Master B is a 13 year-old soccer player with a 6-month history of pain in both knees. His pain was located around the inside of both kneecaps. There was no reported injury to the knees or any knee pain prior to the last 6 months. The pain was gradually worsening over the past few weeks to the stage when he was unable to run or play soccer. He had a developed pain walking up and down stairs. He had trials for team selection in 2 weeks and the national’s competition in 6 weeks. He saw his doctor 4 weeks ago and was diagnosed with Osgood Schlatters disease, which is pain around the growth plate on the knee and advised to reduce his running and training volume. His mother reported a recent growth spurt, and a big increase in running within training over the past 12 months.
On examination, Master B. had no swelling or tenderness on touch to the areas of the growth plates. This meant it was less likely that Osgood Schlatters was the problem. He had knee pain when moving down from a step which was improved by changing the position / movement of the kneecap during the step down. This is a common finding with patellofemoral or kneecap tracking problems. Further examination found muscle tightness in his hamstrings, quads and calf muscles and weakness in the gluteal / buttock muscles. Analysis of running or landing from a jump, revealed a control problem where the knees dropped inwards and the landing was high impact (poor shock absorption). The combination of tightness and weakness in key areas, along with his increase in training volume both contributed to his knee pain.
Master B. was taught a program of exercises to reverse the problems leading to increase load on the knees, starting with flexibility / mobility and closely followed with leg strengthening exercises with a gluteal and core focus. He also practiced exercises that helped him improve his control of movement and shock absorption with his landing. We were able to apply tape to his knees during soccer training / games which allowed him to participate with minimal pain. He achieved his goals of playing in both trial games and the national competition 6 weeks later. The treatment and prevention programs involved only 4 physiotherapy sessions over 8 weeks.
If you have knee pain with sport, we can help you. Contact us on 49216879.