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Osgood-Schlatter's In the Army

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EagleEyes
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Osgood-Schlatter's In the Army

#1 Post by EagleEyes »

Hi guys, Just wondering what the sitituation is with Osgood-Schlatter's in the army. I was told i have it when I was about 14-15 I'm now 17. I feel no pain and have no problems with my knees any more.
It would brake my heart If I couldn't join. So, Just wondering if there are anyone in the army with Osgood-Schlatter's? and does anyone think it will hinder me in joining?
Thanks guys...

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#2 Post by Dawber »

i think that may cause problems for you mate although dont take my word for it, i am pretty sure someone on here will tell you exactly what you need to know though
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Doc

#3 Post by Doc »

I dont know much about this condition, am I right in thinking it is not chronic and usually only happens in teenagers? Isnt it really just growing pains? Occuring in otherwise healthy people who are not as yet fully developed and goes when they are fully grown?

If this is the case then I cant see much of a problem, if you have it confirmed as Osgood-Schlatter. My guess and advice really is to go to your GP first, get a note explaining why and what for and take it along to the afco when you first go in. Dont make a big deal of it though. They may send you away for xrays etc just to make sure there are no chronic issues with the knees.

I will say though that its normal for the forces to expect you to have been symptom free and taking no meds for a condition for 5 years before enlistment, this I feel maybe worse case scenerio and as it is clearly labelled as an adolescent condition that rarely affects people past the age of 16 then there maybe a system set for dealing with freaks like you lol

Let us know how you get on, interesting one.

Doc

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#4 Post by partymarty1987 »

I had it years ago aswell mate, it didnt get put on my medical though? To be honest, i think its nothing to worry about. I got it through playing to much football, but had to rest for 6 months and it was gone and i havent had a problem since. Like Doc said, its fit and healthy teenagers that get it.

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#5 Post by gunner75 »

i had it at a young age (about 12 i think) it went by itself. no problem since and had no difficulty joining up or whilst in.
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#6 Post by dave1234 »

Here’s the interesting thing about OS: it is a term used by doctors to describe something that they don’t really understand.

99.9% of all doctors will tell you that OS is caused by “growing pains” where the “bones are outgrowing the muscles”. This is nonsense. The reason I say that is that the condition is almost only seen in active young guys and almost never in “couch potatoes”. If this were a true disease then it would affect every level of the population.

So, if they are wrong, what causes it ?

Muscles attach to bones via things called tendons.

http://www.ehrs.upenn.edu/programs/occu ... endons.jpg

These tendons can be incredibly tough. If the muscles which attach to the tendons are too tight, the tendons over time can actually start to dig into the bone and cause “grooves” to appear. I’ve seen this myself on cadaver bones of athletic people [ when viewed under a magnifier ]. When the body detects this, it has to do something to protect the bone, so it sends calcium to the area. This calcium is to act as a barrier to help prevent further damage. Young people's bones are much softer than those in their thirties and forties.

Exactly the same thing happens with “heelspurs” on your foot [ very painful ].

Doctors will recommend surgery, but that’s the wrong approach.

We have to step back and say “what are the muscles that have caused this pressure ?”

Once we get that established, we can then treat the muscles by stretching etc.

Once the pressure is removed, the body senses that the calcium deposits [ which are much softer than bone ] are no longer needed and are re-absorbed back into the body. The only time this will not happen with a foot heelspur is where the spur has grown back on itself and formed a complete loop. In that case, surgery is required. This however is rare.

So, what to do about your OS?
You need to get a complete check of range of motion of your knee done by a physical therapist. This will establish which muscles are tight.

Next step – is the kneecap [ the patella ] centered EXACTLY in the middle of your knee ?

http://www.eorthopod.com/images/Content ... gery01.jpg

http://www.carltonvet.com.au/files/imag ... atella.jpg

There are a bunch of ligaments [ tissue that connects bone to bone ] around your knee cap. Think of them as tight elastic bands that keep your knee caps in the center of your knees. If one band is tighter than the other, it will pull the knee cap and put pressure on bone. In some cases, calcium will be laid down and OS will develop.



How am I sure that this is correct ? The bloke who treats me has dealt with thousands of cases of OS, and has had success in almost all of them.

Dave

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#7 Post by aphid »

ive got osgood from playing a lot of football as a kid, was put on my medical at selection and the doctor mentioned it and said it was fine, dont worry!

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#8 Post by Ruth »

Eagle Eyes, listen to what Doc says and not Dave. Doc is correct.

Dave, you shouldn't give out dogmatic "medical advice" when you don't know what you're talking about - this case.

"It can't be a disease because everyone doesn't get it" approach isn't sound for anything from ingrown toenails to a stroke. Osgood Schlatter's is a well recognised condition and doctors almost NEVER recommend surgery for it. The reason - it gets better on it's own as you approach skeletal maturity.

There are some other conditions of the knees which can occur in adolescence, completely different, regarding the centring of the patella or a dislocating patella or problems behind the patella - they are nothing to do with Osgood Schlatter's disease.

To deal with a few of the problems with your post, the quadriceps tendon inserts at the top of the tibia over the growth plate and if you are very active in your early teens, then the muscular strength can exceed when this unfused, more cartilagenous area of the bone can take and that's where the problems with pain and sometimes bony swelling occur.
It's nothing to do with tight muscles or tight tendons or a restricted range of movement. As bone strength increases as you stop growing and the growth plates fuse more, the pain goes. Most people are free of problems by the time they are 16 or so, a few are unlucky and it continues for a few years until the skeleton fuses completely by the age of 22 or 23.

As someone who had Osgood Schlatter's disease between the ages of 10 and 22 and who has spent more than 2 years working as an orthopaedic surgeon, I can vouch for the above information.

And no-one was bothered about my past knee problems when I applied for the RAF as they had settled several years before

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#9 Post by EagleEyes »

Great news, Glad to hear there are people In there forces ATM with OS. Thanks for all the help guys..

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#10 Post by dave1234 »

One of the big problems is that very often OS is mis-diagnosed by GP's.

Often they will "lump" almost any type of knee pain as OS.

When calcium forms in the knee it is very, very painful. All the people I have seen with a true calcium deposit were barely able to walk. The deposit digs into the tissues and nerves.

Knee pain almost never is caused directly by the knee itself.

99% of the time the pain is caused by such things as quad muscles being stronger on one side of the leg than the other. This pulls the kneecap [ patella ] away from it's central position [ the knee cap should "glide" up and down in a little channel formed by your leg bones ]. When you get the kneecap away from it's central position, it can wear away cartilage etc.

It's like having a wonky wheel on a car.

Once the muscles surrounding the knee are balanced and stretched, most knee pain disappears.

Knee pain can also be caused by the pelvis being out of alignment. The top leg bone [ femur ] can get twisted slightly which affects the kneecap.

Most cases of OS diagnosed by GP's are actually just local inflammation of the kneecap and not true OS. Provided the person stays off the leg for a while [ no sports etc for a while ], the inflammation usually settles down.

Dave

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#11 Post by dave1234 »

Ruth a few comments about your posting:

1. My first point is in regard to the term OS “disease” which is used by many doctors in the same manner as “degenerative disk disease”. These are not diseases. If the term OS condition was used, then perhaps that would be a more appropriate term. I have seen true diseases in Africa and these are not diseases. When I was told by a doctor that I had “degenerative disk disease”, and knowing nothing about the body at the time, I imagined my spine crumbling away. This terminology can cause great concern amongst the elderly etc. I have seen old women burst into tears when told this, as they imagined the same thing I did.

2. The second point is regarding my “dogmatic medical advice”. Over the past three years I have been told [ by three orthopaedic surgeons – two in the UK and one in the US , and by a dozen specialists ] that I would be paralyzed and crippled for life. They were all wrong. Through my own efforts, study and determination I’m living my life about 90% normally now. I have great respect for emergency work [ broken backs , cauda equina syndrome etc ] that is carried out by orthopaedic surgeons. However the vast majority of back surgeries for herniated disks, degenerative disk disease etc are another case. If you wish to continue this sub-thread on my postings on back pain in the para reg section, I would be more than glad to continue. I have put a challenge on several web sites for any doctor [ or doctors ] in the world to come on national TV [ FOX TV 13 Tampa Bay ] in the United States and we’ll discuss the TRUE causes of back pain. If you would like to do this, you can contact the producer Kathy Fountain on 1-813-870-9652 [ Tampa Fl ]. As well as discussing back pain, we can talk about hip replacement surgery and knee problems. Let me know if you are prepared to do this. I’ll pay for your flight and three days accommodation.

3. The surgery I mentioned was in relation to heelspurs [ I know because that was what they wanted to do to me when I started walking again and developed them along with plantar fasciitis ], not OS.

4. "There are some other conditions of the knees which can occur in adolescence, completely different, regarding the centring of the patella or a dislocating patella or problems behind the patella - they are nothing to do with Osgood Schlatter's disease". The point I was making was that many times these exact conditions are mis-diagnosed as OS. However, there at least three therapists where I live who treat OS problems by re-balancing muscles and getting the knee cap centered as a first step to treating OS.


5. So “muscular strength “ and “tight muscles” are totally un-related in all forms?

6. My main point was why wait for it to go away ? If tight muscles can be relaxed and re-balanced [ I’m well aware of growth plates by the way ], that pain can be reduced fairly quickly. In some cases [ non-growth plate related ] that pain can last a long time. Sure you can just leave things be and hope that everything will be all right, but why not be pro-active.

7. Why not call Al Meilus [ the therapist who works on me ] on 1-727-547-1233 or contact@meilus.com [ www.meilus.com ] and have a chat with him. He works with the University of South Florida on bio-robotic engineering. He has treated many, many cases successfully.


8. Without any disrespect, the fact that you are an orthopaedic surgeon means nothing to me. Over the last three weeks I have helped a woman from Jamaica [ who was told by two orthopaedic surgeons that she MUST have her back fused in two places or she would be wheelchair bound ] get back on her feet and living normally . Guess what the problem was ? An anteriorly rotated right inominate which was caused by a tight iliacus muscle. She also had a tight left psoas. The psoas caused an increase in lumbar curvature which put pressure on the intervertebral disks at L5-S1 and L4-L5 with all the subsequent problems that entailed. I can provide contact details of many people who were told they had to get major spinal surgery by orthopaedic surgeons in the UK and US and who are now living normally – zero surgery. The surgery would address symptoms not cause. PM me and I’ll send you contact details of all of them.

9. I know at least ten people in my area who were told that they needed hip replacements by orethopaedic surgeons. The surgeons simnply put it down to "age". It was found that all of them had tight psoas muscles. As you know, the psoas attaches to the lesser trochanter inferiorly and to the vertrebral bodies superiorly. Tight psoas pulled the femur up into the acetabelum. Once the psoas and deep pelvic rotators were released, not one required surgery. One lady went back to her OS to tell him the good news and he said “Oh sometimes these problems just go away on their own”. And him the one who had booked her in for an operation the following week.

10. This could end up going on into the next millennium, so please let me know me know if you would like to discuss this on TV. It’s an open invitation from FOX. Whenever you get leave you could let me know. They would like to have as many doctors on the program as possible. On the other side, there would just be myself and Al.

11. Bye the way, my L5-S1 disk had collapsed to almost nothing. I won’t even tell you how many orthopaedic surgeons said nothing could be done. All were wrong. My disk is now 50% of it’s normal height using the Pettibon System. You can see before and after shots on the para reg photo section. If you want originals, contact Dr. Erik Lerner on 1-407-292-0909. www.lernerchiropractic.com. I’ve given him permission to release my case history to anyone who calls.

12. In a nutshell why “just let a condition go away on it’s own “ when there are some fairly simple methods that could help relieve pain quicker ? I see at least three kids a week who have been diagnosed with OS [ and who cannot play football, hockey etc ] get back to sports after two or three treatment sessions.



Dave

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#12 Post by dave1234 »

Ruth

Firstly, suggest we take this following topic over to the para reg section or wherever deemed fit or start a fresh topic on this forum.

As you are an orthopaedic surgeon, and I only issue out "dogmatic medical advice " please look at my spinal x-rays on the para reg photo section and tell me the following:

1. Why is there a major difference between the anterior and posterior intervertebral disk height aspects of L5-S1 ? Not just "old age" or "wear and tear". It has to be a response based on a medical or bio-engineering analysis of the x-rays. All the data is there.

2. What did I do to increase the disk height ? Isn't that "medically impossible" according to "conventional medical wisdom" ?

3. What do you think I did to recover from a 14mm bilateral herniation of L4-L5 [ marked with an arrow ] in less than two months when I was told "you need emergency surgery yesterday ?

I would be most grateful for your insight.

Thank you

Dave

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#13 Post by dave1234 »

One last thing Ruth.

A few years ago my wife was diagnosed with scoliosis of the spine.

Every orthopaedic surgeon we spoke to said that the only method to correct it was to insert steel Harrington rods along her spine.

I refused to accept any form of surgery for her.

I researched what CAUSED her scoliosis and found two non-surgical methods to correct it.

Her scoliosis has now been corrected by over 85% and will be 100% corrected by the summer.

Keep an eye out for my posting in a while, and you tell the interested viewers in your medical opinion what I had done to correct it without surgery.

I'll even give you a clue - the person who does the correction actually can perform it whilst the rods are in place.

Again, I will be providing x-rays and access to my wife's medical records.

The pictures will be put in a posting later on scoliosis over on the para erg site.

I'm so wanting to get from a stage of "dogmatic medical advice" to actually knowing something about what I'm talking about and can do with all the help I can get.

What do think I did to get rid of my heelspurs without surgery ?

All suggestions welcome [ was told "I HAD to get surgery done" ].

TTFN

Dave

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#14 Post by dave1234 »

EagleEyes

Here’s some information on growth plates that were mentioned before.

http://www.niams.nih.gov/Health_Info/Gr ... efault.asp


http://images.google.com/images?sourcei ... =en&tab=wi

Many young people who have been diagnosed with a growth plate disorder simply “grow out” of the problem. There is nothing new about that.

However, just a couple of pointers:

1. Sometimes OS is misdiagnosed [ the only reason I put this posting up is because a young lad in Australia contacted me wanting to join the Army and told me he had been diagnosed with OS. He went to see a physical therapist who found that the problem was not OS ]. IF you have a few bob, try to see a good physical therapist just to make sure that you don’t have any other problems with your knees that have been misdiagnosed or not detected. I was misdiagnosed myself when I was younger.

2. Getting your knees checked is important for anyone who will be doing a lot of physical activity. If you are sat in an office all day, it’s not so important, but if you’re tabbing with bergans etc it becomes really important. You can tolerate shoulder problems and sometimes back problems, but having a knee problem in an infantry unit can be a real big issue.

In a nutshell, you will probably grow out of if it is a growth plate problem, but it is always well worth getting your knees checked by a good physical therapist.

I spent my whole childhood from the age of 9 hill-walking. Then it was running, weights, tabbing, parachuting, cycling etc. I never ever stretched [ looked on it as a “bit girly”]. That was a big mistake I made. My knees were killing me for years. Over the last few years, by stretching the right muscles and strengthening the right muscles, I’ve gotten the pain down by about 75%.

An ounce of prevention is worth a pound of cure.

The only reason I put these postings on here is to share with others all the mistakes I made when I was young, and also what I did when I was told “There’s no chance of you walking again – the sooner you get your mind around that the better it will be for everyone”.

I remember exploding in the consulting room and telling him “I’ll f!@#$%^ well walk again even if it’s only to prove you wrong you c!@#”

And I did.

Dave

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#15 Post by dave1234 »

Ruth

Here is a typical example of what I am talking about. I can refer you to umpteen other cases if you want.

http://askwaltstollmd.com/archives/osgood/106123.html

It didn’t just go away.

The knee was never properly examined and she had severe muscular imbalances.


Mind you the website is called “askwalt”


If you want more, contact Al Meilus and he'll be happy to oblige. He has nearly all his patients allow their stories to be told, as most are so grateful for pain relief after years of being told "nothing more can be done". And it's not just him; there are people in the UK who can help.



If anyone wants to read up on OS amongst adults, here are a few links:

http://www.kneeguru.co.uk/KNEEtalk/inde ... =18424.new


http://www.madsci.org/posts/archives/20 ... .Me.r.html

http://www.usgyms.net/Osgood-Schlatter.htm

Interesting part about the muscle tightness.


I see this stuff every week at the clinic I go to. People come in from all over the world to get treated for OS which either didn’t go away after puberty, was mis-diagnosed in the first instance, was correctly diagnosed but had other things going on that were not paid attention to etc.

This is not about me being right or wrong.

It’s about the fact there are so many cases of OS being mis-diagnosed in the first case and also of people who were told that they would “grow out” of it and they haven’t and have paid severe penalties in later life.

Most will “grow out of it” but if you are one of the unlucky people who do not, that can seriously mess you up.

Whilst having a physical therapist check you out may not be the final answer, it may be an added level of protection.



Dave

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