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Physiotherapists And Doctors Services - Osgood Schlatter's

Osgood Schlatter's

Presentation

- Pain at tibial tuberosity (top of shin below patella tendon – can sometimes appear as lump and can be tender to touch)

Contributing factors

- Young athlete – usually 11-14 years of age (boys > girls)
- Relates to period of increased bone growth coinciding with high volume of loading of region (running, jumping, landings etc - not isolated to gymnastic activity – can be secondary to general increases in aggravating activity across a number of pastimes.

Key management points

- Reduce overall loading (reduce volume aggravating activity) until no impairment in function (no obvious favouring of affected side during activity)
-
For gymnasts to continue training levels, eliminate aggravating activity outside of gymnastics during periods of increased pain (e.g. avoid excessive unnecessary activity – running at lunchtime/after school, take out of week sports of less importance to athlete)
- Can resume loading with some pain, so long as no alteration of technique (e.g. limp/loss of power etc)
- Seek physio advice for confirmation of diagnosis, identification of possible contributing factors   

Management strategy

- Reduce overall volume of aggravating factors – start with activities outside of gym (minimise loading school, other sports, home etc). If symptoms persist begin to reduce aggravating gym skills/apparatus – e.g. floor and vault numbers until pain manageable.
- Keep diary of activity levels → if symptoms increasing, reduce overall activity levels until pain begins to subside
- Can tape patella with strip across patella to reduce loading during sport (see physio for correct technique)
- Can purchase patella band to wear all times during training and school/home activity
- Calf  and quadriceps flexibility
- Icing post training if symptomatic
- Continue lower limb conditioning calf/quads/gluts (low impact) to assist muscular ability to absorb loads when landing etc.   
 

Flexibility

- General lower limb flexibility
- Calf  and quadriceps stretches
- Ankle stretches on incline board

Strength/conditioning

- Trunk endurance exercise all planes of support
- Hip/pelvic/lower limb control exercises in position of support
- Calf raises
- Squats/single leg squats (emphasise correct technique)

CV fitness

- E.g. exercise bike intervals (long/low intensity) to maintain general aerobic fitness – reduce running volume

Physiotherapy

- Ankle mobilisations, soft tissue mobilisation of calf/quads/hamstrings, and progression of conditioning exercises, review of suitable training progressions and timelines

Return to sport

- Progression and increased loading depending on pain. If pain levels reduced to level allowing normal function, can resume activity. If pain increases causing modification of technique, then athlete to reduce overall volume of loading (running/jumping etc).

Key management points

- Reduce overall loading until no impairment in function
- Can resume loading with some pain, so long as no alteratio of technique (e.g. limp/loss of power etc)
- Seek physio advice for confirmation of diagnosis, identification of possible contributing factors, management outline   

 
 
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