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   Patellar Tendon Strap

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Wearing a patellar tendon strap, which is designed to reduce inflammation of the patellar tendon and keep the kneecap aligned correctly, can help in the treatment of Sinding-Larsen-Johansson (SLJ) syndrome. A patellar tendon strap is worn around the leg just below the kneecap. It can resemble a thick rubber band, or it can be made of cloth and fastened by Velcro straps. The strap comes in different sizes, and you can choose the one that fits the circumference of your leg. Sometimes, a patellar tendon strap is worn over a knee sleeve that covers the entire knee area. By providing compression to the area below the kneecap, the strap reduces pain around the top of the shinbone or the kneecap, and helps elevate the kneecap slightly, relieving harmful pressure. Some patellar tendon straps fasten above and below the knee, which can reduce the force of the thigh muscle (quadriceps) on the patella tendon. Wearing a patellar tendon strap will not restrict blood circulation to your lower leg. The strap usually is worn during sports or exercising by athletes who are experiencing mild symptoms of SLJ.

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.