"My knee hurts". You see your young athlete hobble off the field or court, noticeably limping on one leg. The coach comes over, "I don't know what happened, they didn't fall or bump into anybody. It might be a cramp or charley horse." You take your athlete home, have them shower and put ice on their knees. It helps some. As the weeks go by, their are good days, but mostly bad days, and the knee pain gets to the point where they can't run anymore. A trip to orthopedics comes next. After a four minute exam, the orthopedic tells you they have Osgood-Schlatter Disease. Your 30 dollar co-pay gets you the following orders: rest, ice, Tylenol for the pain.
What is Osgood-Schlatter disease? Inflammation that forms on the Tibial Tuberosity (the bump on the top end of the shin bone, just under the knee joint) where the patella tendon attaches to. It is an overuse injury, affecting athletes that do a lot of jumping, hopping and skipping. Once the inflammation takes hold, any running activity will be difficult to perform. It is very common and very often, their are no long term effects. In the X-Ray below, you can clearly see the build up of inflammation just below the patella. As the quadriceps tendon runs over the patella and attaches to the top part of the tibia, one can clearly see how disruptive and painful this disease can be to athletes.
It usually affects young athletes between the age of 10-15 years old. Generally, when they are in the middle of a prolonged growth spurt. Soccer players, basketball players, field hockey players are the most common athletes affected. It can come on gradually or insidiously. Now, the question on everyone's mind: "Can I prevent this from happening?". Not really. As it presents on the growth plate of the Tibia (growth plates are weaker than fully developed bones), it is hard to predict when or if it will happen.
Once diagnosed, if the ice and rest isn't helping, perhaps your child can benefit from being placed in a comprehensive stretching program. At Physical Therapy of Woburn, our Osgood-Schlatter athletes have their Lumbar Spine, hips, knees and ankles evaluated to see if there are any muscle imbalances that could be contributing to the injury. Once evaluated, a stretching program will be developed for the athlete to focus on increasing the muscle length of all the hip flexor muscles, hamstrings, lateral thigh muscles and the calves. We will also use modalities and manual therapies to help reduce the inflammation which will bring the pain levels down.
A strengthening program tailored to the individual sport of the athlete will be gradually introduced. Traditionally, athletes do about 4 to 8 weeks of physical therapy, depending on the severity of the Osgood-Schlatter condition. Many of the older athletes like to do the extended program so they can come in and get stretched and taped before their games and also return the day after games for inflammation control and recovery.
Upon completion of their program here, the athlete will have a strong grasp of their stretching program and pre-game band warm up for their legs. They will also have a good base of hip, knee and ankle exercises to carry forward and maintain their strength. Nothing makes us happier at Physical Therapy of Woburn to have our athletes pop in for quick review of their stretches, or to say hello, or to let us know they made all scholastic!
If your athlete is suffering from Osgood-Schlatter or any knee injury, feel free to call us. If under the care of an orthopedic or Pediatrician for their injuries, request a referral for physical therapy. It could expedite your athlete's return to the field.