October 30, 2018
Children, unfortunately, are not always exempt from aches and pains particularly during periods of intensive growth. Often active children experience knee and ankle pains, and at times on both left and right legs, these are often brushed off as growing pains. To an extent, this the case but let's take a deeper look!
OR JUMPERS KNEE
First reported on in the 1900’s (Circi, Atalay, & Beyzadeoglu, 2017) by two physicians in which adolescents complained of pain around the tibial tubercle (at the front of the knee) when playing jumping and running sports hence both Osgood and Schlatter were recognised as identifying this condition. Explained as a process occurring in children who are undergoing rapid growth and who place stress on the developing tubercle or growth plate through pulling forces of the patella tendon (Circi et al., 2017). The cause of pain in adolescent boys and girls is due to the repetitive loading of the area – the medical term deemed a traction apophysitis of the tibial tuberosity of which the patella tendon is tensioned by the quadriceps muscles straining the unfused growth plate and tibial tuberosity attachment point or its point of insertion. In recent studies shortening of the rectus femoris muscles have also been identified to be a contributing factor (Circi et al., 2017).
The cause or aetiology behind the disease is an inflammatory process which starts in the region and if not treated and monitored appropriately can develop into patella tendinopathy (a continuum of tendon pathology), multiple subacute fractures leading to irregular ossification of the underlying bone matrix (Circi et al., 2017)
Osgood-Schlatters or Jumper's knee was previously thought to affect boys more than girls. However, we are seeing more and more young females develop the condition with some studies finding no significant difference in prevalence between girls and boys (de Lucena, dos Santos Gomes, & Guerra, 2011). It is typically seen between the ages of 8-13year olds in females and 12-15-year-old boys (Gholve, Scher, Khakharia, Widmann, & Green, 2007). It affects approximately 21% of the athletic population and 4.5% of age-matched non-athletic populations; it is bilateral in 20-30% of patients (Kim & Karpas, 2002).
The treatment of Osgood Schlatters or Jumper's knee is usually guided by the severity of symptoms. Osgood-Schlatters is a self-limiting injury which resolves with skeletal maturity (Circi et al., 2017). It may be reoccurring for 12 -18 months as the epiphyseal plate (growth plate) ossifies. Conservative treatment can include ;
When required use customised orthotics to maximise the biomechanical chain
All treatments are aimed at maximizing the patient's ability to perform while managing pain and being aware of the underlying condition. At times with severe cases that do not respond to conservative management and those which do not receive early intervention - injection therapies and surgical techniques are in a minority of cases viable options (Circi et al., 2017).
It is important to get assessed by your physiotherapist or podiatrist to determine the stage of the injury and the appropriate management to assist in alleviating symptoms and keeping you on the move!
Circi, E., Atalay, Y., & Beyzadeoglu, T. (2017). Treatment of Osgood–Schlatter disease: review of the literature. Formerly La Chirurgia degli Organi di Movimento, 101(3), 195-200. doi:10.1007/s12306-017-0479-7
de Lucena, G. L., dos Santos Gomes, C., & Guerra, R. O. (2011). Prevalence and Associated Factors of Osgood-Schlatter Syndrome in a Population-Based Sample of Brazilian Adolescents. The American Journal of Sports Medicine, 39(2), 415-420. doi:10.1177/0363546510383835
Gholve, P. A., Scher, D. M., Khakharia, S., Widmann, R. F., & Green, D. W. (2007). Osgood Schlatter syndrome. Curr Opin Pediatr, 19(1), 44-50. doi:10.1097/MOP.0b013e328013dbea
Kim, M. K., & Karpas, A. (2002). The limping child. Clinical Pediatric Emergency Medicine, 3(2), 129-137. doi:10.1053/epem.2002.126756