Defined

Osgood-Schlatter's Disease is caused by repetitive stress or tension on a part of the growth area of the upper tibia (the apophysis).  It is similar in biomechanical operation to Sever's Disease, but occurring at the tibial tuberosity and characterised by inflammation of the patella tendon and surrounding soft tissues at the point where the tendon attaches to the tibia.

Symptoms

It is usually young people who suffer with this disease, experiencing pain just below the knee joint and patella which usually worsens with activity.  It is also associated with an avulsion injury, stretching the tendon so much that it tears away from the tibia and in extreme cases takes a fragment of bone with it.

A bony bump may appear on the upper edge of the tibia (below the knee cap) that may be particularly painful when pressed.  It has been misdiagnosed in the past as "surfer's knee" (a myth that only surfboard riders suffered from the condition).  The hinge motion of the knee is not affected.  Pain may last a few months and may recur until a child's growth is complete.

Most commonly this condition affects active young people, particularly boys between the ages of 10 and 15 who play games or sports that include frequent running and jumping.  Also affected are netballers who are required to stop, turn and push off on one leg during the game which brings enormous pressure on the lower joints and soft tissues.

Biomechanical Aetiology

Excess internal tibial rotation associated with excess pronation is a contributing cause to abnormal tractional forces on the insertion of the patella tendon.  An imbalance of growth spurts in soft tissue and osseous growth with children aged 8-14 years together with excess pronation is an exacerbating factor.

As these conditions occur, disruption of the tibial growth plate takes place and the child will experience secondary swelling and pain.

Treatment

An x-ray may be normal or show an avulsion injury or, more typically, show that the apophysis is in fragments.  This is an extreme situation but not uncommon.

ICB Orthotics control internal rotation of the tibia.  This in turn will reduce tractional forces placed on the knee joint and growth plate of the child, however restriction of the tractional force by applying the strapping technique as pictured will greatly assist.  By using both strapping and ICB Orthotics together the child will be able to continue participating in sporting activities.

Additional Treatment

R.I.C.E.

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