Osgood-Schlatters Disease

What is it?

Osgood-Schlatters disease is an injury that occurs when the patella tendon repeatedly pulls on the the bony attachment at the tibial tuberosity (top of the shin bone). The repeated force of the tendon pulling on the tibial tuberosity causes microtrauma to the bone. If this continues over a prolonged period it may lead to a build up of extra bone at the tibial tuberosity. The disease is more commonly found in boys than girls and in 20 – 30% of time it will affect both knees.

Causes of Osgood-Schlatters Disease

  1. Shortness of the quadriceps muscle (thigh Muscle);
  2. Fast periods of bone growth;
  3. Trauma to the front of the shin bone; and
  4. Poor biomechanics, which may include reduced pelvic stability or pronated (flat) feet.

Treatment / Rehabilitation

  1. Ice after exercise;
  2. Quadriceps muscle stretches;
  3. Soft tissue release of the quadriceps;
  4. Taping of the patella tendon;
  5. Insoles (orthotics) if required for patients with flat feet;
  6. Non Steroidal anti-inflammatory medication in severe cases; and
  7. Reduction in exercise load.

Recovery and Prognosis

Symptoms normally resolve over a 1–6 month period. Symptoms often resolve as the growth period slows. The patient can sometimes be left with a lump at the tibial tuberosity as the body lays down extra bone to strengthen the area. Osgoo-Schlatters Disease cases ongoing symptoms in only a small percentage of sufferers.

 

Date added

17th March 2013

 

Hamstring Injuries

What are they?

A partial or complete tearing of one or more of the three hamstring muscles that run from the back of the pelvis and attach on the shin bones. Strains of the hamstring are graded according to the degree of loss of function.

Grade 1 Strain: mild loss of muscle function with minimal loss of flexibility and strength.

Grade 2 Strain: significant loss of muscle function which causes significant loss of strength and flexibility.

Grade 3 Strain: all muscle fibres ruptured. Unable to walk without pain and gross loss of muscle strength and flexibility.

Causes of Hamstring Injuries

Hamstring injuries can occur due to overcontraction of hamstring either while it is working in a concentric muscle fashion (to flex the knee or extend the hip) or in an eccentric fashion (muscle working while it is lengthening as occurs when the hamstring muscle works to control the pace of knee extension prior to placing the foot on the ground during running). Hamstring injuries can also occur when bending forward quickly causing an excessive stretching of the hamstring that leads to muscle fibre tearing.

Biomechanical Factors that Contribute to Hamstring Injuries

  1. Hamstring muscle weakness;
  2. Gluteus maximus muscle weakness and inactivity;
  3. Hamstring muscle inflexibility;
  4. Fatigue;
  5. Pelvic asymetry;
  6. Hamstring/quadriceps muscle strength imbalance;
  7. Sciatic nerve irritation/tension; and
  8. Uncompleted rehabilitation from previous injury.

Treatment / Rehabilitation

  1. RICE (rest, ice, compression, elevation) for first 24-48 hours;
  2. Appropriate strengthening of the hamstring or gluteus maximus muscles;
  3. Hamstring stretches;
  4. Muscle energy techniques to correct pelvic asymetry;
  5. Lumbar spine mobilisation/manipulation to reduce sciatic nerve tension;
  6. Soft tissue massage and ultrasound therapy to loosen scar tissue;
  7. Graduated running program; and
  8. Eccentric flick/catch training.

Recovery

Grade 1 hamstring strains usually recover in a 2-3 week period. Grade 2 strains may take 3 –6 weeks. Grade 3 strains can take anywhere from 8 weeks to 6 months to fully repair.

 
Date added

13th January 2013

 

Severs Disease

What is it?

Severs Disease is a pain surrounding the growth plate at the back of the heel in adolescent children between the ages of 9 and 15. The posterior heel area is irritated by repetitive muscles actions that pull on the bone, often from running and jumping.

Causes of Severs Disease

  1. Shortness of the calf muscles (gastrocnemius and soleus) and their common tendon (calcaneus tendon);
  2. Poor position of the mid foot (pronation or supination) or rear foot (calcaneal inversion/eversion); and
  3. Fast periods of bone growth during growth spurts.

Treatment

  1. use ice after exercise;
  2. calf muscles and calcaneal tendon stretches;
  3. soft tissue massage release of calf muscles and calcaneal tendon;
  4. heel lifts to reduce stretch on soft tissue;
  5. taping to support foot arches and prescription of orthotics;
  6. taping to glide the calcaneal tendon medially or laterally; and
  7. Anti Inflammatory medication in severe cases.

Recovery

Varies in length from 2 weeks to six months. Severs disease will not cause any long term biomechanical issues.

 
Date added

23rd November 2012