In the Spotlight | Overuse Injuries in Children…Osgood Shclatters Disease

Osgood Shclatters disease and its symptoms are a result of microtrauma to the tendon below the knee cap and is common in young athletes. When we talk about athletes we mean any person taking part in regular sport and activity.

The large muscle group at the front of the thigh is called the quadriceps muscle which contains four muscles that combine and eventually form a strong tendon which surrounds the knee cap and attaches to a small bony elevation on one of the lower leg bones, the tibia (shin bone).  The muscle and knee cap complex plays a large role in generating forces to help propel the body while walking, running, jumping, squatting or climbing as well as playing a large role in deceleration force production and stability.  The forces transmitted through the knee and tendon can be up to 3 times a child’s body weight..!

As the young athlete trains and competes at a high volume load, the patellar tendon is frequently pulling at the developing bone which can result in microtrauma to the tendon and bone. Before there is a chance to adequately rest and heal, the next training session occurs and further microtrauma occurs. This can be complicated by growth spurts where the bones grow at a faster rate than the adapting muscle, leading to tight muscles and a greater pull at the bone.

If this cycle is repeated over time it can lead to multiple stress of the tibial tuberosity (bony prominence below you knee cap and at the top of the shin) and inflammation of the patellar tendon which both promote excessive bone growth resulting in the textbook lump seen below the knee.

Signs & Symptoms
As this condition is progressive, it initially manifests as mild pain during and following activity, but if ignored, can lead to pain even when resting and can be painful to the touch.  In the later stages, the characteristic lump is evident below the knee and as such, it is essential to recognize the symptoms of overuse and listen to what the body is telling the child or teen.

What Can I Do?
As with any condition, prevention is the best treatment. Some tips to help prevent the onset of Osgood Schlatters Disease are :

- Progressive stretching program to increase the length and extensibility of muscles
- Avoid intense forces incurred by plyometrics (hopping and bounding exercises) and resisted exercise (weights)
- Allow adequate time between training sessions to allow healing and the training response to occur (typically 1-2 days between sessions)
- Keep training sessions to a maximum of 1 – 1.5 hours
- Rest from aggravating activities
- Seek professional advice and get help! Call iQ on 01270 872522 to book a consultation with one of our expert Physiotherapists

What Can a Physiotherapist Do?
Initially, treatment consists of moderation and rest of the aggravating sport or activity allowing for adequate rest time between bouts of exercise. In some cases it might be necessary to take an extended period away from the activity, and usually, this is enough to resolve the condition. However, return to activity should be progressed and supervised by a chartered physiotherapist who is able to prescribe and progress an exercise program that addresses strength, flexibility, balance, biomechanical deficits, and muscle imbalance.  In addition, the therapist can employ manual techniques aimed at reducing pain and addressing deficits and imbalance.

Prognosis
With appropriate treatment, the condition can often be controlled within a reasonable time limit, however, and frustratingly, Osgood Schlatters is a condition which can recur for up to 24 months. As such, it is vital that one, you listen to what the child’s body is saying, and two, you get the appropriate guidance of an experienced health professional.

Finally, and this is important for any overuse injury, it is necessary to consider the long term implications rather than the short term. As difficult as it is for any athlete to miss an event or training session, if we don’t allow the body to heal adequately, we can profoundly affect the rest of our athletic careers, and overall quality of life.

If you suspect that your child is suffering from Osgood Schlatters, contact the iQ clinic on 01270 872522 to book a consultation with one of our expert Physiotherapists.

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