Osgood-Schlatter Disease

Osgood-Schlatter disease is an overuse injury, medically known as a traction apophysitis.

It is a disease seen commonly in adolescent boys and is more common in athletes as compared to non-athletes.

The increased activity combined with rapid growth during the adolescent period predisposes athletes to develop this condition.  High intensity sport activity causes repetitive tensile stress over the tendon-tibial tuberosity and results in minor avulsions with an underlying inflammatory reaction.

Clinical presentation

Most commonly seen between 11-year and 13-year-old girls and between 12-year to 15-year old boys.

They generally present with pain over the tibial tubercle just below the knee. The pain is bilateral in only 20%-30% of patients. The pain is usually aggravated by sports involving jumping, squatting, kneeling and is relieved by a period of rest.


Treatment is conservative.

  • Activity modification
  • Rest, Ice
  • Short course of NSAIDs are usually used to reduce pain and inflammation
  • Massage
  • Stretching

Self limiting and will resolve when full skeletal maturity has been achieved.

Overuse injuries of the knee in young athletes

Knee pain is a common concern for which young athletes present to general practitioners, sports physicians and orthopedic surgeons.

Acute macro trauma to the knee, especially in contact or collision occurs less frequently and management is often in consultation with an orthopedic surgeon.

Overuse injuries affecting the knee account for the vast majority of adolescent related knee pain.

Causes of overuse injuries in the young athlete

The underlying pathophysiology of these injuries are related to repetitive and excessive strain on the musculoskeletal structures. This is often associated with a sudden increase in the intensity, duration and volume of physical activity, poor sport specific conditioning, insufficient sport-specific training, poor training techniques and inappropriate equipment for the sport.

Knee pain can either originate intrinsically from within the knee (see below) or referred from hip conditions and spine conditions.

Common causes of knee pain

  • Idiopathic anterior knee pain
  • Osgood Schlatter’s disease
  • Sinding-Larsen Johansson syndrome
  • Bipartite or multi-partite patella
  • Plica Syndrome
  • Iliotibial band (ITB) friction syndrome
  • Quadricep tendonitis
  • Popliteus tendonitis