What Causes Osgood-Schlatter Disease? | A Complete Guide (Causes, Symptoms, and Treatment)

tibial tubercle, causes Osgood-Schlatter

In children, the main cause of Osgood-Schlatter disease is playing jumping or running sports. During childhood, these repetitive motions can irritate the tibial tubercle. (1)

In adulthood, the main cause of Osgood-Schlatter is bone fragments. This can happen if you don’t treat the disease properly in childhood. The fragments can also cause flare-ups while playing sports. (2)

The treatment for both groups is similar. Most of the time it gets better with home care and rest. But severe cases in adults may need surgery.

Here’s what you’ll find below:

  • Main causes of Osgood-Schlatter disease in children and adults.
  • Symptoms of the disease.
  • Evidence-based treatments.

Let’s start with the basics:

What is the cause of Osgood-Schlatter’s disease?

Osgood-Schlatter disease is an inflammation of the tibial tubercle. It often happens after repetitive movement.

To better understand that, here’s a short anatomy lesson:

Your quadriceps muscles have a tendon called the patellar tendon. It covers your kneecap and attaches to your tibial tubercle (which is right at the top of your shinbone).

Now, your quadriceps muscles pull on your shinbone through your patellar tendon. Thus, straightening your leg.

Repeating this movement over and over again sometimes irritates those structures. Which, ultimately, leads to Osgood-Schlatter’s disease. But, there are a few differences in how it happens, depending on your age.

Causes of Osgood-Schlatter disease in children and adolescents

Osgood-Schlatter disease is a common cause of knee pain in adolescents. This is because of bone growth.

You see, the tibial tubercle starts off as a growth plate during childhood. Growth plates start off as cartilage. But, as children mature to become adults, these plates harden and become bone.

This is why children who take part in sports that involve running and jumping are more prone to OSD. These activities put a lot of stress on the delicate cartilage. And, eventually, lead to inflammation of the tibial tubercle (i.e. Osgood-Schlatter disease). (1)

In severe cases, the traction can even detach a fragment of the tibial tuberosity.

Also, Osgood-Schlatter disease usually happens at the same time as growth spurts.

Sometimes during a growth spurt, the muscles and tendons can’t keep up with the bone. This increases the stress on the tibial tubercle. In turn, it may trigger or worsen Osgood-Schlatter disease.

This disease often happens in one knee. But, 20-30% of the cases may have OSD in both knees. Children at risk of Osgood-Schlatter disease include (1, 2):

  • Active girls between the ages of 8 to 13 years.
  • Active boys between the ages of 10 to 15 years.
  • Those who play jumping and/or running sports. Like basketball or volleyball.

Depending on the symptoms, the child’s doctor may suggest home care. Severe symptoms may need anti-inflammatories, wearing knee braces, or doing physical therapy.

What causes Osgood-Schlatter disease in adults?

The main cause of OSD in young active adults is not seeking treatment during childhood. Or, not doing the treatment as recommended.

During childhood, our bodies can heal the tibial tuberosity and the tendon. But, once the growth plate closes, any remaining bone fragment on the tendon will stay there. These bone fragments can cause knee pain while (2):

  • Running.
  • Jumping.
  • Kneeling.
  • Climbing stairs.

What are the symptoms of Osgood-Schlatter disease?

This is an inflammatory disease. So, it causes pain and swelling on the tibial tuberosity. Osgood-Schlatter can look like a painful bump on the tibial tubercle.

At first, the site will only be painful only during physical activity. But, over time, the pain will be present whether you’re playing sports or not. It can even hurt to do certain knee movements, like bending the joint.

Rest can stop your tendon from pulling on your tuberosity. Which, in turn, relieves symptoms and promotes recovery.

Treatment for Osgood-Schlatter disease knee pain

Treatment focuses on managing the symptoms and preventing future episodes. The treatment options are similar for children and adults with flare-ups. These include:

PRICE protocol

The PRICE protocol can reduce pain and swelling. It stands for:

  • Protection. Avoid making the injury worse. Wearing a knee brace for Osgood-Schlatter can help with this.
  • Rest. This is key for recovery. Resting will promote healing on the tuberosity.
  • Ice. Apply ice for 10 minutes, 2-3 times per day. This will reduce swelling without compromising the tissues.
  • Compression. This can “squeeze” the extra liquid out of the area. It can also keep pain under control.
  • Elevation. Raising the knee above your heart will reduce swelling as well.

Anti-inflammatory medication

NSAIDs like ibuprofen can reduce swelling and knee pain. Your doctor may recommend something stronger if necessary.

If symptoms don’t improve with oral drugs, your doctor may suggest injecting a local anesthetic. This can help some people, but results aren’t guaranteed. (3)

Physical therapy

Stretching and strengthening your lower leg can improve symptoms. And, a physical therapist can find the best exercises for you so you don’t make the injury worse.

A therapist can also give you strategies to prevent flare-ups.

For example, you may need to improve your technique to reduce strain on your tendon. Or, you can off-load the pressure on the tuberosity with a well-designed routine.

Our team knows how PTs can make your recovery easier. Better yet, we can help connect you with a qualified physical therapist in your area!

Surgery

The recovery may be slow, but most people will improve with the treatments above. Surgery isn’t an option for children. Most cases resolve when the growth plates close. But, in rare cases, adults may need surgery. (3)

For example, surgery can help adults with OSD and knee pain while kneeling. This type of pain suggests the patellar tendon may have bone fragments. (2)

Also, surgery can help if you’re not feeling better with rest, medication, and therapy. In that case, your surgeon will need x-rays to see the affected structures. You’ll also need physiotherapy after surgery.

FAQs:

What can Osgood-Schlatter lead to?

If left untreated in childhood, it can lead to flare-ups in adulthood. This disease doesn’t cause any long-term complications.

What causes Osgood-Schlatter’s to flare up?

Repetitive running or jumping motions on the knee. Like playing basketball, volleyball, or soccer.

Is Osgood-Schlatter disease genetic?

No. But, it can look like Osgood-Schlatter “runs” in the family. If a family enjoys playing sports, the children may be prone to Osgood-Schlatter disease. This isn’t due to genetics, but because of the environment children are growing in.

Conclusion: Causes of Osgood-Schlatter disease

Osgood-Schlatter disease in children happens due to playing sports. The traction from the tendon irritates the tibial tuberosity.

In adults, the main cause is not treating OSD properly in childhood. This can leave bone fragments that cause flare-ups in the future.

The good news is that most cases resolve with home care. The PRICE protocol and rest will do the trick. Some medications can also reduce symptoms. And, although rare, severe cases of adult OSD may need surgery.

If you have flare-ups often, please seek medical advice. Your doctor or physical therapist can give you strategies to prevent them!

Resources

  1. Smith J M, Varacallo M. “Osgood-Schlatter Disease.” [Updated 2021 Jul 30]. StatPearls. Retrieved on August, 2021 from: https://www.ncbi.nlm.nih.gov/books/NBK441995/
  2. Vaishya, Raju et al. “Apophysitis of the Tibial Tuberosity (Osgood-Schlatter Disease): A Review.” Cureus vol. 8,9 e780. 13 Sep. 2016, doi: 10.7759/cureus.780
  3. Neuhaus, Cornelia et al. “A systematic review on conservative treatment options for OSGOOD-Schlatter disease.” Physical therapy in sport: official journal of the Association of Chartered Physiotherapists in Sports Medicine vol. 49 (2021): 178-187. doi: 10.1016/j.ptsp.2021.03.002