Introduction:
Osgood-Schlatter disease presents as a painful point just below the kneecap which often has a noticeable bump that accompanies it. It commonly occurs below just one knee but can involve both.
The predominant feature is that the person often participates in regular sport which involves high-impact footfall with quick changes of movement; sports such as soccer, netball and dancing are common precursors.
Osgood Schlatter generally occurs in girls aged 11-12 and boys aged 12-14. However, this can vary as it is understood that significant hormonal changes and subsequent growth spurts, during these age brackets, can be quite variable between young adolescents.
Like all pain, the level of intensity varies from individual to individual and often has little to no correlation with the degree of physical irritation that is occurring. For this reason, indicators such as a large bump just below the kneecap and a decrease in the level of physical activity or increased discomfort during physical activity should also be used to determine whether or not to visit your Physiotherapist.
In some instances, a young adolescent may not display an obvious bump and have little to no pain outside of physical activity. One of the more common situations where this occurs is in young adolescents who play netball and do not do much heavy physical activity outside of this. These people have short, sharp bursts of high intensity, high speed and high impact movement that allow aggravation to occur, but also allow for recovery between each training session or game.
Knee
Intervention:
There are a number of proposed interventions which have all been found by various groups to have various degrees of efficacy. These include knee braces, knee strapping, icing the area, resting the joint, stretching the quadriceps and hamstring muscle groups and taking up a more diversified training and activity load. The latter two more consistently show better symptomatic changes. However, this intervention would mean that the child has to miss out on sports.
Physiotherapy intervention varies greatly between individuals depending on the severity of pain and functional limitation, the type and duration of the sport they’re involved in and the period of time they’ve had the bump on their knee. Generally, though, treatment involves a combination of diversification in training load, appropriate strengthening of the related muscles and often, an assistive treatment such as strapping or stretching.
Outcomes:
Overall, the period of time and how much tolerance to pain exists is highly variable between each patient. For some, a resolution can occur within a few weeks whereas for others there may be ongoing and varying irritation for 12-14 months. In any situation, a Physiotherapist will guide each individual to achieve their desired activity outcome all whilst assisting in the reduction of pain and inflammatory symptoms. The balance between these factors is crucial in delivering a patient’s desirable outcome.