Knee
> Sinding-Larsen-Johansson
Syndrome
> Treatments
Quadriceps
Strengthening
Home Recovery
If you have been diagnosed with Sinding-Larsen-Johansson
(SLJ) syndrome, your physician may suggest stretching
and strengthening exercises focusing on the quadriceps
(thigh muscles), to improve strength and flexibility
and to help prevent your condition from getting worse.
If you have a more severe case of SLJ that requires
immobilization or bracing of your knee, you will probably
will not be able to begin these exercises until you
have been cleared by your physician. If your symptoms
do not improve after a week or week and a half of beginning
stretching and strengthening exercises, you should see
your physician.
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), 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.
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