The Sporting knee: Osgood Shlatters
Osgood Shlatters is an overuse injury of the knee which commonly affects children and adolescents. Symptoms usually develop during a growth spurt due to an increase in tension on the tendon that attaches from the kneecap to the shin, placing excess load onto the growth plate (a cartilage point in immature bone) of the shin bone. This condition tends to affects boys more than girls between the ages of 10-15 years old with symptoms typically presenting during activity or exercise and improving with rest. There will be tenderness on the bony prominence of the shin bone with possible swelling and the child may be reluctant to put weight on the affected side resulting in limping or a change in walking pattern.
Children who regularly play sports involving repetitive running, jumping and twisting such as soccer, netball and tennis have a higher risk of developing Osgood Shlatters due to the increased load on the knee. Other factors which may cause an onset of symptoms are tightness in the thigh muscles or hamstrings, a history of a previous knee injury, weakness around the hips and pelvis, poor foot posture or non supportive footwear. There can also be external factors such as a sudden increase in training frequency and intensity and competitions.
A physiotherapist is able to diagnose Osgood Shlatters through a detailed review and examination. In some cases, especially if the symptoms have been ongoing for a long period of time X-ray imaging may assist with diagnosis but is not essential. Once diagnosis is confirmed it is important to rest from sport and aggravating activities. A physiotherapist is then able to begin a gradual, pain free return to sport program when the child is able to manage. Tapping or bracing is an effective way to offload the tendon and can assist with pain relief. Other treatment techniques include massage, ultrasound therapy, advise on footwear and strengthening and stretching techniques.
If your child has been complaining of knee pain with their sport it is important to have them assessed to ensure they have effective treatment and management. Our physiotherapists at Hinteractive Physio will be able to assist with an evidence based approach of management and return to sport.
Return to Sport: Ankle Injuries
It’s coming up to sport season again. Footie boots, netball gear, orange slices and all of the aches and pains that are synonymous with kids sports. But how bad should an ache or a pain be before you go and see someone? Ankle sprains are the most common injury in active and sporting individuals. From a simple rolling of the ankle to a ligamentous tear, a physiotherapist can help. Mild sprain injuries result in a stretching of the ligaments which normally act as a passive restraint and support the ankle with twisting movements. As these ligaments stretch, it becomes easier and easier to re-injure the ankle. Ankle injuries can present with swelling, stiffness and pain.
Sometimes, pain may present in three ways; 1) pain only during activity, 2) pain upon rest following activity, or 3) pain upon waking the following morning after an activity. The presence of pain is the body’s way of warning you that a certain activity may be causing you harm, such as the stretching and tearing of the ligaments around the ankle. Pain following an activity indicates the presence of inflammation. Playing through pain may create a cycle of chronic inflammation which will hinder healing and prolong an injury. Inflammation is commonly treated with rest, ice, compression and elevation.
If your child is complaining of persisting pain and swelling around the ankle, it may be time to visit your local physiotherapist. With ligamentous stretching, the ankle becomes unstable and people may also experience a loss of balance. Commonly physiotherapists advise rest for 3-5 days in an acutely inflamed ankle, giving a compression bandage to help alleviate swelling. As pain diminishes with rest, your physio will prescribe exercises to help improve ankle stability to reduce recurrence risk.
The next big question is should your child use tape or a brace during sport? Ideally, the exercises prescribed by your physiotherapist will aim to improve stability. Though while the ankle is strengthening (which can take six to ten weeks) your child will be heading back to sport. There are pro’s and con’s to both options as seen in the table. Ultimately it is personal preference. If you are concerned about your children’s ankles in the upcoming sporting season, why not give our friendly physiotherapists a call at Hinteractive Physio on 5442 5556 and book an appointment.
| PRO | CON |
| TAPING | |
| Not Bulky | Skin irritation and pain with removal |
| Improves joint position awareness | Expensive long term |
| Difficult to self apply | |
| BRACING | |
| Long lasting | Bulky, difficult to fit in shoe |
| Easy to self apply | Brace slipping with movement |
Avoiding Sporting Injuries – A Guide for Adults and Older Athletes
By Craig Steele (Sports Physiotherapist)
With winter well and truly upon us, we tend to start seeing the injuries flow into the clinic from various sports such as soccer, rugby, touch football and tennis. With Australians being encouraged to take up more activity and organised sport, it is timely to take a look at the causes of sports injuries and what we can do to minimise the risks of being injured in the first case.
The broad term of “sports injuries” refers to injury sustained whilst undertaking not only organised sport, but also physical activity/exercise. They can occur for a number of reasons including accidents, poor training surfaces, poor equipment, poor technique, lack of conditioning or inadequate warm up or stretching.
If starting a new sport, it is important to seek coaching to ensure that your technique is correct, you are using the correct equipment for your shape and size and you are exercising on the correct surfaces. Sports injuries can affect any part of your body, but typically relate to the musculoskeletal system (muscles, bones and joints). Some of the most common injuries are sprains, strains and fractures.
A sprain refers to stretching or tearing of the ligaments – the thick band that joins one bone to another. Sprains can range from Grade 1 (minimal stretch) to Grade 3 (complete tear of the ligament) and usually result from trauma such as a fall or knock from fellow competitors. It is important to know the Grade of sprain, as this dictates the course of rehabilitation. Symptoms include pain, swelling, laxity or inability to weight bear through the joint.
A strain is a pull or tear of the muscle or it’s tendon (attaches the muscle to the bone). It usually results from overstretching or overcontracting the muscle. Symptoms may include pain, muscle spasm and weakness.
How to Treat Sports Injuries:
If you experience a sporting injury, you should follow these principles until you can seek further assessment from a physiotherapist or suitably qualified health professional:
1. Rest – it is important to immobilise the area injured if the pain is severe, or reduce your activity as your pain dictates, especially in the first 24 hours.
2. Ice – apply ice packs to the injured area to reduce inflammation and swelling. Always put ice pack in a damp tea-towel to reduce the risk of ice burns and apply for no longer than 20min at a time. This can be applied regularly in the first 24-48 hours.
3. Compression – is used to support the area and reduce swelling. Bandages or tubular bandages such as “tubigrip” may be used
4. Elevation – elevating the injured area (especially for lower limb injuries) helps to reduce swelling in the area.
Tips for Preventing Injury
1. No weekend warriors! – don’t be inactive through the week, then go and play lots of physical sports or overdo the exercise. Try to spread your activity throughout the week.
2. Increase your exercise level gradually, especially when starting back at sport or exercise
3. Ensure you have a good technique – coaching may be necessary
4. Accept your bodies limits and modify your activities as needed
5. Use the correct safety gear
6. Maintain good overall fitness. It is important to combine cardiovascular activity with weight training and stretching exercises.
7. Seek treatment early on if experiencing pain or discomfort.
Remember, it is always easier to treat conditions early before they become chronic. Physiotherapists are trained to accurately assess sports injuries and implement an appropriate treatment program. Sports
Physiotherapists have undergone extra tertiary level training to refine their skills in assessing the biomechanics of sport, assessment of injuries and the implementation of thorough and sports related treatment programs.
Craig Steele has a Masters Degree in Sports Physiotherapy and owns Hinteractive Physio. He can be contacted on 5442 5556.
What is Physiotherapy and Can it Help Me?
As physiotherapists, we are often asked what we do and how it benefits the client. Physiotherapists primarily deal with movement. Another words, we ensure that your body functions and moves in an optimal, pain free and effective way. Problems with movement can be related to congenital (birth) issues, be a result of an accident, sporting or workplace injury, or be due to a major medical event such as a stroke or neurological condition. So whether you are young and active or elderly and sedentary, chances are at some stage in your life, you may benefit from physiotherapy.
Physiotherapists use a variety of techniques to ensure the optimal functioning of the muscles, joints and nerves. These include joint mobilisation or manipulation, muscle releases/massage, muscle retraining, exercise programs, electrotherapy to speed up healing and reduce inflammation, strapping and assistance with using various aids or braces. These techniques are used to help treat a variety of problems, including:
*Back pain
* Neck pain, headaches and whiplash,
*Arthritis
*Sports Injuries
* Rehabilitation from neurological disorders such as stroke, head injuries
* Upper limb pain including RSI, rotator cuff strains, tennis elbow etc
* Childrens problems such as cerebral palsy
* Pregnancy pain and weakness as well as incontinence
When you visit a physiotherapist, they will take a detailed history, perform a thorough physical examination, provide hands on treatment to address the problems found, advise you on the best course of management for your condition, and provide a home exercise program for you to optimise your physiotherapy consultation. The number of consultations required will depend on the severity and duration of your problems. If you have any queries about how physiotherapy may help you, please call your local physio who will be more than happy to answer any questions.
Rebecca Steele owns Hinteractive Physio in Cooroy and can be contacted on 5442 5556.