Overuse knee injury affects young athletes

Knee pain affects many Americans. Chronic conditions including arthritis, cartilage damage and ligament tears are common. More striking is when knee pain affects athletically active adolescents. 

The knee is a complex joint consisting of bones, ligaments, tendons and cartilage. It is a weight-bearing joint that allows stable movement in multiple directions. It also provides shock absorption. 

Osgood-Schlatter disease is a painful condition affecting approximately 200,000 adolescents each year in the United States. It is the result of inflammation of the tendon connecting the knee cap (patellar) and the principal weight-bearing bone of the lower leg (tibia).

 The patellar tendon attaches to the upper end of the tibia on a portion of the bone known as the tibial tuberosity. Osgood-Schlatter disease is signified by painful swelling on the tibial tuberosity. It typically occurs in males between the ages of 13-14 and girls between the ages of 12-13.

 It is particularly common in young athletes who participate in sports that require running, jumping and rapid changes in direction. Sports such as basketball, volleyball, gymnastics, soccer and skating seem to have the highest numbers of cases. 

“Osgood-Schlatter disease is the result of a traction where two ends of bone intersect in a skeletally immature person,” reports Dr. Cory Edgar an orthopedic surgeon at UConn who specializes in sports-related injuries. “This is an overuse type of injury and should serve as a sign to rest and modify workouts.”

A common misconception is that Osgood-Schlatter will lead to a fracture or tendon rupture if untreated. It actually will cause chronic pain that will persist until the athlete’s skeletal structure matures.

Acute treatment consists of early diagnosis followed by rest, ice and anti-inflammatory medications. Stretching of the quadriceps muscle is an important part of rehabilitation.

Like other overuse injuries, moderation is key to a successful recovery.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu

Muhammad Ali displayed fortitude in Parkinson's fight

Muhammad Ali became one of the most recognizable people in the world. His recognition eclipsed the sports world and extended into politics, religion and human rights. His contribution to neurologic sciences may also garner recognition.

Ali was first diagnosed with Parkinson’s Disease in 1984 at age 42. Some experts believe he displayed some early signs of the illness at the time of his last fight against Larry Holmes in 1980. Typically, PD is diagnosed in an older population but a small percentage can be seen in younger adults.

PD is a neurodegenerative disease that primarily affects motor function.

It is the result of a chemical imbalance in an area of the brain known as the basal ganglia. These structures are responsible for the synthesis of dopamine. Dopamine is crucial to allowing for smooth movements. Treatment is based on replacing dopamine with L-dopa, a drug administered in a pill form.

The principal features of PD are a tremor that is most recognizable at rest, a slow, shuffled gait with susceptibility to falling as well as muscular rigidity. Approximately a million Americans suffer from PD and 60,000 new cases are diagnosed each year.

Motor activities to maintain motor function include swimming, yoga, ballroom dancing and ironically, boxing workouts.

Ali’s ability as a high-performance athlete made the loss of motor function particularly striking.

The goal of a boxing contest is to neurologically impair your opponent. Despite this, most neurologists believe that repeated head blows did not play a significant role in Ali’s condition.

Ali approached his disease with uncommon fortitude and acceptance to the point where he set an example for anyone who may be faced with a neurodegenerative disease.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu