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Monday, March 10, 2014
Any Exercises For Osgood Schlatter's?
My daughter, almost 10 years old, has just been diagnosed with Osgood Schlatter’s disease. She is off of crutches. What exercises, training etc. will help her avoid future problems?
Osgood Schlatter`s can be problematic for a young individual. If she is off crutches, I assume the pain is gone at the knee. Since it is a problem that occurs with growth, your daughter will be most at risk when she goes through a growth spurt again. Because of the patellar tendon's pull on the tibia tuberosity, a few exercise options should be addressed.
First, theory is that the bone grows faster than the muscle causing some of the abnormal high pull. To decrease this pull, the hamstrings need to maintain their flexibility. Hamstring stretches performed statically are recommended.
An easy way to do this is to have the child sit on the floor up against the couch, keep the back tight to the couch, and slowly straighten the legs. A hold of 20 to 30 seconds is recommended for 3-5 repetitions. I usually suggest holding the stretch during commercials and doing it for every commercial during a favorite TV show.
The traditional exercise is the straight leg raise (SLR). In an almost sitting position, bend the opposite leg, hold the exercising leg straight as it is raised 6-12 inches from the floor. If it cannot be performed in this position, it is easier to do lying flat on the back.
I usually ask the client I see with this problem to do the SLR's on their sides and stomach also to balance the entire leg strength. To further address the pull, the hamstrings need to be strong enough to counter the quads. This is another reason I suggest the stomach position. The hamstrings are worked in this position.
The final exercises I recommend involve doing short arc exercises with the quad, either sitting or standing, while emphasizing the lengthening part of the exercise. If you sit in a chair and raise the leg to straighten it, that is the positive part of the exercise. When the leg is lowered, that is the lengthening part.
The straightening part should take a second while the lowering or lengthening part should take 5-6 seconds. This can be done as well while standing in the form of a mini squat or wall slide with the feet 12-18 inches from the wall. Going down is the lengthening part now. Recommended repetitions depend on pain and strength to start.
Do not exercise through pain in the knee; muscle soreness is part of getting the muscles stronger. Do the number that is comfortable at first and increase as she gets stronger. If she can do more than 20 repetitions, start adding weight one pound at a time and she should be able to get to 20 again easily before adding more weight. At the age of 10, I would not use more than 5 pounds as the maximum weight or no more than 10% of her body weight as a guideline.
To summarize: hamstring stretching, straight leg raises for the quad and the hamstring, short arc exercise that emphasize the lowering phase of the exercise, are my recommendations to start. Again stay in a pain free range of motion while doing the lowering exercises.
I would suggest a visit to your local sports medicine professional for instruction in an individual exercise program suited to your daughter's needs.
Rose Smith, LPT
College of Allied Health Sciences
University of Cincinnati