What causes Osgood Schlatters?

Osgood Schlatters is more than just growing pains

To understand what causes Osgood Schlatter Disease (OSD) you first need to understand what it is.

Put simply, Osgood Schlatters occurs when the bones of the thigh are growing too fast for the quad muscles to keep up.

With every step the athlete takes the quad muscles are pulling at that attachment causing pain and discomfort.

The muscle highlighted in the image below is the rectus femoris (part of the quad muscle group). Notice how the lower tendon (in yellow) runs from the quad muscle and across the patella into its attachment site at the top of the shin bone (the tibial tuberosity). Where a tendon connects to bone is called the enthesis.

Diagram of quadriceps and rectus femoris.
The rectus femoris, one of the longest muscles in the body and a key factor in Osgood pain

Osgood Schlatters is it a disease or an injury?

While rapidly growing bones are one of the key factors driving Osgood Schlatters in kids, it’s not the only thing.

Osgood Schlatters is as much a disease caused by rapidly growing bones as it is an overuse injury of the tendon/enthesis in active children who are not strong, mobile, or skilled enough to handle the amount of activity they do. In this sense Osgood Schlatters and Patella Tendonopathy (Jumpers knee) are quite similar, and can both be rehabilitated with the right exercises.

We take lessons from knee tendon rehabilitation experts across the world, who all agree on one crucial point: Tendons love consistency.

We can invert this statement as it applies to Osgood to say: Osgood Schlatters hates randomness.

Key factors that can cause or aggravate Osgood Schlatters

It is often the case that a promising young athlete who is rapidly moving up in their sport encounters many of these common circumstances that are associate with Osgood Schlatters:

  • Training frequency changes
  • Intensity increases in running and jumping
  • Changing sports or introducing a new sport
  • Harder or softer training surfaces
  • Shorter rest periods (less time on the bench or sidelines)
  • Fewer days off between training and games
  • Variation to warm up and cool down methods

Of course many of the above points are inter-related; taking up a new sport or moving up to a higher team will almost always involve several of these changes!

It’s typical for Osgood to first start like this. Not surprisingly we see the biggest surge in new Osgood clients in our gym in the first month back to school from summer break.

We also occasionally see young athletes all but cure their Osgood Schlatters, only to dive straight back into a full training schedule. After many weeks of reduced training during the treatment their Osgood pain returns simply due to the spike in training load.

Osgood Schlatter Disease hates poorly planned training load

In sports science there is a concept which encapsulates the above: Load Management. It is also known as the Acute to Chronic Workload Ratio.

Correctly managing load is a balancing act between how much training you have done over the past four weeks (chronic workload) and your current or new activity levels (acute workload).

Keeping these in balance is a big part of our job as Strength and Conditioning Coaches. It is also something we are super passionate about at Core Advantage.

A graph of common training load mistakes
A typical training load mistake that can lead to injury a few weeks later.

What you may notice in the diagram above is that the original mistake is the reduction in training load, which is then compounded by the error of increasing training load again too quickly.

This balancing act of acute and chronic training loads is also why we don’t recommend taking weeks or months of rest with Osgood Schlatters. It makes it so much harder to successfully return to full training in the future.

Instead we recommend a period of relative rest (with a small % drop in training and activity), followed by a smooth, gradual return to full sport load.

This can be easier said than done, especially for energetic teenagers and children!

Throughout The Secret to Curing Osgood Schlatters seven week training program we guide you on how to get this balancing act right with exercises, warm up methods, and recovery instructions to get you back to sport pain-free as quickly as possible, we also provide the methods and tools to create consistency in your training week for strong, pain free knees.

Osgood Schlatters treatment program

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

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