Physiotherapeutic intervention

In physiotherapy/physical gymnastics, the diagnosis is supported by manual tests and pain tests for movement, stress and pressure. The doctor makes the diagnosis by means of ultrasound, an X-ray or possibly an MRI scan. A distinction is made between ligament injuries, fractures or the so-called jumper’s knee, which also represents an overloading of the front thigh muscles with very similar symptoms.

If the patient is suffering from Schlatter’s disease, the first step is to relieve the knee, reduce pain and filter out the cause. Relief can be achieved in physiotherapy/physical gymnastics using various manual techniques such as traction, i.e. a gentle pull, the sling table, bandages or a tape system. Blood circulation should also be encouraged.

Cross friction is suitable for this, but it can be very painful and is not appropriate in all phases or simply by movement without load. It is important to remove the tension from the tendon, i.e. to loosen and stretch the front thigh muscle. Relaxation is achieved through heat, such as the hot roll or classic massage grips.

A stretching of the muscle quadriceps femoris is achieved by bending the knee and stretching the hip. Thus, while standing, the heel can be guided towards the bottom and fixed with one hand. For reinforcement, simply push the pelvis forward.

Pain relief and anti-inflammatory effects can be achieved with ice (ice lollipops, cool packs), i.e. local cooling or quark. The advantage of quark is that there is no danger of hypothermia and natural substances have a positive effect on the inflammation in Schlatter’s disease. Good, simple and can be done at home without any danger.Another method is the combination of ice therapy and stretching: The muscle and its painful base are spread out with ice lollipops and finally brought passively and slowly into a stretching position – either the lateral position (the affected leg is on top and can be moved freely by the physiotherapist) or the supine position with an overhang in which the affected leg hangs freely.

In this way, the strong hip flexor can be stretched at the same time in the sense of the continuing muscle chain. This procedure is repeated several times. A functional massage, in which the muscle is stretched by transverse kneading, can also reduce the tension.

Fascial techniques involve entire muscle chains and are also suitable for relieving tension. If pain and inflammation are no longer in the foreground, active physiotherapy can be started for Schlatter’s disease. Here, the focus is still on stretching the quadriceps femoris muscle, which can now be performed more actively, as well as on strengthening surrounding muscles such as the ischiocrural muscles and the gluteus, i.e. the gluteal muscles.

The pelvic position and general trunk posture should also be controlled and corrected, as these malpositions can also trigger or strengthen increased muscle tension in the knee. An exercise from physiotherapy for Schlatter’s disease for the above-mentioned muscles and good body stabilization is called “bridging”. In the supine position, the heels are put up, the tips of the feet are pulled up to build up tension, the back is pressed firmly onto the support and now the pelvis is slowly lifted with tension and force until the thigh and belly form a diagonal, held briefly, lowered again without putting the pelvis down completely and the whole thing is repeated over three sets 12-15 times each.

An increase is to perform the exercise one-legged, i.e. to lift the pelvis with the force of one leg while keeping the other leg stretched out – both thighs are at the same height. Caution, do not place the feet too close to the body, the steeper the angle the greater the knee load again. Pain is always a warning and when it occurs the exercise should be downgraded, omitted or optimized.

The therapy concept called PNF (Proprioceptive Neuromuscular Facilitation) is also suitable for optimizing movements, strengthening specific muscle chains and moving in physiological patterns. Pelvic malpositions, which can be partly responsible, can also be treated with the above-mentioned concept. Further passive therapy methods are electrotherapy or local ultrasound treatments (Attention: contraindication growth plate!

The physiological growth process can be disturbed). The therapy/physiotherapy for Schlatter’s disease is very individual and problem-oriented. The adolescents should be freed from pain and movement disorders. This also includes information on how to avoid overloading the body and taking the initiative to reduce any excess weight.