Osgood Schlatters

[marcdholl]

Hello. I'm currently completing a literature review surrounding evidence into conservative treatment for Osgood Schlatters Disease (OSD). However, i have only found one article on the use of infrapatella strap and not a lot else. Would be grateful if anyone could inform me of papers looking at quadricep stretching, ice etc for the treatment of OSD.

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[neurospast]

Osgood slatter is in principle a inflamation and should be treated like that. The reason why you will not find any literature is because 1 it is self limiting, 2 a chronic inflamation which becomes worse in case the patient is doing to much. 3 nto seen as any different chronic inflamation where q-ceps are involved.
So feel free to make up your own treatment.
Advice; restrict force on insertion in tibia.
good luck.

[annelizeferreira]

Hi

I work with 16/17 year old junior soldiers and in our department we frequently see Osgood Shlatters. Like the previous auther said,it is a self-limiting disorder and the only treatment that works is rest from aggravating activity. In our enviroment, 90% of the time, Osgood Shlatters results in a medical discharge from the Army, they are allowed to rejoin after about a year or two, once their symptoms have settled. It is essentially caused by abnormal pull of the Quads via the Patella tendon on the enthesis of the Tibial Tuberosity. The apophysis of the tibial tuberosity can come away from the proximal tibia itself.

Osgood Shlatters is a progressive condition and therefore patients should be progressively returned to normal activities i.e. running and sport, once their pain has settled. Remember some boys grow untill they are 18/20. If they still actively growing Osgood Shlatters might be symptomatic untill their bone structure are more mature and robust.

Good luck with the lit review.
Annelize

[tomc90]

hi,

as a physio who worked for many years with junior soccer i strongly feel rest is of no benefit to OS. the condition is present when there is a growth spurt and only after this has stopped will the symptoms resolve.

rest for OS does not reduce the symptoms, just inactivates the child and makes it less likely that they'll grow into adults who exercise as part of their lifestyle.

additionally what is the harm in continuing activity with OS? it is not as if there is any catostrophic damage that can occur to the knee if it is not rested. What i would advise though is the use of ice and ibuprofen gel pre- and post exercise and passive stretches to hip, knee and ankle musculature to encorage the muscles to lengthen to the new size of the bones. additionally normal lower limb strenghtening and proprioception work is of benefit to again allow fast adjustment to the growing frame.

Only when pain is at its absolute worst would i advocate a reduction in activity, but certainly only a reduction, not cesassion.

this has been the approach i have taken for many years with no adverse affects and feel that if rest had been implamented many footballers i have seen would have simply dropped out of their sport.

hope that is helpfull

tomc90

[marcdholl]

Thank all authors for their contributions. This should help in composing my literature review.

Thanks again,

Marc

[annelizeferreira]

Re tomc90

I am sure your approach treating Osgood Schlatters works very well.

In my experience rest, in the active stages of the condition, from aggravating activities is necassary to aid the healing process and decrease pain.

I do not think the previous auther or me ment total rest from all activities... This would certainly be detrimental to the healing process of the bone and soft tissue. Graded stretches and functional activities and strengthening forms the basis of the treatment for the condition. Pain in this condition do tell you something though....Possible tissue damage!!!!!Exercises should be done within the patient's pain limits and should not cause any longterm disability or pain afterwards.

I wonder what the effect of the Ibruprofen gel is prior to exercise???Would that not mask symptoms and risk the patient overtraining???

Cheers
Annelize