Gary Moller: [DipPhEd PGDipRehab PGDipSportMed(Otago)FCE Certified, Kordel's and Nutra-Life Certified Natural Health Consultant]. ICL Laboratories registered Hair Tissue Mineral Analysis and Medical Nutrition Consultant.

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Friday, March 12, 2010

A young gymnast with Osgood-Schlatters Disease

Boney bump below knee
Hello Gary
I love receiving your newsletter. My son is a 13 year old Level 9 gymnast (Level's go to 10 and then college competition). He has developed O-S and other than the traditional ice and rest (which won't happen) do you have any advice?
Gary responds:
Prior to the adolescent growth surge, most young boys have excellent flexibility, not dissimilar to that of girls.  With the onset of puberty the surge of testosterone initiates rapid elongation of the long bones of the body as well as a hardening of connective tissue, including the tendons.

In addition, the rapid bone growth draws on every available store of minerals such as calcium and magnesium, depleting muscles and other organs.  Calcium and magnesium regulate muscle tension.

Points where the long bones grow (Growth plates) become vulnerable to injury from sudden traction and compression forces such as when landing during a vault, or kicking a ball.

As the long bones elongate, the muscles and tendons tend to lag well behind causing a loss of strength, agility and flexibility.  The loss of flexibility may appear to happen almost overnight and can easily happen unnoticed by the coach.

Protein and other nutrients are needed in large supply throughout the day and are often in a state of chronic shortage in the adolescent athlete, very much thanks to the predominance of cereals, low fat foods and the instant noodle.

The mineral depletion, lack of quality protein, plus the loss of flexibility leaves the young athlete vulnerable to the kind of injury that is Osgood-Schlatters.  Osgood-Schlatters happens when the large tendon of the qudriceps (thigh) muscles contract suddenly, such as kicking or jumping.  This injury may appear as a hard, tender bump below the kneecap (Refer image above left).  A similar injury may occur at the heel bone where the large calf muscles attach via the Achilles tendon.

Very intense knee pain is usually the presenting symptom that occurs during activities such as running, jumping, squatting, and especially ascending or descending stairs and during kneeling. The pain can be reproduced by extending the knee against resistance, stressing the quadriceps, or squatting with the knee in full flexion. Pain is mild and intermittent initially. In the acute phase the pain is severe and continuous in nature. Impact of the affected area can be very painful.

While nobody has ever died from this condition and full recovery is inevitable once growth is complete, it can result in loss of form and enjoyment of activity.  The young athlete also risks being left with a permanently unsightly and often annoying pair of boney lumps.

My inclination is to do whatever is necessary to prevent this from happening.

Prevention and recovery
  • Rest - But this does not necessarily mean stopping the gymnastics.  What this entails is rest from the offending activities.  This means your son can do everything other than leaping and landing for as long as is necessary for the pain to disappear.  This time can be the opportunity to concentrate on areas of weakness that do not involve tumbling and vaulting.  If he has not learned to swim, as all boys and girls should, then now is the opportunity.
  • Active Elements 2.1 and 2.3 - These have the tissue salts that the growing body requires for bones and tendons that are strong and resilient.  He can take about 6 per day for as long as there is any pain and discomfort.
  • Anti-inflammatories - Read my article here about why these drugs should not be taken, especially by youngsters.
  • Cortisones - No!  Read my articles here about the horrors of this misguided treatment.
  • Stretch gently - and avoid vigorous bounce stretching.
  • Frequent meals - five per day, high in protein, complex carbs, fats and minerals from relatively unprocessed sources.  You will gather that I am not a fan of pasta and noodles.
  • Please read this E-Book here which I have written for parents and coaches of talented young athletes.
Above all, be patient, give it time to settle and always ensure you place his longterm welfare before all else.

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