Osgoode-Schlatters - How can physical therapy help?

Osgoode-Schlatters - How can physical therapy help?

Osgoode-Schlatters is a fairly common condition affecting the tibial tubercle (the bump about 2” below the knee cap).  The condition is more common in boys than girls during large growth spurts.  The tibial tubercle is the site where the patellar tendon attaches to the tibial bone.  The patellar tendon is part of the quadriceps muscle group.  The tibial tubercle is also the site of a growth plate.  So, during times of growth, the bone is softer and the tubercle becomes painful and often is enlarged as the patellar tendon pulls on the bone during activity.

The pain is typically worse with running and jumping activities and eases with rest.  The diagnosis is made from both the history and clinical examination.  X-rays are typically not helpful as they won’t provide any help in establishing the diagnosis.

Physical Therapy management will include:

• A thorough clinical examination determining any biomechanical dysfunctions that will put extra stress on the knee.  Muscle tightness, poor muscle control and altered biomechanics can all put extra stress on the knee.
• Advice on specific therapeutic exercises for stretching and strengthening.
• Knee taping.  If this provides significant relief a patellar tendon strap can be prescribed.
• Orthotics and/or proper running shoes can also help if there is an increase in pronation (excessive foot flattening).
• Advice on activity modification.

The good news is that the condition is self-limiting, i.e. when the knee is sore it is best to reduce activity.  The soreness will increase when there is a large growth spurt and will disappear in between growth spurts and will entirely disappear once growing is completed.  Often there will be a prominent bump that remains at the tibial tubercle into adulthood.