Combined Physical Therapy and Hold-Relax Technique for Adolescent Osgood-Schlatter Knee Pain

Summary

This pilot study evaluates the preliminary effectiveness of a combined rehabilitation program incorporating hold-relax (H-R) stretching techniques and progressive therapeutic exercises on knee pain and range of motion (ROM) in adolescent athletes diagnosed with Osgood-Schlatter disease. Utilizing a retrospective, single-group pre-post design on a cohort of six athletic participants, this study aims to generate preliminary clinical evidence and assess feasibility to inform future larger-scale randomized controlled trials. Participants underwent a structured, multi-week rehabilitation protocol, with primary clinical outcomes assessed before and after the intervention period using validated measures of pain intensity and knee joint mobility.

Conditions

• Osgood-Schlatter Disease

Interventions

BEHAVIORAL

Hold-Relax Proprioceptive Neuromuscular Facilitation (PNF)

A target-specific, manual stretching technique administered by a physical therapist to address muscular tightness in the lower extremity. The protocol focuses on the bilateral quadriceps and hamstring muscle groups to reduce the cumulative tensile traction forces exerted on the tibial tuberosity. For each target muscle group, the procedure is performed as follows: Passive Stretch: The physical therapist moves the joint to the limit of comfortable range of motion (ROM) where mild muscle tightness is felt. Isometric Contraction: The participant performs an active, sub-maximal isometric contraction (approximately 50% of maximum voluntary contraction) against the therapist's manual resistance for 6 to 10 seconds, ensuring no actual joint movement occurs. Relaxation and Deeper Passive Stretch: The participant is instructed to relax completely, and the therapist immediately moves the limb passively into a newly gained, deeper range of motion, holding the stati

BEHAVIORAL

Progressive Rehabilitation Program

A structured, step-by-step active exercise program designed to build lower-limb load tolerance, correct biomechanical compensations, and stabilize the knee joint complex. The rehabilitation progresses systematically through targeted phases based on individual pain levels and movement quality:Phase 1 (Pain Mitigation and Muscle Activation): Focuses on isometric quadriceps setting, straight leg raises (SLR), gluteal bridging, and ankle/hip mobility exercises to avoid direct loading of the patellar tendon while minimizing disuse atrophy.Phase 2 (Strength and Load Tolerance): Introduces closed-kinetic chain exercises with controlled ranges of motion, including shallow wall sits, leg presses, bilateral squats, and progressive calf raises.Phase 3 (Eccentric and Functional Progression): Focuses on eccentric quadriceps strengthening (e.g., controlled step-downs) and sport-specific functional retraining to prepare the adolescent athlete's patellar tendon and tibial tubercle to absorb high groun

Sponsors & Collaborators

• Benha University

  lead OTHER

Principal Investigators

• Mahmoud El sayed, Bachelor of Physical Therapy · Benha University

• Ahmed Said, Bachelor of Physical Therapy · Benha University

Study Design

Allocation

NA

Purpose

TREATMENT

Masking

NONE

Model

SINGLE_GROUP

Eligibility

Min Age

14 Years

Max Age

18 Years

Sex

MALE

Healthy Volunteers

No

Timeline & Regulatory

Start

2026-01-02

Primary Completion

2026-03-30

Completion

2026-04-15

Countries

• Algeria

Study Locations