Growth plate injuries around the knee

Knee

By Jason Wells
Sports and Spinal Physiotherapist

Don’t be fooled, growing pains can be helped and longer term tendon and bone changes minimised.

The growth plate at the front of the young athlete’s knee is the most frequently involved skeletal area associated with growing pains. When symptomatic, the condition is called Osgood Schlatter’s Disease. The condition essentially arises when the forces around the knee exceed the ability of the cartilage and surrounding tissues to adapt and cope. This leads to the typical swelling, pain, and bump. Limping and muscle weakness often ensues. A trip to the doctor often results in an xray being ordered. Changes at this area may or may not be demonstrated on the xray. Growing pains is often the diagnosis and rest from sport is often prescribed. However, this condition can be very well managed and controlled by addressing the amount and intensity of sporting activities, controlling local swelling, and controlled exercise that promotes healing and addresses underlying weaknesses. Consequently, significant down time and rest away from sport can be minimised.

The growth plate area at the front of the knee is most active between the ages of 9-12 years. The cartilage has transitional layers which increasingly become more like bone as the years roll along. However, early on, the cartilage is weakly attached to bone and tendon. Repetitive traction and compressive forces from the quads will create an ever widening area of discomfort that involves surrounding tissues. Changes in the tendon and growth plate can develop and evidence suggests that long term tendon symptoms can ensue. Tendon does not have the healing qualities of muscle and regeneration may be possible up to a point after which longer term tendon collagen tissue changes would be expected.

The most important aspect to managing this condition is to reduce the running volume and intensity, but not stop if possible. Controlling the symptoms with local management including ice, light compression bandages, light weight bracing, leg stretching and strengthening, while addressing any underlying mechanical mal-alignments is the best practice. Sports Physios are experts in this area and can set a management program that can safely return the young athlete to physical activities and minimise any longer term damage. If you have growing pains, don’t just rest them, manage them!

Jason Wells is a sports and spinal physio at Mead Physio Group in Kalamunda, Forrestfield, and South Perth. He specialises in treating the younger athlete. To see him or one of his physio colleagues, call the Forrestfield or Kalamunda rooms on 93593011 or 92931800, respectively, or book online at www.meadphysiogroup.com.au