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Background: Intensive physical load can damage epi-/apophyseal growth. Osgood-Schlatter disease is a well-known and sport-associated overuse injury of the tibial tuberosity apophysis. Long-lasting load-associated pain and a reduced ability to play sports can be the consequence. Aim of the Study: The aim of this study was to analyse the safety and effectiveness of extracorporeal shock wave therapy (ESWT) for recalcitrant Osgood-Schlatter disease. Patients and Methods: 14 adolescent patients, median age 14 (13.2-14.7) years, suffering from recalcitrant Osgood-Schlatter disease (16 symptomatic knees) were treated with radial extracorporeal shock waves. The nine boys, median age 14 (13.5-15.0) years and the five girls, median age 12 (10.8-15.2) were retrospectively followed up 5.6 (3.4-6.7) years later using the disease specific VISA-P-G questionnaire which is validated for jumper's knee. Results: At follow up the median VISA-P-G score was 100 (82.9-100.9). Twelve of 16 knees (75%) reached 100 out of 100 VISA-P-G points. Four patients changed their sports activity due to persisting problems at the distal patellar tendon insertion. Four knees had persisting tibial tuberosity pain when playing sport. Pain induced by activities of daily living (stair climbing) was stated in two cases. No side effects or long-term complications were reported. Conclusions: This pilot study demonstrates that radial ESWT is a safe and promising treatment for adolescent athletes with recalcitrant Osgood-Schlatter disease

Background: Manufacturers attribute specific shoe and sole constructions to induce neuromuscular training. Thus, injury prevention or rehabilitation from injury is aimed. Hypothesis: H 1 = Different shoe and sole constructions result in different load to the neuromuscular system and postural control. Study Design: Controlled laboratory study. Methods: 10 healthy subjects were tested for postural stabilization using a force plate and EMG-recordings. First, each person performed three 20 sec single leg unshod stance trials (control condition). Then, MBT® shoe, Finnamic-Rollenschuh® and ReflexControl® shoe were applied and tested in a randomized order. Results: No difference in EMG-activity was detected comparing the barefoot condition with MBT® and Finnamic-Rollenschuh® (p = 0,051-1,000). However, with one exception (barefoot M. gastrocnemius med. EMG-activity; p = 0,110) puttingon the ReflexControl® shoe increased the EMG activities relative to all three tested muscles and shoe/barefoot conditions (p = 0,000-0,001). Moreover, the ReflexControl® shoe led to highly significantly higher postural sway (p = 0,000-0,072), while MBT®, Finnamic-Rollenschuh® and barefoot conditions were not statistically different (p = 0,818-1,000). Conclusions: This study confirms that during upright stance the ReflexControl® shoe is a means for neuromuscular training, while MBT® and Finnamic-Rollenschuh® simulate barefoot stance.