6 Tips for Parents With Kids Who Have Osgood-Schlatter’s Disease

Article featured on Orthogate
Anterior knee pain is a common complaint of young athletes participating in sports. As a teenager, most of the aches and pains disappear as fast as they show up. However, when the pain doesn’t go away it can be frustrating and scary to deal with as a parent. Osgood-Schlatters Disease (OSD) is one of the common ailments that cause pain in the front of knee particularly in teenage athletes ranging from 12-15 years old. Injuries at this age can be a challenge, as kids of that age have difficulty communicating their pain, understand their diagnoses, and can get frustrated with the missed time on the playing field.
Osgood-Schlatters also tends to linger and stay longer than any teenager would like. That’s when you decide to see a doctor. However, OSD is just common enough and not serious enough that some doctors might brush it off as unimportant. What’s a parent to do? Here’s a guide to help you and your growing teenager get through it and maintain the sanity of your household through the process.

What is Osgood-Schlatters Disease?

First, the word disease can be a little misleading. Osgood-Schlatters Disease is less of a disease and more of an overuse injury involving the patella tendon. OSD is most common during the adolescent growth spurt as the bones are maturing. The pull from repetitive movement such as jumping causes tension through the patella tendon on Tibial Tuberosity. This traction injury can cause inflammation, tenderness to the touch, and formation of a painful bony bump to form on the front of the shin.

Risk Factors for Osgood-Schlatters Disease?

The primary risk factors for Osgood-Schlatter disease are repetitive movements during a certain age range. Other risk factors include:

  • Age – OSD is most common during puberty and large growth spurts. The typical range for boys is 12-15 and girls from age 10-13
  • Gender – OSD occurs more frequently boys but the incidence is increasing in young girls as more young ladies are participating in sports
  • Sports – Most commonly found in sports with high force production in the legs such as running, jumping, and cutting. Basketball, hockey, and soccer are the most common sports associated with OSD.

Top Tips for Patients To Help Recover from Osgood-Schlatter Disease

Create a Schedule

This might be the most important tip to consider. Recovering from OSD requires consistency and a schedule can help. Create a daily schedule to ice the tendon, to stretch the quadriceps, and to even perform self-massage can speed up recovery. Also, schedule some downtime to allow the knee adequate rest. Kids tend to have a really hard time understanding the importance of treating their injuries seriously. For good time management skills try writing out daily, weekly, and monthly recovery goals.

Take Active Time Off

OSD is an overuse injury from repetitive patellar tendon tension. If the young athlete continues to play and practice without adequate tendon rest it could re-injure the tendon. This can prolong the recovery timeline and cause more frustration. The tendon needs proper time to heal and this can be difficult during the middle of the season, especially for a teenager. Try to help them understand that active movement and activities such as walking and biking are good but they need to take a break from jumping, running, and sports. Figure out other ways they can be involved with the team while they heal as OSD can take up to 6-8 weeks to heal in severe cases.

Brace it

For mild cases and athletes returning to their sport, a brace may help with pain and prevent a recurrence. A brace for Osgood-Schlatters changes the location of tension from the Tibial Tubercle to the brace. The tendon is allowed to heal with less tension but yet your athlete is still able to participate. This may also stop the progression of new cases of OSD before they become severe and help them get back to sports sooner.

Emphasize Proximal Hip Strengthening

The knee is a slave to the hip and ankle. The knee joint bends forwards and backward but the rotation of the knee is controlled from the joints above and below it. One of the best ways to stabilize the knee focuses on the lateral hip muscles through exercises such as the side-lying clamshell and the single-leg deadlift. The stronger the hip gets, the more stable the knee will become and it will be able to handle more stress. These exercises also won’t aggravate OSD, so they are safe to start at any time.

Talk about Expectations

Taking 4-6 weeks off during the middle of the season may seem like an eternity for a 13-year-old but it’s important to talk about expectations and timelines. The younger teens may not understand the importance of healing now to prevent future complications. They shouldn’t be running or jumping while at school. Take time to talk to them about how they feel about missing playing time. The young athlete may be seen apprehensive about losing their starting spot in the lineup or worry that they will be forgotten by their teammates. Feeling depressed about their injury is fairly common.

Prevent it with Cross-Training

One of the best ways to prevent OSD from returning or starting in the first place is through cross-training. Specializing in one sport has been shown to increase the injury rate in young athletes. The demands of participating in different sports change the repetitive trauma to the muscle, tendons, and ligaments. By playing multiple sports over the year it promotes well-rounded muscle development, better movement quality, and needed rest between seasons. Kids need to be well-rounded athletes before they can specialize.

Conclusion:

Osgood-Schlatters can be a frustrating and scary injury to deal with as a parent. However, with a solid game plan, proper communication, and maintaining active rest,  your young athlete will be back on the field in no time.


New Mexico Orthopaedics is a multi-disciplinary orthopaedic clinic located in Albuquerque New Mexico. We have multiple physical therapy clinics located throughout the Albuquerque metro area.
New Mexico Orthopaedics offers a full spectrum of services related to orthopaedic care and our expertise ranges from acute conditions such as sports injuries and fractures to prolonged, chronic care diagnoses, including total joint replacement and spinal disorders.
Because our team of highly-trained physicians specialize in various aspects of the musculoskeletal system, our practice has the capacity to treat any orthopaedic condition, and offer related support services, such as physical therapy, WorkLink and much more.
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Bone, Joint, and Muscle Infections in Children

Article Featured on AAOSChildren can develop infections in their bones, joints, or muscles. Often referred to as “deep” infections, the technical names for these conditions are:

  • Osteomyelitis (bone infection)
  • Septic arthritis (joint infection)
  • Pyomyositis (muscle infection)

This article covers the most common types of deep infections in children and includes the ways doctors identify and treat them.

Cause

Infections are usually caused by bacteria that are present in our normal living environment. The most common bacteria causing bone, joint, or muscle infections in children is Staphylococcus aureus (often referred to as “Staph” infections).

Bacteria can get into the body in a variety of ways. They circulate through the bloodstream until they reach a bone, joint, or muscle. Bacteria then leave the bloodstream and multiply in the bone, joint, or muscle tissues.

Description

Deep infections most often occur in the joints and at the ends of long bones where they meet to form joints. These include the hip, knee, and ankle joints of the leg, and the shoulder, elbow, and wrist joints of the arm.

The large muscle groups of the thigh, groin, and pelvis are the most common locations for deep muscle infections.

The reason infections occur in these areas is due to the way blood flows to these locations. There is a strong blood flow to the ends of bone near growth centers (called growth plates), the lining of the joints, and the large muscle groups. This allows bacteria to easily find their way to these areas.

The blood supply to the spine, pelvis, and heel is similar to that of the long bones, and infections often develop in these areas, as well.

Infections pose special risks to young children for a number of reasons:

  • Children under the age of three are easily infected. Their immune systems are not fully developed and they tend to fall down a lot, opening the skin to infection.
  • Infections spread quickly through a young child’s circulation system and bone structure.
  • Damage to bones and joints caused by infection can harm a child’s growth and lead to physical dysfunction. Infection of child’s hip joint is a surgical emergency.

Symptoms and Signs

Children who have infections of their bones, joints, or muscles often have the following:

  • Fever
  • Pain
  • Limited movement of the infected area — your child may limp or refuse to walk if the infection involves the legs or back
  • Infants may be irritable and lethargic, refuse to eat, or vomit

Many children who have bone, joint, or muscle infections have had recent injuries. The symptoms of infection are often masked by those of the injury. Because parents assume the injury will get better over time, it may take them longer to notice the infection.

It is important to bring your child to a doctor immediately if symptoms are not quickly resolving at home.

Doctor Examination

Medical History and Physical Examination

Make sure to tell your child’s doctor the circumstances surrounding the symptoms, such as when the symptoms began, and whether there was a prior infection or injury.

After discussing your child’s symptoms and medical history, your doctor will examine the painful area. He or she may ask your child to move the affected area to see whether movement increases the pain.

Tests

Other tests that may help your doctor confirm a diagnosis and plan your child’s treatment include:

  • Blood tests and tissue cultures. Tests on your child’s blood, as well as fluid and/or tissue from the infected area, can help identify the bacteria or other organism causing the infection. This information about the infection helps your doctor determine the most effective ways to treat it.
  • Imaging tests. Tests, such as x-rays, magnetic resonance imaging (MRI) scans, and ultrasound, provide your child’s doctor with pictures of the bones, muscles, and soft tissues in the affected area. Your doctor will look for swelling around bones and muscles, or fluid within the joints that are infected. This information helps your doctor when making the decision whether to treat the infection with antibiotics alone or to perform surgery to help resolve it.

Treatment

Antibiotic Treatment

Prescribing antibiotics is the mainstay of treatment for infections.

  • Intravenous. At first, your child will need to stay at the hospital to receive antibiotics through the veins (intravenous or IV). How long your child will stay in the hospital will depend on how severe the infection is. Most children with bone, joint, or muscle infections are in the hospital for 1 to 2 weeks.
  • Oral. For many children, the antibiotic is eventually changed to a form that can be taken by mouth (oral) and given at home.
  • PICC line. Some children can continue to receive an antibiotic by vein at home through a special intravenous device called a PICC (pronounced “pick”) line. This is a peripherally introduced central catheter (PICC).

The amount of time on antibiotics that is needed to resolve an infection varies from child to child but, in general, is 4 to 6 weeks for a bone infection and 3 to 4 weeks for joint or muscle infections.

It is very important to have your child take all of the antibiotics he or she is given, in exactly the way they are prescribed.

Surgical Treatment

In mild infections, antibiotics alone may resolve the condition. Many children, however, will need surgery to remove infected material (pus) from the area of infection. This will reduce pressure and inflammation and improve blood flow, which will make it easier for the antibiotics to reach the infected area. For most children, one surgical procedure is enough, but more severe infections may require two or more surgeries to help resolve the infection.

Infected biceps muscle

An infection in the biceps muscle has caused pus to accumulate in this child’s upper arm. During surgery, the pus will be drained so that antibiotics can effectively reach and resolve the infection.
Courtesy of Children’s Medical Center of Dallas

Outcome

Most children will completely recover from deep infections after proper treatment. They are not likely to develop the same infection again. In most cases, children have no further problems and return to all of their activities.

In general, children do better when the infection is recognized early. There is a greater chance for full recovery when the infection is quickly recognized and treated. The later the diagnosis is made, the more likely it is that the infection will cause greater damage to the bones, muscles and other tissues that are involved.

Some problems can occur in children who have serious and prolonged infections. These include blood clots, growth arrests, deformed bones, fractures through bone that is weakened from infection, bone death (called necrosis), and joint stiffness. However, these problems are rare.

Methicillin Resistant Staphylococcus Aureus (MRSA)

In many communities, deep infections are more frequently being caused by a particular type of bacteria known as MRSA. This bacteria is more able to resist antibiotics that previously worked well to treat these infections.

Currently, there are several antibiotics that work very well against MRSA and are tolerated very well by the children who are treated.