Osgood Schlatter Disease Phase 2

Phase 2 comprises:

  • Cold therapy
  • Taping/Bracing
  • Massage/Foam roller
  • 6 stretching exercises
  • 6 strengthening exercises
  • 2 functional exercises
  • 2 core exercises
  • 1 cardiovascular exercise

This is the ‘Re-Load’ phase. The aim of phase 2 is to continue to protect the area and improve the condition of the muscles.

Check Exit Criteria to learn when it is safe to move to phase 3.

Treatment

To be done daily.

Cold therapy

Continue to apply cold therapy, especially after activities, if you have been on your feet a lot, or if your knee is sore.

Taping/Bracing

Protect your knee by taping or wearing a patella tendon strap.

This will help reduce the load on painful areas of the tendon. If your knee is painful then wear support all the time.

Massage/foam roller

Use a foam roller over your quadriceps (front thigh) before stretching. This is a good alternative if massage is not available.

This exercise performs a myofascial release and stretches on the quadriceps muscles at the front of the thigh.

The roller is applied along as full a length of the muscle as possible with more emphasis or weight from the knee upwards, following the direction of blood flow along the muscles.

This can be done daily for 2 to 5 minutes to release any muscle spasms or knots.

Calf stretch

Teaching Points:

  • Calf stretches should be done with your leg straight to stretch the larger gastrocnemius muscle and bent to target the deeper soleus muscle
  • 2 sets for 45 seconds each side

Hip flexors stretch

Teaching point:

  • Kneel with one knee on the floor and the other foot in front with the knee bent
  • Push your hips forward and keep the back upright
  • Hold for 45 seconds

Quadriceps stretch

Teaching point:

  • Hold the foot of the leg to be stretched and gently pull up behind
  • Aim to keep the knees together and pull the leg up straight not twisted
  • A stretch should be felt at the front of the leg – It should not be painful!
  • Hold the stretch for 45 seconds
  • 2 sets

Hamstring swing

Teaching point:

  • The affected leg is the one you swing
  • Take it forward and backward, keeping the knee straight
  • Take it as far as you feel comfortable
  • 2 sets for 45 second
  • 8 – 10 reps

Glute stretch

Teaching point:

  • On your back cross your right ankle over the left knee
  • Grip the thigh of your left leg and pull the knee towards you, lifting your foot off the floor
  • Pull the knee further towards you to increase the stretch
  • Hold for 45 seconds

Adductor stretch

Teaching point:

  • Swing the leg out sideways, making sure you rotate your leg so your toes point upwards as your leg swings upwards
  • 2 sets of 45 seconds

Note: Dynamic adductor swings must be done within a pain-free range of motion.

Strengthening

2 to 3 times a week.

Hip thrusts

Teaching Points:

  • The bridge exercise works your gluteal muscles
  • Perform raised on a bench or similar
  • Raise the buttocks and lower back up off the floor as high as possible
  • Ensure to really squeeze the glute muscles
  • 3 sets of 6 reps

Note: Try a single-leg bridge if the double-leg is too easy.

Single leg calf raise

Teaching Points:

  • Ideally, these should be performed in a gym using a Squat (Smith’s) machine so you can increase the load on the muscles
  • 3 sets of 12 reps on each side

Squat (Bodyweight)

Teaching point:

  • Start with your feet shoulder-width apart and tense your abs
  • Sit back – make sure to move your butt backwards, don’t just bend your knees
  • Keep your knees in line with your toes
  • 3 sets of 8 reps

Note: Look straight ahead and don’t round your back.

Isometric knee extensions

Teaching point:

  • This can be done on a leg extension machine at the gym
  • Or using an elastic resistance band
  • If you prefer you can substitute this exercise for isometric leg press
  • 3 sets of 15 seconds each side

Single leg long lever bridge

Teaching point:

  • Lie on your back and push up into a bridge position
  • Raise one leg up and hold, moving your knee side to side
  • 3 x 15 secs each side

Romanian dead lift (RDL)

Teaching point:

  • This is a bodyweight Romanian deadlift
  • Keep your back straight for this exercise
  • 3 sets of 6 reps

Core

Can be done daily.

Dead bug

Teaching point:

  • Take the opposite arm to the opposite leg into an extended position
  • Straighten the leg while extending the opposite arm
  • 3 sets of 15 seconds

Mountain climbers

Teaching point:

  • Keep your abs tight when performing mountain climbers
  • You can vary the position of the knee, either between your arms or outside your arms
  • 3 sets of 15 seconds

Cardiovascular fitness

Up to 3 times a week.

Stationary cycle

Teaching point:

  • Make sure your bike is in a low gear, or with low resistance and seat position is high
  • Do 20 mins steady every other day, to a maximum of 3 times per week

Functional

Can be done daily.

High knee step up

Teaching point:

  • Working leg is on the step
  • The other leg comes up into a hip flexion position (90 deg)
  • 3 sets of 8 reps each side

High knee reach out

Teaching point:

  • High knee lift into a lateral reach out
  • Toes should be pulled up towards the ceiling
  • Great for hip mobility, quad and glute activation
  • 3 sets of 8 reps each side

Move on to phase 3?

Check if you are ready to move on:

Exit criteria

You are ready to move on to phase 3 when:

  • Pain-free to touch over tibial tuberosity
  • Pain-free isometric VMO activation
  • Pain-free quadriceps stretch
  • Pain-free hip flexor stretch

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