Tibial Tuberosity
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What is the Tibial Tuberosity?
This article will be focused on the anatomy of the tibial tuberosity, function, and diagnosis related to this landmark. Additionally it will cover treatment options. The tibial tuberosity is a bony protrusion on the anterior aspect of the tibia. The tibia is the larger bone in the lower leg, also known as the shin or shin bone. The tibial tuberosity is located right below your kneecap. Your patellar ligament attaches to the tibial tuberosity. This serves as a lever to the knee joint to prevent the knee from buckling.
Tibial Tuberosity
Injuries Associated with Tibial Tuberosity
Osgood-Schlatter Disease (OSD) is an overuse injury that is most common in children going through their growth spurt. It usually occurs around 9-14 years old. Osgood-Schlatter Disease presents as pain and swelling at the tibial tuberosity. Symptoms usually occur because the patella tendon is being pulled over the growth plate. High levels of stress such as sports that require lots of running and jumping can irritate the cartilage surrounding the growth plate. Treatment for this disease includes stretches, anti-inflammatories, and avoiding activities that increase pain levels. OSD typically goes away when the child’s bones stop growing. Long-term effects are rare and minimal.
Tibial Tuberosity Avulsion Fracture
Tibial Tuberosity Avulsion Fracture is a rare injury that is usually associated with a sudden force through the patella tendon. This force causes a separation between the tibial tuberosity and anterior aspect of the tibia. This injury is more common in young males participating in high intensity sports. More specifically, the initial movement of a jump or the contact from the landing of a jump. These positions put the tibial tubercle at risk for an avulsion injury.
If the bone is minimally displaced the injured leg is put in a long leg cast for three to six weeks. This is for immobilization. However, type II and III avulsion fractures require surgery. Open reduction with internal fixation utilizing screws is usually necessary. Recovery from a fracture requiring surgery could potentially last up to four to six months. Therefore, physical therapy can be beneficial to build quadricep strength and knee stability.
Physical Therapy for Tibial Tuberosity Injuries
Initially, physical therapy is focused on easing symptoms to decrease inflammation and pain levels. This can include:
- Soft tissue mobilization
- Stretching
- Modality usage
The beginning stages of physical therapy for a tibial tuberosity avulsion fracture is slow and light to allow for bone healing. Around four to six weeks post-surgery, therapy will be focused on strengthening of the quadricep muscles as well as other muscles of the knee. Patients will be put on weight bearing restrictions. This means they will need crutches and a knee brace.
Recovery From Tibial Tuberosity Avulsion Fracture
Weaning out of brace and assistive device reliance depends on the stability of the knee. As well as quadricep strength and your physician’s medical opinion. The patient will be prepared to return to sports anywhere from six weeks to six months. This is dependent on the person and extent of their injury.
Written By: Mariah True PTA
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