Osgood Schlatter Disease

Osgood-Schlatter disease is an inflammation of the bone, cartilage, and/or tendon at the top of the shinbone (tibia), where the tendon from the kneecap (patella) attaches. OSD usually strikes active adolescents around the beginning of their growth spurts, and may last up to 2 years. Children increase their risk for OSD if they engage in activities involving running, twisting, and jumping, such as basketball, football, volleyball, soccer, tennis, figure skating, and gymnastics.

How is it treated?

Your child may need to rest or do activities that do not cause knee pain. Ice packs should be applied to the knee for 20–30 minutes every 3–4 hours or until the pain goes away. If the knee is swollen, it should be elevated by placing a pillow under it. Your child’s doctor may prescribe an anti-inflammatory medication, and may recommend rehabilitation exercises.

How can Osgood-Schlatter Disease be prevented?

Osgood-Schlatter disease may be difficult to prevent. The most important thing to do is to have your child limit activities as soon as he/she notices the painful bump on the top of the shin bone. Proper warmup and stretching exercises of the thigh, hamstring, and calf muscles may help prevent Osgood-Schlatter disease.

How is Sever’s Disease Diagnosed?

The physician will examine your child’s heel to test for areas of pain, and will probably order an x-ray to rule out the possibility of a broken bone.

When can my child return to his/her sport or activity?

The goal of rehabilitation is to return your child to his/her to sport or activity as soon as is safely possible. If your child returns too quickly the injury may worsen, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to his/her sport or activity will be determined by how soon your child’s knee recovers, not by how many days or weeks it has been since the injury occurred.

In general, the longer that your child has symptoms before starting treatment, the longer it will take to get better. Your child may safely return to his/her sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:

  • Your child’s tibial tuberosity is no longer tender
  • The injured knee can be fully straightened and bent without pain
  • The knee and leg have regained normal strength compared to the uninjured knee and leg
  • Your child is able to jog straight ahead without limping
  • Your child is able to sprint straight ahead without limping
  • Your child is able to do 45 degree cuts
  • Your child is able to do 90 degree cuts
  • Your child is able to do 20 yard figure-eight runs
  • Your child is able to do 10 yard figure-eight runs
  • Your child is able to jump on both legs without pain, and jump on the injured leg without pain

Rehabilitation Exercises

Hamstring Stretch
Lie on your back with your buttocks close to a doorway, and extend your legs straight out in front of you. Raise your injured leg and rest it against the wall next to the door frame. Hold this position for 30–60 seconds, feeling a stretch in the back of your thigh. Repeat 3 times.

Standing Calf Stretch
Facing a wall, put your hands against the wall at about eye level. Keep the uninjured leg forward and your injured leg back about 12–18 inches behind your uninjured leg. Keep your injured leg straight and your heel on the floor. Next, do a slight lunge by bending the knee of the forward leg. Lean into the wall until you feel a stretch in your calf muscle. Hold this position for 30–60 seconds, and repeat 3 times.

Quadriceps Stretch
Stand sideways to a wall, about an arm’s length away from the wall, with your injured leg towards the outside. Facing straight ahead, keep the hand nearest the wall against the wall for support. With your other hand, grasp the ankle of your injured leg and pull your heel up toward your buttocks. Do not arch or twist your back. Hold this position for 30 seconds. Repeat 3 times.

Straight Leg Raise
Sit on the floor with your injured leg straight and your other leg bent, with your foot flat on the floor. Move the toes of your injured leg toward you as far as you can, while pressing the back of your knee down and tightening the muscles on the top of your thigh. Raise your leg 6–8 inches off the floor and hold for 5 seconds. Slowly lower it back to the floor. Repeat 20 times.

Prone Hip Extension
Lie on your stomach. Squeeze your buttocks together and raise your injured leg 5–8 inches off the floor. Keep your back straight.