When you first learn that tight muscles (particularly the quadriceps) contribute to Osgood Schlatters, it sounds logical to start stretching it out. Unfortunately treating Osgood Schlatters isn’t that easy, and aggressive stretching can make it worse. This is one reason why many doctors and physical therapists advise that the only treatment of Osgood is total rest or even surgery. (Thankfully we think in most cases they are wrong!)
While stretching can feel great, in the case of Osgood Schlatters treatment you have to use the right stretches, at the right time, in the right way.
Osgood is largely caused by tight quad muscles and fast-growing bones. But directly stretching the quadriceps can actually have a negative impact on the knees, pulling on the sensitive tendon attachment site at the anthesis. We explain details of the attachment site and much more in our article about what causes Osgood Schlatters.
So what can we do?! We want to gently increase the length of muscles pulling on the knees, but we need to avoid irritating the tendon by pulling on it directly or putting direct pressure on the sore part with kneeling stretches. There are several strategies that can help you use the correct stretches at the right time.
Tight muscles are often weak muscles
There is a myth that strength exercises make muscles tighter. In fact, the exact opposite is actually true!
When we strengthen our muscles we actually increase our mobility at the connected joints. Our bodies are incredibly intuitive, if the brain senses that you do not have enough strength through a joint (say the knee) it will restrict movement and mobility in that joint. One of the ways it does this is by restricting the muscle’s available length, preventing us from going into risky ranges of motion. This stiffness or tightness is actually a protective mechanism.
Doing strengthening exercises is therefore a critical aspect of resolving Osgood Schlatters. By strengthening the muscles around the knee we can help create the length and mobility required to play sport. The correct exercises will also help improve the tendon elasticity and strength too! You can check out our article about the best strength exercises for Osgood Schlatters for more information.
Stretching is a part of the solution, but you cannot just stretch your way out of Osgood Schlatters. You must treat the cause of the tightness which is often largely a lack of strength around the knee in specific positions.
Foam rolling before stretching for Osgood Schlatters
One tool we have in our arsenal for creating length in the quad is gentle foam rolling. Instead of rushing to pull your quad as tight as possible to feel a strong stretch (and making your tendon more sore), it is really helpful to roll the quad diligently to create some length and help begin the healing process.
Because foam rolling works by applying pressure to the muscle and doesn’t directly pull on the knee we have found it to be an instrumental component of pain elimination in our program for treating Osgood Schlatters.
After some length has been created by foam rolling it becomes possible to introduce some very gentle and strategic stretching.
Helpful stretches for Osgood Schlatters
We use several great stretches in our treatment plan for Osgood, but it is absolutely essential they are only used at the correct time and in combination with other tools like foam rolling and strengthening.
The adductor is a muscle in the upper leg which contributes to mobility issues, but because the adductor doesn’t directly attach at the site that causes Osgood we start using this stretch early on in our treatment plan to gain additional knee and hip mobility.
Kneeling Hip Flexor Stretch
Tight hip flexors not only pull on the tendons of the knee directly but also contribute to poor movement patterns and even reduce your speed and jumping ability. Early in a treatment plan it is possible to start using a gently hip flexor stretch to start improving load bearing. It is absolutely critical to use a soft knee pad when performing this stretch because any pressure at the site of pain can make Osgood Schlatters worse.
Lying Glute Stretch
The glutes tend to react poorly to the altered running and walking patterns (limping) seen when Osgood is present by getting a little tight. Later on in a treatment program it makes sense to ensure the glutes are strong and flexible. The lying glute stretch is easy on the body (it’s done lying down!) and can feel really good too.
Kneeling Rec Fem Stretch
An advanced but critical stretch for Osgood Schlatters treatment, there is significant risk in using this stretch too early in a treatment and making any symptoms worse. Again, it is important to use a knee pad for this stretch.
Standing Calf Stretch
Calves don’t get a lot of attention in Osgood Schlatters treatments, but later in the process you will be learning new movement patterns and often athletes find they start to have more “spring” in their gait. This is a lot to do with the calf, so it is good practice to introduce some calf stretching to keep them nice and happy!
⚠️ Remember, it is very important not to rush into stretching. Doing aggressive stretching, or using these stretches too early in your rehabilitation program can definitely make Osgood Schlatters worse.
Putting these stretches into a plan
Gentle and methodical is the name of the game when stretching for Osgood Schlatters.
After working with hundreds of athletes in our gym, and thousands more online through our seven-week program we have arrived at a sequence and combination of foam rolling, stretching, strengthening and movement skill that is incredibly effective at rapidly and drastically reducing knee pain in those struggling with Osgood Schlatter Disease. These stretches are introduced gradually throughout the program based on the progression in your pain and function levels.
You can start the training plan and follow the exact prescription in our seven week treatment plan for Osgood Schlatters.