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Osgood Schlatters – Causation, Considerations and Solutions

By starttraining | In Education, News | on June 9, 2019
Lisa Campbell | Running | Pole Vault
Lisa Campbell

Osgood schlatters is a condition most feared by growing athletes. Its diagnosis is often vague with no real direction for the athlete other than rest and waiting. It can be extremely painful and debilitating for young athletes.

Firstly, Osgood Schlatters is pain on the tibial tuberosity of the knee and is related to the development of the quadriceps. The problem with the generic term “anterior knee pain” is that the solution to the problem is vastly different if the pain is 2cm higher, lower or to the side of the knee, so it is important to get the exact point of the pain from the athlete.

The patella tendon inserts right onto the growth plate of the tibia, so as the athlete grows, this puts stress on the patella tendon pulling away from the tibial tuberosity. This is compounded by an overdevelopment of the quadriceps, creating too much force through rectus femoris. Osgood is more commonly found in males more than females. This is due to the large increase in testosterone males experience as they hit puberty. These hormonal changes result in muscle growth around 14-16 years of age causing an increase in force development through the quadriceps. Furthermore, incidence is higher in males due to large growth spurts causing rapid changes in height and muscularity compared to females who grow more steadily.  Other considerations relate to large increases in volume of activity on harder surfaces in a short period of time.

However, the problem is still seen in females, particularly in sports where there is a high volume of training with high force application. Furthermore, higher incidence is seen in sports where quad dominance is common; such as gymnastics, running and volleyball.

Therefore, treatment and management is key!

  1. The first thing to remember when treating Osgood is that you must control volume. This does not always mean a complete deload but it does mean being acutely aware of volume, overload and deloading appropriately.
  2. The second thing you need to address is the overdevelopment of the quadriceps. Balancing out the hamstrings is key, specifically working at a 2:1 hamstring to quad ratio. You will need to make sure you target upper range hamstring work and recruit through the correct ranges of motion.
  3. Mobility – Making sure you get range of motion will deload the stress on the patella tendon attachment. However, it is important you do so not by constantly stretching as this will pull on the attachment point and could make things worse. It is ideal to use alternate modalities such as massage and rolling in order to improve range.

Written by Lisa Campbell – Accredited Exercise Physiologist, Sports Scientist

If you know someone who is struggling managing Osgood, give us a call on 3356 9119 to book in with Lisa today!

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