Knee > Sinding-Larsen-Johansson Syndrome
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   Non-Steroidal Anti-Inflammatory Drugs

Home Recovery

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.

Rehabilitation  

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.

Prevention [top]

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.


Treatments
Bracing and Immobilization
Rest
Quadriceps Strengthening
Patellar Tendon Strap
Non-Steroidal Anti-Inflammatory Drugs
   Home Recovery
   Rehabilitation
   Prevention
 

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