upper tibia. It also occurs frequently in male pole vaulters aged 14–22. Diagnosis Diagnosis is made based on signs and symptoms. Ultrasonography This test can see various warning signs that predict if OSD might occur. Ultrasonography can detect if there is any tissue swelling and cartilage swelling. Ultrasonography's main goal is to identify OSD in the early stage rather than later on. It has unique features such as detection of an increase of swelling within the tibia or the cartilage surrounding the area and can also see if there is any new bone starting to build up around the tibial tuberosity. Types OSD may result in an avulsion fracture, with the tibial tuberosity separating from the tibia (usually remaining connected to a tendon or ligament). This injury is uncommon because there are mechanisms that prevent strong muscles from doing damage. The fracture on the tibial tuberosity can be a complete or incomplete break. Type I: A small fragment is displaced proximally and does not require surgery. Type II: The articular surface of the tibia remains intact and the fracture occurs at the junction where the secondary center of ossification and the proximal tibial epiphysis come together (may or may not require surgery). Type III: Complete fracture (through articular surface) including high chance of meniscal damage. This type of fracture usually requires surgery. Differential diagnosis Sinding-Larsen and Johansson syndrome, is an analogous condition involving the patellar tendon and the lower margin of the patella bone, instead of the upper margin of the tibia. Sever's disease is an analogous condition affecting the Achilles tendon attachment to the heel. Prevention One of the main ways to prevent OSD is to check the participant's flexibility in their quadriceps and hamstrings. Lack of flexibility in these muscles can be direct risk indicator for OSD. Muscles can shorten, which can cause pain but this is not permanent. Stretches can help reduce shortening of the muscles. The main stretches for prevention of OSD focus on the hamstrings and quadriceps. Direct stretching of the quadriceps can be painful so the use of foam rolling for self myofascial release can help gently restore flexibility and range of movement Treatment Treatment is generally conservative with rest, ice, and specific exercises being recommended. Simple pain medication may be used such as acetaminophen (paracetamol), or NSAIDs such as ibuprofen. Typically symptoms resolve as the growth plate closes. Physiotherapy is generally recommended once