Physical Therapy for Osgood-Schlatter Disease

Osgood-Schlatter disease is an inflammatory condition of the knee caused by repetitive trauma to the patellar tendon during growth spurts that is common among active adolescents. Osgood-Schlatter disease (OS) is a common cause of knee pain in growing and active pre-teens and teens, affecting 1 in 10 adolescents. 

It is most common among young athletes who engage in sports requiring excessive jumping, running, and rapid changes of movement, such as soccer, basketball, volleyball, and gymnastics.

When teens go through rapid phases of growth during puberty, typically between ages 10-15 in boys and 8-12 in girls, the patellar tendon can pull abnormally on its insertion point on the shin bone, which can lead to pain and a noticeable OS lesion, or bump, just below the kneecap. 

Symptoms of Osgood-Schlatter disease can include: 

• Pain below the knee at the top of the shin bone that worsens over time

• Pain that worsens with exercise or playing sports

• Swelling and tenderness at the top of the shin

• Boney growth (OS lesion) at the top of the shin

• Loss of strength in the quadriceps muscle

• Loss of knee range of motion

• Discomfort when kneeling, squatting, or walking up or down stairs

Osgood-Schlatter disease can be managed conservatively and effectively with physical therapy.

Physical therapy can help teens with OS ease pain, increase muscle strength, and restore function for a safe return to sport. Osgood-Schlatter disease can be managed conservatively and effectively with physical therapy.

Physical therapy treatment for Osgood-Schlatter disease can include:

• Patient education on activity modification to reduce stress on the patellar tendon and tibia

• Pain management using ice, heat, or braces to alleviate swelling, inflammation, and pain

• Range of motion therapy, involving gentle exercises to move the knee and surrounding structures to restore normal range of motion

• Stretching exercises of the hamstrings, quadriceps, calf muscles, and IT band. It’s especially important to stretch the quadriceps to decrease pulling on the patellar tendon. 

• Strength training, targeting muscles around the knee to ease stress on the knee joint as well as strengthening of the quadriceps, hamstrings, and hip muscles for proper muscular balance, stability, and lower extremity alignment. The therapist may also implement core strengthening to establish a strong base of support for the athlete’s movement.

• Manual therapy, involving gentle soft tissue and joint mobilizations of the kneecap and patellar tendon to improve motion and flexibility in the knee joint

• Functional training and sport-specific training to prepare for a safe return to sport and ensure proper alignment and body mechanics when doing sports activities to reduce stress on the knee