Learn about Osgood-Schlatter Disease

Casey Bass: Winer Smitzo and Hafovizin (ph) those are the only two German words I know, but apparently there is some German sounding syndrome that gets kids keep involved and victim too that -- I don't really know a lot about. So today, we are going to learn together on ClubHouse Gas. I am pleased once again to be joined by friend of the show, Director of Sports Medicine at Children's Healthcare, Atlanta, David Marshall and his son Grant(ph). Guys, thank you for joining us. David Marshall: Thanks for having us. Casey Bass: I want to talk today about Osgood-Schlatters disease, long name, confusing, just like everything we talk about, and was discovered in Eastern Europe by these names that we are getting. What is Osgood-Schlatters disease? David Marshall: Osgood-Schlatters disease is a growth plate condition. It's very, very, very common. Way back in 1903, when two German physicians Osgood and Schlatter figured this out. They called everything diseases. I don't like to tell a kid he has got Osgood-Schlatters disease because I get this very frightened look on their faces. I like to call Osgood-Schlatters pesky condition or Osgood-Schlatters syndrome, and it's one of those pesky growth plate conditions again that seems to ail our young athletes. Casey Bass: Why don't we use our young model here to explain to us exactly what it is? David Marshall: I have drawn a couple of pictures on Grant to represent the growth plate. It's a problem where the thigh muscles attach. The largest and strongest muscle he has in his body is the quadriceps. All four of those quadricep muscles form a tendon that crosses the kneecap and it anchors right on a little dime sized area at the top of the shin bone, and that growth plate is made of cartilage which is nearly as strong as bone, very similar to how plaster compares to cement. If you take a cable and attach it to a screw into the plaster wall and keep pulling on it, you get little tiny microscopic cracks in that plaster and that's exactly what happens with Osgood-Schlatters disease. They get little tiny microscopic cracks in that bone, and that's what causes the pain. Casey Bass: Alright, Grant, well, we're going to let you go and work on your homework. We are going to go and sit down, and talk about this a little more. Alright so I know what Osgood-Schlatters is. What are some of the symptoms? David Marshall: Well, the symptoms basically is pain and swelling. The kids will come in after workout, after playing outside, after doing an activity, and they will be limping, they will be complaining of pain and they are very specific, they point right to that area on the top of that shin bone, that tibial tuberosity, so the very easily localized area, pain to that areas. So pain and swelling are the classic symptoms. Casey Bass: I talked to a mother who said that her son have been diagnosed of Osgood-Schlatters. He never had a lot of pain but every once in a while he had been standing there, and his knee would just give out on him. Is that something that you see? David Marshall: Not typically. If the knee gives out, I think there need to be a little deeper investigation as to something more insight the knee, the tendons, the ligaments, the cartilage, all those things that stabilize knee. Osgood-Schlatters condition really doesn't cause an unstable knee. So there if there is sense of instability or symptoms suggestive of that, they need to see their doctor. Casey Bass: So what causes it? How do you end up with the syndrome? David Marshall: Well, Osgood-Schlatters condition, it's an overuse injury. So the more they run, the more they jump, remember they are using those thigh muscles. And when those thigh muscles or the quadriceps attached to a growth plate, which is weak spot, similar to cartilage compared to cement, that growth plate starts to fail. So they get little tiny microscopic cracks in that growth plate, and that's what causes the pain. So it's basically due to repetitive pulling or use of those thigh muscles during running, jumping, sprinting, cutting, acceleration etcetera. Casey Bass: So how about the treatment? David Marshall: The treatment of any overuse condition as we said before is really to under-use it. So the first thing they need to do is identify what part of their workout, or what aspect of their workout causes the pain. Try to minimize the jumping, try to minimize the suicides, try to minimize the weightlifting, squats, power cleans, lunges. If it's avoidable, try to avoid that. The second thing that they need to do is ice. Ice is a very effective anti inflammatory treatment and I will like to have the kids do simple ice-cup massage. Basically, take a styrofoam coffee cup, fill it to the top of water, and put three or four of them in the freezer, so they are always there. And then when they come home from the workout before they do dinner, homework, watch TV, ice that knee for 8-12 minutes. Basically you can just take an inch of the paper around the bottom of the cup to have this frozen snow cone, like a push-up pop. It's insulated, so their fingers don't freeze and they should put some direct ice over that sore spot, and do some circular compressive massage for 8-12 minutes till it goes numb. Casey Bass: You said avoid it if you can avoid it. But, what about games? David Marshall: Well, that's the thing. For example, if they are a soccer player, yes they need to play in the games, but during practices, they don't need to do the corner kick drill, they don't need to do the running up and down the field 37 times for conditioning; they don't need to do the ladder drills for speed and agility. So if we can maybe avoid or minimize the unnecessary assets of their workout, maybe have the kid do push-ups or sit-ups during the conditioning drill so their teammates don't hate them, and think they are faking it. But, if we can avoid the avoidable stuff, maybe that will kind of give us some time or lessen the inflammation to where they can tolerate playing in a contest. Casey Bass: Well Dr. Marshall we appreciate you being here. Something that just peeked my interest and I hope that you'll come back and talk with us about this, and we will tease a future show hopefully. Kids who have been playing all day long, all year long, for as long as kids have been around. Now we are seeing more and more and more of these overuse injuries, I will like to have you back and talk about maybe the way we are playing now that's related to these overuse injuries. David Marshall: I'd be happy to. Casey Bass: Alright. That's going to do it for us today. We will see you right back here next time for another great edition of ClubHouse Gas.