Developmental stage and lower quadriceps flexibilities and decreased gastrocnemius flexibilities are predictive risk factors for developing Osgood–Schlatter disease in adolescent male soccer players

Abstract

Purpose This study aimed to elucidate the influential predictive risk factors of Osgood–Schlatter disease (OSD) on the support (non-kicking) leg among adolescent soccer players considering peak height velocity (PHV) age and investigate the cut-off values of the predictive variables. Methods A cohort of 302 Japanese adolescent male soccer players aged 12–13 years were followed over 6 months. All players underwent physical examination, tibial tubercle ultrasonography, anthropometric and whole-body composition measurements, and muscle flexibility test of the support leg at the baseline. The developmental stage was evaluated from the PHV age. The OSD of the support leg was diagnosed 6 months later; players were divided into the OSD and control (CON) groups. The predictive risk factors were analyzed by multivariate logistic regression analysis. Results There were 42 players who had developed OSD at baseline and they were excluded from the study. Among the 209 players, 43 and 166 belonged to the OSD and CON groups, respectively. The predictive risk factors of OSD development were PHV age ± 6 months at baseline (p = 0.046), apophyseal stage of tibial tuberosity maturity at baseline (p < 0.001), quadriceps flexibility ≥ 35° at baseline (p = 0.017), and decrease in gastrocnemius flexibility in 6 months (p = 0.009). Conclusion PHV age ± 6 months at baseline, apophyseal stage of the tibial tuberosity at baseline, quadriceps flexibility ≥ 35° at baseline, and decrease in gastrocnemius flexibility in 6 months are predictive risk factors of OSD development in the support leg among adolescent male soccer players. It is crucial to know the PHV age of each player, and not only the flexibility of quadriceps muscle but also the gastrocnemius should be monitored to predict OSD. Level of evidence II.

The Incidence of Osgood-Schlatter Injuries in Young Athletes and Non-Athletes - A Systematic Review

“…OSD is most common during adolescents' growth spurts when their bones are growing rapidly, making the tibial tubercle particularly vulnerable (Zumwalt, 2023). Although the cut-off value for quadriceps femoris flexibility during OSD onset has not been studied enough, it is a commonly reported risk factor in OSD development (Takei et al, 2023). To the best of the authors' knowledge, the first study on this topic by Orava and Virtanen (1982) revealed that OSD occurs most frequently in track and field sports and football.…”