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Sinding Larsen Johansson Disease

What is Sinding-Larsen-Johansson Disease?

Sinding-Larsen-Johansson Disease (SLJD) is named after the doctors who discovered it. Rather than being a disease, it's better described as an overuse injury.

Sinding-Larsen-Johansson Disease is an inflammation of the bone at the bottom of the patella (kneecap), where the tendon from the shin bone (tibia) attaches.

Who Suffers Sinding-Larsen-Johansson Disease?

SLJD usually strikes adolescents who are active during their growth spurts, which is the two year period where they grow most rapidly.

Growth spurts can begin any time between the ages of 8-13 for girls and 10-15 for boys. SLJDis most common in 11 to 14 year olds. Growth spurts make kids vulnerable because their bones, muscles, and tendons are growing quickly and not always at the same time.

SLJD is more likely in teens who participate in sports that involve running, twisting, and jumping, such as basketball, football, volleyball, soccer, tennis, figure skating, and gymnastics.

With exercise, the muscles place increased stress on the growth plate at the base of the patella. The growth plate is a layer of cartilage near the end of a bone where most of the bone’s growth occurs. It is weaker and more vunerable to injury than the rest of the bone during this growing phase.

What the Symptoms of Sinding-Larsen-Johansson Disease

Swelling or tenderness is felt at the base of patella (kneecap), where the patella tendon inserts into the patella

The pain usually:

Worsens with exercise
Is relieved by rest
Causes you to limp after exercise

What is the Symptom Progression?

While a mild case of SLJD can resolve within days, severe cases must be professionally managed to avoid growth plate damage. The pain and swelling symptoms can last for years. Longstanding SLJD can result in an avulsion fracture of the tendon, which can sevrely affect your ability to walk or run.

Fortunately there is something that Physiotherapists can do to help!

Contact PhysioWorks or Book Online

Treatment for Sinding-Larsen-Johansson Disease

Physiotherapy assessment and treatment is highly recommended in the treatment of Sinding-Larsen-Johansson Disease.
It is important to ensure that SLJD is the actual diagnosis. Other sources of anterior knee pain require different treatment.

A similar but different injury is Osgood Schlatter Disease.

Acute Injury Management

A combination of ice treatment and a home tens unit will reduce pain and improve the healing rate. This usually hastens the recovery rate of sufferers. Ice is useful at home or after exercise.

Rest is also important in the management of SLJD and relief of pain. In mild cases it may enough to just limit the physical activity you do so that the pain is only mild and only lasts for 24-hrs. When symptoms become worse it may be necessary to take a short break from your aggravating sports. Discuss your workload with your physiotherapist for advice on how to best manage yoiur sport and your injury.

Stretching

One of the common reasons for developing SLJD is excessively tight quadriceps muscles, hamstrings and calves. Your physiotherapist will prescribe specific stretches for you.

Ask us about our LOCKEROOM stretch-bands which make stretching a breeze. It's one of the only products that we've found kids enjoy using, which improves their compliance with a stretching program. Stretchbands are now used by most elite sporting teams, after being pioneered by the Australian Wallabies Rugby team.

Strengthening

Your muscle control around the knee will usually need to be addressed to control or maintain your symptoms during the active phase of Sinding-Larsen-Johansson Disease. Your therapist will commonly prescribe or modify exercises for your quadriceps, hamstrings, calves, foot arch muscles and gluteals (buttock muscles).
Is there any Support that helps?

Taping or a patella tendon support may provide pain relief and load reduction at the painful site.

Occasionally foot orthotics may need to be prescribed. There are mixed views on how effective these are, since the foot structure is rapidly changing at this age. Ask your physiotherapist or podiatrist for advice.

For more information, please ask your physiotherapist or book your appointment for a thorough assessment and SLJD management.