Why does my knee hurt?

You know you're getting old when you start an article with the phrase, "When I was that age...", but sometimes it is appropriate. There was a time when the fall season meant football and soccer, winter was for basketball and wrestling, and spring was for baseball and track. Summer was for fun.

Now, it seems that there is no end to a season and it is becoming more and more difficult for kids to play multiple sports. For some that means concentrating only on one sport, but for others they play several sports at once and it seems to get worse in the spring.

Recently, we have seen several patients who are playing a spring sport for their school and competing on at least one club team in another sport. There are some who are playing three different sports at the same time. This can be very difficult for anyone but especially for patients who are still growing with open growth plates in the bone.

Back in the old days when kids switched from one sport to another, each sport would use different muscles and different skills. With endless seasons these days, there is seemingly no time to rest and recover. One of the most common things we see in young athletes is something called Osgood-Sclatter disease. It sounds like something awful, but is really only the young person's version of tendonitis.

When the bone is growing, there is a cartilaginous growth plate in the leg where the tendon attaches and, with continued non-stop use, this area will become extremely sore and make athletic participation very difficult. Sometimes it will get so bad that daily activities such as walking will become painful and, in extreme but rare cases, may lead to a detachment of the tendon itself.

The treatment for the problem is ice, stretching and, most importantly, rest. It is amazing how much resistance we receive when we suggest a period of rest to patients and their families. For a lot of our patients, rest means dropping perhaps one sport or one club team without consideration of the fact that simply stopping all sports for a brief time will resolve the problem. In a perfect world, the best way to treat any overuse condition is to not to let it happen in the first place, which would mean reducing the amount of overall time in sports.

Don't get me wrong, I'm not trying to suggest that this problem is something that was just discovered. Osgood and Sclatter described this condition in the early part of the 20th century. In fairness, I had the problem myself when I was a young athlete, but it seems that overuse injuries in general are occurring more frequently today with the schedules that some of our young athletes keep.

I was shocked to learn from a patient that his son played over 80 basketball games last summer. These games started just before the end of the school year and ended just before school began in August. Some of you may read this and say that sounds just about right. But to offer some perspective, remember that the NBA plays an 82-game schedule from October to April. They rarely play back-to-back games, whereas some teenagers will play more games in the course of two weeks than they will play during an entire high school basketball season. Some of the kids are also playing baseball, soccer or volleyball at the club level at the same time.

Sports have many advantages and certainly young athletes should not be discouraged form playing sports, but we should think about how much is too much. All of us need and occasional rest from work and activity to be at our best, it is no different for our young athletes.