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Clinical corner


Adolescents knee being examined

This is the first in a series of pathologies we will be exploring. We start with Clinic Director, Paul Aston, discussing Osgood-Schlatter's Disease (OSD).


What is it?

Osgood-Schlatter's Disease is a cause of knee pain in children and adolescents. It affects those who are active and have gone through a rapid growth spurt. The bony prominence at the front of the shin beneath the knee (tibial tuberosity) can become painful and swollen especially if they participate in regular high impact sports and activities.


Causes

The muscle at the front of the thigh (quadriceps) facilitates straightening of the knee by pulling on the knee cap (patella) and the (patellar) tendon which attaches to the bony prominence. Continued stress and traction from the quadriceps muscle in the area of this attachment can cause pain and swelling. As this heals a hard bony bump may develop.


Symptoms

  • Pain and swelling at the bony prominence (tibial tuberosity).

  • Bony lump which is sore on palpation or when kneeling.

  • Pain during sport and activities that involve running, jumping, squatting and kneeling.

  • Level of symptoms can vary depending on type and amount of physical exercise undertaken.

  • Pain is relieved by rest.

  • Usually only one knee is affected but can affect both.


Physiotherapy treatment

  • Advice about rest periods, activity modification including avoiding impact sports and taking regular breaks, pain relief, and ice compression, checking with GP vitamin D level (>50nmol/L) and reassurance that symptoms will ease as growth slows.

  • Addressing muscle imbalance and prescription of appropriate rehabilitation exercises including lower limb muscle stretches (quadriceps, hamstrings, gastrocnemius and gluteals) and a graded strengthening programme.

  • Clinical interventions such as western acupuncture (dry needling), electrotherapy e.g. LASER, soft tissue techniques, offload taping and bracing can also be very effective.


If you or someone you know is being troubled by these symptoms, do call us to discuss making an appointment to see one of our physiotherapists.

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