There is nothing more frustrating for a junior athlete than to be unable to play the sport they love; and there’s nothing more frustrating than seeing your child in pain and limping around. In the adolescent athlete, Osgood-Schlatter disease is potentially the most common culprit for disrupting sport.
Unfortunately, adolescents with this issue are often told that Osgood Schlatter is something they have to put up with until growing stops, however this is not the case. Physiotherapists can successfully manage this issue to minimise its impact on sport and day-to-day life.
First of all, what happens during Osgood-Schlatter disease? During growth spurts, bones lengthen first, and it takes a while for the muscles to catch up. As the thigh bone (femur) lengthens during the growing process, the thigh muscles (quadriceps) become relatively short compared to the thigh bone. The thigh muscles are now under tension and this causes a “traction” force aka traction apophysitis, where the thigh muscle attaches on the top of the shin bone (tibial tuberosity). This attachment site can then become quite painful and a physical lump can often be felt.
There are multiple factors to be considered when treating this issue, but here are my big three to start with:
- Stop stretching your quadriceps muscles! We know that Osgood Schlatter disease is caused by a relatively short quadricep muscle, so it is intuitive to want to stretch this muscle. However, stretching the quadricep muscles will create further pulling/traction where the muscle inserts, leading to further irritation. So, at least in initial stages, put quadriceps stretching on the back shelf!
- Start foam rolling or massaging! Stretching is not recommended, but we do want to loosen the quadriceps muscle to take the tension off its attachment point. A great alternative to stretching is foam rolling or deep tissue massage. In initial stages of management, when pain relief is king, your foam roller will be your new best friend!
- Get strong! Now that you have done your share of foam rolling or massage, it’s time to get strong. A targeted strength program for the quadriceps will help to remove the load from the knee. But don’t just focus on the quadriceps – other muscle groups such as the glutes, hamstrings and calves are also very important. Your physiotherapist can design a tailored program for you.
Whilst these are three things which can be considered when treating this issue, it is not an exhaustive list. Load management (reducing activity or spreading it through the week), modifying footwear and manual therapy to compliment foam rolling are commonplace amongst many other options.
Osgood-Schlatter disease is not something that you just have to put up with – it can be managed well to get you back doing the things you love!
This article is written by Tom Collier, Physiotherapist at Back In Motion Eltham.
If you would like further information, please contact our practice on 9439 6776 to book in a consultation with Tom.