Rishita, once a very active child who loved playing cricket, football and swimming, prefers to play indoors. She avoids situations that demand running or jumping. This was not due to a sudden change in her interests but rather result of a fluctuating knee pain caused by a medical condition known as Larsen-Johansson disease or Sinding-Larsen-Johansson Syndrome.
Does your child also frequently complain of a knee pain?
Tendon attaches muscles to bones. The patellar tendon attaches the bottom of kneecap (or patella) to the top of shinbone (or tibia). There is another set of muscles called quadriceps muscles which are located in front of your thigh. These quadriceps muscles are connected to patella through quadriceps tendon. Thus, quadriceps muscles, quadriceps tendons and patellar tendon work together to straighten the knee.
During growth years, the patellar tendon is attached to a growth plate at the bottom of the kneecap. Any activity that puts a lot of stress on the growth plate at the bottom of the kneecap causes it to become inflamed and painful. In younger years, when children are going through a period of rapid growth, their bones and muscles don't always grow at the same rate. Many a times, bones grow longer and muscles and tendons become stretched and tight. This puts a lot of strain on the patellar tendon and growth plate. This condition is known as Larsen-Johansson Disease and is characterized by severe knee pain.
What are the causes?
- Active sports that involve lot of running and jumping
- Excessive exercise regimen
- Incorrect postures during training
- Wearing shoes that don't support the feet enough
- Weak or inflexible quadriceps muscles
- Intense activities like lifting heavy objects, squatting, walking up and down stairs
Who are at risk?
Teens during period of rapid growth, and those involved in active sports that involve lot of running and jumping.
What are the signs and symptoms?
Pain at the front of the knee Swelling and tenderness around the knee Severe pain when doing activities like climbing stairs, jumping, kneeling or squatting
How is Larsen-Johansson Disease diagnosed?
Doctor will do the following to diagnose the condition: Inquire about your pain and involvement in any sports or other physical activities. Discuss your medical history Do physical examination to look for swelling and tenderness Rarely, will ask for X-ray or MRI scan to rule out possibility of a fracture or infection
How is Larsen-Johansson Disease treated?
Larsen-Johansson disease is largely related to growth years when the bones and muscles are not yet fully mature. It's a tricky situation. The pain may come and go as you indulge in activities. It may frustrate a child on being sidelined due the condition but the sensibility lies in taking good care of one's muscles so as to strengthen them for future. Being patient and refraining from intense activities is the key. Speak to your doctor who'll be best to guide you whether to resume sports or not. When the pain occurs, use RICE formula: a. Rest: Limit activities and avoid any strain on your knee b. Ice: Apply ice packs to the affected area every few hours until pain goes away. c. Compress: Give added support to your knee by using a brace or strap. d. Elevate: Keep your knee higher than your heart to bring down the swelling. Seek your doctor's advice about starting a physiotherapy program to strengthen muscles, increase flexibility and vigor.
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The most noteworthy advice to keep Larsen-Johansson Disease at bay is don't overdo things and keep it balanced when it comes to playing sports and doing other activities during growth years!
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