My client has Osgood-Schlatters disease. Would you explain a little more of what it is and what exercises may help?
What a name for this common malady affecting the knee. Dr. Osgood and Dr. Schlatter first diagnosed the condition in 1903 and they named it after themselves. It is a condition where the tibial tuberosity is causing pain while it is taking on its shape. This condition afflicts teenagers during their growing spurts, usually in their early teenage years. Most cases will last about a year. In the most severe cases the child will have pain until the bone has stopped growing altogether and becomes hardened. It can take until age 18 in some extreme cases.
Now we know what it is, what do you do? Here are some suggestions. First, if you work with teenagers and they complain about soreness around the bottom of the knee you should refer them to their physician. If the case has been diagnosed as Osgood–Schlatter’s disease there aren’t many restrictions. The remedy is much like any soft tissue issues. Take Advil, ice it and try not to do things that may aggravate further. It is recommended that the individual stay away from jumping or continual pounding.
As far as exercise, we should try to suggest closed chain exercises rather than open chain exercise. The trainer needs to load through the joint rather than across it. The soft tissue around the knee can become more aggravated when there are distractive forces or shear forces being placed upon it. Like most conditions around the knee, the better the quad is developed, the more stress you will take off the joint itself.
One exercise I like to do is the standing terminal knee extension. You can do this exercise with a cable or tubing. Place the tubing around the back of the leg just above the knee. Hold both ends of the tube and have the client bend their knee as far as they can while still having their heel on the ground. Keep the tubing taught at all times. Have them extend their knee against the resistance of the tubing. This will keep them in a closed chain environment yet you can then load them affectively.
I would also check the length tension profile at the ankle. If the posterior tibialis and soleus are being eccentrically overloaded it can cause excessive loading and stress on the top of the tibia where the tibial tuberosity is located. It is suggested that you work on lengthening the calf by traditional stretching and possibly some manual or massage therapy to that area. Like any other condition, if the pain worsens with the completion of the exercise, discontinue the exercise immediately and refer them back to their physician.