Knee pain from Osgood-Schlatter Disease affects 1 in 10 adolescent athletes.  The hallmark sign is pain and swelling just below the knee cap where the patellar tendon attaches to the lower leg.  Knee-loading activities like running and jumping aggravate symptoms.

Traditionally, young athletes are told to avoid playing sports until their pain is resolved.  In these cases, athletes would not return to sports for several years.  New research shows modifying activity and strengthening exercises resolve pain and return athletes back to sports much faster.

A Proven Approach: Activity Modification and Knee Strengthening for Osgood-Schlatter Disease

In 2020, researchers from Europe followed 51 young athletes (10 to 14 years old) with Osgood-Schlatter Disease.  Over 12 weeks, physical therapists helped athletes manage their activities to minimize knee loading and pain.  Athletes also performed a progressive knee-strengthening exercise program before gradually returning to sports.

After 12 weeks, 80% had a successful outcome. This increased to 90% at 12 months.  At 12 weeks, 16% returned to playing sports.  And by 12 months, nearly 70% had returned to playing sports.  From this research, it is clear that a progressive treatment approach is superior to waiting for several years for the pain to go away.

Activity Modification to Reduce Load on the Knee

Too much load on the knee leads to painful Osgood-Schlatter Disease. Typically, these problems start during periods of growth. This is because the loads experienced by the knee during sports and physical activity also increase due to growth.  Rapidly growing bones place more load on slower-growing soft tissues.

Loading can be from too much running, too many jumps, or other activities where the knee is strained. Normally, knee pain will disappear after a short break from sports.  However, sometimes knee pain continues for a long time like several months or even years.

Physical therapists develop an individualized activity modification plan for each athlete.  This period usually lasts about 1 month.  Complete rest is avoided. During this time, key exercises are prescribed to maintain strength, flexibility, and general fitness.

How to Safely Increase Load on the Knee

After the first 4 weeks of reducing activities that aggravate knee pain, it is important to start back slowly. To guide a safe return to sport, an activity ladder is used.  Athletes only proceed to the next step on the ladder when they no longer have knee pain during, or the next morning after the activity.  Knee pain should not exceed a 2 on the 0 to 10 scale.

A sudden worsening of knee pain mandates moving 1 step down.  Activity steps can only be started once certain exercise steps are completed.  Important exercises include squat and lunge progressions.   Then skipping and jumping exercises are incorporated along with a progressive return-to-running program.  This process may take 3 months for some athletes.  Many require 6 to 12 months to slowly ramp up their activities and return to sports.

The Importance of Playing Multiple Sports

Compared to athletes who play multiple sports, those specializing in a single sport are 4 times more likely to develop Osgood-Schlatter Disease.  Repetitive loading through participation and training in a single sport leads to overuse injury and poor motor skill acquisition.

Playing multiple sports reduces repetitive loads and provides a more diversified movement experience for developing athletes. Intense training in a single sport to the exclusion of others should be delayed until late adolescence (15 to 18 years old).  Delaying specialization will optimize sports success, minimize the risk of injury, and reduce psychological stress.

See Your Physical Therapist for Help with Osgood-Schlatter Disease

Left untreated, over 1/3 of youth athletes with Osgood-Schlatter Disease continue to have pain 2 years later.  And 1 in 5 of these athletes will quit playing sports altogether.  Long-term exercise and physical activity habits are formed during adolescence.  Thus, avoiding activity and quitting sports will have profound long-term health effects.

Athletes with Osgood-Schlatter Disease should work closely with their physical therapist.  Together, they develop and follow an individualized plan to safely return to play.

Contact our office to schedule an initial evaluation with a physical therapist.  The doctors of physical therapy at BSR have been helping people in Southern Ocean County feel better and get back to sports since 2007.