Osgood Schlatters Disease in younger athletes

With the Summer sports season kicking off many children are beginning to increase their amount of running and jumping.

Along with the usual aches and pains that are associated with pre-season training, some children will find that the off-seasons’ growth spurt has added extra pressures to their joints.

One of the common conditions for younger athletes to experience is Osgood-Schlatter disease where the pain is felt in the front of the knee just at the top of the tibia (shin bone) where the patella tendon attaches.

• Pain in the front of the knee during and/or after activity
• Lump appearing at the top of the shin bone
• Swelling and redness
• Tender spot to touch or put pressure at top of shin bone
• Stiffness after activity
• Change in walking or limping during/after activity

If we look at a diagram of the adolescent knee, we can see that the patella tendon runs down over the knee cap and attaches to the top part of the shin bone. The spot where the tendon attaches is directly on top of the growth plate of the bone.

In young athletes that are going through their growth spurt (girls usually about 8-12 years, boys usually about 12-15 years) this growth plate on the shin bone is super active and producing new bone quite quickly, hence why these children seem to grow almost in front of your eyes. This makes the shin bone length increase very quickly. Unfortunately, the muscles and tendons struggle to keep up with this growth, and if you couple that with very active children then the result can be a traction apophysitis, or Osgood-Schlatter disease.

The condition is usually linked to very active children that participate in sports that require fast backward and forward movements, running and jumping.

Some sports that can trigger Osgood Schlatter disease are:

• Soccer, rugby (league and union), AFL
• Touch football, Oz-tag
• Athletics – running, long jump, high jump, triple jump
• Basketball
• Futsal
• Netball
• Tennis
• Ballet

Luckily x-rays and other scans are not needed to diagnose this condition. Your Physiotherapist can examine the knee and ask questions regarding the activities associated with the pain.

Osgood-Schlatter disease is usually self-limiting and will settle when the growth plate finishes its growth spurt. But whilst the condition is active it can be very limiting and painful for the child. The Physiotherapist can assist in managing the condition and also assess any other possible contributing factors such as knock-knees, flat feet and hip muscle weaknesses. We can give advice on activity levels, whether any bracing/taping can help in the short term and guide return to sport when appropriate. If left unchecked Osgood-Schlatter disease can result in a boney lump at the top of the shin bone that will remain after the condition has settled. This lump, whilst not painful, can interfere with kneeling on hard surfaces as an adult.

Sinding-Larsen-Johansson Disease and Sever’s Disease are also common traction apophysitis conditions related to growth of bone and over activity. Their causes and symptoms are very similar to Osgood-Schlatter Disease, just in different spots on the leg.

Sinding-Larsen-Johansson occurs at the bottom tip of the patella (knee cap). It can present very similar to Osgood-Schlatter disease but is slightly higher up the leg.

All these conditions can be assessed and managed by your physiotherapist, all you need to do is book in.