Dear Dan,
Firstly I'm assuming by paeds you mean 11-12 years old? I haven't
come across OS in a much younger age group.
I have treated several 11 year olds for the condition with quite
good results. I believe treatment is two fold, firstly symptomatic
relief, and secondly biomechanical correction (or I really do things
the other way around). Check mum or dads feet and note whether
they pronate as they walk into the room, then watch the patient.
Does he/she have poor arches instance, calc varus/valgus, what
about midfoot control. Then you need to determine if orthotics
or a change in footwear is most appropriate. If you are not familiar
with this or it is a difficult case referral to a podiatrist is most
appropriate.(I have one in the clinic I work in so I refer all of these
cases to him - not all problems need expensive orthotics to fix,
heel wedges are a cheaper alternative).
Then look at muscle length. Yes the child is growing so they will
be tight everywhere, but specifically the ITB, Adductors, Quad(lat)
piriformis and hamstrings and calves. I use trigger points to TFL
and piriformisand deep tissue massage to the quads(vary pressure
depending on childs age, physique,maturity in handling pain etc.),
calves, ITB and adductors and prescribe stretches for these.
Depending on the childs maturity you may be able to use some
electrotherapy, but you should be there the whole time (eg, US).
I wouldn't use this in a child under 12 though.
Then you need to strengthen the gluts (Max and med), and quads
(these kids often have skinny legs and poor muscle bulk). I doubt
that you will cure this condition, but you will make it managable
give good pain relief. As you know it is self limiting. If you have
any questions re:why those muscle groups get tight or my
trreatment regime please write.
Scott Epsley
Physiotherapist.
On Wed, 20 Oct 1999 14:04:08 Dan Spence wrote:
>
>Hi folks!
>
>Does anyone have any references for the physio
>treatment of osgood schlatters disease in paeds?
>
>Or could anyone give me some advice on symptom releif
>of the syndrome again with relevance to kids?
>
>Thanks v much in advance
>
>Dan Spence.
>
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