Osgood Schlatters Disease

A condition is most often seen in very active early teenagers who have just gone through a growth spurt. This may seem like a gross generalisation however those are the facts. Now this does not mean that we never see Osgood Schlatters (OS) in any other individual, just more often in this age/activity bracket. Although called a disease OS is strictly a biomechanical problem caused by the long bones in the leg (femur, tibia and fibula) growing at a very swift rate as often happens in the teens at very unpredicteable times, usually around hormone fuelled radical changes in character!! The muscles in the legs get rapidly stretched beyond the length they can comfortably work at and this places excessive strain on all the joints they control or move over. In the case of OS we are dealing with the bimechanical changes in the Patellofemoral (between kneecap and the femur) and the tibiofemoral (Femur in upperleg and Tibia in lower leg) and the tibiofiblar (tibia and fibula) joints. The changes in the way the quadriceps, hamstrings and calf muscles act on the bones places a large amount of strain on the bony muscle attachments. In the case of OS this is specifically the tibial tubercle (the bony protruberance on the front of the shin just below the knee). With time the repeated overload from the quadriceps muscle causes the surface of the bone where the patella tendon muscle attaches to become inflamed and to swell. The next stage is progressive and the body lays down new calcium to try and repair the damage resulting in an ever increasing lump below the knee. This is accompanied by pain which will gradually appear earlier in exercise so that eventually walking will be uncomfortable. This is a tricky problem to treat and the only real answer is rest and time allowing the inflammation to calm down and the muscles to adjust to the new leg length. Physiotherapy can help with advice, stretches, ice, unloading strapping and ultrasound and should be accompanied with a course of antiinflammatories prescribed by a GP. However as mentioned time and rest are the best healers for this problem. No miracles!