Monday, August 29, 2011
I have included one of my famous drawings as an illustration to understand where the actual injury site is.
The tibial tuberosity is the location where the actual pain, discomfort and in some severe cases the dislocation of bone or calcification of bony spurs develop.
As the beginning of the new school year approaches and the athletic seasons begin I felt it was important to talk about athletic topics that address the needs of our adolescent athletes. One such topic is Osgood Schlatter Disease.
I think it's important to educate the athletes themselves, their parents and extremely important for the coaches that interact with them. The days of "it's just growing pains" is over. I remember when my mom would say that.. I laugh now.. but it's not funny... the pain is really there and we need to listen to them when they come to us.
Osgood - Schlatter Disease ( Tibial Tuberosity Apophysitis)
WHAT IS IT ?
Osgood -Schlatter disease (OSD) is a condition involving the irritation and inflammation at the site of the quadriceps tendon inserting on the tibial tuberosity in adolescent immature bone.
This condition occurs when the quadriceps muscle group are vigorously used in combination with rapid growth of the leg bones.
WHO GETS IT ?
OSD is a condition that is practically EXCLUSIVE to adolescent youngsters who participate in athletic activities.
It is very common among young athletes who participate in sports such as:
To include running, jumping or making fast, tight turns.
This condition occurs both with girls & boys, however it is more common with boys. ( research indicates this ratio to be 3-1)
Onset can occur anywhere from the age of 11-18 years of age.
Cases range from mild to severe. In mild cases the tibial tuberosity is inflamed. In severe cases there is a complete separation of the tibial tuberosity from the tibia.
To put this in perspective: the tibial tuberosity is a “bump on a bone” - a location for tendon attachment. In this situation it would be the quadriceps tendon to the tibial tuberosity. The tension in the muscle is so significant it creates inflammation at the musculotendinous junction to the tibial tuberosity causing the separation of this structure.
There are two (2) causes of Osgood-Schlatter disease (OSD)
1. INDIRECT TRAUMA - pulling force produced by powerful contractions of the quadriceps muscle group.
2. OVER USE REPETITIVE STRAIN - a result of repeated stress such as: knee flexion & extension
As young athletes go through puberty and are significantly involved in athletic activities, they are more likely to develop this condition. The bone growth is faster than muscle growth, creating the pain cycle ~~ and because the juvenile skeletal structure is not yet ossified (hardened) ~~ this is where the most significant bone spurs, calcification's & bone separation happens .. right at the the tibial tuberosity of the tibia. There is such stress and tension placed at this location.
The common theme of "growing pains" is occurring , but lets be proactive for our athlete.
FIRST: listen to them!
SECOND: ask questions, ~~ questions like "where is the pain", "what is the intensity of the pain" ... have them describe what they are feeling.
THIRD: get the issue checked out.. get a medical professionals diagnosis, that way we have a better understanding for treatment.
Fourth: set a plan in motion for rehab & recovery.. the common protocol is PT... but lets look outside the "box" and include SPORTS MASSAGE.
We can aid in the overall recovery and be part of the sports medical model to help get the athlete back on the playing field!!
Traditional PT is going to incorporate EXERCISE & some soft tissue mobilization. On a larger scale, SPORTS MASSAGE will provide the following:
* ice massage
* soft tissue mobilization
* decrease fascial restrictions
* decrease scar tissue build up
* increase range of motion (ROM)
* increase flexibility
we are not restricted in our approach as traditional PT
HOWEVER, BOTH PT & SPORTS MASSAGE work best together for the benefit of the athlete!!
Things to also mention:
Rest the quad's, minimize or completely take time off from excessive activities that involve the flexion & extension of the knee.
Ice the quadriceps muscle group... not just at the knee.. all portions of the muscle.
Get a clear diagnosis of whats going on.
Please let me know if you have any questions... I'd be glad to answer them.