"Growing Pains In The Knee"-Issue 3

    
If you can recall from last month’s issue, the tissues most at risk for injury in a growing athlete are the soft, cartilaginous growth centers or growth plates. During a growth spurt, bones grow faster than muscles. This places increased stress on the growth centers where they attach. When a growth spurt is combined with increased physical activity, the repetitive stress on the growth center can result in injury. In fact, it has been reported that at least 15% of all youth sport injuries occur along these delicate growth centers.
       Osgood Schlatter’s Disease is the most common overuse injury in children and it involves the growth center at the knee. It is estimated that 20% of young athletes ages 8 to 15 suffer from this diagnosis.       
        Osgood Schlatter’s involves irritation of the growth plate at a location called the tibial tubercle. This is the bump on the front of the shin bone where the patellar tendon attaches. If the tension of the muscle tendon across the bone becomes great enough, the growth center will start to pull away from the bone. This results in pain, swelling, and often times a large bump that occurs a few inches below the knee cap.
       These symptoms usually begin gradually over time with no real mechanism of injury. Occasionally, initial symptoms can be tied to a sudden increase in activity or direct trauma to the knee.
       Typically, your child will complain of pain that worsens with running, jumping and kneeling activities and that decreases with rest.
       Generally, treatment for Osgood Schlatter’s includes a combination of relative rest, stretching for the muscles on the front of the thigh and hip, strengthening for the muscles on the back of the thigh and hip, and use of ice and NSAIDs to manage pain and inflammation.
      Occasionally, physicians will recommend a patellar tendon strap/brace to provide additional pain relief. This helps to decrease the tension of the patellar tendon across the tibial tubercle, but will not resolve the underlying muscle tightness that should be addressed with stretching.
       If you would like more details on specific stretches and exercises to prevent or treat Osgood Schlatter’s Disease, contact your physician or physical therapist for more information.


  

References:

1.Watkins J, Peabody P. Sports Injuries in Children and Adolescents Treated at a Sports Injury Clinic. J Sports Med Phys Fitness 1996;36(1):43-48.
2. Phil SG, Flynn JM, Ganley TJ. Managing and Preventing Overuse Injuries in Young Athletes. J Musculoskel Med 2003;20:434-442.
3. Krause BL, Williams JP, Catterall A. Natural History of Osgood Schlatter Disease. J Pediatr Orthop 1990;10(1):65-68.