Children at young ages are getting more involved in playing specific sports. Kids are developing sport injuries, which had been previously seen in adults. During the past 10 to 20 years, injuries among children playing sports have increased eight – fold. Common cause of knee pain in young athletes is Osgood – Schlatter disease (OSD, Bone infarction, ischemic necrosis or osteochondrosis). In 1903, originally described simultaneously by US orthopedic surgeon Robert Osgood and Swiss surgeon Carl Schlatter.
It causes swelling, pain, and tenderness as result of an enlarge bump (tibial tuberosity) of the Shin Bone (tibia) just below the knee. Upon observation, bony enlargement at the top of the Shin Bone, measuring about two centimeters. This bump may persist to some degree, throughout a child’s life, but isn’t a cause of concern. It won’t interfere with knee function. The disease occurs mostly in boys, 13 to 14 years old and girls 10 to 11 years old, when the bones are typically growing faster than the muscles and tendons or growth spurt years of adolescent (Common form of growing pains or overuse in early adolescence involves the Shin Bone and the knee).
Twenty to thirty percent of cases affect both knees. Mechanically Osgood – Schlatter disease occurs from the pull of the large strong muscles in the front of the thigh (quadriceps). The quadriceps join with the patellae tendons (Quadriceps tendon and patellae tendon are thick fibrous tissues. The tendons do not expand and contract. They are strong tissues, performing to transmit the pulling force of the quadriceps muscle), which run through the knee and into the tibia, connecting the muscles to the knee. When quadriceps contract, the patellae tendons can start pulling away from the Shin Bone, causing pain. The problem has been seen in young athletes, who play football, soccer, basketball, and children performing gymnastics or ballet. When a child stops growing, Osgood – Schlatter disease will usually stop affecting the child, noticeable pain and swelling go away, because patellae tendons become much stronger. The disease may continue for two or three years. Rarely this disease will continue beyond the growing stage of a child or beyond puberty. Examination of the knee and x- ray taken by a doctor, will either confirm the diagnosis of this disease or the pain attributed to some other cause.
Treating Osgood Schlatter disease involve simple and easy solutions. Reducing time spent playing until the pain has been gone for two to four months. Especially avoiding deep knee bending, running at a slow speed or shorter distances and jump less often. Applying ice onto the affected area for twenty minutes, three times a day. The ice will prevent swelling and pain. One or both knees affected, should be wrapped with an elastic bandage and elevated (Placing pillows underneath one or both knees). An easy method for children or adults to remember these methods of treatment abbreviation: R. I. C. E. (rest, ice, compression and elevation). If these treatments provide hardly any relief, a physician may suggest a child wear braces that will reduce the tension on the petaller tendons and quadriceps. Aspirin, Advil, Aleve or ibuprofen may be recommended to relieve pain, and reduce any swelling. Also, some physicians recommend taking vitamin E. The child may have to use crutches for while during the time of healing. If the child is over – weight recommend a reduction diet, alleviating stress on one or both knees. Besides, during the growing age, recommend a lot of proteins, vitamins, and minerals. When all methods of treatment fail, surgery maybe necessary, however rarely recommended.
Preventing Osgood Schlatter disease from occurring again, exercise treatment maybe prescribed. A physical therapist will supervise exercises: Raising and strengthening the leg (Securing an ankle weight that is lifted ten times on the effected leg. The leg is lifted about 12 inches and kept straight or held for five seconds. Then slowly lowering the leg and relaxing.), leg curls, and quadriceps exercises (Place rolled blanket or rolled up towels under the affected knee to raise it about six inches from the floor. Then strengthening the leg until it is about 12 inches from the floor. Hold for about five seconds. Lower the leg and repeat the exercise from ten to fifteen repetitions). The therapist will instruct the child how to perform these exercises while at home. Ice should be applied to the area after exercising to prevent pain and swelling. A child should avoid playing or participating in sport activities when experiencing pain, making treatment more difficult. The best recommendation to avoid this painful disease by warm – up and stretching exercises of the thigh, hamstring, and calf muscles. Also, exercising to build muscle strength and avoid over training.