Sindig-Larsen-Johannson Disease

What is it? 

Sindig-Larsen-Johannson Disease refers to a condition occurring during pre-adolescence that causes pain, swelling and soreness on the knee cap (patella). The medical term for this condition is patellar apophysitis. It occurs directly on the lower part of the knee cap, during a certain period of pre-adolescent development when the growing kneecap is vulnerable to overuse. Children/teens who are involved in a lot of running and jumping activities are at high risk for developing Sindig-Larsen-Johannson.   

Why come to The Children’s Hospital for treatment of this condition?

Children’s has the only sports medicine program in Colorado that is focused solely on caring for young athletes. Our team of sports medicine experts understand the demands that sports programs place on school-aged athletes and the importance of customized, age-appropriate care. Since many young athletes are still growing, they need special kid and teen-specific treatment that takes this into consideration.

Our pediatric specialists are fellowship-trained in sports medicine, giving them the focused expertise that makes The Children's Hospital the best choice for young athletes looking to maximize performance after recovering from a sports injury.

What are the signs and symptoms?   

Young athletes with this condition will complain of pain with activity and tenderness in the front of the knee, on the lower tip of the knee cap. There may be mild swelling and the area can be painful to touch. The pain and swelling often improve with rest.

How do we treat it?

Sindig-Larsen-Johannson is treated mainly by controlling the pain. This condition can be frustrating as the child is prone to this pain during the length of the growth spurt (usually around 2 years). Once the growth spurt is over, the pain should resolve. In the meantime, the child may choose to participate in less activity to avoid pain.  Rest should be encouraged based on the pain, but the child should be allowed to return to activity once the pain is under better control.

Ice over the area of pain after activity can be helpful.  For severe pain, over the counter medicine may also be considered.  Stretching the muscles around the knee such as the hamstrings, are protective of the knee and should be routinely recommended.  Wearing a knee brace can also be helpful for some patients.

Who gets it, and can it be prevented?

Sindig-Larsen-Johannson only occurs during a certain period of pre-adolescence, when the knee cap is going through a rapid growth spurt. In girls this typically occurs around the ages of 8 to 10, and in boys around ages 9 to 11. The condition is more common in active, athletic children.  

Sinding-Larsen-Johannson is difficult to prevent completely, but making sure to modify the amount of activity will help control the pain.