Osgood Schlatter Disease

My name is Brian Campbell and I have Osgood Schlatter disease (OSD). No need for worry however, because OSD sounds a lot worse than it actually is.

This is especially true for a young athlete hearing those dreaded words for the first time in a doctor's office. The first question I had for my doctor was, "how much time do I have left Doc"?

OSD is a pain limiting disorder of the knee found in growing children. The inflammation (swelling) is localized just below the kneecap. Some extreme cases of OSD results in a bump (outgrowth) of the bone. The area of swelling maybe painful to the touch. Pain with this condition can be present during weight bearing squats, kneeling, or jumping.

The site of pain and swelling in OSD occurs at the insertion (ending) of the quadriceps muscles, where the muscle is connected to the bone. Muscles have an origin (where the muscle starts) as well as an insertion (where the muscle ends).

OSD is sometimes referred to as "Growing Pains", not to be confused with the 80's TV show. While growing pains are often dismissed as something to be endured, OSD should not be ignored. Since OSD is commonly found in young athletes, it is important to develop an understanding of the causes, management of symptoms, and special considerations for young athletes trying to participate in sports.

When a child grows, bones are the first to lengthen. Muscle will then grow in length to respond to the newly developed bone. When normal growth rates occur, the muscle usually has enough time to lengthen along with the bone. However in abnormal growth spurts, bones will grow at an increased rate.

In the case of OSD, the bones of the leg are growing faster than the quadriceps and hamstrings which run in parallel. The muscles are then playing catch up to lengthen in response to the longer bones and this can lead to muscle tightness in the quadriceps and hamstring muscles. This tightness is then translated into greater stress applied at the insertion and the end result might be OSD. Hamstring tightness is correlated with OSD. Tight hamstrings will not relax normally to allow the quadriceps to extend the knee efficiently. This phenomenon forces the quadriceps to work harder when jumping, running, and kicking.

How do we get the muscles to lengthen faster? We stretch them.  Particular attention should be given to stretches that focus on the quadriceps and hamstrings.

  • Each stretch should be held for 20-30seconds.
  • A total stretching program should be done everyday and should last between 15-30 minutes and can be done while watching your favorite TV show.
  • Increased warm up time before a game or practice will also help.

During a game was never a problem for me, when the blood was flowing and the hormones were racing, my knees did not hurt. Pain may begin after half time or during a breather on the bench.

I am not suggesting never resting an athlete with OSD, but knowing that the window of staying warm is lower with OSD athletes than non-OSD athletes is important. After only a few minutes of inactivity, the knees will start to ache and become stiff.

Athletes with OSD should be encouraged to "stay warm" while not directly involved in activity. Following activity, ice is a good way to minimize pain and inflammation. Applying ice for up to 20 minutes, after activity, can really make a difference.

Young Athletes with OSD can participate in sports. Common sense and a few special considerations can allow a child to compete effectively with OSD. The most important component to minimize OSD pain is stretching and ice.

Brian Campbell, MS, ATC Kenny Howard Fellow Doctoral Student Auburn University