Osgood-Schlatter Disease In Adults | A Complete Guide

Adult Man with Osgood Schlatter Disease

Osgood-Schlatter disease in adults is rare. It’s a common cause of knee pain during adolescence. But, about 10% of patients may carry the symptoms into adulthood. (1)

Adult Osgood-Schlatter disease happens when bone fragments don’t fuse. This can cause anterior knee pain during athletic activities, while kneeling, running, or jumping. (2)

There are different ways to treat Osgood-Schlatter disease. But, this depends on your symptoms and how limiting they are. Most cases resolve well on their own, though. (1)

In any case, allow me to take you through the symptoms and treatment options for Osgood-Schlatter in adults. I also talk about the disease in general.

So, let’s start with:

Symptoms of Osgood-Schlatter disease in adults

Osgood-Schlatter disease causes knee pain and swelling. The symptoms are on the tip of the shin bone – the “tibial tubercle.” As you already know, it’s common in children and teens.

As an adult with OSD, you’ll also have knee pain in the tibial tubercle. Every movement that works your thigh muscles may cause pain. The pain can get worse during certain activities, like:

  • Climbing stairs.
  • Running or jumping.
  • Kneeling.
  • Bending your knee.

The affected knee may also have a bony bump below the kneecap. It can be painful and tender to the touch.

Bone fragments can cause Osgood-Schlatter disease in adulthood.

During childhood, the growth plate on the bone is like cartilage. Your body replaces that cartilage with bone, causing growing pains.

For children with Osgood-Schlatter, the pulling from the patellar tendon can remove a piece of bone. This often heals with rest.

But, if you don’t follow the treatment, that bone will remain on the tendon after your growth spurt, causing Osgood-Schlatter as an adult. (2)

The pain may last several years in some people. (1)

How is Osgood-Schlatter treated in adults?

In childhood, the treatment of Osgood-Schlatter disease focuses on rest. This will let the growth spurt pass. The patellar tendon will adapt to the new length of the bones. Which, in turn, will heal the injury.

But, Osgood-Schlatter treatment in adults is dictated by pain levels. This involves several conservative treatments, including the PRICE protocol, medications, and physical therapy. (1)

Let’s talk about each one.

PRICE protocol and medications

PRICE is a protocol that can reduce pain and swelling. It stands for:

  • Protect. Avoid making the injury worse. Wearing a knee brace can help. (3)
  • Rest. This is the main treatment for Osgood-Schlatter, regardless if you’re young or an adult.
  • Ice. Ice packs can reduce pain and swelling in the first days.
  • Compression. A compressive wrap can reduce symptoms as well.
  • Elevation. Raising the knee can reduce inflammation too.

After the diagnosis, your doctor may recommend activity modification. This will promote healing in the area and reduce symptoms. (2)

Anti-inflammatory drugs can also help reduce your symptoms. You’ll be able to return to your sports activity once you feel better. (3)

This might help: Knee braces meant for Osgood-Schlatter

Physical therapy

Physiotherapy for Osgood-Schlatter focuses on strengthening and stretching the lower leg. Working on your hamstring muscles and quadriceps muscles will improve your symptoms. (2, 3)

Your physical therapist will also give you prevention strategies. That way, you’ll be able to avoid future episodes. The main goal is returning to your physical activity safely.

P.S.: If you’re not sure where to find a skilled PT in your area, we can help.

Surgery

In rare cases, some adults with Osgood-Schlatter may need surgery. Your orthopedic surgeon may recommend it if your symptoms don’t get better with physical therapy and medication.

People with constant pain while kneeling are candidates for surgery. This type of pain suggests there may be a bone fragment on the patellar tendon. (2)

The type of surgery will depend on your symptoms. For severe cases, some orthopaedic surgeons may decide to remove (1):

  • The bone fragment on the tendon,
  • The overlying bursa, or
  • The bony prominence.

Surgery is a case-by-case decision. You will also need physical therapy afterward to return to your usual physical activities.

What is Osgood-Schlatter disease?

To fully understand Osgood-Schlatter disease, you need to know a bit about the knee joint.

Your quadriceps muscle has a strong tendon that goes down your kneecap. That tendon is called the “patellar tendon.”

Your patellar tendon attaches to your tibial tuberosity. That’s a medical term for the tip of the shin bone. Another term for the same spot is “tibial tubercle.”

During childhood, your tibial tubercle is a growth plate (where bone growth happens). When you stop growing, that means your growth plate is closed.

Certain jumping sports, including basketball, gymnastics, and figure skating, constantly pull on your patellar tendon. This repeated stress can cause painful inflammation of the tubercle.

This inflammation is Osgood-Schlatter disease.

Osgood-Schlatter disease is also common during growth spurts. This is because bones, tendons, and muscles grow at different rates. Sometimes, the patellar tendon can’t keep up with bones.

The thigh bone grows, but the patella tendon didn’t have time to adapt to the new length. So, it pulls the tibial tubercle, causing Osgood-Schlatter disease.

20% to 30% of adolescents have Osgood-Schlatter disease in both knees. (1) But, the disease often gets better after you stop growing.

Risk factors for developing Osgood-Schlatter disease include:

  • Being a male between the ages of 12-15 years.
  • For girls, ages range between 8-12 years.
  • Having a growth spurt.
  • Playing running or jumping sports.

FAQs:

Does Osgood-Schlatter go away in adults?

In most people, yes. Following the recommendations of your doctor is enough most of the time.

Is Osgood-Schlatter disease permanent?

No. Yet, some adults may have recurrent episodes of Osgood-Schlatter pain. In that case, surgery may be an option. Talk to your doctor about the best treatment options for you.

What can Osgood-Schlatter lead to?

Osgood-Schlatter disease won’t cause permanent damage. But, it can leave a bony prominence on the tibial tubercle. Adults may also have ongoing knee pain if they don’t treat it.

Conclusion: Osgood-Schlatter in adults

Osgood-Schlatter is a common cause of pain in the lower leg in adolescents. It often happens after growth spurts. Children that play sports involving jumping or running have a high risk of having it.

Although rare, an adult can have Osgood-Schlatter disease. A high-risk factor is having the disease as a child and not recovering properly.

Regardless of your age, however, treatment focuses on rest to let the tendon heal. You may need physical therapy to help prevent future episodes as well.

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