Osgood Schlatter

What is an Osgood-Schlatter knee?

An Osgood-Schlatter knee (sometimes called Osgood-Schlatter disease) is a overuse injury of the knee. The problem is specifically at the attachment of the patellar tendon. This tendon connects your kneecap to your shinbone. The place where the tendon attaches to the tibia is called in the medical world the tuberositas tibiae. In children and adolescents, this attachment point still consists largely of softer cartilage, whereas in adults this tissue has already fully hardened into bone. Because this growing cartilage is weaker than fully grown bone, it is more vulnerable to the tensile forces exerted by the leg muscles via the patellar tendon. When these forces become too great, minor damage and inflammation occur. This causes the characteristic pain and thickening just below the knee.

Causes and genesis

The main cause of a schlatter knee is the combination of rapid physical growth and intense exercise. During the growth spurt, your bones often grow proportionally faster than your muscles and tendons. As a result, there is already naturally more tension on the patellar tendon. In addition, when you are active in sports that involve a lot of running, jumping and sudden braking, your knees have to put up with a lot. We therefore often see this injury in sports such as football, hockey, athletics or basketball. The strong thigh muscle pulls very hard on the knee tendon with every jump or sprint. This repeated overloading irritates the growth cartilage on the tibia. Although the symptoms sometimes seem to start suddenly after intense training, the underlying cause is usually a process of gradual overuse over a longer period of time.

Typical symptoms of a Schlatter knee

The most recognisable symptom of an osgood schlatter knee is a nagging or stabbing pain at the front of the leg, just below the kneecap. Almost always, a hard, sensitive lump also develops at that exact spot. The symptoms typically worsen during and immediately after exercise. Especially explosive movements such as sprinting and jumping provoke the pain immediately. In addition, you may find that everyday movements that involve bending the knee far or putting pressure on the kneecap are painful. Examples include climbing stairs, making deep knee bends, cycling for long periods or sitting on your knees. At rest, the pain usually subsides again. Usually, only one knee is affected, but it is common to have symptoms on both knees at the same time.

Diagnosis at Fysio Fitaal

When you come to Fysio Fitaal in Tilburg with knee pain, we always start with a comprehensive consultation and physical examination. The diagnosis osgood schlatter is usually easy for our physiotherapists to make based on your story and the exact location of the pain and lump. We test the strength of your leg muscles and examine the mobility of your joints. If we are in doubt or want to rule out other injuries, we can ultrasound deployment. Using our ultrasound machine, we visualise the structures under the skin. This allows us to view the patellar tendon and its attachment to the bone in detail and accurately map the degree of tissue irritation. This way, we know exactly where we stand and can make a targeted plan.

The treatment process and rehabilitation phases

Treatment for a knee osgood schlatter focuses primarily on reducing pain and optimising load capacity. It is good to know that it is a condition that will eventually stop on its own once the skeleton has grown, but until then, we will guide you through the process with a clear plan.

Phase 1: Cushioning pain and adjusting load

The first phase is all about soothing the knee. This does not mean sitting still on the couch for weeks, but we temporarily adjust the sporting load. We often advise putting explosive sports activities where you do a lot of jumping and sprinting on the back burner for a while. Relative rest helps reduce inflammatory symptoms. In acute pain immediately after exercise, cooling the bump with an ice pack can provide relief. Our physiotherapists will guide you in finding the right balance between rest and exercise.

Phase 2: Building strength and flexibility

Once the worst pain has subsided, we shift the focus to strengthening the muscles and improving flexibility. Because muscles can be relatively tight due to the growth spurt, we pay a lot of attention to stretching exercises. We do this before the quadriceps (the muscles at the front of your thigh) and the hamstrings (the muscles at the back of your thigh). We also start with targeted and controlled strength exercises. By strengthening your leg muscles and trunk stability, we ensure that the blows during sports are better absorbed and the patellar tendon is relieved.

Phase 3: Sports resumption

In the final phase, we prepare you for a safe return to your own sport. We call this the return-to-sport phase. We build up the sport-specific movements step by step in practice. We practise specific turns, jumping forms and sprinting. We monitor your knee's reaction to these more intense loads very closely. Only when you can perform these exercises in a controlled manner and without pain will we give the green light to return to full training and competition.