Comparison of Three Treatments for Lower Extremity Apophysitis
Comparison of Three Treatments for Lower Extremity Apophysitis
The purpose of this study is to compare three different treatments for these types of lower
 extremity apophysitis- Osgood-Schlatter syndrome (OSS), Sinding-Larsen and Johansson syndrome
 (SLJ), or Sever's disease.

 The investigators hypothesize that adolescents who perform a home exercise program (HEP)
 consisting of active elongation exercises will have decreased pain and earlier return to
 sports and activities as compared to those who perform a HEP that consists of static
 stretching exercises or those who use symptomatic treatment with ice, acetaminophen or NSAIDs
 and activity modification.
Osgood-Schlatter syndrome (OSS), Sinding-Larsen and Johansson syndrome (SLJ), or Sever's
 disease are three types of apophysitis, or secondary growth center irritation, that
 frequently affect children and teens. Although these conditions are common, there is very
 little data from high quality studies to support a particular treatment method in affected
 patients. The purpose of this study is to compare three different treatments for these types
 of apophysitis. The investigators plan to compare two types of home exercise program (HEP),
 one involving active elongation exercises and one utilizing static stretching, with
 symptomatic treatment consisting of icing, over-the-counter medications and relative rest.
 The investigators hypothesize that the active elongation HEP will result in improvement in
 pain and earlier return to athletic activities when compared to the static stretching HEP and
 symptomatic care. This pilot study will recruit subjects at the Ann & Robert H. Lurie
 Children's Hospital outpatient sports medicine and orthopaedic clinics with any of the
 following types of lower extremity apophysitis: OSS, SLJ or Sever's disease. Subjects will
 complete a baseline evaluation and questionnaire and will be randomized into one of the three
 treatment groups. At 2, 4, 6, and 8 weeks, subjects from all groups will use a secure website
 to complete an online survey to complete questions regarding current pain level, compliance
 with their home exercise program, if applicable, use of other forms of treatment or pain
 management (e.g. splinting, icing, rest from activities) and current activity level. The
 investigators will compare results from each group to determine which treatment(s) resulted
 in the largest improvements in pain scores and the highest rates of participation in sports
 and recreational activities.
Inclusion Criteria:

 -  diagnosis of OSS, SLJ, or Sever's disease

 -  must have regular access to the Internet

 Exclusion Criteria:

 -  history of prior treatment for OSS, SLJ, or Sever's disease

 -  history of previous injury to the affected joint requiring more than 1 week off of
 sports or activities