Orthopedics Pediatric Orthopedics Exercise Program for Osgood-Schlatter Disease By Brett Sears, PT Brett Sears, PT Facebook LinkedIn Twitter Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy. Learn about our editorial process Updated on January 16, 2022 Medically reviewed by Mohamad Hassan, PT Medically reviewed by Mohamad Hassan, PT LinkedIn Mohamad Hassan, PT, DPT, diagnoses neuromuscular and orthopedic conditions, including sprains, strains, and post-operation fractures and tears. Learn about our Medical Expert Board Print If your child has knee pain, it may be from a condition called Osgood-Schlatter disease. This is characterized by swelling in the area below the kneecap and above the shinbone. Your child may benefit from a course of physical therapy to help improve flexibility, strength, and balance. Physical therapy (PT) can reduce stress and strain on the knees, helping your child get back to normal activity levels. Exercise should be the main component of a PT program for Osgood-Schlatter disease. The exercise prescription from your physical therapist should be personalized to your child's specific needs after an initial evaluation. This article outlines what types of exercises might be prescribed for Osgood-Schlatter disease. It discusses how these exercises can improve flexibility, strength, and balance and take pressure off the swollen area. If your child has Osgood-Schlatter disease, you must check in with your pediatrician before starting this or any other exercise program. 1 Quadriceps Stretching Verywell / Ben Goldstein Research indicates that a reduced ability to bend your knee, likely due to tight quadriceps, may be one cause of Osgood-Schlatter disease. Stretching the quads, the muscles in front of your thighs, can help take pressure off structures in the knee. This includes the area of the patellar tendon, which connects the kneecap and shinbone, and the tibial tubercle, a bony bump at the end of the shinbone. An easy exercise for children to do is the towel quad stretch. To perform the stretch, lie on your stomach, and bend your knee up as far as possible. Loop a towel around your ankle, and grasp the towel to gently pull your knee up further. You should feel a stretch in the front of your thigh. Hold the stretch for 15 seconds, and then release slowly. Repeat three times. Recap By stretching your quads, you can take pressure off the parts of your knee where you feel pain. You can do this stretch either standing or laying on your stomach while using a towel around your ankle. 2 Hamstring Stretches Verywell / Ben Goldstein The hamstring muscles are located along the back of your thighs from your hip to just behind your knees. Tightness here may create excessive tension in the knee when your child is straightening it. Stretching your hamstrings can be an important part of your Osgood-Schlatter exercise plan. Performing the towel hamstring stretch or a standing hamstring stretch are simple ways to improve the flexibility of these muscles. Hold each stretch for 15 seconds and repeat three times for each stretch. Recap Stretching the hamstrings in the back of your thighs may help with knee tension. You can either stretch your hamstrings while standing or while sitting on the floor using a towel around your foot. 3 Calf Stretches Verywell / Ben Goldstein Tightness in your calf muscles may change the way your knee moves when walking and running. This may place increased stress through your patellar tendon in the knee, leading to Osgood-Schlatter disease. Working on calf stretches can help improve the flexibility of your lower legs, leading to a decrease in knee pain while running. Be sure to hold your stretches for about 15 seconds and repeat each one three times. Stretches should be done slowly and gently and should be stopped if pain is felt. Recap Stretching the calf may help improve knee pain caused by walking and running. When stretching, stop if you feel any pain. 4 Strengthening Exercises Verywell / Ben Goldstein Osgood-Schlatter disease is mainly thought to be a problem that comes with rapid growth in a child. A lack of muscle flexibility is considered the main cause of the knee pain that comes with the diagnosis. Does that mean that strengthening should be ignored? Not at all. Keeping your leg muscles strong can help keep stress and strain to a minimum at the painful areas in the front of your knees. Your physical therapist will work with you on which exercises you should do. These may include: Knee exercises Hip strengthening Ankle strengthening Most people benefit from doing 10 to 15 repetitions of each exercise a few times a week. Recap While lack of flexibility is a cause of Osgood-Schlatter disease, strengthening leg muscles can also help ease knee pain. 5 Balance and Coordination fizkes / Getty Images Some with Osgood-Schlatter disease may exhibit problems with balance or proprioception, which is awareness of the position of your body. This may place excessive strain on the knees, especially during high-level sports and activities. Keeping balance in tip-top shape may help lessen the pain that your child feels in his or her knees. Balance exercises may include: The single-leg stance, in which you stand on one foot The T-stance, where you stand on foot and lean forward with your leg extended behind you and arms outstretched The BAPS board, an irregularly shaped disc that's unsteady when you stand on it Proprioception exercises require situations where you feel off-balance, so safety is important at all times. Check with your physical therapist to find the best way to accomplish this task. Recap Your physical therapist may suggest exercises to improve your balance. Check with them on how to stay safe and avoid falling when doing these exercises. Summary If your child has Osgood-Schlatter disease, physical therapy may help relieve symptoms. It can also help improve balance, strength, and flexibility. A physical therapist will help your child develop an individualized exercise plan. Some of the exercises may include stretching the quadriceps, hamstrings, and calf muscles. They may also include exercises to strengthen leg muscles and work on balance. The therapist will work with your child to make sure these exercises are done in a correct, safe manner. A Word From Verywell If your child has knee pain, check in with your pediatrician to get an accurate diagnosis and start on the right treatment. Physical therapy can and should be a part of treatment for Osgood-Schlatter disease. Your therapist can teach exercises like the ones in this program. These can relieve stress and strain on the knees and help your child get back to normal activities quickly and safely. 6 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Cairns G, Owen T, Kluzek S, et al. Therapeutic interventions in children and adolescents with patellar tendon related pain: a systematic review. BMJ Open Sport Exerc Med. 2018;4(1):e000383. doi:10.1136/bmjsem-2018-000383 Tzalach, A, etal. The correlation between knee flexion lower range of motion and Osgood-Schlatter's syndrome among adolescent soccer players. BJMMR. 2016;11(2):1-10. doi:10.9734/BJMMR/2016/20753 Czaprowski D, Leszczewska J, Kolwicz A, et al. The comparison of the effects of three physiotherapy techniques on hamstring flexibility in children: a prospective, randomized, single-blind study. PLoS One. 2013;8(8):e72026. doi:10.1371/journal.pone.0072026 Nakase J, Goshima K, Numata H, Oshima T, Takata Y, Tsuchiya H. Precise risk factors for Osgood-Schlatter disease. Arch Orthop Trauma Surg. 2015;135(9):1277-81. doi:10.1007/s00402-015-2270-2 Siddiq MAB. Osgood-Schlatter disease unveiled under high-frequency ultrasonogram. Cureus. 2018;10(10):e3411. doi:10.7759/cureus.3411 Kaya DO, Toprak U, Baltaci G, Yosmaoglu B, Ozer H. Long-term functional and sonographic outcomes in Osgood-Schlatter disease. Knee Surg Sports Traumatol Arthrosc. 2013;21(5):1131-9. doi:10.1007/s00167-012-2116-1 By Brett Sears, PT Brett Sears, PT, MDT, is a physical therapist with over 20 years of experience in orthopedic and hospital-based therapy. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit