OSD is an overuse injury at the tibial tuberosity — the bony bump just below the kneecap — caused by repeated stress from the patellar tendon during periods of rapid bone growth. It’s not a disease in the infectious sense; it’s a growth-related orthopedic condition that most commonly affects adolescent athletes between 10 and 15 years old.

The hallmark pattern is pain at or just below the kneecap that worsens with activity — especially jumping, running, and going up or down stairs — and may improve with rest. There’s often a visible or palpable bump at the tibial tuberosity. That said, knee pain in adolescents has several possible causes. A proper assessment by a Doctor of Physical Therapy or orthopedic provider is the right first step. We offer a free consultation to help determine whether OSD is the right diagnosis and whether TBD is the right fit.

It depends. Short answer: Not necessarily — and in many cases, total rest isn’t the best approach. The goal of proper OSD management is to find the right training load: enough to maintain fitness, skill development, and conditioning, while avoiding the specific activities that spike symptoms beyond a manageable threshold. Our protocol is built around keeping your athlete in the game as much as possible, safely.

Without rehab, OSD can persist throughout the entire growth phase — often 12–18 months or longer. With structured management, most athletes experience significant symptom reduction within 6–8 weeks and are able to return to full competition within 3–5 months, depending on severity. TBD’s 5-phase protocol is designed to compress that timeline without cutting corners on tissue readiness.

Yes — and we’ve had strong outcomes with athletes from around the world. OSD rehab involves specific exercise progressions, load management strategies, and movement training that translate well to remote delivery. Our online sessions are fully live and 1-on-1 with a licensed DPT, not pre-recorded videos or automated programs. For manual therapy needs, we recommend combining online coaching with occasional visits to a local provider.

General PT is valuable. The difference is specialization. TBD’s protocols are built specifically around basketball — the mechanics, the sport demands, and the return-to-sport criteria that matter on the court. If your current provider isn’t basketball-specific, there may be gaps in the progression. We’re happy to consult alongside an existing provider or take over the care plan entirely — whatever serves your athlete best.

OSD primarily affects athletes between 10 and 15 years old, and that’s our primary OSD patient population. We’ve also worked with athletes 16–18 years old, who are still in the active growth phase or dealing with residual issues from an earlier OSD episode. If you’re unsure whether your athlete is appropriate for our program, the free consultation is the right place to start.

We are considered “out-of-network” insurance providers for in-person physical therapy in Orange County and Los Angeles County. We offer superbills for you to seek reimbursement from your insurance upon request. Please contact us directly to verify your coverage. Online coaching is typically a private-pay service not covered by insurance. Both options offer flexible payment structures — reach out and we’ll find a path that works.