The Secret to Curing Osgood Schlatter Disease

We have been quickly and quietly fixing serious and debilitating Osgood Schlatter pain for well over a decade.

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 well over a decade. Time and time again we have defied conventional wisdom, and rapidly helped young athletes return to sport pain-free while still in the middle of a growth spurt. It is one of the meaningful 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. By writing this article I hope we can help more athletes who aren’t able to see us in person.

Update (post-publication):

Since writing this article in 2014 we have been overwhelmed by the sheer volume of requests for information about our Osgood program. It turns out Osgood is as common around the world as it is here in Melbourne, and it is just as poorly managed!

In response, we decided to build a complete online program for all those young athletes suffering from Osgood Schlatters who aren’t able to access our training facility here in Melbourne, Australia!

The program features a seven-week plan that includes everything you need to rapidly beat Osgood Schlatters. We have created detailed written and video instructions on every facet of our approach including our techniques for foam rolling, isometric holds, movement skill training and a bunch more.

Significantly cheaper than weeks of physical therapy, and much less invasive that surgery, this program is an incredible resource with an amaxingly high success rate - most people see immediate pain-relief and are able to continue with at least some sport participation whilst following the program.

To find out more about the 7-week program you can press this link, or continue reading the article and find more information below.

Either way, good luck and thanks for reading.

All the best,
Coach Durham

Osgood Schlatters case study: Sarah

The catalyst for this article is basketball athlete Sarah and her sore knees. Sarah was referred to us eight weeks ago having carried serious Osgood Schlatters pain for 18 months.

Two weeks after starting with us her Osgood was almost completely pain-free.

Now at week eight she is a 0 out of 10 for pain, and moving around the court like the true athlete she is.

Foam rolling for Osgood Schlatters
Rolling on a rock-hard piece of PVC pipe is not for beginners, but it is amazingly effective.

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. Not one!

To me, her previous program was all frosting and no cake. Lots of fiddling around in the margins but nothing striking at the true heart of the problem.

What is Osgood Schlatter Disease?

To understand our solution to Osgood Schlatter Disease (OSD) you first need to understand the problem. Put simply, OSD 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 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).

Osgood Schlatter tight muscles
Here is a shot of the rec fem from the side. As you can see it pulls directly on the Patella (kneecap).
Osgood Schlatters cause of the pain
The tuberosity is actually under the tendon so imagine this arrow pointing through it.

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.

If that isn’t bad enough, it is compounded by the fact that the attachment sights are not fully bonded, as they need to stay like semi-set glue to allow for further growth and skeletal maturation. With tall kids who have no glute muscles, terrible running styles, and a 48-week season on a hard surface it’s not surprising to see plenty of Osgood cases, particularly in soccer, basketball, tennis, and netball.

So that’s it: Bones growing too fast for tight muscles resulting in still-developing attachment points getting angry.

How can you treat Osgood Schlatters rapidly?

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 by stretching the quad you are actually pulling on the sore bit. Not cool. Especially if you are sore and flared up. This vicious cycle is what trips up most people.

This is where rolling for self myofascial release comes in handy. The beauty of 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.

Foam rolling the quads for Osgood Schlatter disease
It is very important to do this slowly and release off all the trigger points. Throughout the program we provide detailed video instructions on all the exercises for beating Osgood Schlatters - This image is licensed under a Creative Commons Attribution 4.0 International License.

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 rec fem 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
Best Stretches for Osgood Schlatter disease
WARNING: THIS IS A LATE-STAGE ADVANCED STRETCH. Not be done in the early stages of Osgood rehabilitation. Always to this super gently

As you can see from the pic, 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.

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 but 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 switched off, leaving the tendons and attachment sites to take the brunt of the force.  

For our purposes, 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.

The wonder of isometrics

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.)

Osgood schlatter disease strengthening exercises
Sarah's sister helping her into position for the knee isometric holds.

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.

Exercises for Osgood Schlatters
Isometric knee holds using gym equipment - This image is licensed under a Creative Commons Attribution 4.0 International License.

So there you have it.

The first step to training your way out of Osgood Schlatter Disease. Foam roll to loosen the quads, the magic of isometrics to ease the pain and start strengthening your way out of the problem.

The rest of the program involves re-patterning exercises to change athletes from a knee dominant movement pattern to a glute dominant pattern along with strategies to reduce ground reaction forces, and create a deload needed for young tendons to adapt. 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.

All of these components are included in our seven week online Osgood Treatment program. You will receive training logs, bonus articles, instructional videos and our ongoing support to help you or your child rapidly beat Osgood Schlatters and return to sport pain-free. You can purchase the program by clicking the link below.

Osgood Schlatters treatment program

Get the Osgood Schlatters treatment program

A comprehensive seven week training plan to treat the cause of growing pain in the knees. Includes helpful resources,  professional support, and access to a supportive Facebook community.

$59.95 USD

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