Cramp – It’s a pain

By Mark Roe

How good were the FA cup finals of the 1980’s!? Every year was special even though Everton or Liverpool played in just about every game.  The sun was always shining, there was TV coverage of players in their hotel, Jimmy Tarbuck and Stan Boardman telling the same jokes, and hoards of excited fans walking up Wembley Way.

I still love watching the matches but, since qualifying as a physio, I now look on with a shake of my head when I see how many players used to go down with cramp in the last 20 minutes.  That never seems to happen anymore.  Or at least not as often.  Cramp!  Ouch, so painful they should have named it twice.

I get lots of players at my clinic asking what it is, and why they get it.  Cramp is actually an involuntary tightening (spasm) of a muscle, usually the calf, which can be caused by dehydration, poor sodium/potassium balance, compression of a muscle, tight muscles, or poor nerve supply to a muscle.  So for a lot of amateur players it depends on your lifestyle and age, as well as not stretching or drinking enough fluids.

The effect on fluid and dehydration is possibly the biggest cause of muscle cramps in most players.  I constantly find myself nagging players of the importance of drinking fluids before, during and after games.  It may be difficult to believe, but just a three percent loss in fluid will give you a ten percent loss in strength and an eight percent loss in speed.  If we put this in football terms, think about a full back and winger who are matched evenly, but the full back doesn’t drink at half time.  In the second half the winger will ‘skin’ him more and more throughout the game.  This is the difference between winning and losing.

Quite often I get asked what is the best type of drink?  With all the different types of sports drinks on the market – isotonic, hypertonic, hypotonic, to name just a few – it’s difficult to know where to begin.  If you are at a professional club, this will probably be arranged and carefully measured for you, but for the amateur, you can’t go far wrong with water before, during and after a game. Try and drink plenty throughout the day before a match too. Drinking fluids helps to keep the muscle fibres mobile and therefore prevents them from drying out and tightening up.

Not only is what we drink important, but how we drink it, according to some managers.  Football is now becoming so technical, so clinical and so serious that everyone is looking for that one percent advantage over their opponent.  Arsene Wenger insists his players only drink fluid at room temperature so it is easier for the body to absorb.  If the fluid is too cold, it may cause cramp in the stomach, as the blood supply to our internal organs will be increased to help settle this and therefore our external muscles in the limbs will be less efficient.

Lack of sodium in the diet has also been noted as a possible cause of cramp in some people, so try a few more shakes of salt on your fish and chips. If this doesn’t help it may be due to lower levels of potassium, so stick a banana in your pack-up at work and see if this makes a difference.  Potassium levels are also linked to weaker muscles.

One of the more common problems I see in children is wearing sock ties which are too tight, or the elastic ties on the back of shin-pads which are again too tight.  Other kids try to copy their heroes by putting lots of layers of tape round their socks, and wonder why they get cramp.  If you imagine squeezing your calf muscle, while you run around for 90 minutes, it’s bound to be uncomfortable.  Anything that compresses the lower leg will affect the blood supply, the nerve supply and the performance of the muscle.

Not a lot of people realise that cramp can also be caused by lower back problems.  If the joints in the lower part of the spine compress against the sciatic nerve, this can prevent the nerve sending normal signals to the muscles, which causes cramp in the calves.  A common feature of this is if you wake during the night or early morning with cramp even if you haven’t been active the day before.  This all leads back to lifestyle.  If you do a desk bound job, spend a long time on your PlayStation, or do a lot of driving, this can also cause cramps.  If this happens to you, try a few back stretches before going to bed, or see a physio for a bit of treatment.

Stretching is usually a good help for all muscle cramps, so if you do get shot by cramp towards the end of a match, make sure you stretch.  Pulling your toes upwards with the knee straight is a good help.

Whilst we’ve gone back to preaching about lifestyles, think about yourself on a Sunday morning… You wake up late, dehydrated from last night’s alcohol, without breakfast inside you.  You run onto the pitch just in time for kick off – without stretching off.  Shin-pads taped on tight, thinking that this bit of exercise will get rid of that stiff back you get when sat at the computer for 40 hours a week.  Do me a favour.  At least have a drink of water at half-time, and after the match, before you pour that first refreshing pint down your throat!

Cheers.

Mark

For more information or for some help visit Mark’s website: www.markroesportsphysio.co.uk 

A parent’s role – Dad aids daughters rise up football ladder

Doncaster Rovers Belles striker Jess Sigsworth, 17, has enjoyed a magnificent rise up the football ladder.

Her journey, which has culminated in her being involved in the England U19 set-up, has seen her start off at grassroots level, and progress to the Sheffield United Girls’ Centre of Excellence before signing for Women’s Super League side Doncaster Rovers Belles.

Jess tells us about her career so far, and the important role her parents have played in supporting her.

“From having a passion for football for as long as I can remember it is a dream come true to now be a part of Doncaster Rovers Belles and England u19’s.

“It all started at Branton Boys at the age of seven when my dad took me down for training after I enjoyed a kick-about in the garden with me him and my brother.

Jess Sigsworth and Family

“Teams used to turn up to play us, Branton Boys, and say ‘this will be easy they’ve got a girl.’ I just used to laugh and show them that girls could do just as well. At U11’s level we were unbeaten, which was fantastic especially when Dad used to help with training every Saturday morning.

“I’m very lucky to have a dad that is so supportive and loves football like I do because without him I wouldn’t be where I am now. I wouldn’t have been able to get myself everywhere I’ve needed to be.

“After Branton Boys I moved to Junior Doncaster Belles for three seasons. I then went on to play for the Sheffield United Girls’ Centre of Excellence. I trained twice a week in Sheffield, Mum taking me once and Dad taking me once.

“It was nice that my Mum and Dad would both do the travelling because it showed they were both very supportive of my football.

“My mum doesn’t really understand football so it’s nice to have a Dad that you can talk to before and after a game and he can understand exactly what you’re saying and feeling.

“Even after a bad game my dad always had something positive to say that always used to make me feel better.

“Whilst playing for Sheffield United I broke into the England U17’s squad. I went on to play in phase two of the Euros in Poland and one of my dreams came true when I scored against Sweden in a one-nil victory.

“My dad took the time off work to come and support me, which was fantastic. It is always nice to know you’ve got someone with you, and in some respects it does make you play that little bit better.

“I am so happy that my dad got to see that goal because I don’t think he’d ever lived it down if he didn’t.

“After three great seasons in Sheffield I came back to Doncaster to train with the Belles first team and signed for the second half of the Women’s Super League season in 2011.

“It’s been such a privilege to play in the best women’s league and against some of the best female players.

“I am also very lucky not just to have great support from my family but also my friends and teachers, especially my PE teachers who take a massive interest in what I do. I don’t take it for granted and I am always very grateful for everyone’s support.

“After all the miles my dad must have clocked up supporting me I am happy to be playing in the WSL and I’ve got a few caps for England so nothing he’s done has gone to waste. Hopefully a place in the England first team will repay everything he’s done for me.”

Her Dad, John, added: “I can’t begin to tell you how proud you feel when the opposing fans applaud a goal or a good pass made by your own kid, and this happened a lot. The success that the teams had that Jess played in was very high.

“I’ve been a chauffer, fan, and as assessor of performances, which sometimes led to heated discussions on those long journeys back following a defeat. I’ve had to pick her up when things aren’t going so well.

“Your weekends become a thing of the past, and I daren’t begin to think how many miles I have driven to matches and to training, but it is not something you think of at the time. Saturdays would start at 6am, in order to get her to Sheffield for the 7am coach, and we wouldn’t get back until about 4pm.

“You also have to try and help them strike a balance between football and schoolwork. I have been very lucky with Jess because she has always got in from school and done her homework straightaway on training night because she wouldn’t get back from training at Sheffield United until 9.45pm.

“I dare say some parents will have difficulty in getting their sports mad kids to see the importance of their schoolwork if the team was playing away at Sunderland or Newcastle.

“I’m sure mums and dads up and down the country have similar stories to tell: you sacrifice a lot of your time, you kick every ball with them, you wince at every tackle made on them, you celebrate all the highs, you have to try and pick them up from the lows, you have to try and be very tactful when discussing not so good performances but I wouldn’t change anything.

“To all parents out there – your kids couldn’t do it without your great help.”

‘Yanks’ very much

Sheffield & Hallamshire FA were delighted to find out that level one referee Michael Naylor has been selected to officiate at the Dallas Cup, the oldest international youth football tournament in the United States.

Michael, who will represent the PGMO (Professional Game Match Officials) alongside Carl Berry and Tim Robinson, is looking forward to following in the footsteps of distinguished referees Martin Atkinson and Mike Riley by refereeing at the tournament.

He said: “From speaking to other colleagues who have been in the past, particularly Sheffield and Hallamshire CFA referee Craig Pawson, it seems that the main differences centre around the cultures of the various teams around the world.

“You could go from refereeing a South American team against a European Team, to refereeing an Asian Team against a North American Team perhaps within the same day; all four teams will require different levels of communication and management techniques.”

Michael will officiate at up to three games per day over the course of the tournament, which runs between April 1 and April 8.

He added: “It will be difficult being away from home for over two weeks, however I feel I will return a better referee than when I leave and I am very grateful for this opportunity.”

Teams entering the tournament range from U13s up to the U19s and it is seen by many professional clubs as a perfect way of aiding player development, with Manchester United’s Tom Cleverly, Sunderland’s Frasier Campbell and Arsenal’s Emmenuel Frimpong being notable alumni.

Michael said: “I understand the final list of teams is yet to be finalised but I believe Manchester United and Everton have already confirmed attendance in the Super Group along with Paris St Germain, Eintracht Frankfurt, Cortiba and Esporte Clube Bahia from Brazil as well as Seleccion Nacional de Mexico Sub 20 – so there is real calibre of teams there.

“Along with the PGMO representation of 3, the FA also sends 12 academy referees over, which again represents a fantastic opportunity for the Academy officials to develop and test their skills as referees.”

We wish Michael the very best of luck.

 

A Woman in a Man’s World: Gemma Gale

Gemma Gale is the Girls and Women’s Football Development Officer at the Sheffield & Hallamshire FA. Here, the 28-year-old level six referee talks to University of Sheffield student Shimeng Ren about her experience as a woman working in a male-dominated world.

 Part 3: Challenging perceptions

Q: How do people usually react when you tell them you referee football games?

Most people are shocked and don’t understand why. A lot of people ask me: “why would you

want to put yourself in that position and get the abuse?” But I am passionate about football and want to be involved in the game. I really enjoy refereeing; I get a buzz from it.

Q: To what extent can a woman make a living from becoming a football referee?

Referees are categorized into different levels, depending on how much experience and ability you have.

When you first start out as a referee, regardless of being male or female, you are at level nine, which is classed as a trainee referee. When you reach level seven you are classified as being a fully qualified referee and from this stage you can then progress down the levels: six, five, four…with zero being FIFA standard, which would be a referee such as Howard Webb. Until you progress towards these levels it would be hard to make a living from it.

Q: There are 1,300 female referees trained by the FA and more than a million women play some form of football across the country. From your point of view, how do people perceive football in England?

 When I was a young girl there were no separate sex opportunities to play football. I played in the boys’ team for quite a while and trained with them as there was no female provision. Now we’ve got a women’s league, we’ve got a girls’ league, we’ve got female match officials, referees and player development centres. The game has grown massively -female football in England is the third fastest-growing sport in the world and that is fantastic.

Q: Could you ever see a woman refereeing one of the big competitions one day, for example the World Cup or the European Champions League?

Hopefully. I’d like to say that one day it will happen and it appears to be going in the right direction. I think Sian Massey has opened the door for women to be welcomed into the higher level of competitions.

Q: Have you any advice for girls who are interested in taking up refereeing?

If you enjoy football but don’t want to or can’t play anymore then don’t give it up!  Instead get involved as a coach or as a referee. The good thing about refereeing is that you stay active, stay involved in the game, and you are physically a part of the game. There’s the sense of enjoyment and respect you do get once the 90 minutes is up and everybody shocked by how well you handled the game. For me, that’s a massive achievement and makes me feel good at the end of the day.

Q: You have been a player, and you are a referee now, is there any other position you’d like to try?

I’ve also completed my UEFA B (level 3) coaching license and Youth Award Module 1, 2 and 3, so there is that option as well. Football is something I live and breathe and I’ll always be involved with it no matter what, it’s my life!

Futsal…Foot what?

By Nick Wright, Assistant Press & Publicity Officer at Sheffield FC

What is Futsal? This has become a commonplace exchange of late when I tell people that I’ve started getting involved with Sheffield FC Futsal, so I suppose I should address this question at the outset.

Let’s deal with black and white facts first, Futsal is a form of football generally played with five players aside, indoors but not using walls or boards like other forms of indoor football.

However, this would be a rather dull blog entry if I just ran through what rules differentiate futsal from football, and to be honest if you wanted to read that why wouldn’t you just go to Wikipedia? (You can by the way- http://en.wikipedia.org/wiki/Futsal). So instead I thought I would give a flavour of what Futsal offers by relaying the more notable events from the first game that I attended- the FA National Futsal League North clash between Middlesbrough and Sheffield FC Futsal, and trust me the game was more exciting than the long winded league name might suggest.

The background: Sheffield are the reigning Northern League champions but after three impressive early season victories Middlesbrough  must have felt themselves significant pretenders to the crown. However, Sheffield’s early high energy and determined play was rewarded as they raced into a two goal lead.

Applying pressure and working hard from the kick-off is fundamental in Futsal. Mistakes are almost always punished, meaning that concentration, skill and handling of pressure are as important in this game as they are at the highest level of the regular game. The unerring pace of the game was brought to the fore as the play got underway again immediately without any Premier League style orchestrated celebrations from the scorers or the all-too-familiar gripes and complaints aimed at officials from the side who conceded.

The high octane action continued throughout, with players showcasing their skills as they looked to maximise the little time and space they were given. This was especially true of Sheffield on the day, who built a number of lightning-quick counter attacks capped by cool finishing to race into a 6-1 half time lead.

This is not to say that the home side didn’t play their part in the first half as they too showed good movement and skill but were thwarted by excellent defensive work which in Futsal is typified by positional awareness, pace and a willingness to throw your body in the line of fire on a regular basis. A quality keeper always helps too of course and Sheffield and England keeper Curtis Holmes also played a big part in keeping Middlesbrough at bay throughout.

In the second half there was not only more of the same unbroken pacey, skilful play but also a number of things you would never be likely to see in regular association football, and more’s the pity. I mean who wouldn’t want to see a side who are trailing periodically swap their keeper for a more skilled outfield player to get involved up the pitch leaving the net unguarded? Or an opposition player take advantage of this by scoring from their own half before then also converting a penalty within a minute? All this excitement meant that the second half flew by, with Sheffield comfortably winning 9-3 in the end.

The feeling upon the hearing the full-time whistle? Futsal is great.  It has pace, skill, passion and desire, as well as almost unceasing action, that in many ways combines exciting elements of a number of sports such as Ice Hockey and Basketball as well as keeping the key aspects which make football of all kinds our national obsession.

I hope that this does give a flavour of what Futsal is all about and wasn’t as dry as a run-down of the rules of the game, but the best way to see what it’s all about would be to go along and see for yourself.

Celebration of Sport service

By Joe Allen, MA Broadcast Journalism student at the University of Sheffield

The life of a Lino

By Simon Hall, Sheffield & Hallamshire FA level 5 referee

When you talk to some referee’s they will tell you that being an assistant referee, or “lino,” is actually harder than being the referee.

You have to learn to assist the referee and not insist in a job where having numerous eyes in multiple directions would be a major help. The man in the middle, the referee, is in charge and you are there to assist him or her when help is needed and always be credible.

“You’ve seen that lino,” spectators and players will shout at you. As assistant I often think “don’t tell me what I’ve seen, how can you possibly know what I am looking at.”

An assistant referee has so much to take in and, most importantly, (apart from the other two assistant referees and maybe an assessor) no-one knows what the instructions are from the ref.

Usually assistant referees will receive their pre-match instructions an hour-or-so before kick-off; a lot of these instructions are the same but some referees change certain areas. As an assistant you need to know what they want and make sure you don’t give the referee any surprises.

So, what does an assistant referee do?

The senior assistant usually patrols the dug outs and ensures that competition rules are being followed by both sides. Normally, two are allowed to stand, with one person shouting instructions. All substitutions will be made from the half-way line and they will make sure a player leaves the pitch before the substitute enters the field of play. The assistant must also make sure the player wears no jewellery (including bands around their wrist), that under armour garment colour matches the kit colour and, finally, he or she will check boots and studs.

The assistant then needs to get back in position, which is line with the second rear-most defender. People think that awarding a throw-in is just a case of pointing the way you think- but it’s not always that easy.

What if two players from opposing teams go in on the ball at the same? You don’t want the referee to give the throw to the home team and then you, as an assistant referee, give it to the away team.

Both sets of players will see it as their ball and fiercely argue their case – this is why officials are appointed.  If the team of officials are unsure then the decision will go in favour of the defensive team.

Sometimes match officials convey messages “downstairs” – the ref will point one way below his waist and the assistant, if unsure, can look and ensure that they ‘go the same way.’  Alternatively, if the assistant is certain a little shake of the flag in the right direction below the waist will assist the referee.

What other things come into consideration when deciding which way a so-called “simple” throw-in goes?

How far away are you? Your position should be the second rear-most defender. If the defenders are sitting really deep then you can be a good distance from the ball, which is where the teamwork comes in.

You must bear in mind that there are three areas. Firstly, there is ‘your area,’ which is the space immediately around you. Secondly, is the area a bit further down the line, which is where the ref is usually situated if the ball is there, and, finally, the third which is furthest away from you. In this area, as assistant ref, you always look at the referee and go with him, no matter what you think – assisting not insisting.

A simple throw is not so simple all of the time.

So, with that in mind, what would you do in this situation?

Red team are attacking down the wing – running right next to the line – and the blues are defending and trying to tackle.

The assistant is looking down the wing. He or she needs to know if the ball goes out of play for a throw-in and, remember the whole ball has to cross the line to be a throw-in, he or she also needs to be in line with the second rear-most defender.

Apart from looking down the line for the throw-in, the assistant is also checking for offsides at a 90-degree angle to where play is. Try doing it – it’s much harder than it sounds.

The ball is then whipped in and the assistant has a whole new set of tasks. Was it defender or attacker that headed the ball? Was it a goal kick or corner? Or was it hand-ball? Was it in the box? Was there a push? Was the player in an offside position, and, if so, was he interfering with play? Where is the referee positioned? If there was an incident will he need my help? Is the incident outside of my credibility zone (the further away the less credibility an assistant has)?

That is an awful lot of information for the assistant to digest – and it all comes from one cross.

Then you hear the shout, “You must have seen that, Lino?”

Again don’t tell me what I’ve seen. I was looking at the offside, the three heads that went up, the keepers encroaching movement, if the ball’s in-play or over the line, and, and this is a big one, was there a late tackle as the cross came in?

Amazingly match officials get the majority of these decisions spot on. Per game, the percentages of correct decisions made by officials are a lot higher than those of the players. It’s brilliant – considering how hard these decisions are.

Then, with all this happening, the assistant referee still has to keep control of the dugouts when there isn’t a fourth official available.

So, at your next game, please spare a thought for the assistant referee.

This is just a small insight into an assistant referee on match day…….

Advantage or Minefield?

By Keith Goulding, Secretary of Worksop Referees Association

“To play or not to play, that is the question”, words first uttered by William Shakespeare who played in goal for Brentford!

Whenever you apply advantage in a game you have to consider the football skills needed to fashion a goal-scoring opportunity from your shout of “Advantage, Play on”, coupled with the double-arm signal which, when given on the run, makes you sound like a neutered tomcat. You also have to consider in which part of the field play is operating, and for an advantage to have any chance it needs to be the attacking third of the field. Consider also whether it would affect your control for the rest of the game. So there is plenty to think about.

Let us consider this scenario. Play is in the final third of the field, and a defender makes a reckless challenge on an opponent for which a yellow card would be shown. If you apply advantage do you need to mentally note the perpetrator’s number so that you can return in the ensuing dead-ball time to administer it?

And secondly, you ask yourself if it is a gold-plated advantage with a goal the likely outcome. If your answer is no to either of those questions, then I would strongly suggest that you do not apply advantage and that you award the free kick. Players would forgive you if a goal were not scored, but would not forgive you if the reckless challenge went unpunished. This could seriously affect your control.

You must consider where you are on the field of play. If a central defender is fouled twenty yards from his own goal but retains the ball, is that an advantage? I would suggest that it is merely possession, and should you choose to apply advantage and another tackle comes flying in and fells the defender, then match control would be lost and a mass confrontation may ensue with several cards being the outcome of dubious practice.

I have already stated that in my opinion you should not apply advantage unless you are in the final third of the field, but consider this. One team is attacking and the whole team except their goalkeeper is in their opponents’ half of the field. A defender intercepts a pass, then punts the ball into his opponents’ half where a team mate, in his own half when the ball was played, runs onto the ball and has a clear run to his opponents’ goal. I would suggest that this is an excellent time to apply advantage, even though the play was nowhere near the last third. This, though, is the exception to the general rule.

We now move on to the ‘unspoken’ advantage where a petty foul was committed and you do not want to spoil the flow of play. The Premier League boys seem to have their own unofficial signal, which is to point at the ball for a couple of seconds to show everyone that they have seen it. This unspoken advantage could be a precursor to a real advantage at the next stage of play. I am sure we have all done it, but the time lapse is so short. At this point you can only think, “Petty foul, he still has possession, I can bring it back for the initial foul and give the free kick if I need to”.

Having said that, there is always a danger that a second more robust tackler may come flying in that could seriously affect your control. The players would then accuse you that it was your fault as the referee, you caused that situation because you should have given a free kick earlier, and so on. Are you being brave or foolhardy in that situation?

I would say that early in the game you might ‘test the water’ for about fifteen minutes and give the free kick until the players have confidence in your decisions. For things like throw-ins, be pedantic and insist they are taken from the right place. Then when the petty foul happens which is not an advantage but you want to maintain the flow, shout, “Seen it, fella, seen it”, and I think the players will accept it and realise what you are trying to do to benefit the game for all of them.

You may go through a whole game without a sniff of a real advantage, but always be looking for it. Do not penalise a team by not applying the law on advantage.

Be aware of the difference between possession and advantage.

Be aware of the individual ability of players to capitalise on your decision.

Be aware of where you apply it on the field.

From the Danube to Doncaster: England Women’s to take on Serbia

International football is coming to the Keepmoat Stadium as the England Women’s team prepare to take on Serbia in a UEFA Euro 2013 qualifier on Wednesday 23 November.

The two sides met in Belgrade in September when a Vesna Smiljkovic equaliser deep into added time earned the Serbs what had, at times, appeared an unlikely 2-2 draw.

But with Group 6 rivals Holland battling with the Three Lions for Group 6 supremacy, England defender Sophie Bradley recognises the importance of a win in Doncaster next month.

“We should have put the game to bed long before they scored their first,” Bradley said, of the two sides’ last encounter.

“In the first half we had so many chances, we just didn’t put them away. But we felt comfortable at half-time; we were 2-0 up and all over them. Fair play to Serbia, though, they played well after the break and put us on the back foot for most of the second half.

“Hopefully it’ll be a different story at home,” she continued. “We’ll have our own fans behind us and we’ve learnt our lesson from the last game. We have to be more clinical and not allow Serbia into the game like we did before. But we know we’ve got it in us to win this game, and we have to really, if we are to stand a chance of topping the group.”

Bradley is no stranger to this part of the country, having lifted The FA Women’s Premier League Cup with Leeds Carnegie (now United) in 2010. Neither is she unfamiliar with the Keepmoat, having played here for her current side, Lincoln, in August, and she is nothing but complimentary about the surface and the facilities on offer.

“The pitch at Doncaster is lovely,” Bradley said. “If you can’t play football on that, then you can’t play football on anything. It’s brilliant to be able to play this game at such a great stadium, with great facilities and a great pitch and hopefully that will give us an advantage because of the style of passing football we like to play.”

And not only is the 22-year-old keen to collect three points here, she also hopes the game attracts as many women’s football fans as possible. Her time with Leeds has proved to her that there is a genuine appetite for the game in this area and the success of Doncaster Rovers Belles in the inaugural FA Women’s Super League has increased the interest further.

“When I was at Leeds there were girls coming through all the time, at every age group, so there is definitely a love for women’s football in Yorkshire,” she said. “We’ve seen that with the Belles as well. Hopefully as many female players as possible can come to watch us at Doncaster.”

Tickets for the game are on sale now, priced £5 for adults and £2.50 for concessions (U7s go free when accompanied by an adult). Ticket hotline 01302 762 576.

Knobbly Knees

by Mark Roe

We have all had team mates who complain about knee pain, and if you have ever had it yourself, you’ll know it can be quite disabling at times, especially when you are in adolescence.  Often, parents take their children to the doctor only to be told “it’s growing pains – rest from sport for 6 weeks”.  This was the worst thing any doctor could have said to me at 14 years old! However I did as I was told, and eventually (much more than 6 weeks later) the knee pain settled.

As our bodies grow, particularly through puberty, we go through something called a growth spurt.  This is where many children develop knee pain in the form of ‘Osgood Schlatter’s Disease’ (OSD) or heel pain which is called ‘Severs Disease’(SD).  It is thought that as we grow, our bones enlarge faster than our muscles.  This makes it feel like the muscles are really tight, and they become painful on parts where the tendon of the muscle attaches to the bone.

Although this can happen at several areas of the body, the most common seem to be directly on the front of the shin just below the kneecap (OSD) and at the weight-bearing point of the heel (SD).

Today we are going to look specifically at OSD.

Who gets Osgood-Schlatter’s disease?

OSD is common in young teenagers, between the ages of 12-15 and seems more prevelant in boys. It is uncommon over the age of 16. Teenagers who play a lot of sport involving kicking, running, or jumping or activities which involve repeated and vigorous use of the quadriceps muscles, more commonly suffer. However, it can also occur in children who are not sporty.

The main symptom is pain just below the kneecap. The pain can be variable and more people report it as a problem during, and just after, activity. However, it does tend to ease with rest.

The pain typically lasts a few months, but for some youngsters it can last much longer until the ‘growth spurt’ has finished. This means that in some cases it can last up to two years.

As well as activity related pain, we need to look out for a small, tender, bony bump may develop where the pain centre is below the kneecap. This bump can enlarge with increased activity, and although the bump becomes permanent, the pain here will eventually settle down. The actual knee joint is not affected, so fortunately, knee movements are normal, although it does cause people to walk with a limp.  In a third of cases, teenagers will have the problem at both knees.

What causes Osgood-Schlatter’s disease?

It is thought that overuse of the thigh muscles (quadriceps) during the growth spurt is the most common cause. The tendon which attaches the thigh to the top of the shin, (via the kneecap) becomes inflamed and causes pain at the site of the attachment. In some cases, a small flake of bone is pulled off the top of the shin bone. Healing bone called a callus then forms over this area causing a hard bony bump to develop.

What is the treatment of Osgood-Schlatter’s disease?

The pain usually goes within a few months without any treatment, but looking after your muscles and being sensible can speed the process up. It needs to be said that the condition is not serious and will eventually settle on it’s own.

Many years ago, doctors used to advise complete rest, however more recently it has been found that complete rest is not always necessary.  It is now thought that best management is to follow a stretching programme for the lower limb muscles, take appropriate pain relief or anti-inflammatories as approved by your pharmacist, regular icing and ‘relative rest’ from sport or aggravating activities.  The stretching needs to be done everyday – not just when playing- and should target the main muscles of the leg. Ie. calfs, hamstrings, quads and buttocks.

How much sport can I play?

Although sport or physical activity is not likely to cause any permanent damage, it will usually make the pain worse. With this in mind difficult decisions may have to be made about training schedules and sporting commitments. I would always advise to reduce the amount you play in every case.  Even if you only play 15 minutes at each training session and match, the body is active, you are still keeping some match-fitness and the manager doesn’t forget about you!  This is better than being scared of missing out and playing through the pain as this will only hinder your performance and you then risk being dropped altogether.  Also think about how much you play in the school yard, or with friends in the evening.  If you do this less, it may mean you will be able to manage longer at the weekend matches.

The time during a growth spurt can be very frustrating for a player as often they may be one of the best players in the team, but over a brief period suddenly look poor, or slow.  This is where managers and parents need to look after the player and reassure them that this is temporary, and their form will return when the symptoms settle.

If this is happening to you, make sure you tell your manager and parents, and follow the guidelines above.  It is wise to have an initial consultation with a registered physiotherapist to confirm the diagnosis. Follow up sessions of physiotherapy should not really be necessary if you follow the management ideas above.

Stay focussed, remember this problem will resolve, and work hard at your stretches to speed up your time on the sidelines!

Good Luck! Mark