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osgood schlatters disease
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osgood schlatters disease - September 21, 2004 4:17:00 PM
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MPT
Posts: 161
Joined: April 4, 2004
From: Syracuse, New York
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Has anyone had luck treating this?
What criteria should be used to determine if sports should be stopped?
Thanks
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Re: osgood schlatters disease - September 21, 2004 5:00:00 PM
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bonmar
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From: Boston, MA
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Generally, the MD allows the patient to continue activities to tolerance.
Stretching/strengthening the surrounding ms groups, checking the feet for abnormalities (overpronation, etc),icing, and trying a chopat strap are the most helpful treatments that I have found.
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Re: osgood schlatters disease - September 21, 2004 5:27:00 PM
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Augustine5I
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From: NJ
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Hey MPT,
Don't know how much of a "disease" this is but it can be quite stubborn b/c of the age group it is related with. Meaning, compliance with a HEP and the such can be a challenge.
Soft tissue work over the tibial tuberosity via cross friction is helpful. Follow this up with an ice "massage".
Stretch as Bonnie suggested.
Getting control of the inflammation is key. Keep therex as pain free as is possible. The client should avoid activity that further irritates or increases activity.
Good luck,
Tom
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Re: osgood schlatters disease - September 21, 2004 6:32:00 PM
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eam
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Flexibility is very important here. The quads need to be stretched as well as the other lower quarter musculature. Good luck!
Erica
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Re: osgood schlatters disease - September 21, 2004 7:54:00 PM
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chiroortho
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One might suggest avoiding activities requiring frequent kicking (soccer, place kicking) and jumping for a while (particularly when symptomatic), but I suppose that's debatable, and I agree with Augustine that OS is not really a disease per se.
Remember the old days when kids were placed in long leg casts?
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Re: osgood schlatters disease - September 22, 2004 4:41:00 PM
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MPT
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From: Syracuse, New York
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Thanks for the replies. I have pretty much started everything that was suggested. He does have some over pronation with forefoot valgus. There really is not any inflammation, seeing as he only has pain when active.
I am fitting him with orthotics and am going to give him a chopat brace.
PS, I am not the one that defined it as a disease. I found it in several text books as osgood-schlatter disease
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Re: osgood schlatters disease - September 22, 2004 4:48:00 PM
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Shane Steimel
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From: Indiana
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I think this would be a great question to our new Sports & Fitness forum moderators - who we are very excited to have contributing to our body of knowledge.
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Re: osgood schlatters disease - September 23, 2004 7:31:00 AM
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Brian Smith, PT, CSCS
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In regards to should sports be stopped, I think you first have to determine the physical requirements needed for the particular sport.
Then next I would suggest putting the athlete through a functional progression with the focus on completing the progression without significant sxs.
The progression should involve running/ plyometrics/ agilities/ and sport specific drills after evaluating the athlete's sport.
If the athlete, has significant pain with these type of activities stopping sports may be beneficial or suggested until sxs are more controlled.
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Brian Smith, PT, CSCS
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Re: osgood schlatters disease - September 25, 2004 11:58:00 AM
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jma
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From: NY
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Hello,
I have seen kids during their growth spurts with this. Their MD's have advised not to do any jumping activities or to negotiate stairs on a continuous basis. Stretching quads to tolerance was advised as well as ice massage around the kness/tubercles. Once the growth spurt stops, then, if everything else is okay, can they return to previous sports activities. Easier said that done though.
JMA
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Re: osgood schlatters disease - September 25, 2004 12:33:00 PM
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Brian Schiff, PT, CSCS
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In my experience, kids with this problem all respond a little differently to rehab and treatment. Some recover quickly and some slowly.
One thing to consider is gradual integration of plyometrice (low level) after the athlete has demonstrated the ability to run straight ahead with minimal to no pain. Low level plyos would include line jumps, ankle springs, shuttle hops, etc.
I have found that these type of conditions require year round strengthening, stretching (don't forget the hamstrings) and plyometric training. By performing routine plyometric conditioning (1-2 x/week depending on the season/ompetition schedule) the athlete better prepares his/her body to handle the stress of the sport. The plyo training will also serve to strengthen the tendon. This again must be done to tolerance and it is essential to monitor how long discomfort persists after activity. Anything less than 24 hours typically doesn't concern me.
Once they tolerate the plyometrics and move through a logical progression, they should be able to return to practice/play.
Brian Schiff, PT, CSCS
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Re: osgood schlatters disease - September 28, 2004 8:22:00 AM
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Dr.Wagner
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I would have to agree with all of the above...this really is NOT a disease, but rather a condition. Avoidance of activities that acutely inflame the area, while at the same time ensuring appropriate flexibility is needed. Slow progression back to activity is warranted.
There should be no stress on the early return to activity, slow and steady. This condition should not require many visits in rehab at all.
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Moderator of Medical Complexity Forum
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Re: osgood schlatters disease - May 29, 2005 9:08:00 AM
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BenNewton
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From: England
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Can you still have Osgoods, without an extremely large 'bump' at the top of your shin? and if it doesn't hurt when applying pressure (after resting) but when you are excersizing and add pressure it hurts; can you have it?
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Ben
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Re: osgood schlatters disease - May 31, 2005 9:59:00 AM
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USAPT
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You asked a very open question. Sounds more like you are talking about patella femoral syndrome..whatever that is:) Is this an acute problem? Try avoiding the stressful mediators, rest and ice it.
It's difficult to answer this question without further information.
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Jason, PT
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Re: osgood schlatters disease - June 1, 2005 5:48:00 AM
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JLS_PT_OCS
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In young athletes, this can be managed well in just a few visits, but I have to say in my experience it is the activity modification that really does the most good.
J
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Jason Silvernail DPT, OCS, CSCS
"It isn't what you're able to do that requires your courage but rather what you have come to understand and are willing to express." - Barrett Dorko,PT
**I no longer post on RehabEdge**
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Re: osgood schlatters disease - June 3, 2005 6:48:00 PM
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AllAboutMovement
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I recently read an article from Dave Tiberio(associate of Gary Gray) in which he spoke specifically about this topic. I'll see if I can attach the link in another posting when I find it.
I'll attempt to summarize the main points.
Those who are familiar with Gary Gray knows he's one of the pioneers of understanding function. When dealing with this condition, the term "Integration Isolation" is most important. The ability to utilize the entire "chain reaction" of the body to functionally feed the knee. Increase the role of the hip extensors and ankle plantarflexors while reducing the load of the quadriceps....which sounds like common sense to me. Knee flexion is minimal and stress to the extensor mechanism is tolerable. The knee is proprioceptively integrated with the hip and ankle. So basically the idea is to bring all the knees friends together...Integration, while allowing the knee to heal through proper motion. This can be done a number of ways via the trunk, foot position, etc. As the symptoms resolve and the growth center heals, than it only makes sense to start taking away some of the knee's friends...hip, ankle, trunk.....through proper "tweaking" and start isolating it out......in a functional manner of course.
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David Westerman, NSCA-CSCS,FES, LMT
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