Is your child a sports nut? If yes, then it is only normal as a parent to regularly worry about him or her. Perhaps, every time when your boy goes in for a girdion tackle or your daughter for a header at the football field, you start sweating in tension. But, there is one injury or physical condition that most parents are unaware of. In medical terms, it is known as Osgood-Schlatter Disease.
Adolescence is a phase when children are at the peak of physical growth and more so the maximum growth spurt strikes a kid during puberty. OSD primarily affects adolescents during the phase of puberty. Well, has your kid been complaining lately of a consistent knee pain? Do look out on the severity and recurrence of this pain because OSD or Osgood-Schlatter disease is one the most common causes of this condition.
Most explanations in medical terms might confuse you. So, here a simplified guide that will help you better understand the disease, its roots, symptoms and probable treatments.
The disease, Osgood-Schlatter triggers the condition or the disorder that causes a painful inflammation in the region right below the knee. The inflammation precisely occurs in the attaching area of the tendon to the shinbone.
How does the Osgood-Schlatter disease actually hit?
Surely, you know that adolescents encounter a growth spurt at the time of their puberty. But, what you perhaps do not know is this that the tendons and muscles during this period tend to grow quickly and not at the same rate always. The growth plate lies at the top of the shinbone which is under constant stress during the growth spurts of adolescence.
Now, what are growth plates? Growing children have growth plates which are cartilage areas situated at the end of bones. These growth plates harden to form a solid bone by the time the kid reaches adulthood.
Factors like strength and size differences of the quadriceps muscle and vigorous physical activity cause consistent stress on this growth plate since it acts as the connector for the tendons. The growth plate is covered by a bony bump at the brink of the tibia and the quadriceps attach to the bump.
Now, the repetition of contraction of the muscles and the tibial tubercle (bony bump) causes the growth plate to become inflamed. Thus, when overused it becomes irritated. There, you have the green signal on Osgood-Schlatter disease. Hang on! You need not panic much because the condition is not really a disease but, more practically an overuse injury that isn’t permanent. However, you must still consult a doctor before being certain.
Who does it affect?
Many early studies concluded that mainly adolescent boys at the start of their growth spurt during puberty are commonly diagnosed with the Osgood-Schlatter disease. Today, the gender gap is blurring as even girls have started becoming involved in different kinds of sports.
You may think that OSD hits both boys and girls at the same time. But, that isn’t true. OSD develops at different ages for both sexes because they go through the growth spurts of puberty at different ages.
OSD ideally develops in the girls of 11-12 years of age and boys of around 14. It occurs during the sudden growth spurt when on gaining puberty both girls and boys grow rapidly in height. The condition can happen in either or both the knees and typically lasts for almost 2 years and fades as the child becomes an adult.
Causes & Risk factors
The Osgood-Schlatter disease is caused due to excessive physical activities (common among teenagers) in the form of sports like ballet, basketball, soccer, volleyball etc. All these sports include activities like bending, running and jumping.
The child’s quadriceps or the thigh muscles, during these activities, pull on the connecting tendon that attaches the growth plate to the kneecap at the part near the top of the shinbone. The area where the tendon actually enters into the shinbone, that part of the growth plate gets pulled due to repeated stress. This directly results in the swelling and painful inflammation since the tendon is forced over-time to separate from the shinbone. That’s how the symptoms of Osgood-Schlatter disease develop.
The condition may take a slightly risky turn if the activities are vigorously continued after the development of OSD. Teens associated with tennis, gymnastics other sports involving massive running, jumping and twisting are more prone to risk.
Doctors acknowledge the involvement of physical stress and overuse in this case but, they often don’t agree to the mechanics causing the injury which is termed as Osgood-Schlatter disease.
Symptoms & Indications of Osgood-Schlatter Disease
The pain caused due to the development of Osgood-Schlatter Disease may range from severely-constant (restricting the ability to perform any physical activity) to mild (only felt while performing stressful physical activities). So, the signs of OSD vary in different people.
The most common symptoms and signs of OSD include the following:
- Worsening of pain with high-impact physical activities
- Pain relieving signs when at rest
- Tenderness, swelling and redness over the shinbone and under the knee (precisely, the kneecap)
- Presence of a bony lump right under the kneecap (as the body tries to fill the gap by growing a new bone)
- Tightness in the quadriceps and hamstring muscles (surrounding the knee)
- Limping post any sports activity
There are also some non-typical symptoms of the disease that you may not know. They include sudden waking from sleep due to severe pain, thigh pain or pain at rest.
Do you need to see a doctor? When is it time?
In case of acute knee pain, you must consult your child’s doctor. Take the pain to be acute when you see that the child is facing interferences while performing daily activities. If your child shows signs of knee-joint instability and fever or you see that the knee has swollen, take that as a red signal. It is time to call in professional medical help.
Can Osgood-Schlatter disease be diagnosed?
The answer to that is a straight Yes. First of all, the doctor will discuss the general health of your child and the symptoms. Post the discussion; the doctor will perform a detailed examination of your child to ascertain the cause of his or her knee pain.
During the examination process, the doctor will apply pressure on the tibial tubercle to understand whether it is tender. The tenderness directly indicates that your child is suffering from Osgood-Schlatter disease. To identify if the knee pain is triggered or aggravated by movement, the doctor might also ask you kid to kneel, run, walk or jump. These generally provide sufficient information to lead the doctor to a successful diagnosis of Osgood-Schlatter disease.
However, the space for doubt always remains and the data gathered from the examination may at times be confusing. This is when a professional medical help asks to get a bone X-Ray done to rule out and confirm all related causes for the knee pain with the help of the reports.
Does OSD bring in additional complication?
Complications are not at all common in Osgood-Schlatter disease. Nonetheless, even if complications crop up, they do so in the form of localized swelling or chronic pain. Plus, if the condition becomes chronic, a slightly bony bump may persist below the kneecap on the shinbone, even after the symptoms are resolved. The persistent bump generally doesn’t cause any kind of hindrance to the child’s knee function but, the bump might last throughout the child’s life to a certain degree.
The growth plate might be pulled away and separated from the shinbone. However, this too occurs in the rarest of Osgood-Schlatter disease cases. Over the counter medication can relieve the discomfort and pain. In extremely acute cases where the tendons in the knee and the bone don’t heal correctly, a surgical incision may be required.
An avulsion fracture of patella tendon is the worst case scenario of a longstanding Osgood-Schlatter disease. But, thanks to physiotherapy, the condition can be successfully handled and treated.
Is OSD treatable?
As said earlier, more than being a disease it is an overuse injury. It is one of those injuries that in most cases disappear from adolescents as and when the bones stop growing which is usually when they jump from teenage to adulthood. So, there are no specific treatments for it. The condition is self-healing. The key to that is time and rest (abstaining temporarily from heavy-duty physical Exercise).
Treatment for OSD is typically conservative and focuses mainly on relieving the symptoms rather than eradicating the disease because that’ll eventually happen when the growth spurt ends. Swelling, redness, and knee pain are the primary symptoms that are looked into for treatment.
The knee joint can be stabilized with the help of exercises that can strengthen the thigh muscles. Tension on the spot near the attachment of the shinbone and tendon can also be eased out by incorporating by similar exercises that help to relieve the tightness around the hamstring and thigh muscles. At the early stages of these stretches, pain at the spot of OSD can be relieved through light massage.
Do take a note of the following treatment options that can help relieve the symptoms to a great extent:
Applying an ice pack on the affected area can help in reducing both the swelling and the pain. This can be repeated 3 to 4 times on a daily basis. It is an effective anti-inflammatory treatment.
There will be times when the pain becomes unbearable for the child. Under such circumstances, over the counter pain relieving medications can help in emergencies.
This treatment is unparalleled. You must have understood by now that the symptoms of Osgood-Schlatter disease will only flare up if activities like bending, running, kneeling and jumping are continued post-diagnosis. So, it speaks for itself. Your child needs to take some time off from the sports activity that he or she is associated with.
This is mandatory no matter how much they love and are passionate about the sport. Make them understand that continuing with such heavy physical activity will make things worse for them. It’s not that you’re asking them to quit the one thing they absolutely love.
They can again gradually resolve their sports activities when the symptoms fade away with physical therapy involving strengthening and stretching exercises.
KNEE-BRACE OR STABILIZATION STRAP:
It is a strap that is specially used during activities to anchor the tendon in place. The benefit is that it evens out some of the pressure that falls on the shinbone. These Patellar tendon straps fit around the leg, just below the kneecap.
SELF-LIMITING PHYSICAL ACTIVITY/ CROSS-TRAINING:
While your child is taking time off from the high-impact activity of choice, something different and of low-impact can be a worthwhile alternative. Cycling or swimming can very well be incorporated as cross-training.
As and when the initial symptoms of Osgood-Schlatter disease mellows down, physiotherapy is generally advised in order to prevent recurrence. Physiotherapy, in this case, will include exercises to improve the strength of the gastrocnemius, thigh and hamstring muscles. An orthopedic cast can help in pain reduction and give some comfort but, doesn’t guarantee reinforcement of joint immobilization.
When in rehabilitation, to avoid additional injuries, the child must be accompanied by a strict instructor who would give proper guidance on performing the prescribed exercises at home. The benefits of physiotherapy in healing the symptoms of OSD are proven as the percentage of patients that respond well to this non-operative treatment, totals to about 90%.
Which specialists treat and manage OSD?
Generalists, pediatricians, orthopedists, sports-medicine physicians as well as family practitioners are certified to manage and treat the Osgood-Schlatter disease.
Do OSD hit Adults?
Here’s the good news- OSD is referred to as the ‘growing pains of knees’. This means that the pain normally stops as the growth stops, which is by the age of 18. Talking about adults, the disease is not unheard of even though it is rare. Well, but, you are lucky enough if you an adult and have the symptoms of OSD because unlike the case of teenagers, grown-ups don’t experience acute pain and generally have one affected knee.
If you are getting it as an adult, do not worry. You aren’t alone on the boat! Studies say that 10% of the teenage patients with OSD are most likely to continue experiencing a few symptoms as adults. The cause and treatment of this recurrence in adulthood are almost similar as in adolescence. Some adults suffer due to irritation caused by unresolved Osgood-Schlatters.
The Final Word!
So, to put it in a nutshell, Osgood Schlatter disease is prevalent in kids and teenagers. The same is extremely rare in adults as the condition and its symptoms ideally resolve with the end of the growth spurt of a child during puberty. The medical condition is triggered by repeated stress on the growth plate caused by heavy and vigorous physical or sports activities like running, skating, soccer, ballet, basketball etc. Continuation of the same can serve as fuel to severe the injury. Osgood Schlatter disease is treated by using conservative home remedies. Complications in the case of OSD are in fact a rarity.