Osgood-Schlatter's+disease

1) Introduction 2) Classification 3) Signs and symptoms 4) Causes 5) Treatment 6) Diagnosis 7) Effect on future performance 8) Osgood-Schlatter's crossword puzzle

1) Osgood-Schlatter’s disease, also called tibial tubercle apophyseal traction injury, was named after the two physicians who first independently described the condition in 1903, doctors Robert Osgood and Carl Schlatter.

Osgood-Schlatter’s is the most common cause of knee pain in athletic adolescents. It is extremely common in growing children who actively participate in sports involving running and jumping. It occurs most commonly in young athletic males aged 10 to 18, when they are in their periods of most growth. This is because the root cause of it is putting an immature patella tendon under stress. The patella tendon attaches the quadriceps muscle on the front of the thigh to the tibial tuberosity, the protrusion at the superior end of the tibia. Activities such as running and jumping stress this tendon as it is on the receiving end of force from the quadriceps muscle during these activities. If this force on it is too frequent, it becomes inflamed and causes pain. This is why patients have a large lump underneath their knee cap.

It is a chronic condition which will last in the least for several months, or until the patient is finished growing strong and mature tendons, muscles and bones. If untreated, patients will often keep the tender lump on their knee throughout their adult life. The only way of minimise symptoms is to rest the knees for a period of at least two to three days after intense exercise to allow the patella tendon to recuperate from stress on it. A tight quadriceps muscle will also worsen the condition, so stretching as therapy is also affective. a knee affected by Osgood-Schlatter's disease

2) Osgood-Schlatter’s would be classified as an indirect overuse soft tissue injury, as it is caused by excessive running and jumping exercises which make use of the quadriceps muscle, consequently and indirectly stressing the patella tendon, tendons being classified as soft tissue.

Because it is an overuse injury, which occurs in periods of rapid growth, it is most common in young children aged 11 to 18 who actively participate in sport, with 21% of this demographic reporting cases compared with only 4.5% of inactive children having reported cases. Children with Osgood-Schlatter’s would all have some kind of involvement in an activity that made excessive use of the quadriceps, such as basketball, dancing or cycling.

A much higher proportion of people who suffer of Osgood-Schlatter’s are boys than girls, with the ratio reportedly being from 3 to 1 to as high as 7 to 1. This is not due to any difference in the anatomy of the sexes, but rather a higher rate of participation in athletic activities by boys.

3) Strong knee pain when doing exercises that involve running, jumping, squatting and an obvious swelling underneath the knee are most prominent symptoms of Osgood-Schlatter’s disease. In most patients, any extension of the knee causes pain as this is when the quadriceps muscle puts stress on the inflamed patella tendon. Direct impact onto the knee causes extreme pain to the sensitive bump, and kneeling is often impossible for patients.

4) Osgood-Schlatter’s is caused by overtraining in sports which involve running, jumping, and fast starts and stops when the bones, muscles and tendons of a person are growing and therefore softer and more vulnerable than usual. This kind of movement is a part of nearly every demanding physical activity, hence the extremely high percentage of active children that have it (over 1/5!).

It’s the overuse of the quadriceps muscle which attaches the patella tendon to the tibial tuberosity in order to move the knee in these activities which is the initial cause of the problem. Stress on a growing and immature tibial tuberosity will lead to inflammation of the tendon and in some cases may cause avulsion fractures, which are very severe. This leads to excess bone growth in the tibial tuberosity, which adds to the long term lump patients get underneath their knee cap.

5) The condition only heals with maturing of bones and tendons, but to minimise symptoms the RICE principle should be applied whenever the knee is painful. Frequent rest should be taken from physical activity, with a two to three day break between bouts of intense training. In severe cases of Osgood-Schlatter’s, patients should take a full break from any sporting activity until such time as the problem has recovered to a less severe level, only gradually returning to training under supervision of a physiotherapist or sports physician.

6) Osgood-Schlatter’s disease is fairly easy to diagnose for a medical practitioner, as it is the most common cause of knee pain in active adolescents. As a starting point, they will question patients as to the location of the pain and whether it is present in one or both knees, as it is not impossible, but very uncommon for Osgood-Schlatter’s disease to be present only in one leg. This may occur in for example a long or high jumper, who focuses on jumping off of one leg, but most sports involve equal use of both. The medical practitioner would then ask the patient how it feels to do different movements of the knee and hip, such as a squat or simple flexion at the knee to check which movements cause pain, as pain when doing these is always a symptom of Osgood-Schlatter’s. They would check if the patient had the full range of movement in their knee and hip, as in severe cases Osgood-Schlatter’s will have an effect on this. They would check for the telltale swelling and tenderness under the knee cap, and question the patient on the duration and severity of the pain to rule out things such as a simple blow to the knee. If uncertain they may perform an X-ray to rule out other possibilities such as this.

7) Patients can still perform with the condition, but as frequent exercise makes it worse, the only way to minimise its symptoms is to take enough rest, and apply the RICE principal. This may be detrimental to a patient’s skill and fitness level, but necessary if they wish to recover. The condition will only fully resolve itself with RICE applied and when a patient’s bones fully mature.

As, after this, patients will make a full recovery, the only long term effect it may have on an individual’s performance would be that while suffering the condition they may have frequently missed trainings etc, and had to spend time resting instead of being involved in their sport. This may make some recovered patients feel that they were not able to reach their peak, or a level of performance they would have reached were they not suffering from Osgood-Schlatter’s disease.

8)

**Osgood-Schlatter's disease puzzle**
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 * [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||  || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] || 7 || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   ||   ||   ||   ||   ||   ||   ||   ||
 * [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||  || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||   ||   ||   ||   ||
 * [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||  || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] || 8 || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   ||   ||   ||   ||
 * [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||  ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||   ||   ||   ||   ||
 * ||  ||   ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   ||   ||   ||   ||
 * ||  ||   ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||   ||   ||   ||   ||
 * ||  ||   ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   ||   ||   ||   ||
 * ||  ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||
 * ||  ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] || 9 || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||
 * ||  ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||
 * ||  ||   ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   ||   ||   ||   ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   ||   ||   ||   ||
 * ||  ||   ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||   ||   ||
 * ||  ||   ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] || 10 || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   ||   ||
 * ||  ||   ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||   ||   ||
 * ||  ||   ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   ||   ||   ||   ||   ||   ||   ||   ||   ||   ||   ||   ||   ||   ||   ||   ||
 * ||  ||   ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/h25.gif width="25" height="1" align="center"]] || [[image:http://www.variety-games.com/CW/Puzzles/p.gif width="1" height="1" align="center"]] ||   ||   ||   ||   ||
 * ||  ||   ||   ||   ||   ||   ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] || 11 || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   || [[image:http://www.variety-games.com/CW/Puzzles/v25.gif width="1" height="25" align="center"]] ||   ||   ||   ||   ||
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 * |||||| **ACROSS** ||
 * **4** ||  || One of the physicians who first described the condition in 1903 ||
 * **6** ||  || Another physician who independently described the condition in 1903 ||
 * **7** ||  || ____ of the knee puts the tendon under stress and causes it to become inflamed ||
 * **9** ||  || _____ is an effective method of minimising symptoms due to the fact that a tight quadriceps muscle often worsens them ||
 * **10** ||  || This sex suffers the disease more often than the other sex, due to a higher participation in sport ||
 * **11** ||  || Osgood-Schlatter's is an ______ injury as it is caused by over exercising || ||   || |||||| **DOWN** ||
 * **1** ||  || The condition always occurs in active adolescents in times of ||
 * **2** ||  || Severe cases of Osgood-Schlatter's may involve _____ fractures ||
 * **3** ||  || It is a _ injury as it affects the patella tendon ||
 * **5** ||  || Stress on this tendon from the quadriceps muscle is the root cause ||
 * **8** ||  || The ______ tuberosity is connected to the quadriceps muscle by the patella tendon || ||