Osgood-Schlatter Disease: A Case of Successful Treatment

Osgood-Schlatter Disease: A Case of Successful Treatment in a Young Hockey Player


In October 2022, a woman brought her 11-year-old son to a private clinic , as he constantly complained of leg pain.


The boy complained of warmth in his knees and a dull, aching pain radiating to the upper part of his legs when walking and running. Sometimes, he felt like limping.
The painful syndrome eased slightly at rest, but during active movement, especially during hockey practice, the pain became very intense.
Symptoms were more pronounced in his right leg; when the boy was still, the left leg didn’t hurt, but he felt slight discomfort in the right one even at night.
The woman also mentioned that over the summer, her son had suddenly grown by 4 cm.
Pain worsened with any leg movement, and its intensity depended on the severity of the load.

The first painful sensations appeared in early May, but the child didn’t tell anyone, thinking he just bumped himself during practice. Moreover, the pain subsided by morning. However, it recurred during every practice, and after a while, the boy finally informed his parents. They, in turn, didn’t attach much importance to his words, attributing the symptoms to hockey training.
Meanwhile, the pain continued to worsen, and pain-free periods decreased. As there was no fever, the parents decided to treat the child themselves by applying Viprosal to the leg. Throughout this time, the boy continued training.
In August, during sports vacations, he felt better, but upon returning to training, the situation worsened again. By the time of visiting the clinic, the child hadn’t practiced hockey for 2 weeks due to severe pain.
The boy had been strong and healthy since birth, starting sports at the age of four.
None of the parents or close relatives had experienced a similar problem.

Tenderness and swelling were observed on examination around the tuberosities of the tibia. The knees resisted extension. When the boy lifted each leg alternately, there was no pain. Body temperature remained normal, with slightly elevated knee temperatures. The skin was normal in color, without redness.
During the Ely test, where the child lay on his stomach and the doctor placed one hand on the pelvis and held the ankle joint with the other, the boy felt pain in the muscles of the anterior thigh.
The quadriceps muscle was tense, and the patellar tendons were shortened. A solid bump was present at the site of the tibial tuberosities.

X-rays showed structural changes in the tuberosities, especially on the lateral view. Ultrasound confirmed abnormalities in the tuberosities, soft tissues, and quadriceps tendons.
Complete blood count, C-reactive protein analysis, and rheumatoid factor test ruled out autoimmune and infectious joint diseases.

Osgood-Schlatter disease.


The boy was prescribed massage on both legs and lower back using post-isometric muscle relaxation (PIR) technique, where muscles are alternately relaxed and stretched. To reduce swelling and pain, parents were advised to apply ice to the knees and give the child nonsteroidal anti-inflammatory drugs (NSAIDs).
He also underwent 6 sessions of shock wave therapy, followed by a course of physiotherapy focusing on stretching the thigh muscles and using a foam roller.
Throughout the treatment, the boy was not allowed to train, and he wore special tapes around the tuberosities and patellar ligaments.
After a week of treatment, leg pain significantly decreased and only appeared towards the end of the day. Swelling subsided, and knee movement improved.
After two and a half weeks, the painful syndrome completely disappeared.
After completing the therapy, the parents were instructed on how to adjust the child’s diet and were prescribed vitamin D3 supplements. The child was only allowed moderate physical activity on his legs. At home, he performed a special set of therapeutic exercises and wore a knee brace.
Under parental supervision, the child strictly followed all recommendations. Thanks to this, three months after the start of treatment, he successfully returned to the sports team.

This clinical case demonstrates the importance of listening to children’s complaints. If they feel physical discomfort in the same place and signal it more than once, the child should be promptly examined. Even if everything appears normal, it will reassure you and prevent the development of incipient disease.
Osgood-Schlatter disease often occurs in boys aged 9 to 14 who are actively involved in sports. If detected early, treatment is quick and easy, unlike more advanced forms.