What is it and how does it occur?

• Osgood-Schlatter's lesion involves pain and swelling in the small bump on the bone in your shin (tibia) just below the kneecap, and affects the area where bone growth occurs. Too much stress on the growing bone causes pain and swelling. This pain is often worsened with activity and eased by rest.
• The main cause of Osgood-Schlatter lesion is too much tension on the patellar tendon. The tension can occur from overuse from sports, growth spurts, or abnormal alignment in the legs. During sporting activities, the quadriceps muscle on the front of the thigh works, pulling on the patellar tendon, which in turns pulls on the tibial tuberosity. If this tension is too great or occurs too often while the bone is developing, it can pull on the growth area of the tibial. During growth spurts, the tendon may not be able to keep up the rate of bone growth in your lower leg and may become too short. For abnormal alignment, kids who are knock-kneed or flat-footed change the angle formed between the quadriceps muscle and the patellar tendon. This angle puts more tension on the growth plate of the tibial tuberosity, increasing the chances of developing Osgood-Schlatter's.

What can physical therapy do for this problem?

• The first thing that physical therapists address is to ease the symptoms. We may use ice, heat, ultrasound, or electrical stimulation to help control inflammation and pain
• Next, we work on flexibility, strength, and proprioceptive exercises for f all the leg muscles. Many times, tight hamstrings and quadriceps put an athlete at risk for developing different injuries, so maintaining overall good flexibility is important. We strengthen muscles of the lower leg and core to make sure the athlete has good muscle balance in the knee, hip, ankle, and core. Balance activities also help teach the athlete to learn where their body is in space and to use all different leg muscles together as a team
• Postural education and exercises are also important in order to address any abnormal alignment that is found. Sometimes, orthotics, or shoe inserts, are needed to help correct flat footedness or knock-kneed positions
• Finally, once symptoms have decreased, therapists work on sport specific activities and movement patterns, in order to help improve form and reduce knee strain during sports
• Physical therapy at the Johns Hopkins All Children's Sports Medicine program is provided in an atmosphere developed for teen athletes with a one to one ratio for the highest quality of care needed for maximum outcomes and return to play. Physical therapy will get you back in the game!