Rest and various other treatments can help you cope
with the symptoms of Sinding-Larsen-Johansson (SLJ)
syndrome, but you may need to take non-steroidal anti-inflammatory
drugs such as aspirin or ibuprofen to reduce the pain.
If your symptoms generally decrease or disappear when
you are not engaged in strenuous physical activity,
you still may need to reduce pain and inflammation in
the hours immediately after exercise. This can be done
by taking anti-inflammatories, applying ice to the affected
area of your knee, and elevating your knee to restrict
blood flow to the area. Ice should be used for 20 minutes
at a time, three times a day while pain or soreness
persists, or for 20 minutes after exercise if your knee
hurts. It is important to follow the directions on the
bottle when taking anti-inflammatories. Excessive of
these medicines can cause ulcers, kidney problems, liver
problems, and bleeding problems. You may want to contact
your physician prior to starting. It is usually OK to
use anti-inflammatories before exercise, but check with
your physician before making this a routine.
Quad stretching and strengthening
is crucial to restoring leg strength and flexibility,
as well as preventing Sinding-Larsen-Johansson (SLJ)
syndrome 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 getting worse. 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 physician
for a complete evaluation.