How Core Advantage Fixes Osgood Schlatter Knee Pain (in Weeks)
Today I’m going to reveal how to cure Osgood Schlatter Disease in a matter of weeks
We have been quickly and quietly fixing Osgood Schlatter Disease, a serious and painful problem around the world, for years. Our approach defies the conventional wisdom of “just rest it out”, consistently helping young athletes return to sport pain-free while still in the middle of a growth spurt. It is one of the most meaningful and rewarding rehabilitations we do at Core Advantage.
We think this is a really big deal, but until recently we didn’t realise HOW big a deal. More and more promising young athlete’s dreams are being shattered because the standard treatment and advice just aren’t working.
UPDATE:
I originally wrote this article way back in 2014. After publishing on the Core Advantage website, we were overwhelmed by requests from parents all over the world hoping to help get their teenager or child back to sport and out of pain from Osgood Schlatters.
We discovered most people were still being told that the cure was complete rest and to stop playing sport for months or even years! (It isn't). So to help these young athletes who aren't able to get to our gym here in Melbourne, Australia, we created a complete online program and launched this website; osgoodschlatters.net.
The seven-week Osgood plan includes everything you need to rapidly beat Osgood Schlatters. There are detailed written and video instructions on every facet of our approach, including our techniques for foam rolling, isometric holds, age-appropriate strengthening, movement skill training and a lot more. I am so proud of our amazingly high success rate over the years, with thousands of cases of Osgood successfully treated both in our gym and online via this program.
Get access to the entire program for a single upfront payment, more affordable than a series of therapist appointments, and much less time or financial cost than invasive and risky Osgood surgery.
Check out the program linked below to learn more, or continue reading the article to learn about how we developed our approach and how you can apply these methods to rapidly and safely relieve your Osgood Schlatter pain in weeks — the same methods we have been using to successfully treat Osgood Schlatters for over a decade.
Start fixing your Osgood now
Osgood Schlatters Treatment Case Study: Sarah
The catalyst for writing this article is our basketball athlete Sarah and her incredibly sore knees.
Sarah was referred to us eight weeks ago having carried serious Osgood Schlatters pain for months.
Two weeks after starting with us she was almost completely pain-free! We just hit week eight and she is scoring a 0 out of 10 for pain, and is back moving around the basketball court like the true athlete she is.
Sarah is a 12 year old kid of normal height hobbled by severe pain in her knees. Despite having excellent genetics and a strong athletic frame she did not move well. In fact when I saw her on court, I thought she looked more like an over-60s player than an under-14s!
Throughout her prolonged injury, Sarah had been under the caring and focused treatment of a diligent and excellent health practitioner. They were kind enough to send me a 2-page letter detailing all the adjustments, mobilisations, activations and rehab activities prescribed to Sarah in an effort to alleviate her pain, all to no avail.
After training her and getting immediate improvement in Sarah’s pain levels, I went back to the practitioners letter. I was struck by the fact that despite being a textbook application of the traditional modalities for treating Osgood Schlatter Disease, the treatment list didn’t include ANY of our top treatments here at Core Advantage. Not one!
To me, her previous program was all frosting and no cake.
There was a lot of time and effort spent fiddling around in the margins to try to help with her pain, but nothing striking at the true heart of the problem.
I think this is because the normal medical understanding of Osgood Schlatters is that it cannot be cured until the growth phase stops. As a result, even the most helpful doctors and therapists tend to give pain management treatment, or recommend stopping sport altogether.
But luckily Melbourne Australia is a hub of sports-science research, and I was able to discuss potential solutions with some of the brightest minds in the field.
What causes Osgood Schlatter Disease?
To understand our solution to Osgood Schlatter Disease we first need to understand what Osgood Schlatter Disease is and what causes it, and why it is a problem.
Put simply, Osgood Schlatter Disease occurs when the thigh bone (femur) grows too fast for the longest quad muscle (rectus femoris) to keep up. This means with every step the athlete takes the muscle is pulling aggressively at its attachment site below the knee cap (the tibial tuberosity).
Below is an isolated picture of the femur and rectus femoris, and a closer view of the knee. The shiny thing in the middle is the prepatellar bursa which sits in front of the kneecap itself (the patellar). You can see the tendon runs from the quad and down to its attachment site at the top of the shin bone (tibia).
Looking at this it is pretty easy to understand that a tight quad that can’t keep up with a rapidly growing femur is going to cause drama at the tibial tuberosity. It’s as though the bones are trying to tear the tendon off its attachment site at the top of the shin.
The issues are compounded by the fact that in teenagers the attachment site at the tibial tuberosity are not fully bonded, and stay like semi-set glue to allow for further growth (this is known as the growth plates).
But for tall kids who have super weak glute muscles, terrible running styles, (and a 48-week season on a hard court surfaces) it’s not surprising we see plenty of Osgood cases, particularly in sports like soccer, basketball, tennis, dance, gymnastics, and netball.
How to Effectively Treat Osgood Schlatters Disease
Understanding Osgood Schlatters Disease (OSD) as a growth-related injury – where rapidly growing bones outpace muscle adaptation, causing stress at the tibial tuberosity – completely changes our treatment approach. This understanding of Osgood as an injury instead of as a disease is crucial because it leads us to a solution that actually works, rather than just waiting and hoping for the best.
Why Traditional Rest-Only Treatment Fails for Osgood
The standard medical advice of "complete rest until it goes away" creates three major problems:
- Athletes miss crucial development time in their sport
- Muscles become even tighter due to inactivity
- The underlying issue isn't addressed, leading to high chances of recurrence
If the tight muscles are already struggling to keep up with bone growth, complete rest does not help them adapt to the stress of sport, it just temporarily takes away the pain trigger. In the long term it often makes the condition worse by creating even more weakness and lost fitness.The Game-Changing Treatment ApproachWhen we start treating Osgood Schlatters like a stress response injury rather than a bone disease – everything changes. By addressing the actual mechanical issues at play, we can help young athletes return to sport in weeks rather than months or years.Osgood Schlatters Disease like an injury instead of a bone disease This shift in perspective is revolutionary because it means:
- We can actively treat the condition rather than passively waiting
- Athletes can often continue participating in their sport (with proper management)
- Treatment focuses on solving the root cause, not just managing symptoms
The key is implementing a structured program that helps muscles adapt to rapid bone growth while managing load appropriately. This active approach has helped thousands of young athletes return to their sports faster and stronger than traditional rest-only methods.Here is how we start this structured approach.
Step one: Create length in the quad
The first and most important thing to do is to create some length in the quad to accommodate the rapid bone growth and take some pressure off the attachment site. That’s the obvious bit.
Unfortunately, stretching with Osgood Schlatter Disease is not always the best starting place - especially in the early phases of the rehab when your knees are still painful and sensitive. Because stretches that lengthen the quad also pull on the sore part of the knee. Not cool. Especially if you are sore and flared up. This vicious cycle of pain - not stretching - more tightness trips up a lot of people and causes a lot of frustration.
This is where foam rolling for self-myofascial release comes in super handy. The beauty of foam rolling for Osgood is that it allows us to lengthen the quad and help it catch up to the femur without pulling at the sore bit.
Once the rolling starts working and the muscles in the thighs are starting to loosen and the knees are responding to the strengthening (more on tha below), you can then start stretching gently.
The kneeling quad stretch shown below is my favourite for Osgood, as it locks down the rectus femoris from both ends giving it nowhere to hide.
This stretch is vastly superior to the standing quad stretch which is never done properly, and the sitting hurdler stretch which I just flat out hate!
While effective, it is a pretty strong stretch so:
- Be gentle and start slow
- Make sure to engage your core and maintain a neutral spine and a “tucked under pelvis”
- Always rest the knee on something super soft
NOTE: This quad stretch is an intense, late-stage exercise in the Core Advantage Online Osgood Program, do not attempt with knees that are still sore. This is an advanced stretch designed for the later stages of your Osgood rehabilitation (it’s added in the online program in week 7).
This blog goes in depth on stretching for Osgood Schlatter Disease →
As you can see from the picture, Sarah’s quad flexibility is still a work in progress. The cool thing is you only need to create a tiny amount of length to dramatically reduce the traction on the tuberosity and give the tendon and bones the space needed to drastically reduce knee pain and get out of the angry early phases of Osgood.
Step two: Create strength in the quad
I like to think of athletic qualities like vitamins. Some we tend to overdone on and have too much of, some we have too little, and some might depend on your own unique profile and training style.
In these terms, strength is the vitamin deficiency that ranks a very close second to flexibility as a missing athletic quality in children and teenage athletes. This strength deficiency often remains hidden as it doesn’t always get exposed and is harder to measure directly, especially in strong-looking and rapidly growing bodies.
Part of this strength deficiency in athletes struggling with Osgood stems from muscles becoming reflexively inhibited in the presence of pain.
Although inhibition reflexes like this are handy safety precautions in normal healthy bodies, they are problematic for rapidly growing athletes with knee injuries like Osgood, the muscles like the quads that should be soaking up the kinetic energy of movements are instead inhibited, weak, and leaving the tendons, bones and attachment sites to take more of the brunt of the force than they are built to handle.
For the purpose of recovering from Osgood Schlatter Disease, this inhibited-muscles-with-knee-pain reflex is a bad reflex. The great news is we can fight back against this reflex and activate and strengthen these muscles to get the quads back online doing their job by using isometric holds.
Isometric holds (or ‘Iso holds’) are an incredibly effective, safe and age-appropriate strength exercise for tendons and tendon-related problems like Osgood Shlatter Disease. I have seen isos take someone with Osgood from a 7/10 in knee soreness to 0/10 in less than 5 minutes. At Core Advantage we have found that near end-range holds are so beneficial that we just start and finish with the leg in this position as pictured below. (Exercises through range are also valuable for. We get this work in later in the Osgood program with squats)
Iso holds at close to end-range do a couple of great things for helping with Osgood Schlatters
First, they fight back against the inhibition seen in our quads. Sarah was so weak that when she started she couldn’t even hold the lightest weight the machine offered for 5 seconds. I’ve trained elderly people who were considerably stronger!
The second thing iso holds do is take advantage of an amazing phenomenon called mechano-transduction. Mechano-transduction takes advantage of isometric loads to change the physical properties of the tendon helping it heal faster and become stronger.
Putting Together Your Osgood Treatment Program
So there you have it. These are just some of the steps we take with all our athletes to get them cured of Osgood Schlatter Disease rapidly and back to playing sport pain-free.
Our full online Osgood training program extends on these steps providing athletes with a progressive and detailed plan to make sure they not only beat their current knee pain and get back to sport but also set up the athlete with the strength, flexibility, skills and knowledge to avoid having Osgood never come back again in the future.
The program is an integrated approach to helps young athletes get back to sport in a matter of weeks, with just a few minutes of training per day.
- Movement Pattern Correction: Converting knee-dominant movements into glute-dominant patterns to reduce stress on the patellar tendon
- Impact Management: Implementing proven strategies to minimize ground reaction forces during athletic movements
- Strategic Deloading: Creating the perfect balance of activity and rest to allow young tendons to properly adapt
- Athletic Skills Retraining: Teaching athletes how to run, jump, and change direction efficiently, reducing knee stress while improving performance
The program includes training logs, detailed instructional videos, an online support group with access to our coaches, and a progressive week-by-week plan tailored for young athletes struggling with Osgood Schlatter Disease.
Most importantly, our program keeps them active and playing sport throughout the process instead of taking months or rest for however long their growth spurt goes on, a disaster for too many young athletes today.
The full rehabilitation program is available online in our at-home seven-week training program for Osgood Schlatters.
Learn more about the program here →
