My knees, their story

Osgood-Schlatters disease


This short story (if I can call it that) is the reason why I became a Chiropractor in the first place. At the age of 14 in the midst of a promising young football career, I developed a disease called Osgood Schlatters in both legs. This disease is due to the repetitive pull of the quadriceps on the knee cap and therefore the patellar tendon that attaches to the lower leg. This repetitive pull along with the softer adolescent bone leads to very subtle avulsion (pulling away) of the periosteum (outer bone layer) by the ligament itself. This condition does not last for ever, though it can last months, years and, rarely, it can recur. At the time of onset it stopped me from playing Football (Soccer) for 6 months. I was playing football 6 days a week for 3 different teams with out any manual therapy to maintain my muscles and joints, so in retrospect it was not surprising that my body failed eventually.

What Happened?

Initially I was diagnosed as having Osgood Schlatters in my right leg which lasted around 3 months, however on returning to playing football again I had it in my left leg and was out for another 3 months. At the time I was playing for the youth academy of my local professional Football team Bristol Rovers and also had hopes to go professional as I was progressing well. When the team’s head Physiotherapist assessed me I was told that I had Osgood Schlatters, told I had tight Hamstrings, to stop playing football for 3 months and was recommended a specialised strap for my knee as well as being told I had an ‘abnormal gait’. Your ‘gait’, is basically the style in which we walk, and everyone has one, however my parents were not academics and I was told that I had a ‘gait leg’, amusingly this led me to believe that I walked as if I was hurdling a gait on one side… as you can imagine for a 14 year old this was very confusing indeed.

I am now in my late 20s and have decided to write this post to help younger aspiring athletes to find a solution to their problem. I am now a Chiropractor, with extra qualifications and experience in treating sports injuries and can now treat this condition effectively.

What is it like to have?

Imagine running, and every time your foot hits the floor it feeling like someone has hit a bruise that you have at the top of your shin lightly with their knuckles. This would occur over and over again as you run, then kicking a ball would feel like someone has hit you a bit harder. Its not a sharp pain, just a very intense dull ache that following each session of running can last for 30 minutes or so after. It is draining as you cannot perform at your max and it makes you feel weak.

Why does it occur?

Osgood Schlatters occurs due to a combination of 1) Playing too much sport, 2) The type of sport that is played, 3) The compensations the body makes and 4) Nutritional intake. Now I do not have any studies or written evidence to back up what I am about to tell you, all I have is my knowledge from books, the blogs I follow and my experience.

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Not all causes of Osgood Schlatters will be the same, the only true way to get the cause examined is an in depth assessment by a sports specific manual therapist that is recommended and has experience in treating athletes. You have to find the initial cause of the problem, the obvious cause is the Quadriceps pulling too tightly on the point of insertion at the tibial tuberosity (the point that enlarges). So a simple recommendation is to stretch all four of the Quadriceps, this can be achieved in lots of ways, just look at youtube! I would recommend using a foam roller on the quads as well as the stretching routines you can find generally. Once the heels can reach the buttocks on both sides you can start working on strengthening the Quads to make sure minor strains and the build up of tightness does not recur.

How can you stop it coming back?

Now as mentioned above, it is an injury that usually goes away with time. However the bit that will stop it coming back and speed up your receovery is by having a full bio-mechanical check over of the muscles of the pelvic region, along with the lower limb muscles joints and feet (this means checking muscle tightness, compensatory muscle imbalances and correcting muscles that are not firing correctly). This is hard to do at home and a specialist (a good Chiropractor, Osteo or Physio) can tell you which areas to work on to improve this area.

Now, here are my recommendations:
i) Stop all sporting activity other than swimming (non-weight bearing and maintains fitness), also mentally prepare yourself for a slow recovery. It is a fracture after all.
ii) Use an ice pack on the region 10-15 minutes 2-3 times a day initially (2 weeks) and after each time it feels sore. Consider Ibuprofen gel/tablets to aid this as required.
ii) Foam roller on the quads and after a week of this begin using general Quad stretches, make sure your pelvis does not tilt forwards with these stretches as this is cheating and decreases the benefit of the stretch.
iv) Once you heel can reach your buttock on each side, progress on to gentle wall squats increasing the angle of squat each time till you reach 90 degrees without pain.
v) At this point try gentle jogging on soft grass progressing in intensity over a week, then try on concrete for a week, then make the intensity more sport specific by changing direction as you run. All the time you are returning to sport make sure you are stretching and icing the knee region. If pain is felt again at the knee, stop immediately, Ice the region and take 2 steps back, then build back up again. Pushing through the pain will not gain you anything but more pain with this problem.
vi) Have a specialist check over to see if there is anything else you can do at home to improve function of the pelvis.
vii) Increase Vitamin D, Vitamin K and Calcium intake as this ensures good bone density and will aid in the healing of the region of bony avulsion.
viii) Read my post called What should I be eating?, you do not have to change everything in your diet, though I would highly recommend trying some of it as decreasing your level of Pro-inflammatory fatty acids and increasing your anti-inflammatory fatty acids will increase your general healing rate as an athlete exponentially. Remember, ‘you are what you eat’ and the general UK diet is high in grains which is not normal for the human body, crops are only a very recent development!

ix) E-mail me, I am always happy to help others with Osgood Schlatters, teams or individuals, it is a very common problem which affected me personally and my Football career. No team wants a Footballer that can’t play for months on end and I hate hearing of others, and their potential careers, suffering unnecessarily.

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