written by DancingDoc  on 29.03. at 03:47:51

Oh. and Dr. Dancebelt....I'm not the same DancingDoc as DanceDoc on danceart.com

I did train in Rheumatology after I decided I really didn't like orthopaedic surgeons, as a group, and didn't want to be part of them.  I don't know DanceDoc's training.  I no longer practice clinical medicine (I don't see patients)....I kind of "retired" to a job that would allow me more time to dance.

Back to the point, Osgood-Schlatter Disease occurs when the tendon from the bottom of the knee cap, which arises from the tibial tubercle, the top part of the larger lower leg bone, pulls too much -- but in an adolescent whose epiphyses (the bone growth plates) have not yet grown together.  

The bone growth plates are in most bones of the body.  They are the areas that continue the growth in length of the bones.  These normally are still growing through puberty, and finally close in early adulthood.

Typically Osgood-Schlatter's is on one-side.  David H has described the symptoms...pain, swelling and tenderness at the insertion of the tendon.

The origin of the disease is believed to be from trauma from the excessive tension against the growth plate.

It may be no comfort, but Osgood-Schlatter's typically occurs in boy between the ages of 10 and 15.

Now the real tough part of this discussion. Although the problem often clears up by itself after afew weeks or months, the treatment principle is that to relieve the pain you need to avoid sports and excessive exercise, especially deep knee bends, read grande plies.

orthopaedic surgeons may immobilize the joint in a plaster cast, may go into the area to remove loose bodies, may drill and may graft, but these treatments, thank the good Lord, are infrequent.  Alternatively, I know orthopaedic surgeons and Rheumatologists who may inject the area with a steroid.  BUT, injection of a steroid may lead to changes in the growth plate, like changing the rate of growth (remeber the other side will still grow at the same rate).

So from the pathology involved and the mechanisms that lead to pain, if I had a patient with Osgood-Schlatter I would advise rest and avoidance of excessive exercise.

NOW YOU STILL HAVE TO RELY ON YOUR PERSONAL PHYSICIAN....I CANNOT EXAMINE YOUR JOINTS AND MONITOR THE CHANGES...ONLY YOUR PERSONAL DOCTOR CAN DO THAT.

I don't know any more to say.  I doubt that any changes in your dance exercises would relieve the pain.  It's hard to balance this area with development of alternate or opposing muscles, because you'll still have the excessive pulling at the tibial growth plate.  I know of no alternative exercises that would help.

Sometimes the basic pathological process is just to familiar and too difficult to interrupt in someone who does not want to rest the joint.  Years ago we used to hospitalize, on bed rest, patients with severe arthritis; nowadays the insurance companies won't allow that, so the patient has to rest at home.

David...is there anyway for you to cut down on your classes, or to take classes that are less strenuous?  

You should also talk to your physician about anti-inflammatory medications other than Motrin, or if it's OK for you to take a more increased dose of something like Motrin without adverse effects. S/he will be best able to judge that.

Good Luck!  Please keep me informed!  DancingDoc

>>   This question is particularly for BalletMaster or DancingDoc, but anyone else who has advice is great too, I'm open to any suggestions. >   I've been dancing for about 3 years and last year I found out I had a "disease" (if you even want to call it that) that many athletes get, especially around my age (14 yrs). I'm not going to even try to spell it but it sounds like "osh-good slaughters" disease. It's when your main thigh muscle gets to be really strong and froms a tendon ehich then attaches to right below the knee. What causes the pain is when the tendon pulls upward and actually pulls part of the bone away from the rest of the knee. I was told by my doctor that it would eventually go away by the time I was an adult, and that I should keep dancing just as long as I was careful. Well, it hasn't gotten better. Right now I'm dancing every day, for long periods of time, especialy for my age. By 9:30 at night, after 4 other classes in that same day, my knees are really really inflamed it hurts to walk. This is what I go through every night. I've tried everything: ice, heat, tons of Ibuprofen, and a bunch of other stuff my dance instructors, choreographers and friends have told me to try. None of them have really helped. The Advil helps sometimes but I'm concerned about liver and kidney problems later. Anyway, I was hoping for some advice. I'm willing to try anything.>Thanks again,>-David