Feature Story


The Hockey Doc on Osgood-Schlatter’s syndrome

 

 

QUESTION: My knees ache a lot after skating. I have been told that I have Osgood-Schlatter’s syndrome. What is this and what can I do for it?

 

ANSWER: Osgood-Schlatter’s syndrome is probably the most common cause of pain over the top of adolescent athlete’s knees. In some skaters, it can be quite debilitating and can limit on-ice performance.

Osgood-Schlatter’s syndrome was named after the two physicians who originally described it. It is caused by having very tight hamstring muscles while one is in a growth spurt. Due to very tight hamstring muscles, it becomes more difficult for that particular athlete to straighten their knee out. This puts extra stress on the quadriceps muscles, on the top part of the thigh, to work harder to pull the lower bone, the tibia, forward.

The location where the quadriceps muscles force is directed is at a small growth plate on the front of the knee. This is where the patellar tendon attaches. Because of the extra force placed on it, athletes with tight hamstrings are in effect pulling harder on this growth plate then normal. This is where the pain comes from. In fact, the tight hamstrings over time could cause this growth plate to be pulled forward enough that one has a noticeable bump on the front part of their knee.

The treatment for Osgood Schlatter’s syndrome is based on treating the symptoms. Because it is caused by tight hamstrings, one must work very hard on a hamstring stretching program to address it. This could involve hurdlers stretches or just putting ones leg out on a chair and reaching over it and touching one’s toes. The whole key to being able to effectively stretch one’s hamstrings is to do it several times a day rather than just once a day.

In addition to hamstring stretching, it can be useful to ice down the area after competition and also to take some acetaminophen or any of the anti-inflammatory medications when one anticipates putting a lot of stress on their knees.

Almost always, the symptoms of Osgood-Schlatter’s syndrome resolve once one stops growing. While many people with Osgood-Schlatter’s syndrome have a bump of bone where their patellar tendon attaches on their tibia, this is very rarely an area of pain into adulthood. The main key with Osgood-Schlatter’s syndrome is to work on a good hamstring stretching program and ice down the area after activity so that you can continue to participate in on-ice activities without interruption.

 

Dr. Rob LaPrade, MD, PhD, is the team physician for the University of Minnesota men’s hockey team and a professor in the Department of Orthopaedic Surgery at the University of Minnesota. If you have a question for the Hockey Doc, send it to 2721 East 42nd Street, Minneapolis, MN  55406, fax it to 612-729-0259 or e-mail it to editor@letsplayhockey.com.