After playing soccer, a 15-year-old boy came home limping, with severe pain and swelling in his left knee. His thigh muscles also felt sore and the area was red in color, and warm to touch. The parents took him to the doctor who diagnosed the condition to be due to Osgood-Schlatter disease. This condition is named after physicians Dr. Robert Osgood and Dr. Carl Schlatter who defined it.
About Osgood-Schlatter disease
The Osgood-Schlatter disease is a painful knee condition that manifests as painful lump below the knee cap. It occurs mainly in children who take part in sports activities like basketball, soccer, ballet, figure skating, and other activities that involve jumping and running. It is seen to occur in boys between the ages 13 years to 14 years, while in girls between the ages 11 years to 12 years, due to growth spurt during these ages.
The Osgood-Schlatter disease causes pain in the knees that can be mild to severe in nature. It can occur in single knee or both the knees, and pain may last for months. The swelling and pain may be present on the prominence of bone on the upper part of shin bone, below the knee cap. Surrounding muscles like the quadriceps (thigh muscles) may become tight. This knee pain increases during sports activities or activities like climbing stairs, jumping, and running. The pain subsides on taking rest.
In children, arms and legs are made of long bones that have growth plates made of cartilage, present at the end of the bone. It is the growth plate which is responsible for the growth and increase in the length of the bone, and thereby height of the body. Too much stress on this growth plate may result in inflammation, causing swelling and pain in the area. Further, the knee cap is connected to the shin bone by tendons. During sports activities, the thigh muscles may pull the tendon, causing it to pull away from the shin bone, resulting in swelling and pain.
Diagnosis
The diagnosis is done through X rays of the bones of the leg and knee, and also the area where the shinbone is attached to the kneecap tendon.
Treatment
The Osgood-Schlatter disease goes away on its own by 18 years of age, when growth has stopped and the bones are mature. The most active kids have to, unfortunately, suffer from Osgood- Schlatter disease. If it is mild in nature, then the doctor advises the child to lessen their activities. If the pain becomes severe, then it may be required to take a break from all sports activities. Pain relief medications like ibuprofen (Motrin, Advil) and acetaminophen (Tylenol) are advised. If there is a bony growth under the knee cap, then surgery may be needed.
To decrease stress on the knee, wearing shock absorbent insoles may be helpful. After a strenuous sports activity, it is advised that one should apply ice for 20 minutes on the knee area or moist heat for 15 minutes. To protect shin from bruises and bumps, basketball knee pads and wrestling gel pads should be used. The legs should be kept elevated. The four basics in treatment can be recalled by remembering the word ‘RICE’ where R stands for rest from painful activity; I, stands for applying ice for 20 minutes thrice a day; C stands for compression of the affected area with elastic bandage; and E stands for elevating the leg.
Avoiding recurrence
To prevent Osgood-Schlatter disease from coming back, the doctor prescribes exercises that one can do at home to strengthen the muscles. The physical therapist can also be consulted. It is very important for the child to keep applying ice on the area after any sports activity and stop playing when pain is increasing. If the child continues to play in pain, Osgood-Schlatter disease may recur with greater severity and treatment may become difficult.
Sports safety
The National Youth sports safety foundation has declared that the second most cause for injury is sports activities. According to the guidelines for sports safety, the responsibility to train children to protect their bodies from sports injury lies on coaches and parents. All sports programs should be supervised by trained coaches. Children who are injured should never be encouraged or forced to play. A warm up for 15 to 30 minutes is essential before beginning any sports activities. The parents and coaches must remember that sports are only for the physical and emotional well-being of the child and not for personal interests of the team. The students should also be given basic instructions regarding sports safety through physical education programs.
