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Sinding-Larsen-Johansson Syndrome "Sinding-Larsen-Johansson syndrome is irritation and inflammation of the growth plate (apophysis) at the bottom of the kneecap (patella) where the patellar tendon inserts. In a child, the bones grow from areas called growth plates. The growth plate is made up of cartilage cells, which are softer and more vulnerable to injury than mature bone. Sinding-Larsen-Johansson is most often seen in children between the ages of 10 and 15 and usually appears during a period of rapid growth."


Causes


"Sinding-Larsen-Johansson syndrome is caused by increased tension and pressure on the growth center. This pressure usually results from overuse of the knee (repetitive running and jumping). Having tight quadriceps muscles (in the front of the thigh) also puts pressure on this growth center and may make this condition more likely to occur. Tight muscles are more common during a growth spurt. "

References: http://www.luriechildrens.org/en-us/care-services/conditions-treatments/institute-sports-medicine/Pages/basics/knee-leg-sports-injuries/sinding-larsen-johansson-syndrome.aspx


Treatment


Functional movement patterns must assessed and improper muscular length-tension relationships must be accurately addressed throughout the latissimus dorsi musculature, L/S, hips, knees and ankles, which  can lead to an increase stress applied at the inferior pole of the patella . A physical therapist can create a specialized program that is specific so that "active rest" can occur, while continuing to address muscular limitations. "Active Rest" refers to performing a well-balanced therapeutic program that addresses functional and structural limitations and progressively allows the athlete to lengthen restricted muscular and strengthen weak musculature, while introducing proper body mechanic and functional movement awareness during the rehabilitation process. This will minimize the severity and intensity of symptoms when & if they do return, while providing the athlete with the proper education to reduce symptoms prior to moderate functional/ movement impairments which will lead once again to limiting activity.

ProSport Physical Therapy, 1000 N. Bristol St, Ste. #25, Newport Beach, CA (949)250-1112
Article produced by: Ray Roman, PT, DPT, SCS, OCS, ATC, ART