Guest guest Posted December 16, 2007 Report Share Posted December 16, 2007 Did the player have OS when he was younger? If you've ruled out both a cyst and patellar tendinitis, there's not much left in the toolbox to get him through another game that you probably haven't already tried. Deep quadriceps tissue massage has worked with some to alleviate the discomfort. Ken Jakalski Lisle High School Lisle, Illinois USA Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 16, 2007 Report Share Posted December 16, 2007 --- ushouldblifting wrote: > Hello all, > > I have a college football player who has > osgood-schlatters on his left knee. It usually only > > flares up when he plays basketball in the off season > and even then it is really not that bad. > Since Hawaii is going to a bowl game this year they > had off for a week and a half and > returned to practice last Thursday. He only made it > through half the practice when it became > too painful to even run. I tried everything. > Friction, heat, TKE's, and a cho-pat device/brace > for his left patella, with less than favorable > results. This thing is just not responding to > anything. If anybody has any other alternatives I > am wide open to ideas. Thank you and have > a great holiday season. > > > Kidawski > Spartan Training Systems > Honolulu Hawaii > web.mac.com/ckidawski first of all congratulations to your team for the great season. I am not an orthopedic specialist so I cannot give you specific recommendations for the treatment of your athlete. I did some research on Osgood-Schlatters and I have provided excerpts from several sources below. In summary O-S is an overuse injury which occurs mostly in male adolescents and is caused by repetitive stress on the knee. It is most commonly seen in sports in which cutting and jumping are an important component. In my reading of the literature I get the feeling that there is no quick fix other than avoiding cutting and jumping as well as rest. Do you have access to an Orthopedic Sports physician? If so I would ask him about anti inflammatory medication. I would be cautious about using anything that would mask the pain since it could lead to more serious chronic pain. I hope the references provided below can be of some help. Ralph Giarnella MD Southington Ct USA ******************* Childhood and Adolescent Sports-Related Overuse Injuries American Family Physician - Volume 73, Issue 6 (March 2006) - Copyright © 2006 American Academy of Family Physicians Osgood-Schlatter disease presents as anterior knee pain localized to the tibial tubercle. Diagnosis is made clinically, and most patients respond to conservative measures. Osgood-Schlatter disease often is encountered in children 10 to 15 years of age who participate in cutting and jumping sports such as soccer, basketball, gymnastics, and volleyball.[26] The exact cause of this condition is unknown, but it is thought to be secondary to repetitive microtrauma or a traction apophysitis of the tibial tuberosity.[26 Osgood-Schlatter disease usually is self-limited. However, some complications can occur, such as mild discomfort with kneeling, a residual bony deformity ( Figure 6 ), and painful ossicles in the distal patellar tendon.[26] Most patients are able to return to full activity within two to three weeks. The use of an infrapatellar strap for six to eight weeks may provide symptomatic relief during activity 26. Wall EJ. Osgood-Schlatter disease: practical treatment for a self-limited condition. Phys Sport Med 1998;26:29–34. ********************************** Sports Injuries Disease-A-Month - Volume 51, Issue 8 (August 2005) - Copyright © 2005 Mosby, Inc J. , MD Osgood–Schlatter disease occurs in skeletally immature patients whose tibial tubercle apophysis has not fused.118, 119 Traction of the patellar tendon on the immature apophysis can cause swelling and pain at the tibial tubercle in conjunction with activities that increase knee flexion or quadriceps tension. Adolescents who have recently increased their running or jumping activity are at increased risk for Osgood–Schlatter disease. The physical examination for Osgood–Schlatter disease reveals tenderness with swelling over a prominent tibial tubercle. The presence of tight hamstrings may be a contributory factor in that the added resistance to knee extension increases quadriceps tension and hence traction on the tibial tubercle. Radiographs show an open tibial tubercle apophysis that may be separated or fragmented. Treatment for Osgood–Schlatter disease requires identifying and reducing the offending activity and reducing resistance from tight hamstrings. Resumption of activity should be gradual and permitted only after making specific plans to avoid repeating training error ******************************** Musculoskeletal Injuries in Sports Primary Care: Clinics in Office Practice - Volume 33, Issue 2 (June 2006) - Copyright © 2006 W. B. Saunders Company - About This Clinic Musculoskeletal Injuries in Sports Dilip R. Patel, MD a, b, & #8727; J. Baker, MD, PhD, ATC OSGOOD-SCHLATTER DISEASE Osgood-Schlatter disease is a traction apophysitis affecting the insertion of the patellar tendon over the tibial tuberosity. The immature patellar tendon–tibial tubercle junction is highly susceptible to repetitive tensile stress, leading to minor avulsions at the site and subsequent inflammatory reaction [1], [26]. The condition is far more commonly seen in athletes than in nonathletes; in one study, the incidence was 21% in athletes compared with 4.5% in a nonathlete group [80], [93]. It is most common in athletes involved in jumping sports, such as basketball. Osgood-Schlatter disease is commonly seen during Tanner stage 2 or 3 in adolescent boys [1]. The condition is bilateral in 20% to 30% of patients. Anterior knee pain is aggravated by jumping, squatting, and kneeling and is relieved by a period of rest. There is localized tenderness and sometimes swelling over the tibial tubercle. Plain radiographs may show fragmentation of the tibial tubercle and sometimes an ossicle in the patellar tendon. Pain improves on decreased activity; however, recurrent pain may last up to 2 years in some athletes [91]. Local ice application helps to reduce pain and inflammation. This is a benign self-limited condition, and the athlete should be allowed to continue all tolerated activities. The athlete should regularly perform flexibility exercises for the hamstrings and quadriceps. Complications are rare, with the most common being a localized swelling. Osgood-Schlatter disease is not necessarily associated with a predisposition for complete avulsion of the patellar tendon. There may be ossicle formation in the patellar tendon, a source of chronic pain, which is amenable to surgical removal. *********************************************************** Patient education hand out- Source MD Consult- Osgood-Schlatter Disease: A Cause of Knee Pain in Children What is Osgood-Schlatter disease? Osgood-Schlatter (say: " oz-good shlot-ter " ) disease is one of the most common causes of knee pain in young athletes. It causes swelling, pain and tenderness just below the knee, over the shin bone (also called the tibia). It occurs mostly in boys who are having a growth spurt during their pre-teen or teenage years. One or both knees may be affected. What causes Osgood-Schlatter disease? It is believed that Osgood-Schlatter disease results from the pull of the large powerful muscles in the front of the thigh (called the quadriceps). The quadriceps join with the patellar tendons, which run through the knee and into the tibia, to connect the muscles to the knee. When the quadriceps contract, the patellar tendons can start to pull away from the shin bone, causing pain. This problem becomes more noticeable during activities that require running, jumping or going up or down stairs. It's most common in young athletes who play football, soccer or basketball or are involved in gymnastics and ballet. Osgood-Schlatter disease usually goes away with time. When your child stops growing, the pain and swelling should go away because the patellar tendons become much stronger. Only rarely does Osgood-Schlatter disease persist beyond the growing stage. Your doctor may want to examine your child and get a knee x-ray to make sure the pain isn't caused by something else. How is Osgood-Schlatter disease treated? Your doctor may tell your child to cut down on time spent playing until the pain has been gone for 2 to 4 months. Your child may need to avoid any activity that requires deep knee bending. Your child may also need to run at a slower speed or for a shorter amount of time and jump less often. How should my child's pain be treated? If pain develops, ice should be applied to the involved areas. Using ice can help prevent swelling and pain. The knee should be wrapped with an elastic bandage and elevated. A memory aid that may help remind you of these four basic treatment steps is the word " RICE " : R=Rest the knee from the painful activity. I=Ice the affected area for 20 minutes, 3 times a day. C=Compress the painful area with an elastic bandage. E=Elevate the leg. If these treatment steps don't work, your doctor may suggest that your child wear braces that will reduce tension on the patellar tendons and quadriceps. Pain relievers such as aspirin or ibuprofen (brand names: Advil, Motrin, Nuprin) may reduce the pain and swelling. Your child may need to use crutches for a while to allow complete healing. As a last resort, your child's doctor may suggest surgery. How long will it take for the knee to get better? It may take several weeks or months for the pain to completely stop. When the pain is completely gone, your child may slowly return to his or her previous level of activity. Is there anything that can be done to prevent the disease from happening again? Your doctor may prescribe some exercises such as straight-leg raises, leg curls and quadriceps contractions for your child to do at home or with a physical therapist to strengthen the quadriceps and hamstrings. This should help prevent further problems. While your child is recovering, ice should be applied to the area after exercise to prevent pain and swelling. In most people, Osgood-Schlatter disease goes away on its own with a little rest and time. If your child ignores or plays through the pain, the disease may get worse and may be more difficult to treat. ******************** Osgood-Schlatter Disease Rehabilitation Exercises You can start stretching the muscles in the back of your leg using the hamstring and calf stretches right away. When you have only a little discomfort in the upper part of your lower leg bone (tibia), you can do the rest of the exercises. Hamstring stretch on wall: Lie on your back with your buttocks close to a doorway, and extend your legs straight out in front of you along the floor. Raise the injured leg and rest it against the wall next to the door frame. Your other leg should extend through the doorway. You should feel a stretch in the back of your thigh. Hold this position for 15 to 30 seconds. Repeat 3 times. Standing calf stretch: Facing a wall, put your hands against the wall at about eye level. Keep the injured leg back, the uninjured leg forward, and the heel of your injured leg on the floor. Turn your injured foot slightly inward (as if you were pigeon-toed) as you slowly lean into the wall until you feel a stretch in the back of your calf. Hold for 15 to 30 seconds. Repeat 3 times. Do this exercise several times each day. Quadriceps stretch: Stand an arm's length away from the wall, facing straight ahead. Brace yourself by keeping the hand on the uninjured side against the wall. With your other hand, grasp the ankle of the injured leg and pull your heel toward your buttocks. Don't arch or twist your back and keep your knees together. Hold this stretch for 15 to 30 seconds. Repeat 3 times. Straight leg raise: Lie on your back with your legs straight out in front of you. Tighten up the top of your thigh muscle on the injured leg and lift that leg about 8 inches off the floor, keeping the thigh muscle tight throughout. Slowly lower your leg back down to the floor. Do 3 sets of 10. Prone hip extension: Lie on your stomach with your legs straight out behind you. Tighten up your buttocks muscles and lift one leg off the floor about 8 inches. Keep your knee straight. Hold for 5 seconds. Then lower your leg and relax. Do 3 sets of 10. Knee stabilization: Wrap a piece of elastic tubing around the ankle of your uninjured leg. Tie the tubing to a table or other fixed object. . Stand on your injured leg facing the table and bend your knee slightly, keeping your thigh muscles tight. While maintaining this position, move your uninjured leg straight back behind you. Do 3 sets of 10. . Turn 90° so your injured leg is closest to the table. Move your uninjured leg away from your body. Do 3 sets of 10. . Turn 90° again so your back is to the table. Move your uninjured leg straight out in front of you. Do 3 sets of 10. . Turn your body 90° again so your uninjured leg is closest to the table. Move your uninjured leg across your body. Do 3 sets of 10. Hold onto a chair if you need help balancing. This exercise can be made even more challenging by standing on a pillow while you move your uninjured leg. Published by McKesson Corporation. This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Written by Tammy White, MS, PT, and Phyllis Clapis, PT, DHSc, OCS, for McKesson Corporation Copyright © 2007 McKesson Corporation and/or one of its subsidiaries. All Rights Reserved. Quote Link to comment Share on other sites More sharing options...
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