While Sinding-Larsen-Johansson (SLJ) syndrome normally
runs its course naturally as bones reach full development,
often it is necessary to take time off from physical
activities to speed healing. The severity of your symptoms
will determine how much you need to limit yourself.
For example, if you experience some pain after playing
sports but the pain goes away within 24 hours, it is
probably OK to continue your normal routine. However,
if your symptoms worsen, it is probably a good idea
to take a rest from the activity that led to them. The
goal is to decrease the stress on your knees and lower
legs, which means that even if you are not playing sports,
you should try to avoid strenuous activities that require
deep knee bending, such as jumping. Total curtailment
of sports and physical activity is not recommended,
however, as this can gradually weaken your leg muscles
and increase the chance of injury once you return to
more strenuous physical activity.
If you have taken time off from physical
activity during treatment for Sinding-Larsen-Johansson
(SLJ) syndrome, your rehabilitation is crucial to restoring
leg strength and flexibility as well as preventing your
condition from worsening. Stretching is particularly
important because what often happens during a growth
spurt is that the quadriceps have not increased their
flexibility in relation to the lengthening of the bone.
Strengthening should focus on the quadriceps and hamstrings,
and can include exercises such as straight-leg raises,
wall slides, leg curls, and quadriceps contractions.
These exercises can be done at home or under the supervision
of a physical therapist. It is important to remember
to go slowly and not to push yourself to the point where
you feel pain. It is preferable to do more repetitions
of each exercise rather than fewer repetitions with
higher resistance. Exercises may be necessary for the
entire length of time of the growth spurt in order to
prevent recurrence. It may help to apply heat to the
affected area for about 15 minutes before exercising
or sports, to loosen up your muscles and tendons. After
you finish, icing your knee and keeping it elevated
can decrease pain and inflammation.
It is probably unrealistic to expect
to prevent Sinding-Larsen-Johansson (SLJ) syndrome,
simply because it is related to natural growth spurts.
But you can take steps to minimize its effects. Exercises
that strengthen the quadriceps and hamstrings, such
as straight-leg raises and leg curls, can prevent the
condition from worsening. Avoiding overuse is important,
as is modifying the specific activity. In soccer, for
instance, if you are taking all the free kicks, you
may have to relinquish that role for a while. If you
play an outside position, you could be moved to an inside
position to lessen the amount of running required. If
you are a gymnast who has developed SLJ from repetitive
jumping, for example, you may have to modify or stop
using dismounts in the early, acute phase of the disease.
Occasionally, an athlete may have a foot problem that
can contribute to SLJ. In this instance, custom-made
shoe inserts (orthotics) may be effective in decreasing
stress on the knee and lower leg. See your doctor for
a complete evaluation.