Bumpy Knees

I was one of the smallest kids in my grade up until high school. Over the year between my thirteenth and fourteenth birthdays, I grew about 6 inches. I slept a lot that year and had a lot of pain in my legs, especially around my knees. I played basketball and baseball and my legs hurt, especially after practices and games. The pain was so bad that year that I went to see the doctor, whose diagnosis was that I had Osgood-Schlatter Disease (OSD). The recommended therapy was to ice my knees, take over the counter pain relievers and reduce or stop sport activities. This led me to conclude that all young athletes, especially ones who have a significant growth spurt, will develop OSD.

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Both Dr. Robert Osgood and Dr. Carl Schlatter described the disease, hence, the name.  According to an  article published by James R Gregory, MD, OSD is caused by persistent stress on tendons and muscles surrounding the tibial tuberosity, or the oblong part on the top of the tibia, or shinbone. As per a Mayo Clinic Publication, the disease occurs mostly in boys from the ages of thirteen to fourteen years old and girls from eleven to twelve years old and is worsened by jumping activities such as; gymnastics, running, basketball, soccer, ballet and volleyball. Basically, the pain results from the stretching of the tendons and muscles around bones growing at a faster pace, specifically around the knees. It mostly impacts the Patellar tendon which runs from the thigh and connects to the tibia. If the condition is very bad, the Patellar tendon can pull away from the tibia, called avulsion or separation, causing more bone to grow on the tibial tuberosity; resulting in a noticeable and permanent bump just below the knee cap. This bump represents the result of the body repairing itself. The disease can present itself in both knees and can last as little as weeks or up to months, as it did in my case. It does cease at the point adolescent growth stops. This is a helpful video to describe the disease.osgood-2osgood-1

 

A BioMechanics publication, referenced an injuries audit for youth football, which concluded that only one of twenty child athletes, aged eleven to thirteen showed signs of OSD. Another study, reported in The American Journal of Sports Medicine, stated that of 193 student athletes who participated in a survey, only 21.2% or 41 of them had shown any signs of OSD.

Another study by the National Center for Biotechnology Information, was primarily conducted to assess body types of athletes to determine risk factors for OSD. The study assessed 300 knees of 150 players and established a testing group of 70 knees. One year after the initial observation, 10 knees with OSD or 14.3% were compared with the 60 without OSD to determine variabilities in muscles, weight and strength. This study concluded that methods for stretching could be taught to aid players.

While these studies reported that not all athletes were afflicted by OSD, it was not specifically stated that all the athletes had experienced extreme growth-spurts. The one interesting thing I did come across is that doctors and scientist do not know why bones grow faster than tendons and muscles in some or all adolescents. OSD represents the effects after stress to the impacted area occurs. None of the research I reviewed concluded why it happens, similar to Andrew’s 11/8/2016 lesson about the uncertainty of science.

In conclusion, the studies do show that not all young athletes suffer from Osgood-Schlatter Disease. For those that do suffer from it, the good news is that is stops once a growth spurt ends. Most young people with OSD are able to continue playing sports, however, in severe cases, it is recommended that a break be taken from activities such as jumping and running. Stretching and strengthening exercises may help relieve some of the pain while keeping the area fit. These exercises focus on the quadriceps and hamstring muscles. The bad news is that the damage is oftentimes done. My bumpy knees are a good example of that.

Picture 1 source:    https://www.google.com/search?q=pictures+of+osgood+schlatter+disease&espv=2&biw=1527&bih=836&source=lnms&tbm=isch&sa=X&ved=0ahUKEwijte3X8qXQAhWS14MKHd5-AsMQ_AUIBygC#imgrc=Z92PigIMCAfjXM%3A

Picture 2 source

thttps://www.google.com/search?q=pictures+of+osgood+schlatter+disease&espv=2&biw=1527&bih=836&source=lnms&tbm=isch&sa=X&ved=0ahUKEwijte3X8qXQAhWS14MKHd5-AsMQ_AUIBygC#imgrc=mvmgiVomVFA1BM%3A

Picture 3 source

https://www.google.com/search?q=pictures+of+osgood+schlatter+disease&espv=2&biw=1527&bih=836&source=lnms&tbm=isch&sa=X&ved=0ahUKEwijte3X8qXQAhWS14MKHd5-AsMQ_AUIBygC#tbm=isch&q=charts+osgood+schlatter+disease&imgrc=c6nVxGY93qsf-M%3A

Sources:

http://emedicine.medscape.com/article/1993268-overview

http://www.mayoclinic.org/diseases-conditions/osgood-schlatter-disease/basics/definition/con-20021911

https://www.youtube.com/watch?v=tgo0pjVyoEw&t=109s “Video”

http://www.drreeves.com/sites/default/files/Biomechanics%20OSD%20Article.pdf

http://ajs.sagepub.com/content/13/4/236.short

https://www.ncbi.nlm.nih.gov/pubmed/26133498

1 thought on “Bumpy Knees

  1. Jeremy Perdomo

    Dear Michael,

    I must confess that I wanted to read this article because I have a personal history regarding knee problems; when I was playing soccer my Freshman year of high school, I was aiming for a ball as it was rolling to me and I kicked it as hard as my legs would allow. However, there was only one problem: I missed the ball entirely. It doesn’t sound like it hurts, but take my word for it that it was an excruciating pain! I went to the doctor to get MRI’s of my knees and found out that I hyperextended them and, as a consequence, both my ACL’s got extended. Yes, you heard right: both my ACL’s. Nonetheless, that is why I clicked on your article. LOL.

    Anyways, regarding the article itself, I really enjoyed the fact that you included your personal story to make the blog more relatable; it made me want to read the blog even more! I also enjoyed how I actually learned something new by reading this article; more specifically, I learned what OSD was, which I had never head of before in my life. Also, this was the first article I have come across that did research on any one single disease as the blog itself, so I thought that was pretty cool.

    Finally, if you happened to be interested in any other diseases that might occur with the knees, look no further! I have done the research for you and have come across this website that goes into depth on the many things that can go wrong with, arguable, the most important joint in the human body! :

    https://www.unitypoint.org/madison/diseases-of-the-knee.aspx

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