Dr.

Jo
Pedia


Osg
Descr







Caus


Risk




Symp



ohn A. Schle
atric Orthop
good-S
ription
OsgoodSc
the growt
level of th
This disea
osteochon
The tibial
quadricep
quadricep
at the leve
A growth
ends of lo
growth pl
length thu
height by
Compared
growth pl
pulling on
powerful
subsequen
OsgoodSc
maturity,
This cond
Johansson
patella
e
Repetitive
inflammat
The injury
time, repe
factors
Activities
Boys, espe
Rapid ske
Poor phys
ptoms
Swelling, w
A firm bum
Pain with
echter
paedics and
Schlatte
chlatter dise
h plate on th
e knee at the
ase may also
ndrosis or ap
tubercle is th
ps (front thig
ps results pri
el of the knee
plate is an ar
ng bones or
ates in childr
us allowing a
the age of 16
d to the surro
ate serves as
n a growth pl
muscle like t
nt pain
chlatter Dise
the growth p
ition is very
n Syndrome,
e stress or inj
tion and sub
y has a waxin
etitive stress
that involve
ecially those
letal growth
sical conditio
warmth, and
mp under the
activity, esp
d Sports Med
er Dise
ase is an infl
he tibia (shin
e tibial tuber
be referred t
pophysitis of
he bony atta
gh muscle). C
marily in str
e
rea of develo
areas of mus
ren allow the
a child to reac
6 to 19
ounding bon
s a weak poin
ate, especial
the quadricep
ease is usually
plate seals an
similar in pr
which is a tr
jury to the gr
sequent pain
ngandwanin
can cause a
jumping and
between the

oning
d/or tendern
e knee that is
ecially with k
dicine
ease
ammatory in
bone) just b
cle
to as
the tibial tub
chment for t
ontraction o
raightening o
oping tissue n
scle attachme
e bones to ex
ch his or her
e and muscle
nt. Thus repe
ly from a larg
ps, can resul
y a self limite
nd thus can n
resentation a
raction apoph
rowth plate o
n
ng course. Ev
flareup
d/or jogging
e age of 11 an
ess below th
s exquisitely
knee straight
njury of
below the
bercle
the
f the
of the leg
near the
ent. The
xpand in
full
es, the
etitive
ge
t in injury to
ed disease
no longer cau
and treatmen
hysitis of the
of the tibial t
ven after pai

nd 18
he knee
y tender to to
tening or vig
o the growth
upon reachi
use pain
nt to Sinding
e inferior pol
tubercle resu
in has subsid
ouch
gorous activi
Page
plate and
ng skeletal
Larsen
e of the
ults in
ded for some
ty
1
Dr. Jo
Pedia


Diagn




A
a
I
n
b
Y
i
t
t
P
(
r
a
A
t
I
t
k
b
C
b
t
ohn A. Schle
atric Orthop
nosis
Diagnosis
Difficulty
The area o
also exqui
Radiograp
the area
Activities suc
avoided initi
Ice should be
needed to he
be applied to
Your physicia
improve stre
to physical th
treatment
Pain medicat
(like ibuprof
relieve pain a
as directed b
A patellar ba
tubercle and
In rare instan
treatment ha
knee support
before consid
Complication
bump overly
tearing away
echter
paedics and
of OsgoodS
may be pres
of skin overly
isitely tender
phs may be u
Prevent
W
height
W
W
stretchin
M
strength
A
the knee
Treatm
I
activities
medicati
ch as kneelin
ally
e applied for
elp reduce inf
o the area bef
an can provi
ength and flex
herapy or an
tions such as
fen or naprox
and irritation
by your physi
and, which is
the kneecap
nces, surgery
as failed. A tr
t, cast, or spl
dering surge
ns of this con
ying the tibial
y (avulsion) o
d Sports Med
Schlatter dise
ent with a st
ying the tibia
r to touch
used to rule o
tion
Weight loss t
Warm up and
Warming the
ng
Maintaining a

Avoidance of
in the sitting
ment
nitial treatm
s, ice, stretch
ions
ng, jumping, s
1520 minut
flammation a
fore particip
de a set of at
xibility. In so
athletic trai
s nonsteroida
xen) or aceta
n. These med
ician
a brace situa
p, may help re
y is necessary
ial of immob
lint may be tr
ry
ndition includ
l tubercle, re
of the growth
dicine
ease is made
traight leg ra
al tubercle m
out underlyin
o acquire a p
d stretching b
area with a
appropriate f
f open kinetic
g position ag
ment of this in
hing, strength
squatting, sta
tes to the aff
and pain. Sim
ating in activ
t home exerc
ome instance
ner is neede
al antiinflam
aminophen ca
dications sho
ated between
elieve sympt
y if conserva
bilization wit
ried for 6 to
de a persiste
eoccurrence i
h plate from
primarily by
ise, especiall
may be enlarg
ng fractures o
proper body
before partak
hot compres
flexibility, en
c leg extensio
gainst resista
njury consist
hening exerc
air climbing,
fected knee e
milarly, appli
vities or exer
cises to help
es, a referral
d to augmen
mmatories
an be used to
ould be taken
n the tibial
toms
ative
th an elastic
8 weeks
nce of a
in adulthood
the tibia
y physical ex
ly against res
ged and firm.
or other bon
mass index f
king in physi
ss or shower
ndurance, an
ons (such as
ance)
ts of modifica
ises, and pai
and running
every 2 to 3 h
ication of a h
rcises
nt
o
n
d,
Page
xam
sistance
. This area is
ny injuries in
for age and
ical activity.
may improv
nd muscle
extending
ation of
n
g should be
hours as
heat pack can
2

ve
n
H
1. St
ta
2. Pl
st
3. M
yo
4. Sl
5. Le
up
sh
6. Yo
7. Ho
8. Re
Dr. Jo
Pedia


R
D
Thes
with
your

amstring B
tand and pro
able, or other
lace both han
retching.
ake sure tha
ou are stretch
ide your han
ead with you
pright and ba
houlders. Kee
ou should fee
old this posit
epeat exercis
Figure
ohn A. Schle
atric Orthop
RANGE OF
Disease
e are some
until you se
symptoms
Flexible
Each stre
A gentle
Ballet Stret
p the leg you
r stable objec
nds on the ou
at your hips/p
hing.
nds down the
ur chest/brea
ack straight.
ep your toes
el a stretch in
tion for 30 se
se 2 times, 2
Figure 1
3
echter
paedics and
MOTION A
of the initia
ee your phy
are resolve
tissue is mo
etch should
e stretching
ch (fig. 2)
u are stretchi
ct.
utside of the
pelvis are als
e outside of y
ast bone. Kee
Do not hunc
pointing up.
n the back of
econds.
times per da
1
d Sports Med
ND STRETC
al exercises
ysician, phys
ed. Please re
ore tolerant
d be held for
sensation s

ing on a chai
leg you are
so facing the
your leg.
ep your chest
h over at the
f your thigh.
ay.
dicine
CHING EXE
s you may st
sical therap
emember:
t of the stres
r 20 to 30 se
should be fe
Ham
1.

Lie on
show
2.

Place
keepi
3.

Your
possi
the flo
4.

You s
5. Hold
6. Repea
r,
leg
t
e
Pron
1. Lie on
2. Bend
If you
aroun
3. Pull y
stretc
4. Keep
5. Hold
6. Repea
ERCISES O
tart your re
ist, or athle
sses placed
econds.
elt.
mstring Doo
n your back n
wn.
e the leg you a
ing your kne
buttock shou
ble and the o
oor.
should feel a
this position
at exercise 2
ne Quadrice
n your stoma
your knee, g
u are too tigh
nd your ankl
your heel tow
ching sensati
your knees t
this position
at exercise 2
sgoodSchla
habilitation
etic trainer a
on it during
orway Stret
near the edg
are stretchin
e straight.
uld be as clos
other leg sho
stretch in th
n for 30 seco
2 times, 2 tim
eps Stretch
ach as shown
grasping you
ht to do this
e and grasp t
ward your bu
ion in the fro
together.
n for 30 seco
2 times, 2 tim
Page
atter
n program
againor unti
g activities.
tch (fig. 3)
e of a doorw
ng up the wal
se to the wal
ould be kept f
he back of you
nds.
mes per day.
Figure 2
h (fig. 1)
n.
ur toes, foot, o
s, loop a belt
that.
uttock until y
ont of your th
nds.
mes per day.
3
il
way as
ll
ll as
flat on
ur thigh.
2
or ankle.
or towel
you feel a
high.

1.
2.
3.
4.
5.
6.
7.
8.

Dr. Jo
Pedia


Stren
are so
see yo
resolv



Quadrice
Tighten th
much as yo
flat agains
Tighten th
Lift your le
Tighten th
Lower you
muscle in
possible.
Tighten th
Relax.
Repeat exe
Figure 4
F
ohn A. Schle
atric Orthop
ngthening
ome of the in
our physicia
ved. Please r
Strong mu
Do the exe
athletic tr
of repetiti
Only do yo
bending yo
physician,
eps Leg Lift
he muscle in f
ou can, push
t the floor.
his muscle ha
eg/heel 4 to
his muscle ha
ur leg/heel b
front of your
his muscle ha
ercise 3 time
igure 6
echter
paedics and
Exercises f
nitial exercis
n, physical th
remember:
uscles with g
ercises as ini
ainer. Progre
ions and wei
our exercises
our knees wh
physical ther
t (fig. 5)
front of your
ing the back
arder.
6 inches off t
arder again.
ack to the flo
r thigh as tigh
arder again.
es, 2 times pe
d Sports Med
for Excessive
ses you may s
herapist, or a
good enduran
itially prescr
ess slowly w
ght used und
in a painfree
hile bearing w
rapist, or ath
r thigh as
of your knee
the floor.

oor. Keep the
ht as

er day.
dicine
e Lateral Pate
start your re
athletic train
nce tolerate s
ribed by you
with each exer
der their guid
e range of mo
weight cause
hletic trainer.
Q
1. Li
2. P
to
3. T
m
4. H
5. R
If
or
p
Q
1. Li
2. T
(Q
th
kn
3. H
4. R

e
e
ellar Compre
ehabilitation
ner again or u
stress better
r physician, p
rcise, gradua
dance.
otion. If the e
pain, stop th
.
Quadriceps
ie flat or sit w
lace a _____ in
o bend.
ighten the m
much as you c
Hold this posi
Repeat exerci
f okayed by y
r athletic tra
laced aroun
Quadriceps
ie flat or sit w
ighten the m
Quads) as mu
he knee flat a
neecap towa
Hold the musc
Repeat exerci
Figure 5
ession Syndro
program wit
until your sym
.
physical ther
ally increasin
exercises that
em and cons
Short Arcs
with your leg
nch roll unde
muscle in the
can, and lift y
ition for 30 s
ise 2 times, 2
your physici
ainer, a _____
nd your ank
Isometric
with your leg
muscle in the
uch as you ca
against the fl
ards the head
cle tight for 2
ise 10 times,
Page
ome. These
th until you
mptoms are
rapist, or
ng the numbe
t involve
sult your
s (fig. 4)
g straight.
er your knee,
front of your
your heel off
seconds.
2 times per d
ian, physical
_ pound wei
kle for additi
Contractio
g straight
front of your
an, pushing t
oor. This wil
d
2030 second
3 times per
4
er
, allowing it
r knee as
the floor.
day.
l therapist,
ight may be
ional weigh
on (fig. 6)
r thigh
the back of
ll pull the
ds
day.

t.

1.
2.
3.
4.


1.
2.
3.
4.
5.
6.

Dr. Jo
Pedia


S
C

Quadrice
Stand with
should be
approxima
wall. Your
tip of your
Slowly slid
_____ degre
physician,
will instruc
bend based
Hold this p
rest for 30
Repeat exe
Quadrice
Stand with
place equa
Keep your
Slowly ben
both legs,
Do not ben
You may u
balance if
Repeat exe
Figure 8
ohn A. Schle
atric Orthop
trengtheni
ontinued:
eps Wall Sli
h your back a
shoulderwi
ately 18 to 24
kneecaps sh
r shoes or yo
de down the
ee bend in yo
physical ther
ct you how to
d on your sym
position for 3
0 seconds
ercise 3 time
eps Squats
h your feet sh
al weight on b
r kneecaps in
nd both knee
and return to
nd your kne
use the edge o
needed.
ercise 3 time
echter
paedics and
ing Exercis
ide (fig. 7)
against the w
dth apart an
4 inches awa
hould be in lin
ur second to
wall so that t
our knees. (Yo
rapist, or athl
o progress the
mptoms and d
30 seconds. S
es, 3 times pe
(fig. 9)
houlderwidt
both legs.
n line with yo
es, keeping eq
o a standing
es more tha
of a table or
es, 3 times pe
d Sports Med
es for Exces
wall. Your fee
d
ay from the
ne with the
e.
there is a
Your
letic trainer
e amount of
diagnosis.)
Stand up and
er day.
th apart and
our toes.
qual weight
position.
n 90 degree
counter for
er day.
dicine
sive Lateral
t
d
Q
1. St
kn
2. Sl
op
st
3. D
st
4. U
5. R

t on
es.
Patellar Com
Quadriceps
tand on the e
kneecap is in
lowly step do
pposite leg o
tarting positi
Do not go into
tep if necessa
Use your stair
Repeat exerci
mpression Sy
Kneels (fi
edge of a step
line with yo
own and tou
on the stair b
ion.
o a painful ra
ary to avoid
r rails for bal
ise 3 times, 3
Figure
Figu
Page
yndrome,
g. 8)
p/stair. Mak
our second t
uch the heel o
below you. Re
ange. Stop sh
any pain.
lance as need
3 times per d
7
ure 9
5
ke sure your
toe.
of your
eturn to the
ort of the
ded.
day.