Last Updated on Wednesday, 30 December 2015 16:07
By Dr. Rob LaPrade
http://drrobertlaprademd.com
Question: I am a PeeWee and my knees ache a lot after skating. I have been told that I have Osgood-Schlatter syndrome. What is this and what can I do for it?
Answer: Osgood-Schlatter syndrome or disease, named after the two physicians who originally described it, is probably the most common cause of pain on the front of teenage athlete’s knees. In skaters, it can be quite debilitating and can limit on-ice performance. It presents as a painful lump on the shin just below the knee, and is often related to tight hamstring muscles. Therefore, it can be treated or possibly even prevented with a proper stretching routing.
During growth spurts, tight hamstring muscles can develop that resist straightening of the knee. This puts extra stress on the quadriceps muscles, making them work harder to extend the tibia, or shinbone. Because the quadriceps muscles pull through the patellar tendon that attaches to a small growth plate just below the knee, athletes with tight hamstrings have a much greater force pulling on this growth plate, which can cause irritation. This results in the development of pain and can sometimes cause a raised swelling or bump at the attachment site of the tendon.
To prevent this, preseason and in-season training or warm-ups should include a thorough stretching program that includes hamstring stretches. If an athlete develops Osgood Schlatter syndrome, the treatment is based on managing the symptoms. It is important to rest and avoid aggravation of the injured patellar tendon as much as possible. Because the syndrome is caused by tight hamstrings, one must work very hard on a hamstring stretching program. This could involve hurdler’s stretches or just putting ones leg out on a chair and reaching over it and touching ones toes. The key to affectively stretch ones hamstrings is to do it several times a day rather than just once a day.
When returning to play, one should make sure to properly stretch the quadriceps and hamstrings before any athletic events, and should ice the affected area following physical activity to lessen the swelling and pain.
If needed, taking acetaminophen or any of the anti-inflammatory medications when one anticipates putting a lot of stress on their knees can also be helpful.
Almost always, the symptoms of Osgood-Schlatter syndrome resolve once you stop growing. While many people with Osgood-Schlatter syndrome will have a remaining bump of bone where their patellar tendon attaches on their tibia, this is very rarely an area of pain after adolescence.
In summary, the best way to prevent and treat Osgood-Schlatter syndrome is to address the tight hamstrings that cause it. Maintaining a good hamstring stretching program and icing down the area after activity if it is painful will hopefully allow you to play hockey without interruption.
Robert F. LaPrade, M.D., Ph.D. is a complex knee surgeon at The Steadman Clinic in Vail, Colorado. He is very active in research for the prevention and treatment of ice hockey injuries. Dr. LaPrade is also the Chief Medical Research Officer at the Steadman Philippon Research Institute. Formerly, he was the team physician for the University of Minnesota men’s hockey team and a professor in the Department of Orthopaedic Surgery at the U of M. If you have a question for the Hockey Doc, e-mail it toeditor@letsplayhockey.com.
