Osgood-Schlatter Disease

  • May 13, 2019
Osgood-Schlatter-disease

Osgood Schalatter Disease

The tibial tubercle is an extension of the proximal tibial epiphysis and serves as a point of attachment. Exessive traction of tibial tubercle on the growing bone results in overgrowth of the tibial tubercle.

The prominent tibial tubercle is painfull and looks ugly.

It is an inflammation of the patellar ligament characterized by a painful bump below the knee which worsens with activity and reliefs with rest. Pain episodes last a few weeks to a month.

Males between 10 to 15 yr more prone than females.

Precipitating Factors:

  • Sports activities like running, jumping which demand more quadriceps work. The strong pull of quadriceps as its site of insert exerts traction pull resulting in overgrowth of the tibial tubercle.
  • Mechanical insufficiency of the Extensor mechanism may give rise to Os good Schlatter.

Clinical Feature:

  • One complain of the prominent tibial tubercle and its painfull.
  • Pain is reproduced in squatting, resistive knee Extention, jumping, especially ascending descending stairs and kneeling.

Reduce the flexibility of quadriceps, hamstrings, TA may be present. An x-ray may be either normal or show fragmentation in the attachment area.

Differential Diagnosis:

  • Jumpers knee
  • Hoffa syndrome
  • Synovial plica syndrome
  • Tibial tubercle fractures

Physiotherapy Management:

  • Provide simple knee support like knee cap.
  • Improve the extensibility of quadriceps, hamstrings, tendoachialis.
  • Progressive strengthening of quadriceps and dorsiflexors by low resistance exercise.
  • Pain resolves with time. Cold application to the affected part, stretchings, rest may help to the reduction of pain.
  • If pain is more NSAIDS like acetaminophen, ibuprofen may be used.
  • Less stressful activities like swimming or walking recommended.

Physiotherapy treatment:

Focuses on the strengthening of muscles, pain control to restore knee function and gait training.

Exercises for strengthing of quadriceps, hamstrings such as leg raise, squats and wall stretches.

Stretches of tight structures to increase ROM

Icepacks, knee braces, electrical stimulation to reduce pain and control inflammation.

Pt education such as knowledge of stretches and exercises is important.

Taping: Patellar tendon unloading techniques

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