1, 2, 3). When examining gait, patients with OS will often minimize knee flexion and maintain full knee extension throughout gait to minimize quadriceps activity and stress to the tibial tubercle region (3).

Osgood-Schlatter Disease / Syndrome Treatment Options for a PT
• Rest
• Postural/Functional Training
• ROM exercises
• Stretching (see videos 27, 28 & 30 for hip/groin/knee)
• Strengthening/Stabilization (see videos 17, 21, Z6 for hip/groin/ knee)
• Massage/Soft Tissue Mobilization
• Modalities (ice, ultrasound/phonophoresis/iontophoresis)
• Obtain knee brace

Last revised: July 14, 2010
by Jennifer Hill, MPT, CSCS

References
1) Goodman and Boissonnault. Pathology: Implications for the Physical Therapist. W.B. Saunders Company 1998;609-610.
2) Sullivan JA. Osgood-Schlatter Disease. E Medicine http://emedicine.medscape.com/article/1250936-print
3) Antich T, Brewster C. Osgood-Schlatter Disease: Review of Literature and Physical Therapy Management. The Journal of Orthopaedic and Sports Physical Therapy. 1985;7(1):5-10.