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 back to sport from Osgood Schlatters.
We discovered most people were still being told the cure was to stop playing sport for months or years! (It isn't)
So to help folks who aren't in Australia, we launched OsgoodSchlatters.net, and created a complete online program that anyone can do from home.
The seven-week plan includes everything you need to rapidly beat Osgood Schlatters. There are detailed written and video instructions on every facet of our approach. These include our techniques for foam rolling, isometric holds, movement skill training and a bunch more.
I am thrilled that we have had an amazingly high success rate over the years, and are able to deliver it for such a low cost; much less than a series of therapist appointments, and so much less than invasive surgery.
Check out the Osgood treatment program page linked below to learn more, or continue reading the article to learn about our approach and how you can apply these methods to rapidly and safely relieve your Osgood Schlatter pain. The same methods we have been using to successfully treat Osgood Schlatters for over a decade.
Start fixing your Osgood now
Today I’m going to reveal how to cure Osgood Schlatter Disease in a matter of weeks
We have been quickly and quietly fixing this serious and painful problem for years. Our approach defies conventional wisdom, 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.
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 back to 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 is Osgood Schlatter Disease?
To understand our solution to Osgood Schlatter Disease we first need to understand the 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 literally tearing 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.
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 soccer, basketball, tennis, and netball.
How to treat Osgood Schlatters rapidly
Now that we understand that Osgood Schlatters Disease is basically bones growing too fast for tight muscles resulting in still-developing attachment points getting angry, how do we go about treating it?
If we could wave a magic want we would stop the growth spurt temporarily. Of course the standard advice is to stop playing sport and wait it out. Not good.
But if we start treating Osgood Schlatters Disease like a tendon injury instead of a bone disease, we suddenly discover it can be cured in just a few weeks!
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 many stretching exercises and Osgood don't mix - especially in the acute phase when your knees are still super sore. Because with stretches the quad is actually pulling on the sore part of the knee. Not cool. Especially if you are sore and flared up. This vicious cycle is what trips up most people.
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 knee is less angry, you should be able to start stretching gently. The stretch below is my favourite, as it locks down the rectus femoris from both ends giving it nowhere to hide. 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
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 millimetre or two of length to dramatically reduce the traction on the tuberosity and get the knee out of the angry phase. This stretch is vastly superior to the standing quad stretch which is never done properly, and the sitting hurdle one which I just flat out hate! So do it, but gently.
NOTE: This stretch is a late stage exercise in the Core Advantage Osgood Treatment Program, do not attempt with knees that are still sore.
Step two: Create strength in the quad
I like to think of athletic qualities like vitamins. Some we have too much of, some we have too little, and some are up for debate.
In these terms, strength deficiencies rank a very close second to flexibility problems in teenage athletes. Often remain hidden as it is sometimes hard to see weakness, especially in strong-looking bodies.
Part of this weakness often stems from muscles becoming reflexively inhibited in the presence of pain. Although these kinds of reflexes are handy at preventing us from lifting loads so heavy we snap our tendons off, they are very problematic for athletes with knee injuries, as they generally mean that the muscle that should be soaking up the kinetic energy of movements are leaving the tendons and attachment sites to take the brunt of the force.
For the purpose of recovering from Osgood Schlatters Disease, these are bad reflexes. The great news is we can activate these muscles almost instantly and start to get the quads to do their job from day one by using isometric holds.
Isometric holds (or ‘Iso holds’) are incredibly effective for tendons and tendon-related problems. I have seen them take someone from 7/10 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. (We get our range work from squats.)
Iso holds at close to end-range extension do a couple of things for us.
First, they wake up the quads. Sarah was so weak that when she started she couldn’t even hold the lightest weight 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 and become stronger.
Putting together your Osgood Treatment Program
So there you have it. These are the first steps we take with all our athletes to get them cured of Osgood Schlatter Disease. Fundamentally its very simple!
Of course a full treatment extends on these steps to make sure the athlete is set up to avoid having Osgood come back. We will work on re-patterning exercises to change them from a knee dominant movement pattern to a glute dominant pattern, plus implement strategies to reduce ground reaction forces, and create a deload needed for young tendons to adapt. Normally the last piece of the puzzle is movement skill retraining where we teach athletes to run, jump and cut efficiently to reduce the load going to the knees and make faster pain-free athletes.
Athletes who go through our process not only recover from Osgood Schlatters, but also end up even better than ever before, accelerating their sports performance. Most importantly we keep them playing sport instead of stopping for however long their growth spurt goes on, a disaster for too many young athletes today.
UPDATE:
Our rehabilitation approach is now available in our fully online at-home seven week treatment program for Osgood Schlatters.
The program includes training logs, detailed instructional videos and week-by-week template, plus ongoing email support to help you rapidly beat Osgood Schlatters and return to sport pain-free.
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