Osgood-Schlatter syndrome (OSD), also called osteochondrosis of the anterior tibial process, is a leading cause of knee pain in growing adolescents. It is caused by the repetitive contraction of the thigh muscles, which causes the patella tendon to exert some traction on the developing tibia, causing inflammation, pain and often a noticeable swollen lump. This disorder occurs more often among boys, especially those who play a sport that involves running a lot or making sudden jumps and changes of direction, such as football and basketball. It is generally a self-limiting syndrome (tends to resolve spontaneously) and only rarely causes permanent problems or disabilities. However, there are many ways to reduce the pain and make it more bearable until the problem is resolved.
Steps
Part 1 of 3: Using Home Remedies
Step 1. Rest and avoid activities that cause pain
Probably, the most important thing to do to relieve pain is to stop playing sports or the one that contributes most to the problem. Sports that involve a lot of jumping, such as volleyball or basketball, are particularly contraindicated for individuals suffering from this syndrome.
- The amount of rest needed varies widely and depends on each individual, but generally be prepared for a few weeks to a few months before you start noticing a significant reduction in pain and swelling.
- Pain associated with OSD can be sporadic or nearly constant; it usually occurs in only one knee, although it sometimes affects both.
Step 2. Apply ice to the knee
It is essentially an effective remedy for all acute injuries of the musculoskeletal system, including osteochondrosis of the anterior tibial process. You should apply cold therapy to the inflamed bulge (tibial tuberosity), just below the patella, for 20 minutes every two to three hours during the first two days to reduce the frequency of painful episodes and swelling.
- Always wrap the ice or ice pack in a thin towel to avoid chilblains.
- If you don't have ice or a cold gel pack available, you can take a bag of frozen vegetables from the freezer.
Step 3. Put on a knee brace or immobilizer
In addition to rest and ice application, you should also consider putting on a special knee brace or joint immobilizer when walking to limit strain on the patellar tendon.
- You can find this type of devices in orthopedic stores or in major pharmacies; ask a physiotherapist, doctor or chiropractor for more information.
- Alternatively, you can try wearing a patellar tendon strap that attaches around the leg just below the kneecap. This brace provides support to the tendon under pressure during physical activity and distributes some of the weight, reducing the load on the tibial tuberosity.
- When you have Osgood-Schlatter syndrome, it is not necessary to remain completely inactive, but you can choose to do other fun activities that do not involve jumping or running, such as swimming, rowing or golf.
Step 4. Take anti-inflammatories or pain relievers
NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen, naproxen or aspirin are short-term solutions to manage pain and inflammation. Alternatively, you can try over-the-counter pain relievers, such as acetaminophen (Tachipirina). They are quite aggressive drugs for the stomach, kidneys and liver, so you shouldn't take them for more than two consecutive weeks. Always consult your doctor before taking any medication.
- Keep in mind that NSAIDs do not reduce the duration of the syndrome.
- Steroids such as cortisone have strong anti-inflammatory properties, but localized injections should not be given to adolescents suffering from OSD due to the high risk factors, in particular possible weakening of the tendon, local muscle atrophy and a decrease in functions of the immune system.
Step 5. Stretch your quads
When the acute pain has subsided, you should start doing quadriceps stretching exercises. One of the main causes of OSD is the repetitive contraction of these muscles (for example due to jumping too much) and their excessive tension. For this reason, you should learn how to properly stretch this muscle group to reduce tension and inflammation in the area where the patellar tendon joins the tibia.
- To stretch your quadriceps while standing, bend your leg backward at the knee and bring your heel close to your butt. Grab your ankle and pull your foot closer to your body until you feel a stretch in your lower thigh and knee. Hold the position for about 30 seconds and repeat three or five times a day until you notice improvement.
- You can also do hamstring stretches, which are usually tight. A good basic exercise is to lean forward at your hips and try to touch your toes.
Part 2 of 3: Alternative Therapies
Step 1. Get a leg massage
A deep muscle tissue massage is an excellent remedy for light to moderate tension because it reduces tension, fights inflammation and promotes relaxation. Start with half an hour of massage, focusing mainly on the muscles of the thighs and the knee area. Let the therapist go in depth to the maximum tolerable limit.
- If the massage therapist feels there is a buildup of scar tissue, they may use the cross-friction technique on the patella area.
- Always drink plenty of fluids immediately after a massage therapy session to eliminate all inflammatory by-products and lactic acid. If not, you may experience a headache or mild nausea.
Step 2. Try acupuncture
This practice involves inserting fine needles into specific points on the body to control pain and inflammation. Generally, it is not recommended in cases of OSD, but it is theoretically a risk-free therapy and is worth a try, especially as soon as the first symptoms appear. Acupuncture is based on the principles of traditional Chinese medicine and works by stimulating the body to release certain substances, including endorphins and serotonin, which act as natural pain relievers.
- The points that are stimulated during the session relieve knee pain, but may not be in the vicinity of this joint - some are located in distant areas.
- Acupuncture is practiced by various health professionals, such as doctors, chiropractors, naturopaths, physiotherapists and massage therapists; however, you must always rely on a serious and competent professional.
Step 3. Consider wearing orthopedic shoes
One of the risk factors for OSD is poor biomechanics during running and jumping; in some cases, the pain is triggered by flat feet or a posture with the knees bent inward. Orthotics are custom devices that are placed in shoes to support the arch, align the legs, and improve biomechanics when standing, walking, running or jumping.
- The orthopedic doctor can prescribe specific insoles for your needs, while the orthopedic technician will take care of making them according to his indications.
- In certain circumstances, the National Health Service covers the cost of custom insoles; in this case, a medical prescription is required. If you have private health insurance, check to see if the policy provides reimbursement for these devices. If you can't get a custom-built product for economic reasons, consider generic orthotics that are sold in pharmacies and some supermarkets; they are much cheaper and can provide some relief.
Part 3 of 3: Medical Treatments
Step 1. Try ultrasound therapies
These are treatments that are performed by some doctors, chiropractors and physiotherapists to reduce inflammation and stimulate healing following various injuries, including Osgood-Schlatter syndrome. Just as the name suggests, ultrasound therapy uses the sound frequencies emitted through crystals that you cannot hear, but which act positively on the cells and tissues of the body.
- While a single session is sometimes enough to find complete relief from pain and inflammation, it is likely to take three to five sessions to notice any improvement.
- Ultrasound treatments are painless and last around 10-20 minutes.
Step 2. Get examined by a physiotherapist
If you are not finding benefit from home remedies or alternative therapies, consider seeing a physical therapist. It will show you specific and personalized exercises to stretch your quads and knees.
- Usually, physiotherapy must be followed 2-3 times a week for 4-8 weeks to be effective on chronic musculo-skeletal disorders.
- The physical therapist can also treat the problem with ultrasound, apply an adhesive bandage to the patella, and recommend a pair of custom-made orthotics.
Step 3. Go to a specialist
You must see a specialist doctor, such as an orthopedist or rheumatologist, to rule out other more serious conditions that cause OSD-like pain - such as stress fractures of the patella or tibia, bone infections, inflammatory arthritis, bone cancer, osteochondritis dissecans or Legg-Calvé-Perthes disease.
- Doctors may use diagnostic tools such as x-rays, bone scans, ultrasonography, MRIs, and computed tomography to determine the source of pain.
- They may also recommend blood tests to rule out rheumatoid arthritis or a bone infection.
Advice
- Do not listen to those who say that the disease will disappear in two years; you are wrong. Many people suffer from this disorder even in adulthood. However, most of the symptoms go away when the child ends the adolescent stage of development - around 14 for girls and 16 for boys.
- Osgood-Schlatter syndrome often occurs during the development phase, when bones, muscles and tendons change and grow rapidly.
- Knee pads can protect already sore shins from further damage.
