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1461 Views 3 Replies Latest reply: Oct 7, 2012 6:37 AM by JamesJohnsonLMT
cmander4 Rookie 4 posts since
Aug 19, 2012
Currently Being Moderated

Aug 19, 2012 5:25 PM

osgood schlatters as an adult?

I was a very active when I was younger, but then I was diagnosed with OS and I had to limit my physical activity A LOT and wear a knee brace during anything physical. After a  few years the pain went away and only once in a great while did my knee give out or have any pain. Fast forward to now...I'm 27 and have just recently gotten back into running. My knee was feeling fine, but after the last couple of runs it has been sore, and stays sore for about a day. I was curious if anyone else had a similair story? Maybe I'm pushing myself too hard? (but that seems doubtful, I'm doing c25k and only running about 2 miles each run) Or could it be connected to my old childhood disease?

 

Also, I had it in both knees, but my right one was always a lot worse!

  • JamesJohnsonLMT Legend 1,167 posts since
    Aug 23, 2009
    Currently Being Moderated
    1. Aug 20, 2012 3:00 AM (in response to cmander4)
    Re: osgood schlatters as an adult?

    You may be one of the small percentage of OSD sufferers whose symptoms persist into adulthood. Your account wasn't complete, and it doesn't have to be (on a public site like this), but it sounds like you were left hanging after your initial recovery. Doctors know the condition usually resolves itself as the bone matures, and it appears there was no surgery or little follow-up to this day. My guess is it would be treated as a pre-existing condition by insurance, but it would be nice to see a scan of the underlying tissue. Is there still a visible lump on the knee? Is it painful on palpation? What exercises did you do prior to your return to running? Were your quads prepped for this after being inactive for some time?

     

    When you say "gotten back into running," does that mean that competitive running as a child led to the OSD? The patellar tendon is pretty important to a runner, and a sensitive insertion on the Tibia could be a problem now in a minority of cases, regardless of what other OSD sufferers have experienced. However, there is more to know here.

     

    You mentioned your knee having given out.. This is probably not because of a joint problem, but because the quads, usually the V. Medialis, fail to contract with enough force to stabilize the knee when knee irritation is present. Call it a protective reflex, but there could be a substantial amount of residual memory of the original trauma, causing the quads to tighten or behave erratically and bring about knee pain by other means.

     

    Here is an example of what I mean: Let's say Jane has a car accident. She ostensibly recovers from the accident but experiences headaches later. Her doctor blames it on complications from the original whiplash injury, she gets a good lawyer and attempts to sue the crap out of the other party for pain and suffering. The other guy gets a good lawyer whose expert witness explains that the trapezius muscle typically develops trigger points in the belly of the muscle during stressful moments such as driving in traffic, which brings back bad memories for Jane. These trigger points are known to be a primary reason for tension headaches. She then sues the crap out of the guy for psychological counseling and weekly massage sessions.

     

    Patterns of muscle spasm and tension have been known to persist for many years until they are directly addressed by appropriate therapy. It is partly a mind-body problem that does not automatically resolve, even if the original injury is healed. Supposing you are one of those who benefit from surgery to clean up the OSD damage later in life, this muscle memory could still dog you later. It is one of the reasons why people sometimes mistakenly believe that surgery has failed. Sometimes, the muscular dysfunction is more important than the surgery, if the surgery is necessary at all.

     

    Either way, you've got work to do. Before signing on to expensive and protracted protocols, however, I would explore easy ways to relax the quads and condition them for the pounding they remember from before. A combination of a few weeks of daily trigger point massage immediately followed by gentle stretching through the natural range of motion, followed by quad training exercises that you gradually ramp up, might be the final rehab you missed out on before. They wisely waited to see how it would work out, and this is how it worked out. Time to finish the job. While your quads and tendons may be physically intact and appear OK, in behavior they may be unbalanced for neuromuscular reasons, resulting in knee pain. This can be very easy to solve. Here's an interesting read...http://lifeafterpain.com/info/trigger-point/knee-trigger-points-the-case-of-mysterious-falls/

  • RockyMountainMike Rookie 1 posts since
    Oct 6, 2012
    Currently Being Moderated
    2. Oct 6, 2012 10:24 PM (in response to cmander4)
    osgood schlatters as an adult?

    I too have just experienced a flare up at 43 years of age.   I play ice hockey and it turns out there was a risidual piece of plastic inside my shin pad I was not aware of.  It was the size and shape of a pencil tip and apparently had been pressing against my tibial tuberosity during a practice session.  It flared up for the first time since adolescence.  I stumbled later the next day while it was enflamed and stressed it even more.  An xray and MRI revealed fragments behind the pattelar tendon that has been there for years.  Apprentl the direct pressure from the object in my shin guard on just the right spot lead to this.  No doubt age my play a role as well but I'm pretty active and have had no issues till this new shin guard.  After 10 days it settled down only to flare up after bumbing it directly again getting into the car which caused a flare up again.  I'm now sitting at exactly two weeks wondering if it will ever settle down.  So frustrating.

  • JamesJohnsonLMT Legend 1,167 posts since
    Aug 23, 2009
    Currently Being Moderated
    3. Oct 7, 2012 6:37 AM (in response to RockyMountainMike)
    osgood schlatters as an adult?

    Wow! What bad luck... I wonder if those fragments could be successfully removed after so many years.. Might not be worth the risk, but either way, looks like it takes a while for the sensitivity to subside. Did the MRI show inflammation near the fragments or superficial? It makes me wonder if the fragments themselves are the problem, or the re-activation of an old pain memory dialing up the sensitivity.

     

    Pain is an interesting subject. Out of all our potential pains, we'll only wind up feeling a few at a time. The rest get tuned out. Take out the conscious mind, and they disappear altogether, which is why anesthesia works. It sounds like a joke, but a good way to get rid of nagging back pain would be to hit your finger with a hammer lol. It's all relative and priority based. I have read that the longer a particular pain persists, the more likely it is that an image of the pain will be set up in the brain that takes on a life of its own. The phantom limb pains of amputees come to mind. I'm willing to bet that OSD sufferers open up a big can of neurological worms when those knees get bumped. That might explain why some people continue to suffer after otherwise successful surgery.

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