Osgood Schlatter's Syndrome
The following is a typical scenario involving a common condition that is a frequent cause of knee pain in children and adolescence, along with details of some of the current forms of treatment which may help to relieve the pain and discomfort associated with it.
Imagine your child has just started secondary school and has joined as many sports teams as humanly possible from rugby to gymnastics. They are doing really well but begin to complain of a dull aching pain below their knee.You may notice redness and even a small raised bump in the area on the front of the lower leg. The discomfort or pain worsens with activity and especially impact sports such as running on hard surfaces, kicking, jumping, etc, usually easing sometime after the activity has ceased. This can occur in 1 or both legs, with episodes often lasting some months and is known as Osgood Schlatter’s Syndrome. The pain will resolves once growing stops.
The underlying causes are rapid growth and high levels of activity combining to place sustained and increasing tension to the tendon attachment of the powerful quadriceps (thigh) muscles. As young adolescents go through a ‘growth spurt’, bones and in this case the femur which is the longest bone in the body, increase in length whilst associated muscles are placed under stress and must adapt. During this growth period, the tension, and often repeated impact, tugs on its’ bony attachment with potentially serious consequences. As the young person’s bone formation is still ongoing, there is the danger of this bony attachment pulling away from the rest of the bone with its’ tendon, so playing on regardless should not be considered.
Accurate assessment of the severity of this condition is crucial in preventing the consequences described above. To alleviate the problem, the stress at the attachment of the tendon with the bone must be decreased, which might allow exercise to be continued, but strictly subject to the results of a thorough investigation and careful injury management. Sensible warm up and cool down protocols should be maintained, and treatment interventions may include applying cold, particularly after sport to reduce the inflammation, gentle stretching (but not in severe cases), soft tissue massage, dry needling and articulation.
Above all, sensible changes to the activities may prevent the condition getting worse. This means decreasing the intensity and/or the duration of training/games/ competition, which are the main aggravators. This may be really challenging for a young athlete who is keen to progress in a particular sport but easing back or changing the activity in the sort-term may prevent an injury that could require surgery and therefore much longer rehabilitation away from their sport. Once the rate of growth subsides and the muscles have time to adapt, the problem usually goes away leaving the athlete unimpeded although sometimes with a permanently larger bony prominence to the leg, and occasionally longer-term tenderness to this area.
If in doubt, please call and talk to one of the BeActive team practitioners. We will be happy to advise and if necessary, carry out a thorough examination, and musculoskeletal assessment including posture and gait analysis to enable them to give the best possible care and help your sports star back doing the activities they enjoy as soon as possible.
Osteopath at BeActive Clinic