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Managing Osgood Schlatters’ Disease Flare-Ups

If you’re unsure what Osgood Schlatters’ Disease is or if you are trying to figure out if you have it? Check out our Previous Blog and this YouTube Video below to help!

If you are dealing with a painful bump below your knee and you are under the age of 17 it is likely that you could be dealing with Osgood Schlatters’ Disease. It is one of the more common knee conditions for youth athletes who play sports that involve a lot of running and jumping. Osgood Schlatters’ Disease usually occurs following a growth spurt or right before one because bones are growing faster than muscles and tendons. One of the most frustrating things with Osgood Schlatters’ Disease is that there will be flare ups.

In this blog, we will discuss what a flare up is and how to best manage them.

What is a "Flare-Up"?

“Flare ups” are a very common occurrence when dealing with Osgood Schlatters’ Disease. These flare ups occur for several reasons, and we will discuss a few here. 

One of those reasons is a recent or currently going through a growth spurt. Youth athletes aged 12-17 are having the most change in growth and bodily changes during this time. When you pair these changes alongside high levels of activity, these youth athletes are adding more stress that their bodies are not ready for.

Another major reason is many athletes become knee dominant, especially with sports involving a lot of running and jumping (aka basketball). In other words, athletes tend to use too much of their knees and quadriceps muscles with movement and sport. This leads to excessive pulling and load on the patellar tendon and ultimately on the tibial tuberosity, which leads to that painful bump. That is why we sometimes have flare ups during the season or when there are a lot of games or increased volume of practices.

In addition to being knee or quadriceps dominant, a related reason to flare-ups is a lack of ankle mobility and lower body muscle flexibility. These limitations in mobility lead to poor shock absorption when running, jumping/landing, and playing sports. Furthermore, when you have poor shock absorption, more stress is placed on joints and tendons.

How Do You Manage These "Flare-Ups"?

The most common question we get asked is how do you manage these flare ups.

1. Reduce Activity Levels

First, you have to decrease the amount or intensity of activity you have been doing because a lot of the times these flare ups come from doing too much. As we mentioned earlier, basketball tends to be a quadriceps dominant activity, meaning we use more of our muscles in the front of the leg instead of the back of the leg. Therefore, you have to decrease your activity level to decrease the demand on your quadriceps and, ultimately, the patellar tendon at the tibial tuberosity.

2. Ice

Second, ice will help with managing pain. Research has shown that ice has an analgesic effect meaning it will help decrease pain. We recommend athletes to ice at the painful bump for 10-20 minutes after the activity that provoked the pain, which usually is sports or running. Furthermore, decreasing this pain will have an indirect effect on muscle relaxation because your muscles will be less guarded from the decreased pain you were experiencing after icing.

3. Strengthen Posterior Chain

Third, we advocate you to strengthen your body’s posterior chain. The posterior chain includes the lower back muscles, glute, hamstrings and calf to help deload and take the stress from the knee, specifically the quadriceps muscles and patellar tendon. As we mentioned before, being quad/knee dominant can lead to flare-ups; therefore, you have to train the posterior chain during these stages. 

4. Off Load Tibial Tuberosity

Finally, you can use a band around the patellar tendon to help decrease pain with everyday activities. You could use pre-wrap as an alternative to a strap, like in the video shown HERE. Or you can buy a band such as this one

The band will help decrease pain by applying a different focal point on the patellar tendon away from the tibial tuberosity; as a result, it will decrease the stress and pull on the tibial tuberosity. Furthermore, the band will be helpful in allowing you to play sports with less pain than without it. When there is pain, muscles start to become inhibited meaning your muscles aren’t firing the way they need to be; as a result, this will lead to movement compensations and greater risk for injury.

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Sources

Ladenhauf HN, Seitlinger G, Green DW. Osgood-Schlatter disease: a 2020 update of a common knee condition in children. Curr Opin Pediatr. 2020 Feb;32(1):107-112. doi: 10.1097/MOP.0000000000000842. PMID: 31714260.
Neuhaus C, Appenzeller-Herzog C, Faude O. A systematic review on conservative treatment options for OSGOOD-Schlatter disease. Phys Ther Sport. 2021 May;49:178-187. doi: 10.1016/j.ptsp.2021.03.002. Epub 2021 Mar 9. PMID: 33744766.

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Dr. Gabriel Ignacio PT, DPT, OCS, TPI

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