By Calvin Sim, Senior Physiotherapist, Back2Sports
Osgood-Schlatter Disease (OSD) is most commonly characterized by pain on the big tibial tubercle during activities like kneeling or repeated jumping. OSD arises from a strong pull of the quadriceps muscle on the tibial tubercle during a child's growth spurt. This normally occurs around the ages of 9 - 16 years old. This strong pull can happen in sports that require a quick, strong contraction of the quadriceps, like in soccer, martial arts and basketball.
(Image courtesy of author)
The pull on the tibial tubercle has an avulsion-fracture-like effect, as if a small bone fragment broke off from the main bone mass. This would then cause an inflammation of the periosteum. If the child is actively involved in the sport, this effect is magnified as the action is repeated. The frequency and repetitive nature of the sport doesn't allow the periosteum to recover, thus causing a chronic inflammation and the prominence of the tubercle. This leads to a constant, persistent pain, especially on impact. This pain will not only limit the child's performance in the sport, preventing them from excelling, it would also cause a lot of inconveniences later on in their growing years.
OSD can be managed through the following:
- RICER regime (Rest, Ice, Compression, Elevation, and Referral).
- Oral NSAIDs or injection of NSAIDs directly over the painful area
- Ultrasound guided Extracorporeal Shock Wave Therapy (ESWT) by a sports physician to break down scarred tissues and allow for the tubercle to heal
- Stretches and improving muscle control through physiotherapy
- Assessing for biomechanical factors that may cause OSD by sports physiotherapists to prevent recurrence of pain and to maximise the child’s performance in their sport
The best way to prevent the onset of OSD is to ensure adequate stretching and good control of the quadriceps. Adequate prehab is therefore key before starting any form of sport.