Have you or your child been diagnosed with Osgood Schlatter disease or are you just wondering what causes it and the treatment options available.
I will rely on my knowledge as a diagnostic radiographer who has imaged patients with the condition.
And I have also relied and examined what is said in international scientific studies.
Happy reading!😃
Any questions? remarks? Let’s meet in the comments section at the end of this article.🙏Last updated: Feb 2025. Written by Juliet Semakula, a diagnostic radiographer.
Disclaimer: no affiliate links.
Summary: Osgood Schlatter is a long-term pain condition that affects the knee in young children. But with a planned rehabilitation program you can be able to overcome the discomfort it causes.
To be honest, I think it is best to treat Osgood as an injury rather than a disease that needs rehabilitation and strengthening.
▶️What is Osgood-Schlatter disease
This is a condition that affects the knee, around the tibial tuberosity where the patellar tendon inserts.
It’s mainly associated with adolescent growth spur from the ages 8 to 13 in girls and 10 to 15 in boys ( Neuhaus 2021)
The apophysis is the portion of the epiphysis which is attached to a tendon which can be subjected to tensile forces.
Any continuous traction from the quadriceps can lead to a repetitive injury to the growth plate.
Mainly adolescents who come for x-ray for this condition they are regularly involve in high impact sports such as repetitive running, football and gymnastics
▶️How do you know that it is Osgood Schlatter disease and not something else.
I have seen young patients come to x-ray with knee pain thinking it’s Osgood Schlatter disease, yet it turns out to be something else affecting the knee.
Several other possible causes of knee pain can present with features similar to Osgood Schlatter disease.
Your doctor is trained to differentiate between simple knee pain and Osgood disease.
Usually when you go to the doctor a full examination of your knee and the symptoms you are experiencing will be assessed.
If after assessment, you knee is tender over the tibial tuberosity, pain on extension, tightness of the quadriceps and hamstrings muscles, bone enlargement with a normal passive range of movement with no effusion
X-ray is normally not routine but if there is any doubt about the diagnosis particularly to rule out fractures, an x-ray will be requested.
It may be able to show soft tissue swelling, thickening of the patellar tendon or ossicle. or not.
X-ray showing an Illustration of the typical features of Osgood-Schlatter disease in a young child and in an adult (Smith 2023)
Ultrasound and MRI may also be requested for further management and treatment.
Typically pain associated with Osgood Schlatter disease starts in adolescence and you will have the following symptoms.
▶️Symptoms of Osgood-Schlatter disease?
🟠Knee pain: You will feel pain which is localized to the anterior aspect of the proximal tibia over the tibial tuberosity especially during physical activities (Circi,2017)
🟠Pain can be gradual in onset and initially mild but my progress has become severe, it can be in one or both knees tender to touch.
🟠The knee pain can be severe enough to cause limping sometimes accompanied by swelling or no swelling at all.
🟠Stiffness in the knee especially after a period of rest or in the morning upon waking up.
🟠Deformity (bump)around the top of the tibial knee most of the time is well demonstrated
Most people with Osgood Schlatter disease always complain of pain when descending stairs, after prolonged sitting and while trying to kneel.
▶️ Can you remove Osgood Schlatter bump?
When you have Osgood-Schlatter disease sometimes you may develop a hard bump near where it affects the tibial tubercle
Image of the knee showing Osgood Schlatter bump
A teenager with the disease, showing swelling on the anterior tibial tuberosity
I have seen patients wonder if this bump can be completely removed.
The answer to this is between Yes and No
It’s possible to have the bump surgically removed, but most people live with it for the rest of their lives.
That extra bone growth sometimes may be an irritation in the knee.
However usually it is not recommended to be removed by surgery unless it is causing your severe knee pain and more serious knee injury such as ligament tear.
▶️What really causes Osgood-Schlatter disease?
There have been a lot of literature reviews conducted to establish the exact cause and treatment options of Osgood Schlatter disease.
Here is a summary.
Number of scientific publications per year on Osgood disease and indexed in PubMed, the google of medical studies.
Most studies examined do not give a clear view of what really causes Osgood Schlatter disease and the effectiveness of one treatment option versus another type of option.
What is the cause?
It is believed that it could be caused by repetitive microtrauma which causes inflammation and oedema within the tendon.
Some common propositions on the cause of Osgood Schlatter suggests that during the maturation stage, an asynchronous development of bone and muscle soft tissues (the rectum femoris muscle) results in irritation of the tibial tubercle apophysis leading to pain.
Neuhaus et al 2021
▶️What treatment should be implemented?
Treatment is usually symptomatic, and it starts with conservative management.
Treatment of Osgood Schlatter disease is based on two main blades.
1️⃣Relieving pain
2️⃣Try to adapt to the level of physical activities.
Therapeutic approaches, such as:
1️⃣Stretching the calf and thigh muscles:
I have seen patients at my practice having Hamstring and quadriceps stretching and strengthening exercises with the help of physiotherapy.
✅Benefits
🟠When your muscles and tendons are stretched, the loosening will help reduce pressure on the painful area.
❌Disadvantages
🔴However, the exact muscle-stretching techniques as well as the overall bundle of recommended exercises are rarely well-defined according to clinical studies.
🔴Stretching in children can be restrictive leading to worsening inflammation.
2️⃣Combined resting with a structured progressive training plan, plus activity modification.
Normally you will be advised to rest your knee, and this will depend on your symptoms and activity level.
Some young people are advised to take at least 48 hours off running, jumping or sports. And others may require 1 to 2 weeks of light activities.
You can speed a period of rest, with reduced activities levels from 2 to14 days to allow the knee to recover and adapt.
In this phase: knee inflammation and pain will reduce, and initiation of healing will occur.
Then you can gradually increase the duration of activities to promote tissue adaptation.
3️⃣Knee Brace, splint or orthosis
The use of knee orthoses to apply pressure to the patellar has been thought to help reduce the tensile load placed on its insertion point.
🟠Bracing with protective knee pads or a patellar tendon strap to help relieve pain on kneeling.
This is however a theoretical assumption for which there is no real quality empirical evidence that was found.
4️⃣Pain medication
🔴Such as Nonsteroidal anti inflammation and other pain killers have been used to help with pain and inflammation although they do not have a curative effect.
🔴Icing the painful area with an ice pack wrapped in a cloth. In 10-15 minutes up to three times a day, including after exercise.
5️⃣Physiotherapy treatment for example:
🟠Stretching and muscle strengthening
🟠Or pain relief through techniques such as massage or cryotherapy.
Remember physiotherapy sessions and approaches can be different for everyone depending on your needs and level of activities
6️⃣Health food /diet
I have seen some people recommend certain types of food to help improve the symptoms but there is no evidence of a direct effect of diet on the symptoms of Osgood disease apart from general advise on:
♦Having a good sufficient vitamin through fruits and vegetables
♦Drinking water to keep your body well hydrated.
♦Avoid putting on too much weight because it will increase stress on the bones.
♦Good intake of sufficient protein and carbohydrates.
7️⃣Surgical options:
Medical scientific studies agree that surgery is not the most effective treatment for Osgood Schlatter disease.
However, adults with continued symptoms may need surgical treatment if they fail to respond to conservative treatment.
Surgical procedures usually include open, bursoscopic and arthroscopic technique
Arthroscopic techniques seem to be the best choice of treatment of unresolved Osgood–Schlatter lesions (Circi, 2017)
▶️What happens if Osgood goes untreated?
The traditional approach of treating Osgood was thought to be an incurable disease.
Where you simply had to wait for the growth spurt to slow down enough for the pain to settle which could take months or years.
However, in today’s age, it is very important to see a specialist if you think you have Osgood disease. because if left untreated it can lead to more discomfort and limit you from certain activities.
♦Increased knee weakness and imbalance which can lead to other knee injuries.
♦It may limit your athletic potential if you love sports.
♦You may develop a permanent, painless bump below the kneecap.
♦You may live with persistent knee pain especially during activities that put stress on the knee.
▶️How long does the pain or discomfort last: Recovery timeline.
The healing time can vary significantly depending on the approach of treatment you have decided to use.
What does scientific medical studies have to say about the benefits, recovery and pain management of Osgood Schlatter disease.
Here is a summary conservative treatments and outcomes of studies done by different research teams in different countries.
United States: 13 patients between the ages of 17 to 19 with knee pain caused by Osgood disease were treated using tape cross strapping around the knee for a month
Result: And 46.1% improved under treatment, 15.4% were not improved, 15.4% worsened, 23.1% unable to make any follow-up.
In England: 51 patients with knee problems, where 20 patients were treated conservatively by resting, ice packs, plaster cast and steroid injection .And 31 operatively for a period of 6 months follow up, and 2-6 years for the surgical treatment.
Result: 82% were asymptomatic in operated group; 91% in conservative group (Trail, 1988)
France: 30 patients between the age of 9 to 15 with knee problems were treated using a cruro-malleolar immobilisation with resin cast for 4 weeks.
Results: The immobilisation allowed a short time to restart sports and seemed to be correlated with the presence of the ossicle (Duperron 2016)
Germany:14 patients between the age of 13 to 15 with knee problems were treated with radial extracorporeal therapy with a 1 weekly therapy session with a total of 3 to7 therapy sessions. Follow up 5 to 6 years or more later.
Results: 75% reached 100 out of 100 points. Had no side effects and safe and promising treatment for adolescent athletes with Osgood Schlatter disease (Lohrer,2012)
Summary: based on these studies carefully controlled studies on well-described treatment approaches are needed to establish which treatment options are most effective to improve Osgood Schlatter disease.
In most of the studies an integrative view was missing.
▶️What exercises and sports should be avoided with Osgood-Schlatter?
There is no sport or exercises that is formally contraindicated in cases of Osgood-Schlatter condition.
Exercises such as knee isometric holds are effective at loading the quad muscles without moving through uncomfortable ranges of movement.
They effectively help settle down sore knees and strengthening the muscles
Also squatting is a great exercise for Osgood Strength building when performed correctly.
Images showing some of the exercises that can help with muscle strength when you have Osgood disease.
Exercises that you feel bring you a lot of pain when you do them, you should limit or avoid doing them to help ease the pain.
Most sports at risk of increasing pain are all these involving gym, trampoline, jumping, dance and athletics.
The most sports that are less risky are swimming, water polo and cycling.
It will be about you adapting technique and the frequency of training and the intensity of the sessions according to what is bearable, whatever exercise or sports you engage in.
We have come to the end of this article, hope I have answered some of your frequently asked questions, all references below.
Wishing you a quick recovery!🙋 Any questions let’s meet in the comments sections.
📚Source
Circi E, Atalay Y, Beyzadeoglu T. Treatment of Osgood-Schlatter disease: review of the literature. Musculoskelet Surg. 2017 Dec;101(3):195-200. doi: 10.1007/s12306-017-0479-7. Epub 2017 Jun 7. PMID: 28593576.
Neuhaus C, Appenzeller-Herzog C, Faude O. A systematic review on conservative treatment options for OSGOOD-Schlatter disease. Phys Ther Sport. 2021 May;49:178-187. doi: 10.1016/j.ptsp.2021.03.002. Epub 2021 Mar 9. PMID: 33744766.
Gholve, Purushottam A., et al. “Osgood schlatter syndrome.” Current opinion in pediatrics 19.1 (2007): 44-50.
Kridelbaugh, Alvin C. Wyman,Osgood-Schlatter’s disease,The American Journal of Surgery,Volume 75, Issue 4,1948,Pages 553-561,
Trail, I. A. F.R.C.S.. Tibial Sequestrectomy in the Management of Osgood-Schlatter Disease. Journal of Pediatric Orthopaedics 8(5):p 554-557, September 1988.
Duperron,L. A. Haquin, J. Berthiller, F. Chotel, J.-B. Pialat, J.-F. Luciani,Étude d’une cohorte de 30 patients immobilisés avec une résine cruro-malléolaire pour une maladie d’Osgood-Schlatter,Science & Sports,Volume 31, Issue 6,2016,Pages 323-335,ISSN 0765-1597,
Lohrer, H., Nauck, T., Scholl, J., Zwerver, J., & Malliaropoulos, N. (2012). Extracorporeal shock wave therapy for patients suffering from recalcitrant Osgood,Schlatter disease. Sportverletzung – Sportschaden, 26(4), 218e2
Corbi, F.; Matas, S.; Álvarez-Herms, J.; Sitko, S.; Baiget, E.; Reverter-Masia, J.; López-Laval, I. Osgood-Schlatter Disease: Appearance, Diagnosis and Treatment: A Narrative Review. Healthcare 2022, 10, 1011.
Smith JM, Varacallo MA. Osgood-Schlatter Disease. [Updated 2023 Aug 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441995/