Knee pain com­mon in sporty teens

The Weekend Australian - Travel - - Health - LINDA CAL­ABRESI

Linda Cal­abresi is a GP and med­i­cal ed­i­tor of Med­i­calOb­server. Send your queries to lin­da­cal­abresi@gmail.com My 14-year-old grand­son has been hav­ing a prob­lem with his knee for over a month. His doc­tor says he has Os­good Sch­lat­ter dis­ease. He is a keen bas­ket­baller — is this prob­lem go­ing to af­fect him long-term? Is he likely to get arthri­tis in that knee when he gets older? OS­GOOD Sch­lat­ter dis­ease is a com­mon cause of knee pain in teenagers, par­tic­u­larly in boys who are heav­ily into sport. While it can be trig­gered by an in­jury to the knee, it is more likely to oc­cur at the time of a growth spurt. Strictly speak­ing, the prob­lem is not within the knee joint it­self, which means it is not as­so­ci­ated with an in­creased risk of de­vel­op­ing arthri­tis at a later date. In Os­good Sch­lat­ter dis­ease, the re­peated con­trac­tion of the quadri­ceps mus­cle at the front of the thigh causes pain, ten­der­ness and swelling at point where it at­taches to the grow­ing bone, at the tib­ial tuberos­ity, on the shin just be­low the knee. The prob­lem usu­ally gets bet­ter by it­self within a year. But ini­tially it is rec­om­mended to avoid ac­tiv­i­ties that ag­gra­vate the pain un­til the more se­vere symp­toms settle. This usu­ally takes about six weeks, so your grand­son’s sport­ing ac­tiv­i­ties should be cur­tailed tem­po­rar­ily. A phys­io­ther­a­pist can of­ten help and they can also rec­om­mend ex­er­cises that will pro­mote re­cov­ery. It would be very rare to have any long-term prob­lems as­so­ci­ated with Os­good Sch­lat­ter dis­ease. Two weeks ago my hus­band, who is 64 and fit and well, had an episode where his speech be­came slurred. It only lasted about 20 min­utes and af­ter­wards he was com­pletely fine. He put it down to ex­er­tion as he had been work­ing in the gar­den. Is this pos­si­ble? THIS might sound alarm­ing, but it is im­per­a­tive your hus­band goes and has a med­i­cal check-up as soon as he can. While there are a num­ber of pos­si­ble rea­sons for his episode, one of the most im­por­tant is that it could have been a ‘‘ tran­sient is­chaemic at­tack’’, or TIA. A TIA is a stroke that lasts less than 24 hours and from which there is a full re­cov­ery. It re­sults from a blood clot tem­po­rar­ily block­ing a blood ves­sel in the brain, and it is a strong warn­ing sign of an im­pend­ing full-blown stroke. About 20 per cent of peo­ple who have a TIA go on to have a ma­jor stroke within the next three months. He needs to see a doc­tor to de­ter­mine if it was a TIA and, if it was, from where the blood clot orig­i­nated. The good news is that, in the great ma­jor­ity of TIA cases, the risk of an im­pend­ing stroke can be sig­nif­i­cantly re­duced, com­monly through blood-thin­ning med­i­ca­tion and ag­gres­sive treat­ment of other risk fac­tors such as high blood pres­sure. I am36 weeks’ preg­nant with my first child and have just started de­vel­op­ing stretch marks on my stom­ach. What causes th­ese — and can I do any­thing to pre­vent them? STRETCH marks are un­for­tu­nately very com­mon in the late stages of preg­nancy. They oc­cur when the fi­bres of the der­mis, the deeper layer of the skin, tear at the point of great­est stress. Any rapid weight gain can cause stretch marks. What sort of skin you have in­her­ited will largely de­ter­mine whether you get stretch marks. As for pre­vent­ing th­ese stretch marks, there is no guar­an­teed so­lu­tion. You need to watch your diet to avoid ex­cess weight gain and main­tain skin health, and drink plenty of flu­ids so you are not de­hy­drated. The value of creams and lo­tions in pre­vent­ing stretch marks re­mains con­tro­ver­sial; most stud­ies show they don’t work.

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