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Understanding Osgood Schlatter's Disease

Osgood Schlatter's Disease is one of the most common knee injuries among youth soccer athletes. Although it is rarely surgical, it is often a nagging and at times debilitating pathology with a capacity to sideline a soccer player for quite some time. While it is known to be most common amongst young male athletes, the occurrences of Osgood Schlatter have risen substantially for female athletes, perhaps due to the increasing competition in female sports.

What is Osgood Schlatter?
Most common in young children and adolescents ages 10-15, Osgood Schlatter disease happens when repetitive stress on the knee irritates the bone growth plate in the little bump on your shin bone(tibia) just under your knee cap. This bump is known as the tibial tuberosity. Whenever the knee straightens, the thigh muscles (quadriceps) pull on the patellar tendon,which runs over the knee cap and attaches to the tibial tuberosity. This in turn leads to a subsequent pull on the shin bone in the area of the growth plate. And since growth plate is not as strong as bone, repetitive bending and extending in the knee joint can cause significant pain and inflammation. Most physicians diagnose this disease rather easily as they will notice an obvious bump on the shin bone just under the knee with accompanied swelling in the area.
 
What are the signs and symptoms?
The signs and symptoms of Osgood Schlatter include pain with physical activity (running, jumping, and bending movements), swelling, and point tenderness on the tibial tuberosity with pain lasting anywhere from a few weeks to a few months depending on its severity. The tibial tuberosity may also appear much more prominent than normal. Usually, symptoms stop once the athlete has stopped growing. But as long as the young athlete remains in his/her growth phase, a relapse of symptoms may occur.
 
How is it treated?
Rest and rehabilitation continue to be the best forms of treatment. In very rare occasions, perhaps only when bony fragments have been left in the tibia, will surgery be considered. But for most youth athletes, decreasing the activity that exacerbates the symptoms and taking part in a rehabilitations program will likely be the best bet to alleviate symptoms and manage the disease. Typical treatment protocols begin with rest and decreasing the amount of activity that causes the pain. For the youth soccer athlete, the severity of the symptoms will dictate how much activity should be decreased. That may mean restricting practice to low level drills or restricting soccer all together until the symptoms subside.
 
Rehabilitation will focus on the stretching of the hamstring, quads, and hip flexors, as well as the strengthening of the glute muscles. Athletic Trainers and Physical Therapists will also have the athlete undergo several bouts of cold therapy in order to decrease pain and inflammation. Doctors may also prescribe non-steroidal anti-inflammatories (NSAIDS) and patellar tendon straps to help control symptoms during physical activity although more research might be needed to demonstrates its true effectiveness.

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