Dear Simon,
Vivian Grisogono in her book Children and Sport
describes Sindings-Larsen-Johannsen Syndrome as an Apophysitis. 'At the
lower point (pole) of the knee cap (patella), repetitive stress through the
patellar tendon, especially in the mid-teen years, can cause tiny bone
fragments to form, and this is called Sindings-Larsen-Johannsen Disease'.,
p.128.
She goes on to say that the cause of any apophysitis is repetitive stress,
repeated minor trauma, or in some cases an episode of severe traumatic
jarring or tension against the bone. Also, treatment is '.usually rest from
any painful, aggravating activities, combined with any sort of exercise that
can be done without pain.' Icing can be used for pain relief and treatment
continues until patient is pain free, sometimes days but more often several
weeks. Electrical stimulation has been used to maintain muscle function
around the injured bone, ultrasound is thought to be potentially damaging to
the growing epiphysis, but stretching, stabilizing, and strengthening
exercises are recommended where appropriate.
X-Rays are also recommended to assess the extent of damage and to check for
any avulsion. Importantly an avulsion can occur if the patient continues
with sporting or exercise activity while suffering from an apophysitis. as
happened to me many moons ago!
The Oxford Dictionary of Sports Science and Medicine describes recovery in
more severe terms, calling it a juvenile form of Jumpers' Knee - a patellar
tendonitis - an overuse injury most common among elite basketball players
who are tall and have high-riding patellae and elongate tendons: 'Treatment
includes reduction or temporary cessation of exercise for some months.'
To the best of my knowledge, any surgery to remove loose bodies is deferred
until growth is complete.
References:
Children and Sport - Fitness, Injuries and Diet. by Vivian Grisogono. John
Murray, London 1991.
Oxford Dictionary of Sports Science and Medicine (2nd Ed.). Michael Kent.
Oxford University Press, 1998.
Regards,
Ian
Ian Rogers M.Med.Sci.
232, Broomhall St,
SHEFFIELD S3 7SQ
UK
Tel. 0114 276 1018
E-mail: [log in to unmask]
Website: www.sportconsult.freeserve.co.uk
----- Original Message -----
From: Simon Plummer <[log in to unmask]>
To: <[log in to unmask]>
Sent: 21 April 1999 19:00
Subject: Sindings-Larsen-Johannsen Syndrome
A podiatrist colleague of mine has recently had some referrals of
Sindings-Larsen-Johannsen Syndrome to her biomechanics clinic.
Local references have not come up with any details of the
syndrome, which seems to be similar to Osgood Schlatters
Disease. Can anybody enlighten me (and her!)?
Simon Plummer
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