Treatment of Osgood Schlatters Disease involves reducing pain and inflammation, ensuring muscles are in optimal condition then managing training load to avoid it recurring.
It should clear up when the young athlete stops growing and the tendons become stronger, however, it can occasionally persist into adulthood.
Reducing pain and inflammation
Immediate first aid and the best way of relieving symptoms is applying the PRICE principles of protection, rest, ice, compression and elevation.
Protection of the knee from further injury can be done by wearing a patella knee strap or patella tendon taping technique. A patella strap or taping can absorb some of the shock or impact and change the angle the forces are transmitted through the tendon. It can be worn all the time if the knee is painful. A full neoprene knee support can keep the tendon warm and support the whole joint. It may be trial and error to see which type works best for you.
Play video on applying patella tendon taping.
Rest is the most important element of treatment. Only do as much exercise as it will allow without causing pain. Weight bearing exercise will make it worse. Keep your sessions few and lower impact rather than training every day. Switch high impact exercise to swimming or cycling if pain allows. A plaster cast can be applied for three weeks if pain is severe.
Ice - Apply ice or a cold therapy wrap to the knee regularly throughout the day and particularly following activity or sport. Ice should be applied at least three times a day for 10 to 15 minutes. If the injury is particularly painful then ice can be applied for 10 minutes every hour. Ice massage with an ice cube is another convenient way to apply cold therapy to a specific area such as the patella tendon. Keep the ice moving as applying directly to the skin can cause ice burns.
Compression in the form of an elastic support or wrap can help support the area and reduce swelling.
Read more on PRICE principles.
Improving muscle condition
Muscles, specificlaly the quadrieps muscles need to be strong enough to cope with the demands being placed on them. If this injury has been a problem for some time then wasting away of the thigh muscles, particularly the vastus medialis on the inside of the knee. If this muscle is weak then other problems such as patellodemoral pain may also develop.
Medication - A Doctor may prescribe NSAID's or anti inflammatory medication such as Ibuprofen to help reduce pain and inflammation, although this is not good to rely on long term, or mask how bad the condition actually is. Athletes with asthma should not take Ibuprofen.
Stretching exercises - Gently stretch the quadriceps muscles if comfortable to do so. Osgood Schlatters coincides with a growth spurt so if the bone has grown too quickly leaving the muscle tendon unit tight then stretching will help. Keep the knees together and gently pull up on the foot. Push the hips forwards to increase the stretch. Hold for 10 to 15 seconds and relax. Repeat 3 to 5 times.
Read more on exercises for Osgood Schlatters Disease.
Massage - Sports massage for the quadriceps muscles and myofascial release techniques to help stretch the muscles can help ensure they are strong enough to cope with the loads placed on them as well as not being too tight. Massage should not be applied directly to the tibial tuberosity where the patella tendon inserts as this is likely to make symptoms worse.
The most important thing is management of the athletes training program so they can do as much exercise as pain will allow, which may mean focusing on quality rather than quantity. It may just be a case of waiting until the athlete stops growing so fast and the tendons and bones become stronger.
A big part of managing the condition is educating the patient, parents and coaches about the condition and the importance of not over training. It is important to manage the young athletes training program so they only do what pain will allow. If this means training just once or twice a week then so be it. They will make more progress with one or two quality sessions as opposed to daily training where lack of progress and frustration is the outcome.
What often happens is the pain will settle down, then the athlete goes back to the usual levels of training. Then it will get to a stage again where it is inflamed and you will need to rest and calm it down again.
That will be the pattern that quite a few children will do for years and years. They can still get enough training done so they can improve technically so they still have a chance of making it as a professional sports person. But if you keep pushing and pushing and ignore it then you might end up with a situation where it is so painful that you could miss 12 months or more of training and that then could end the chances of that child achieving a career in professional sport.
Premiership football physiotherapist Neal Reynolds talks about managing Osgood Schlatters disease for the aspiring young athlete.