Osgood- Schlatter’s Disease – Childhood Sports Physio

What is it?

Osgood-Schlatter’s Disease (OSD), also known as osteochondrosis or traction apophysitis of the tibial tubercle, is a common cause of anterior knee pain in children. It involves excessive patellar tendon traction over the growth plate at the top of the shin bone (tibial tubercle) during periods of skeletal maturation (ossification).

The ossification process of the tibial tubercle occurs throughout puberty, commonly at 10-12 years in girls and between 12-15 years in boys, which is when OSD can develop. During periods of growth, repeated forced knee extension (e.g. Running/jumping) can increase patellar tendon traction and stress over the immature tibial tubercle, leading to irritation and inflammation. This inflammation presents as knee pain/swelling that is aggravated by physical activity. While physical activity may increase a child’s pain, evidence does not suggest that it causes harm.

Who does it affect?

  • 10 -20% of all adolescents
  • Children during periods of growth
  • Children playing high impact sports involving running/jumping (e.g. Basketball, gymnastics, football)
  • More common in boys (12-15 years) than girls (10-12 years)

What are the signs and symptoms?

  • Pain around the top of the tibial tubercle in one or both knees (20-30% of cases)
  • Swelling/visible bump on the tibial tubercle
  • Associated tightness of surrounding muscles – especially quadriceps and hamstrings
  • Associated quadriceps weakness
  • Pain aggravated by exercise or direct contact (e.g. Kneeling, squatting, stairs, running)
  • Pain eased with rest


Physiotherapists are able to provide a clinical diagnosis based on the child’s history, signs and symptoms. If your child has OSD, treatment may include:

  • Reassurance regarding the self-limiting nature of OSD – symptoms will likely resolve by the time the child reaches full skeletal maturity
  • Advice regarding activity modification and load management to manage symptoms
  • Taping/bracing techniques to offload painful areas
  • Manual therapy to address tightness in surrounding muscles
  • An exercise program designed to strengthen and lengthen surrounding muscles such as the quadriceps, hamstrings, gluteal and calf muscles
  • Addressing biomechanical contributing factors

Pro Physio SA  Clare Turnbull, Physiotherapist

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