osgood schlatter disease physical therapy

Osgood Schlatter Disease Physical Therapy at Home – Fitoont

The goal of osgood schlatter disease physical therapy exercises is for the athlete to return to his or her sport as quickly and safely as possible. But firstly let’s know what is osgood schlatter disease?

Osgood-Schlatter disease is an osteochondrosis. This means that there is a non-infectious inflammation in the area just below the tibial cartilage process. The knee joint is associated with ossification, bone tissue disappears and falls off. The disease mainly affects boys between 10 and 15 years of age.

In physical therapy, the main goal of osgood schlatter disease physical therapy is to choose exercises that protect the affected knee joint, relieve tension, and relax the bones by strengthening the target muscles. There is a selection of exercises to train the patient to take the load off the knee. After surgery the focus is on restorative exercises to restore strength and flexibility.

Cause/Symptom

It occurs when the quadriceps femoris becomes overstretched, and when the knee is repeatedly stretched. The quadriceps femoris pulls the tibial tuberosity through the patellar tendon attachment, resulting in detachment. The main symptoms are swelling of the tibial tuberosity (bone under the plate), tenderness, and pain on movement.

Jumper’s knee is a similar type of sports injury that causes knee pain during growth. Jumper’s knee causes pain in the patellar tendon (○ in the right figure), while Osgood-Schlatter disease causes pain in the tibial tuberosity

How is Osgood-Schlatter disease treated?

Patients with Osgood-Schlatter need to limit activities that cause pain, making it difficult for them to perform activities. For example, for a patient who has a little pain while running, it is OK to continue running. But if running causes severe pain with lameness, the adult should stop running and rest. When the pain subsides (usually after a day or two), the adult can try the activity again.

Telehealth providers (Fitoont Team) sometimes recommend physical therapy to keep the leg muscles strong and flexible while the adult is improving. This doesn’t happen often, but some adults may need a complete break from all exercise and physical activity.

To help adults feel more comfortable during recovery:

  • Place a knee cold pack or bag on your knee for 15 minutes every 1 to 2 hours at a time.
  • Place a thin towel between the ice and your child’s skin to protect them from the cold.
  • If your healthcare provider says it’s OK, you can give ibuprofen (Advil, Motrin, or a store brand) or acetaminophen (Tylenol or a store brand). Follow the directions that come with your medication for how much and how often.

Can adults with Osgood-Schlatter disease play sports?

Yes, adults with OSD can engage in normal activities, including sports, as long as:

  • The pain is not severe enough to interfere with activity.
  • Pain improved after one day of rest.

For adults who play sports, it can help:

  • Wear absorbent insoles in athletic shoes and splints.
  • Before exercising, place a heating pad or hot towel on your knees for 15 minutes.
  • Ice your knees for 15 minutes after your workout (use a towel between the ice and your skin).
  • Wear knee bandages, especially when wrestling, basketball, and volleyball.
  • Do stretching exercises before and after exercise.

Looking to the future

The long-term effects of OSD are usually not serious. Some adults may have a painless lump below the knee that does not go away. In rare cases, a doctor will perform surgery to remove a painful lump below the knee.

Some adults with osgood schlatter disease in childhood or adolescence experience pain when kneeling. If your child still has knee pain after bone growth has stopped, see a doctor. Doctors can check for other causes of knee pain.

Osgood Schlatter Disease Physical Therapy

The goal of osgood schlatter disease physical therapy exercises is for the athlete to return to his or her sport as quickly and safely as possible. Since the main treatments are rest, ice and NSAIDs, the role of physical therapy is limited if used. Pain may take 6-24 months to resolve. A condition in which an individual may worsen if he or she returns to an activity prematurely. Athletes need to improve the flexibility and strength of their Quadriceps and hamstring muscles throughout their rehabilitation to ensure they are ready to return to sports.

1- Acute phase

A physical therapist may recommend several techniques to reduce discomfort and avoid recurrence of the disease. Treatment recommendations depend on the severity of the condition:

  • Construction straps may be recommended during physical activity, but have no proven efficacy.
  • When pain occurs, rest is recommended.
  • Ice should be applied to the area for 20 minutes after the activity.
  • Short-term rest and knee immobilization may be required.

In rare cases, the authors modeled a patient who had severe pain and did not comply with conservative care. This usually happens to parents who want pain relief. Although braces can be recommended, it is questionable whether they will be used in disobedient patients.

2- Recovery phase

Straight leg raises exercise can be done as follows:

  • Lie on the floor with your back supported by your elbows for a few inches.
  • Bend the unaffected knee to a comfortable position using adjustable ankle weights with half-pound increments.
  • Determine a weight that can perform 15 lifts on the affected leg
  • Tighten the quad muscle, lift the affected leg 15 inches, straighten the leg.
  • hold for 5 seconds
  • Slowly lower the legs to relax
  • Start with 10 repetitions on each leg
  • After 15 easy repetitions, add another half pound, then reduce to 10 reps
  • Repeat 15 times, adding weight again if you can, max 7-12 lbs

The short-arc quad exercises are as follows:

  • Bend with unaffected knee (same as straight leg raise)
  • Place some rolled up towels under the affected knee and lift 6 inches from the floor
  • Tighten the quad muscle and straighten the leg until it is 15 inches from the floor
  • hold for 5 seconds
  • Slowly lower the legs to relax
  • Start with 10 reps for each leg and work your way up to 15 using the same ankle weight and rep progression, straight up

Wall loading exercise can be done as follows:

  • Do a wall slide or quarter seat, about 12 inches from a smooth wall
  • Space the backrest about shoulder-width apart
  • Hold a light dumbbell in each hand, arms straight down, bend knees
    Then slowly lower body 4-6 inches
  • If you feel pain, you are squatting too far
  • Hold for 5 seconds, then rise quickly
  • Start with 10 repetitions, then increase to 15, gradually increasing the weight of the dumbbells in the same motion as the straight leg raise

A good rule of thumb for patients with any type of patellar pain is to relatively limit knee flexion to no more than 90°.

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Osgood Schlatter Disease Physical Therapy at Home

The choice and intensity of exercise performed by Osgood Schlatter depends on the stage of the disease. In most cases, the goal is to relieve the muscle where it connects to the tibial plateau. Exercises that stretch the quadriceps femoris muscles, the large thigh extensors, are ideal for this purpose. On the other hand, strengthening the opponent is also important.

1) Stretching Exercise.
  • The patient to grasp the ankle place his foot on the affected side with one hand.
  • He bends his legs and pulls his feet toward his hips as much as possible.
  • He pushes his groin forward as much as he can and tightens his hips.
  • This stretches your hips and bends your knees.
  • The quadriceps are stretched.
  • This position can be held for up to 30 seconds and performed 3-4 times in a row.
  • You should feel a pull in the front thigh and groin. 

2) Another stretching exercise

The exercise while lying down is a good alternative exercise to stretch the frontline thigh muscles stretched in a lateral position.

  • The patient lies on the healthy side with the stretched side on top.
  • As in standing, the patient will grab his surrounding ankles and pull the heels toward the hips.
  • The advantage of the lateral position is that the patient has better control of the hip position because the balance eliminates the problem in the lateral position and the possible shortening of the other side is no longer a problem.
  • Except for the starting position, the execution of the exercise is the same.

3) Strengthening exercise from the supine position (bridge)

This osgood schlatter disease physical therapy exercise that strengthens the hamstrings, the quadriceps. Strengthening hip extensions and knee flexors can correct overload (thickened) tibia from muscular imbalances or poor hip posture caused by:

  • The patient is lying supine.
  • The legs are at a 90-degree angle.
  • The arms are slightly spread out to the side of the body.
  • Now, the patient raises the hips from this position until they form a straight line with the thighs and torso.
  • Tension should form from the hips and back of the thighs.
  • You may feel a stretch in the knee area. Later, exercises can also increase tension in one leg.
  • Exercises are always done in sets of 3-4 of 12 repetitions. 

4) Self-stretching Fascial Rolls

  • This home exercise can be performed with the help of Fascial Rolls.
  • The front of the thigh can be “rolled away” in a prone or semi-prone position as it stretches the front of the thigh and stimulates blood circulation.
  • This can be a little painful, but will lessen the discomfort in the long run.
  • Like the stretch, the movement here is performed slowly.
  • After about 30 seconds, you should take a break.

5) Strengthen the glutes

  • Lie on your side.
  • The lower leg is slightly bent.
  • You can release your arms if you wish.
  • Now, lift the other leg back and lower it again.
  • Do 3 sets of 15 repetitions, then switch sides.

6) Strengthen the trunk muscles with the quadruped position.

  • Now, keep your left leg straight and your right arm straight.
  • Make sure your pelvis is not tilted.
  • Hold this position for 2 seconds, then switch sides.

7) Bend your knees to strengthen your muscles to stand upright.

  • With your legs about shoulder-width apart.
  • Now slowly descend to the bend of your knees.
  • Then sure your back is straight and your knees don’t go over your toes.
  • Perform 15 squats like this.

In addition to these routine exercises, exercises that are easy on the joints , such as swimming or cycling, are also great for returning muscles to full load.

Prevention of recurrence

  • Before exercising, do a sufficient warm-up and stretch after ensuring the flexibility of the muscles of the whole body.
  • Slowly stretch your quadriceps for about 30 seconds without too much recoil.
  • Do the same stretching after exercise to prevent muscle fatigue from accumulating, and use icing to avoid inflammation.
  • It is also useful to massage the muscles while bathing at home and to stretch when the condition is good after bathing.
  • Continue even after symptoms improve.

References

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