Osgood Schlatter’s Disease
April 13, 2014
Osgood Schlatter’s Disease
By: Daniel P. Bouvier, MD
What Is It?
An overuse syndrome resulting in painful inflammation at the top of the shin bone where the patellar tendon attaches to the bone in an adolescent or preadolescent athlete.
This condition is marked by pain and tenderness with or without (usually with) a bump at the top of the shinbone (tibia). The pain is often increased with activity (or just after finishing the activity), and is often relieved with rest. It may be associated with a noticeable tightness in the muscles in the front and in the back of the thigh.
An apophysis is a growth plate that does not contribute to the length of a bone. Growth plates are made of cartilage. Cartilage is weaker than bone in the immature skeleton. Apophyses are often found at sites where tendons attach to bone. Apophysitis is inflammation at these attachment sites, the adult equivalent of which is tendonitis.
Repetitive activities, such as jumping, running, pivoting, etc. , coupled with a child who is growing, can lead to increase pull and tension on these delicate areas. This leads to pain and inflammation in those areas. The body may attempt to repair these areas by forming more bone, leading to a lump forming.
- Age: Usually 11-14 or so, boys 13-14, girls 11-12
- Gender: Boys more often than girls, but that gap is closing quickly
- Sports participation: Up to 20% of child athletes are affected. There is only a 5% incidence in nonathletes.
Osgood-Schlatters is a clinical diagnosis. A plain X-ray is often obtained to rule out other less common problems and to sometimes confirm the diagnosis. MRI IS NOT NECESSARY TO DIAGNOSE THIS CONDITION.
- REST, REST, REST. This can be the most difficult treatment given children’s early sports specialization and year-round participation in a single sport.
- Icing and Stretching – Frequent icing is very useful and stretching the quadriceps is important.
- Pain Control – Medications such as Tylenol or non-steroidal anti-inflammatories, such as Ibuprofen may be used to control pain.
- Physical Therapy – Physical Therapy is often useful to help decrease pain and educate patients and families about stretching and safe strengthening techniques. Often rapid growth leads to increasing lengths of bones and tightness is muscles as they attempt to keep up with the growth.
- Cross Training – Participating in other activities, such as biking and swimming provides fitness and activity without the undesired effect of the pounding.
- Home Remedies – a strap that can be placed just above the tender area can be purchased at sports stores and may help take tension off of the affected area.