This is my second teenage athlete in three weeks that has come to me for knee pain. This young man is still in
high school and has a really busy schedule of basketball practice and conditioning. His chiropractor diagnosed Osgood-Schlatter Disease, often considered a ‘growing pain’, which is knee pain affecting children where the bony protrusion below the knee (the tibial tuberosity) becomes inflamed. You can usually recognize it by the bump that begins to form on that bone below the knee, a bump that lasts throughout adulthood. You can see from the photo that that bump has not really protruded very much yet on the right knee that is affected but if you look closely you can almost see it.
So what can be done about Osgood-Schlatter? This young man does not want to stop his busy practice schedule for fear of being side-lined during the season. So the normal answer of resting to alleviate pain is not an option. Plan B, then, is to find the muscular imbalances and work hard on those and hope for a big change in the pain levels as the muscles become more balanced.
These are the imbalances that I have found so far:
- A weak vastus medialis (the muscle that sits above the knee and to the inside) on the right leg. You can see in the pic that the v.m. is not as developed as it is on the left knee.
- A tendency for internal rotation of the right hip which leads to improper tracking of the hip, knee. Or in other words when the knee bends it points at the other knee instead of where it should be pointing: right over the big toe.
- And this is the big one: very weak gluteal medius and minimus (the muscles at the side of the hip). VERY weak.
The exercises to fix the imbalances:
- Glut Med, Min Stregthener. Side-lying leg series: Lying on one side, bend the bottom leg while keeping the top leg straight. Lift the top leg to hip height and back down ten times. Then lift the leg and hold for 10 seconds. Lastly, circle the leg ten times in each direction. Once this exercise gets easier start adding ankle weights. Build up to 5 pounds.
- Tracking of the knee. While seated, lift the leg off the floor in parallel position (or knee straight to the ceiling). Bend and straighten the knee and watch the tracking. The knee needs to continually point over the big toe. Small variations not acceptable; this is your chance to really focus the movement and groove a healthy pattern. Do it perfectly.
- Strengthening of the Vastus Medialis. Do the same as exercise #2 with this small change: Instead of the knee facing the ceiling, turn the knee to the outside. Bend and straighten. Continue tracking the knee as well. As you bend and straighten the knee will still be pointing over the toes.
Good luck. Let me know if you have any questions. K
p.s. Yes, I know it would be better if the pic were turned 45 degrees right. I have the picture on my computer vertically and when I upload it turns it. If you happen to know how I can fix that, Please! Let me know!