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BJJ Training with a Knee Condition

Hi everyone,

I have this knee condition called Osgood-Schlatters, a condition which is common for growing teens, im 18, still have it…

I’m training MMA and BJJ, and I struggle with takedown when pressure is put on my knees…

I’ve been to a physio, but they are just fools with a book who havent evolved in there study since they qualified 40 years ago (lol).

I’m training with weights and bodyweight exercises, and its improving, but im still not 100%

What other stuff can I do, I do some of the physio stuff as well as my training, and im taking supplements for my joints.

Any help would be appreciated, thanks.

Please help!

wear some wrestling knee pads if you aren’t already. make sure you’re allowing time for inflammation to go down and take precautions to help it, like ice and ibuprofen, when it does flare up. find a good orthopedic specialist that knows what he’s doing.

seak to a sports medicine expert. Normal doctors and physios are looking to get you back to walking around, they are not used to how to deal with someone who wants to do more than walk their dog.

A decent sports medicine expert is used to working with athletes and getting them back from very serious injuries to playing their sport as quickly as possible.

Not sure where you are based but in London I used to go to Pure Sports Medicine for any problems I had and they are amazing. They work with premiership football (soccer) players, international rugby players and top level competitors from a huge range of other sports.

I credit them for the fact that despite a torn rotator cuff and torn meniscus in my knee within the last 2 years I am still competing in BJJ.

It doesnt flare up, is just a weak knee basically…

How expensive are the sports medice ppl usually?

Try and see a physio that specialises in knee issues. I had OS and still did Tae Kwon Do throughout my teens, but I had a good physio.

I’ve had my meniscus trimmed and my ACL reconstructed since, and although I still get some soreness, I’ve been able to train fine in BJJ. I did nine months of rehab on my knee, went to weekly classes, and did a lot of weight training to try and get the muscles to help.

Many NHS physio departments have a sports clinic. You could call and see whether any local hospitals have one, you might need to be referred by your GP.

Isn’t OS usually found in younger adolescents? 18 seems quite late to have it…

I thought you were based in London. My bad if you’re not a Brit and don’t have access to the NHS! Sorry.


Osgood-Schlatter Disease is not a disease but rather a group of symptoms involving the tibial tubercle epiphysis. The tibial tubercle is a small bump on the tibia (shin bone) where the patellar tendon of the quadriceps muscle attaches.

This condition is a result of traction. The tibial tubercle is a growth center (apophysis or epiphysis) located just below the knee joint on the front of the tibia. This conditions will most likely affect males of 12 to 16 and females of 10 to 14 years of age.

The layer under the hard bone of the tibial tubercle is fibrocartilage and is different than any other of the body?s physes. The tibial tubercle physis looks like a layered pastry. During the active growth years these layers are loosely held together. The traction of the quad muscle causes a disruption and inflammation in the layers of the pastry.

In other words, the femur is growing faster than the quad muscle. This causes the quads to place undue pressure on the growth center of the tibia (where the patellar tendon attaches), causing pain. As the X-Ray shows, the traction of the tight quad mechanism is pulling the tibial tubercle away from the body of the tibia.

The symptoms include:

Pain over the tibial tubercle,

Swelling over the tibial tubercle,

Weakness in quad muscle group,

Increased pain & swelling with activity,

Visible lump, and

Pain to the touch over the affected area.

Athletes who suffer from this growth related problem are susceptible, though not likely, to an avulsion fracture of the tibial tubercle. If the growth center has too much traction on it for too long a period of time the bone fails and a fracture results.

Since the quad muscle is elastic, much like an extended spring, if the fracture occurs, the bone fragment will be displaced. Repairing this injury usually results in surgery. The surgical repair usually involves fixing the displaced bone with one or two screws. Surgery is then followed by four to six months of rehabilitation.

Preventing this problem from progressing to a season ending injury is fairly easy. The three symptoms to address are pain, swelling, and flexibility. If these problems are addressed, the athlete should be able to participate at a competitive level.

During competition the athlete should wear a protective pad. The most effective is a standard volleyball knee pad. The knee pad will protect the sensitive tibial tuberosity from impact. Impact to the swollen tuberosity is the most common cause of increased pain during competition.

Some athletes will see pain reduction when a neoprene sleeve is combined with the knee pad. The neoprene sleeve places subtle pressure on the swollen area and retains heat. The light pressure seems to relieve pain by compressing the separating physis. Combining this with the protection afforded by the pad will help to alleviate the most common symptoms during competition.

To control inflammation after activities, ice should be applied to the affected knees daily. This should be done every day, even those without pain. The ice will control the swelling associated with activities and control pain on a daily basis. Non-steroidal anti-inflammatory medications will also help to control these symptoms.

Effective medications are Advil® and Aleve®. These medications should be taken in accordance with package or personal physician?s instructions.

If these medications are taken only when the knee(s) hurt, they will function as pain relievers. If taken daily for two or more weeks they will assist in controlling inflammation. Do not take these medications daily for more than four weeks continuously. Doing so can lead to the stomach upset.

Addressing flexibility is one of the most important treatments for controlling symptoms for the duration of the growth spurt. On the surface, one would expect to stretch the quad muscles. In reality, stretching the hamstrings are more important.

The hamstrings are also undergoing the same stress as the quad mechanism. They are not growing as fast as the femur is. The hamstring insertions are usually not affected the same way as the quad attachments. The hamstring tightness does, however, affect the quad mechanism.

Increased hamstring tightness causes the quad to pull harder during athletic activities, consequently placing more traction force on the tibial tubercle. Increasing hamstring flexibility will help to alleviate the pain. Examples of hamstring stretching are shown on these pages.

Quad stretching will increase the traction forces on the quad attachment, possibly increasing pain and swelling. Quad stretching should be performed with caution so as not to cause increasing pain. Gentle stretching should be performed. Quad stretching is shown above.

Stretching should be performed at least four times daily. Ideally the suffering athlete should stretch 6 times daily. At the minimum, every athlete should stretch after waking, before athletic activities, after athletic activities, and prior to bedtime.

These stretching sessions should attack all major muscle groups with added time emphasizing tight spots. Each stretch should be held for 10 to 30 seconds and repeated three to five times. Do not bounce while stretching, and ease into and out of each stretch.

If the athlete continues to have increasing pain and can not participate on a daily basis, a physician should be consulted. Removal from athletics for a short period of time may help to relieve the pain enough to allow the athlete to return to competition.

If the athlete has to be removed from competition, rehabilitation exercises should be performed to maintain aerobic fitness and strength. These exercises should not exacerbate the symptoms.

Examples of exercises that may worsen symptoms are knee extensions, heavy squats, power cleans, and plyometrics. Any exercise that involves explosive use of the quad mechanism may aggravate symptoms. Appropriate exercises for improving aerobic fitness are cycling (utilize a high seat post), slide board, and swimming. Stair climbing activities may or may not aggravate symptoms, utilize only if appropriate.

For maintaining muscular strength, perform exercises such as straight leg raises, body weight squats, hamstring curls, and calf raises. These should be performed to minimize strength loss rather than increasing strength.

Allowing an athlete with Osgood-Schlatter Disease to continue to lift weights and compete at a high level is appropriate if participation in these activities does not increase pain. Decreasing the intensity of training may be all the adjustment needed to control the pain and swelling associated with this condition.

Most adolescent athletes will experience this problem during their athletic career, it does not mean disqualification from participation.

What are you doing to control inflammation, what kind of therapeutic exercises do you do? what area are you from? My second major for my BS was exercise Phys, I may know someone near you to talk to.

do you use a fish oil or efa type supplement?

The woman that I saw was 75 pounds (about $150 at the time) per half hr. Thank god for insurance.

I live near London, to control inflammation… my knees are not inflammed at all, I passed that phase of Osgood- Schlatters a few years ago. They just seem to be pretty weak, I cannot execute a proper double leg takedown without my knees hurting a lot.

And yes I take Glucosamine, Fish Oils and MSM.

Since you live near London, and have access to the NHS, why not see if your GP can refer you to a sports specialist or specialist physio?

this is where I used to go when I was in London.

Here is the Bio of the girl who put me back together (twice) http://www.puresportsmed.com/bio_rebecca_christenson.asp

The kensington branch is attached to a gym so they can actually really set up your recovery, rehab and prehab plan.

Cheers, in a few weeks I will mae a decision if I am not seeing the improvements I want.

If I am not I will try and get my GP to refer me to a proper specialist.

Not to sound glib but do what doesn’t hurt and don’t do what does. The good thing about BJJ is that you can just work on learning new techniques and practice them at whatever pace you feel comfortable with. The same when rolling; just tell your partner what’s up and he should accommodate you. If certain positions bother you and you end up in one just let him know that you’ll have to restart.

In some ways this might actually end up helping you in the long run as you’ll avoid the pitfalls of getting too competitive while training and focus on technique.