Osgood-Schlater syndrome

Osgood-Schlatter disease is an occurence of pain on the patellar tendon bellow the patella bone and on its connecting point to the shin bone, ie. tibiae which commonly happens with sports active adolescents. The quadriceps tendon located at the upper part of the patella goes above it and descends into the patellar tendon bellow the patella which is then connected to the shin bone and together these two tendons and m.qudriceps form the knee joint extensory mechanism.

The growth spurr which happens in adolescence combined with excesive load and inproper use of loads in sports activities of adolescents cause this syndrome. It happens during the adolescent growth spurr when the bones have a faster growth and elongation speed than the musculo-tendon tissue has and combined with sports activities and added loads on the knee joint those muscles and tendons can get even more shortened and it leads to micro damages in the patellar tendon and its connecting point to the shin bone. So called, avulsion fractures, on the connecting point of the tendon to the tibia happen, ie. micro fractures of the bone at the proxsimal part of the tibia, specifically at the tuberositas tibiae. Avulsions are created when traction happens during certain movement patterns and quadriceps muscle activity which are often repeated. The patellar tendon gets pulled away from its connecting point and chnages in its membrane occur, later when the bone heals it starts to form a calcification, ie. a new bone in that spot which results in a convexity at that part of the shin. Once it is healed that convexity or bump is purely and estetic problem, it does not cause any pain, difficulties in mobility or performance of sports activity.

Incidency of this syndrome happening is highest with the sports active adolescents, more often with boys than girls. With boys it commonly occurrs from 10-15 years and with girls from 8-13 years. It occurs due to repeated performing of a movement or a pattern of movements and therefore it is more common in certain sports. Constant jumping, landing, acceleration, deceleration, running cause loads which impact the patellar tendon and cause Osgood-Schaltter syndrome. The syndrome is oftenly seen in basketball, volleyball, handball, football players or with track and jumping athletes in athletics. Pain, swelling and tenderness of the patellar tendon and its connecting point, which intensifies during above stated activities and decreases during rest, is experienced.

Therapy is aimed at pain and swelling relief in the the acute phase by use of the RICE method (rest, ice, compression, elevation) and the later functional phase consists of massage to relax the tendon and remove the possible edema, different stretching methods of knee joint extensory mechanism (static, dynamic, PNF), careful and progressive eccentric strenghtening of the quadriceps muscle in order for its fibers to get elongated and get the required flexibility and elasticity.

Prevention: proper pre activity warm up and post activity stretching routines, proper use and implementation of loads with training adolescents, preventive use of eccentric quadriceps muscle strenght exercises to decrease the risk of this syndrome occuring, etc.