Osgood Schlatter’s Disease (OSD) is a condition that affects the knee while the bones are still growing. It causes pain at the front of the knee, below the knee cap, which eventually becomes a bony lump. It is a common condition, and many people don’t know that they ever had it until the lump is noticed in passing. When mentioned, they might remember some knee pain in their teenage years, or it may have been so mild they can’t recall a thing.

What Happens in Osgood Schlatter’s Disease?

The quadriceps muscles on the front of the thigh attach to the top of the shin bone. The area of bone where this tendon joins is still soft until the mid to late teens, when growing slows down and this point can mature.

If the quadriceps put a lot of pull on this bit of bone, it can cause irritation. This might happen following a growth spurt, while the muscles are catching up to the growth of the bones, making them relatively tight. High demands of the muscles, such as a lot of running or jumping, can also add stress to the area.

The soft bone is pulled by the muscle, protruding a little and becoming tender, especially to the touch. Over time, this protruding bone matures with the rest of it, and the lump remains. This is typically subtle and painless.

Who Does OSD Affect?

As this is a condition that affects immature bone, patients are adolescents. Boys and girls develop at different rates, so girls are typically affected between 10 and 14, whereas incidence in boys peaks between 11 and 16. After these ages, the bone matures, becoming more stable and no longer susceptible to the pull of the quadriceps.

Adolescents within this age bracket are more likely to develop symptoms of OSD if they are active. Running and jumping sports are most closely linked to the condition, such as basketball and football.

How Can Osteopathy Help?

Your osteopath can work with the quadriceps muscles to encourage them to relax and stretch. This can be done using massage techniques, and active techniques to engage and relax the muscles.

We always look at the patient as a whole person, so if we can identify any other areas that might not be working as well as they should, thus overloading the thigh or knee, we will work on these too. Examples that might affect OSD could include:

• areas of hypermobility

• reduced hip or ankle function

• tight muscles in the hamstrings or trunk

• favouring one side over the other (possibly due to a scoliosis or an old injury that we can help with)

We can also give advice to keep your child comfortable at home. A cool compress might be appropriate, and for patients who do a lot of sport, a new warm up and warm down routine might help to reduce the demand on the area. In some cases, it may be helpful for your child to reduce the amount of sport they do regularly, but we understand that this is not always viable.

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