Osgood Schlatter’s - Why my kids always complain about their sore knee
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Osgood Schlatter Disease (OSD)

Osgood Schlatter Disease (OSD) is a growth related disease located at the knee within the similar entity of growth related disease as severs developing at the hind aspect of the heel. OSD involves the development of apophysitis (irritation at the growth plate between the tibial tuberosity and main tibia bone) at top and central part of the tibia known as the tibial tuberosity. Tibial tuberosity is a primarily fibrocartilaginous structure during the early development stage (<8yrs girls, <9yrs boys) which undergoes the process of ossification (laying down of bone) between the ages of ~8-14 with the presence of an growth plate between the tibial tuberosity and the tibial metaphysis (head). Complete ossification or fusion of previous growth plate (complete bony fusion between tibial tuberosity and tibial shaft ends) to form one complete bone is expected to have taken place by around the age of 15+ year for girls and 17+ years for boys. 


Onset is insidious with a gradual worsening presentation without trauma common during the years 9-17 years for males and 8-15 years for females whereby skeletal immaturity coincides with adolescent growth spurts or peak growth years being 11-15 years for girls and 13-16 years for boys. Prevalence rates of the disease during the peak growth years range from 9-12% of children. 


OSD develops on the background of increased patella tendon traction on the tibial tuberosity secondary to the lag between increased bone growth (femoral shaft lengthening) and tendon and muscle lengthening adaptation resulting in increased traction stress at the growth plate leading irritation within this region termed ‘apophysitis’.


Imaging is not a routine requirement as part of diagnosing OSD with a thorough clinical examination generally providing enough conclusive information necessary to make the diagnosis. There is a strong association with the development of OSD within a short time period during or post a peak growth period, sudden increase volume of physical activity or introduction to those sports such as football, gymnastics or netball/ basketball. Sports which require repeat jumping, landing, change of direction, acceleration or deceleration or sustained periods of sprinting components across a continuous period (half or quarter). Symptoms generally present below the patella with a focal distribution around the patella tendon and insertion in the tibia. Acute symptoms will generally subside with a period of rest ranging from minutes through to 24 hours dependent on severity of ‘apophysitis’ present. Other common predisposing factors including poor quadricep, hamstring and soleus flexibility/length, poor quadriceps strength/plyometric control, poor pelvic control and abnormal dynamic foot posture/ biomechanics. 


Treatment and management of OSD is centred around managing symptoms until the apophysis fuses. Generally, OSD has an excellent prognosis with full resolution of symptoms within 6 months of good quality conservative treatment when following the prescription of a thorough individualised impairment targeted rehabilitation program. Effective management includes but is not limited to patella tendon style compression taping or bracing, modification of the above modifiable predisposing factors and load management. It’s important to note that while frequency of exercises can reduce to 1-2x weekly post initial ‘rehabilitation phase’, to maintain current strength/plyometric adaptations it is important your child remains consistent with their exercises until full apophysis fusion has occurred to prevent re-lapse and re-flaring of symptoms. Alongside this during the phase of a growth spurt risk for re-flaring of symptoms does increase, if symptoms during this period are unable to be effectively managed with reducing workloads and increasing soft tissue releasing techniques, totally withdrawing the child from the provocative activity/sport until symptoms settle and the lag between tendon/muscle lengthening adaptation has taken place in regards to recent bone growth (lengthening) may be necessary. 

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Before most people book a physiotherapist they've never seen before, they'll check the reviews. Google, Facebook, Healthengine, or wherever they happen to land first. Reviews feel like a shortcut to truth — the unfiltered opinions of real people who've been through it. And sometimes they are. But healthcare reviews are a peculiar category, and reading them uncritically can steer you wrong. Here's how to use online reviews intelligently when choosing a physiotherapist. Why Healthcare Reviews Are Different from Restaurant Reviews When you read a restaurant review, you're getting a fairly objective account of a meal. The food was good or it wasn't. The service was attentive or it wasn't. The reviewer's satisfaction correlates reasonably well with the actual quality of the experience. Healthcare reviews are messier. Patient satisfaction ≠ clinical quality. Research consistently shows that patient satisfaction scores don't always correlate with clinical outcomes. A practitioner who tells patients what they want to hear — that their pain will go away quickly, that they don't need to do much work, that they can keep doing whatever caused the problem — may generate glowing reviews from happy patients who didn't actually get better. Conversely, a physiotherapist who gives honest, sometimes difficult feedback (your recovery is going to take longer than you hoped; you need to make meaningful changes to how you move and exercise; your expectations need adjusting) might occasionally receive a harsh review from a patient who didn't want to hear that. Reviews often reflect the experience, not the outcome. Most reviews are written during or shortly after treatment — not months later when the patient has a clear picture of whether they actually got better. A physio who is warm, attentive, and runs a pleasant clinic environment will accumulate good reviews even if their clinical outcomes are average. People review extremes. The most motivated reviewers are people who had an exceptional experience and want to share it, or people who had a terrible experience and want to warn others. The large middle ground of people who had a perfectly adequate but unremarkable experience often doesn't write reviews at all. This creates a bimodal distribution that doesn't reflect the full picture. What Reviews Can Legitimately Tell You None of this means reviews are useless. They're just a signal you need to interpret carefully. Reviews are useful for: Communication and manner. If multiple reviews mention that the physiotherapist explains things clearly, takes time to listen, and doesn't rush, that's meaningful. Conversely, multiple reviews about feeling rushed or not being heard is a genuine red flag. Consistency of the clinic experience. Reviews about wait times, booking ease, clinic cleanliness, and administrative responsiveness are relatively reliable. These are objective experiences that don't require medical knowledge to assess. Patterns across many reviews. A single five-star review means little. Fifty five-star reviews with consistent themes mean more. Patterns — particularly patterns in the content of reviews — carry more weight than individual opinions. Response to negative feedback. How a clinic responds to negative reviews is revealing. A defensive, dismissive response to a complaint is a bad sign. A thoughtful, professional acknowledgement — even without agreeing with everything the reviewer said — shows a culture that takes feedback seriously. Reviews are less useful for: Assessing clinical expertise. Very few patients have the background to accurately evaluate whether their treatment was the best available approach for their condition. Distinguishing between practitioner quality. If a clinic employs multiple physios, the reviews won't tell you who specifically to see. The Five-Star Trap Clinics with near-perfect ratings can look more impressive than they actually are. A very high average rating — 4.9 or 5.0 — often reflects a small number of reviews from motivated patients rather than a comprehensive picture. It can also reflect active review solicitation, where patients are systematically encouraged to leave a review after a positive experience (not inherently dishonest, but it skews the sample). A clinic with 200 reviews averaging 4.6 tells you more than one with 12 reviews averaging 5.0. Also pay attention to recency . A clinic that earned its reputation five years ago might have changed significantly since then — new staff, different ownership, or a growth-at-all-costs approach that's compromised quality. Filter for recent reviews when the overall rating is built on older data. Reading Between the Lines Here's a framework for extracting signal from noise in physiotherapy reviews: Look for clinical language. Reviews that specifically mention exercises being prescribed, progress being tracked, a clear explanation of the diagnosis, or exercises being progressed over time reflect actual clinical engagement. These are more informative than "great physio, highly recommend." Note what's not mentioned. If you're looking for a sports physio and none of the reviews mention sport-specific rehab or return-to-play, that tells you something about the clinic's caseload. Weigh patterns more than extremes. Three separate reviews mentioning that appointments felt rushed is more informative than one review saying the same thing — even if the overall rating is high. Cross-reference platforms. Google, Healthengine, Facebook, and RateMyPhysio each attract slightly different reviewing populations. Looking across platforms gives you a more complete picture than relying on one. When Reviews Shouldn't Be the Deciding Factor There are cases where you should weight reviews less heavily: Highly specialised conditions. If you have a complex condition — Ehlers-Danlos Syndrome, a rare neurological presentation, a post-operative complication — the number of reviewers who can meaningfully evaluate the treatment quality is very small. Seek direct referrals from specialists or patient communities rather than relying on Google. Small clinics. A small physiotherapy practice in a regional area might have a relatively small review count not because they're new or low-quality, but because they've built their reputation on word-of-mouth referrals and loyal patients who don't leave reviews. Don't penalise good clinics for having fewer reviews than large, high-volume practices. Better Ways to Evaluate a Physiotherapist Reviews are a starting point, not an endpoint. Combine them with: Direct recommendations from people whose condition or goals are similar to yours A consultation — either by phone or in person — to assess communication, approach, and fit before committing to a full course of treatment Verification of credentials — check AHPRA registration, relevant additional qualifications, and demonstrated experience with your type of condition Your own instincts in the first appointment — do you feel genuinely heard? Do the explanations make sense? Do you leave with a clear plan? The Bottom Line Online physiotherapy reviews are worth reading — but read them sceptically. Look for patterns in content rather than treating the star rating as the verdict. Weight communication and experience over clinical claims you can't independently evaluate. And treat reviews as one input among several rather than the final word. The best validation of a physiotherapist's quality is ultimately what happens in your own appointments. If you're in Bendigo and want to make a well-informed choice, we're happy to answer questions before you book. Contact Return to Performance Physiotherapy or call (03) 5448 5556 .
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