Wednesday, September 10, 2014 at 10:47PM
Verna Marquez, MD
Knee and lower extremity pain are very common sites of injury in the active adolescent. Most injury is transient and insignificant especially when there is little to no history of direct trauma. Osgood- Schlatter Disease (OSD) is one common orthopedic condition that must be differentiated from other disorders because of its classic presentation and excellent rehabilitation potential.
OSD is an overuse injury commonly found in active adolescents around the early teen years during the growth spurt. Growth spurts can begin anytime between the ages of 8 and 13 for girls and ages 10 to 15 for boys. OSD is more characteristically common in boys, but the incidence is increasing in girls as more girls participate in male dominant sports
OSD most often occurs in sports that involve running, jumping and pivoting (twisting), but can occur with any activities of an active adolescent. The thigh muscle (quadriceps) is attached to the patello-femoral tendon which in-turn attaches to the tibial (shin) area directly over the growth plate. It’s believed that repetitive stress on this active area of growth is responsible for the symptoms leading to OSD.
Symptoms may include:
• Pain that worsens with exercise
• Relief from pain with rest
• Limping
A good history and physical coupled with a high index of suspicion are essential to early diagnosis and appropriate treatment that will lead to a speedy recovery. Sometimes the physician may order an x ray to look for evidence of OSD which appear as calcifications around the knee cap and shin bone. Once diagnosed, the treatment would include pain medication and a limitation of the activity inducing pain. In severe or recurrent cases, an experienced physical therapist can help in the early resolution of the pain with strengthening exercises for the quadriceps which help stabilize the knee joint. The therapist can also teach your child exercises to stretch the thigh quadriceps and hamstring muscles which will strengthen this complex joint and help prevent further injury or recurrence.
Most parents seek medical attention after their child complains of intermittent pain over several months. The pain may range anywhere from mild activity-only pain to a more severe and constant debilitating pain. This presentation makes early intervention difficult so a high index of suspicion and an early visit to the doctor’s office is key. If you suspect your child may have OSD or if your child suddenly stops their routine activities, please have them call our office for a free consultation.