Osgood In The Neighborhood

Osgood-Schlatter Disease (OSD)- fun to say, not so fun to have. Quick time out, can you say Osgood-Schlatter Disease five times fast?

An apophysis is the site at which a tendon or ligament is attached. OSD is an overuse injury that creates traction apophysitis (-itis means inflammation of) of the tibial tuberosity. The tibial tuberosity is an apophysis that serves as the attachment site for the patellar tendon. Um, English please?? Basically, OSD is an overuse injury where excessive pull by a large tendon causes damage to the unfused boney protuberance that it is attached to.

In the developing athlete, the apophysis is considered a weak point biomechanically. The apophysis is predisposed to injury due to rapid skeletal development. When a young athlete’s training demands exceed the ability at which the muscle tendon unit can accommodate these stresses, the increased tension results in bony micro trauma and inflammation of the apophysis. We call this apophysitis.

OSD is particularly common in soccer, gymnastics, basketball, running or track athletes and predominantly experienced between the ages of 10-15. OSD has relatively equal prevalence between boys and girls. Risk for Osgood-Schlatter Disease increases if the athlete has already experienced apophysitis at another location, or whose siblings also suffered from OSD.

Patients displaying OSD often present with history of progressively increasing pain directly over the tibial tuberosity. (1) Symptoms tend to worsen with exercise. Diagnosis of OSD is generally based on physical presentation and history. A radiograph is usually unnecessary.

Although diagnosis is very straight forward, management it is not so straightforward. Identifying the factors that predisposed the patient to this disorder is the most challenging part.

The first step in developing a treatment strategy includes determining the severity of OSD. Some athletes will require extended periods of rest to manage the condition, while others may not have to rest at all as long as they don’t see a sharp increase of pain. Young athletes will benefit from some sort of cross training (swimming, cycling, etc.) while selectively resting their quads. Within the office, we can do various soft tissue techniques, assign home care exercises and stretches, adjust, and even kinesiotape.

We do treat pediatric patients within the office. If a kid you know is struggling with OSD, maybe we can help! Until next time, Dr. Amy

References:

1. Lyng K, Rathleff MS, Dean BJ, Kluzek S, Holden S. Current Management Strategies in Osgood Schlatter: A cross-sectional mixed method study. Scandinavian Journal of Medicine & Science in Sports. 2020 Jun 19.