The Return of Osgood Schlatter Knee Pain

I recently recieved a great question on Osgood Schlatters disease of the knee, a common topic for questions on MikeRyanFitness, that I wanted to share.

The Question:

Hello my name is Carla and I’ve had osgood schlatter since I was 13. Now that I’m 21 years old and I want to ask you a few questions. I have never had any problem with the knee lumps for years but now that I’m doing squats and weightlifting at the gym, my knees have become very sore. Can osgood schlatters persist as I get older and can have problems with it again? And can the lumps get bigger when your older because it looks like they have grown? Thank you Mike!

My Answer:

Hi Carla, Thanks for your email. You ask a great question that I get asked about often. 

Yes, the Osgood-Schlatter’s (OS) bumps can get bigger but it is typically not the bone that is enlarging like it did as a growing teenager. Your growth plates are closed now and the bone landscape remains as is. The soft tissue (tendon, bursa, fascia, muscle and ligaments) in that area can become inflamed and enlarged. I’m sure you’ve bumped or bruised the tibial tubercles (TT) where the patella tendons insert into your shin bones in years past and know how painful they can become.

Because of your OS Hx and knee pain, the angles of your patella tendons have changed. This makes the mechanics of your patella/quads/knees different and you need to account for that in all your activities. That’s not a real bad thing but you need to figure out:

  1. What makes my knees feel better?
  2. What makes my knees feel worse?

What you need to do is to change/stop the squatting and any weight lifting that is hurting your TT’s. Most athletes, young and old, with OS benefit from a conservative leg strengthening program with a majority of the work for the quads (muscle on the front of the thigh) being done with the knee not bending past 90 degrees. The reason for this is when the quads are loaded and bent past 90 degrees, two important factors take place:

  • The compressive forces on the back of the kneecap become extremely high.
  • The force angle at the tibial tubercle becomes very steep.

Both of these factors will not make your OS knee happy, therefore, need to be avoided. With that being said, I strongly suggest you avoid the following exercises:

  • Lunges
  • Deep squats
  • Box step ups
  • Deep leg press
  • Leg extensions while bending the knee past 90 degrees
  • Any strengthening exercises that create knee pain

With this in mind, restructure your leg program, add the leg roller and flexibility before and after your workouts and make ice on your knees a part of post-workout routine.

These two articles from www.mikeryansportsmedicine.com will help:

http://www.mikeryansportsmedicine.com/?s=osgood

Smile, Carla, because your sore knees will be happy again soon and your fitness plan is back on track!

With Healthy Regards,

Mike Ryan

Author: Mike Ryan

After 26 seasons as a full-time certified athletic trainer and registered physical therapist in the National Football League, Mike Ryan has outstanding first-hand experience. His unique professional and athletic background has sharpened his skills in the arts of sports injury management, elite rehabilitation, performance enhancement and injury prevention. Mike is now taking his experience to mainstream America. His mission is simple: Sports Medicine advice that is easy to use and brings fast results. Learn more about Mike Ryan

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