Osgood-Schlatter disease

I have a friend who's son might have Osgood-Schlatter disease. Can you give me some information about it?

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Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

Osgood-Schlatter disease is a problem that effects the knee area in many teenage boys and less commonly in girls. The powerful muscles of the thigh (the quadriceps) attach to a small area of the lower leg just below the knee. This small area also happens to be a place where the bone grows and attaches to the knee-cap tendons. Overuse and inappropriate training may cause repeated microscopic injury to this area thus causing pain and swelling called Osgood-Schlatter disease. In some, the injury may be severe enough to cause this attachment to actually tear away fragments of bone from the upper leg called the tibial tubercle. However, it is important to note that this does not involve the knee joint itself but rather the area below the knee high up on the shin bone.

Tightness of these quadriceps muscles and associated tendons make it more likely to develop this, therefore, warming up, particularly stretching out, is a key component to helping keep this from occurring. However, not overusing the muscles or placing extreme loads on the muscles are important as well.

Symptoms of this disease include pain during running, jumping, going up stairs, or particularly squatting. Diagnosis of Osgood-Schlatter disease can almost always be done by having your doctor do a careful examination, and x-rays are not routinely necessary.

Osgood-Schlatter disease usually improves with rest and some additional physical therapy techniques. However, convincing an active teenager to give it the rest it needs (often at least six weeks) may be difficult. Treatment measures for this disease are similar to how you treat any strain or sprain, namely the RICE technique:

R - Rest. An initial period of about six weeks of relative rest should be used to allow the injury to heal correctly. Of note, studies have shown that those who required surgery for Osgood-Schlatter were the ones who neglected this rest period. While regaining strength, activity should be increased gradually and always stay within a relative pain-free range.

I - Ice. Cold should be applied just below the kneecap before and after physical activity during the first 48 to 72 hours after the injury. This should be applied for about 15-20 minutes with a 1-2 hour break between applications. Cold may be applied using ice in a plastic bag, a chemical cold pack, or even frozen vegetable bags. Be sure to place a layer of material between the skin and the ice to protect the skin from injury.

C - Compression. This may be done using an ACE bandage or splint. While this may help somewhat with the swelling, it mainly serves as a reminder to the teenager to take it easy and not reinjure the leg. Sometimes a knee strap is used later during exercise for extra support.

E - Elevation. Keeping the leg elevated during the first 24 hours may decrease swelling as well.

The addition of anti-inflammatory medications such as ibuprofen help to relieve pain but should not be used just to allow for the athlete to continue playing. After about a week after the injury, stretching exercises may begin.

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