I Turned 17 last september!

The report:

07/02/2008

There is quite marked soft tissue thickening and some fragmentations of bone over the tibial tubercle. ( Oh thats nice. FRAGMENTATIONS??) The patient would appear to be a little old for classic Os good schlatters type situation but there is certainly some type of inflammatory change occuring in the patellar tendon at its insertion to the tibial tubercle with some effacement of the fatty tissues deep to the patella tendon and the radiological appearance are those of an Os good Schlatters syndrome however.

( Basically what I can see in the Xray in comparison to my right [good] knee is that there is a chunk of bone missing a bit beneath the patella, and there is a difference in the gap size between 2 bones (the smaller one[tibia?]) where the gap being larger on my left [bad] leg.

The earlier report: 30/05/2007

Several small bone fragments adjacent to the anterior tibial tubercle which is an irregular shape/ Appearance are suggestive of Osgood schlatters disease.

There is slight overlying soft tissue swelling

The joint spaces and articular surfaces of the left knee are normal

There is no Joint effusion

Conlcusion: Apperances sugegst Osgood schlatters disease of the Left knee.

<i> Just wondering, how much of this makes any sense to youse? I Can kinda make sense of it as it kindof is an area of interest. </i>

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Big problem with osgood schlatter is that the only generally available treatment is lopng term rest, possibly over 6 months and maybe even 6-8 weeks in a cast to fully immobilise the joint.  And the rest must be complete absence from sport, not really just light exercise.  Dare i ask how old you are adam , cause once you have reached the early 20s (maybe late teens in some) the epiphysis will begin to fuse but i am not sure what would happen to the osgood's then, theory says it will start to heal but i dont know if you would get lingering effects (ask your doctor/surgeon and let me know if you can).  If it doesn't heal surgery is an option but is not always popular in the medical community in my experience, the healing time from the surgery would still be significant.

Probably all stuff you have been told already, i know i wouldn't want to take 6 months out!

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ARGH!

I HATE OSGOOD SCHLATTERS!!!!

I very much do dislike it. Mostly, When I'm playing squash, Aslong as I'm wearing good shoes that are done up tightly, my knee is fine. The only good thing is I know when my shoes are losing their cushioning and getting old cause my knee starts hurting (which is about every 6 months I need new shoes)

I'm Hoping to have something done aboutMy osgood before I start training harder, As I would like to make U19 NSW State rankings in the next year, and hopefully U19 national rankings over the next 2 years.

If anyone interested I can try to upload the Xrays of my knee, so you can see the comparison between a reasnably healthy knee and an Osgood knee. And I also have a report that goes with it.

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Hi Guys.

It's the travelling and jet lag that is causing the injuries, one day in Europe , next week U.S.A , tomorrow in Asia and then Middle East next....etc back and forth monthly very taxing on the players.

PSA & Wispa shud work out with Tournament promoters to arrange as such that u finish a series of events like what the U.S are doing follow by one such series in Europe, then Asia and then Middle East so on and so forth according to their summer seasons , otherwise the flying in and out will kill or injure them sooner or later.

Cheers.

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ABC of Sports Medicine: Musculoskeletal Injuries in Child Athletes; BMJ 1994;308:1556-1559 (11 June)

http://www.bmj.com/cgi/content/full/308/6943/1556?ijkey=2e26c189871484e012d86f4aee555ea847ea1117&keytype2=tf_ipsecsha

You may be able to access this article but essentially children have different injuries to adults, which they may recover from as their bodies are more malleable but they must be given the chance to do so.  Over pushing of children will cause long term problems, as it will in adults but children risk;

Osgood Schlatter disease (and variants), slipped upper femoral epiphysis, most interesting from the article are these 2 quotes i feel; "The growing skeletons of children may be injured more easily than the mature skeletons of adults because the bones are more porous and the long bones are further weakened by the epiphysical plates at their proximal and distal ends. Children and young teenagers nevertheless have a lower injury rate from participation in sport than fully mature adolescents" Thus adolescents are at the highest risk, at just the age where sport begins to become competative

"Lesions of the pars interarticularis of the lower lumbar vertebrae occur in those subjected to hyperextension and high axial loading as occurs in gymnastics. In a study of 100 young female gymnasts the incidence of defects was 11%, which is about four times the incidence in the general female population (2.3%). If treatment is started early immobilisation in a plastic jacket will allow healing to occur."  Thus a higher risk of sports injury with serious consequences in younger people.  I know that you can pick holes in the arguement but i think it highlights that care needs to be taken of the training loads of children and adolescents.  I agree long term damage is not proven but we know it is linked to frequent injuries.

I agree that today you need to be younger to break into the top levels but that doesn't gaurentee fitness, today it is probably more targeted to the sport than in the past, Barrington may have had better overall fitness but not so good squash wise.  this may be why squash is reaching its peak and becoming more skills focused.  Look at some of the young tennis players hitting burnout - Hingis is the prime example. 

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I have known numerous players who trained hard at squash and ended up with heart complaints and long term injuries as they developed in life. This might be down to bad genetics or even bad luck, but I'd be VERY interested in seeing the correlation statistics between high levels of junior intensive training and long term injuries / body defects.

I'm sure that there'll be some correlation. I for one have noticed that in order to get the required levels of skill it takes many years of practise where as fitness can be transitioned from other sports. No disrespect intended to him, but I would bet my house that Jonah Barrington would NEVER get anywhere near the top rankings in this day and age if he'd have started so late in this climate. I heard a quote recently that said if you weren't in the top 20 in the world by the time you reach 22 in tennis then you simply aren't ever going to make it. I feel that the same now exists in squash. If you haven't got the skills and fitness by late teens then you can forget making it into the top 5. Sadly this intensity comes at a price (both physical and mental) and only the really special players come through and survive.

At this point you have to acknowledge Nick Matthew and Greg Gaultier. Neither were out and out stars as juniors (until late teens), and I've spoken to people who used to play in the same club team as Nick when he was a junior. They named 3 other players of the same age who were all better than him until mid-teens where he kept going and they took their feet off the gas. That's why he's top ten in the world and they're not. Players like Nick and Greg take things that step further in development and make it big. Both have suffered serious (but not career threatening) injuries in the last year. Injuries that will probably be irritating them for months (or even years) to come. The question has to be asked of whether a lighter playing intensity is the solution or whether the sport has now reached the peak that other sports have reached - especially athletics. In order to jump higher, run faster or throw further it requires perfect technique, perfect fitness and dedication. If squash has reached this level (which I really hope it has), then the players we see contesting the titles are the best role models that this squash generation can hope for. Move over Khan and Power. Your fitness and shot play was phenominal in its day, but now a new breed has come to town and they aren't leaving without a fight!

Adz

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Interesting thoughts, I do feel that there may be over focus on acute, short term injuries that was lacking in the past, previously people played on through them, now operations are more popular, or long term rest is better recognised as treatment.  We know that pros from the past have had joint replacements etc, the big question is will the modern players have that?

Also i would have thought par to 11 encourages shot making more than hand in hand out to 9, that truly was war of attrition squash, i would be intregued to know if modern players could go up against the likes of Jansher/Jahangir's generation in terms of pure fitness.

In comparision to other sports, is squash that bad, footballers have multiple injuries in a season due to the contact nature, same for rugby, what about other racuet sports like tennis, lots of reitrements due to injury there.

As far as taking the sport up goes, it is in the UK a "universitry" sport, many people barely know it exists until they see the stand at freshers week or have a flat/course mate who plays.

I do belive that sport, especially overly competative sport, young is not good for children's health.  I mean competative in terms of "must win" "train harder" attitudes, yes aim to win but when young play for enjoyment and a little for health.  Go at it too hard and your body can't cope, especially with high impact sports like squash, played on a hard floor often, at high pace and frequent twisting.

Apologies for spelling but i now plan to sleep!

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