Patellar Tendon Force Differs Depending on Jump-Landing Tasks and Estimation Methods

Patellar tendinopathy is a chronic overuse injury of the patellar tendon which is prevalent in jump-landing activities. Sports activities can require jumping not only with a vertical component but also in a forward direction. It is yet unknown how jumping in the forward direction may affect patellar tendon forces. The main purpose of this study was to compare PTF between landings preceded by a vertical jump and a forward jump in volleyball players. The second purpose was to compare two different estimation methods of the patellar tendon force. Fifteen male volleyball players performed vertical and forward jump-landing tasks at a controlled jump height, while kinetics and kinematics were recorded. Patellar tendon forces were calculated through two estimation methods based on inverse dynamic and static optimization procedures, using a musculoskeletal model. Results showed that forward jump-landing generated higher patellar tendon forces compared to vertical jump-landing for both estimation methods. Surprisingly, although the static optimization method considered muscle co-contraction, the inverse kinematic method provided statistically significant higher patellar tendon force values. These findings highlight that limiting the forward velocity component of the aerial phase appears to reduce the load on the patellar tendon during landing and may help to prevent patellar tendinopathy.

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Distalising tibial tubercle osteotomy decreases patellar tendon force — A treatment rationale for recalcitrant patellar tendinopathy

The Knee ◽

10.1016/j.knee.2020.02.022 ◽

2020 ◽

Vol 27 (3) ◽

pp. 871-877 ◽

Cited By ~ 1

Author(s):

Michael J. Dan ◽

Joseph Cadman ◽

James McMahon ◽

William C.H. Parr ◽

David Broe ◽

...

Keyword(s):

Patellar Tendon ◽

Patellar Tendinopathy ◽

Tibial Tubercle ◽

Tibial Tubercle Osteotomy ◽

Tendon Force

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Morpho-textural changes of the patellar tendon in professional volleyball players: a six month longitudinal study

Revista Fisioterapia Invasiva ◽

10.1055/s-0039-3402505 ◽

2019 ◽

Vol 02 (02) ◽

pp. 126-126

Author(s):

de Groot Ferrando A.

Keyword(s):

Patellar Tendon ◽

Effect Size ◽

Repeated Measures ◽

Structural Changes ◽

Patellar Tendinopathy ◽

Average Effect ◽

Average Effect Size ◽

Significant Difference ◽

Volleyball Players ◽

Textural Changes

Abstract Introduction Tendinopathy is a term used to describe a clinical presentation of pain and dysfunction, which, at times, is accompanied by pathologic structural changes in the tendon matrix. Jumper's knee has been studied for some time, however the etiology is still unknown. The deep fibers of the proximal region are the most affected area in tendinopathies affecting the patellar tendon. Ultrasound (US) scanning may have the greatest sensitivity for confirming clinically diagnosed patellar tendinopathy compared with other imaging techniques such as magnetic resonance. Some studies have found that a minimum of six months is required to observe significant structural changes, although other studies reveal that structural changes can be visible in a shorter period of time. Thus, sonography has been used to evaluate quantitative variables such as thickness, echogenicity, texture measures and the internal tendon matrix. Objective The purpose of this study was to evaluate the sonographic behavior of morpho-textural changes of the patellar tendon in professional male volleyball players over a one year season. Material and Methods This is an observational, longitudinal and analytical study. A sample of 66 patellar tendons from 33 volleyball players of the Spanish super league was recruited, with an average of: 28 years, 86kg and 192cm. An ultrasound scan was performed using the Sonosite Titan ultrasound system, L38, 5–10 MHz, with a cross section of 5mm from the lower pole of the patella. Two depths were analyzed: a.39mm: echogenicity, echogenicity variation, circularity, width and thickness. b.24mm: entropy and contrast. Statistical analysis and analysis of variance (ANOVA) was performed for repeated measures and, in addition, the effect size was calculated with Cohen's d. The confidence interval was 95%. SPSS Statistics software was used. Results For textural variables: contrast increased significantly with an average effect size, and entropy showed no significant difference. Circularity was significantly lower. Width was shown to be significantly greater, with an average effect size, while thickness was reduced significantly. Regarding echogenicity, no significant changes were detected and variation in echogenicity did not show significant changes. Conclusions Imaging analysis could be a potential tool to detect changes in the pattern of patellar tendons. Some morpho-textural changes were found in male volleyball players: the textural contrast variable increases significantly throughout the annual season, meaning that the tendon becomes slightly flatter and loses circularity in its transverse section. The entropy and echogenic parameters obtained from the gray-scale histogram did not reveal any significant changes.

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Mechanical properties of the patellar tendon in elite volleyball players with and without patellar tendinopathy

British Journal of Sports Medicine ◽

10.1136/bjsports-2013-092275 ◽

2013 ◽

Vol 47 (13) ◽

pp. 862-868 ◽

Cited By ~ 53

Author(s):

Christian Helland ◽

Jens Bojsen-Møller ◽

Truls Raastad ◽

Olivier R Seynnes ◽

Marie M Moltubakk ◽

...

Keyword(s):

Mechanical Properties ◽

Patellar Tendon ◽

Patellar Tendinopathy ◽

Volleyball Players

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Patellar Tendon Straps Decrease Pain and May Alter Lower Extremity Kinetics in Those With Patellar Tendinopathy During Jump Landing

International Journal of Athletic Therapy & Training ◽

10.1123/ijatt.2016-0014 ◽

2017 ◽

Vol 22 (4) ◽

pp. 51-57 ◽

Cited By ~ 2

Author(s):

Adam B. Rosen ◽

Jupil Ko ◽

Kathy J. Simpson ◽

Cathleen N. Brown

Keyword(s):

Lower Extremity ◽

Patellar Tendon ◽

Ground Reaction Force ◽

Reaction Force ◽

Patellar Tendinopathy ◽

Jump Landing ◽

Drop Jumps ◽

Kinetics Of

Patellar tendinopathy is often managed with a patellar tendon strap, however, their effectiveness is unsubstantiated. The purpose of this study was to determine if straps altered pain or lower extremity kinetics of individuals with patellar tendinopathy during landing. Thirty participants with patellar tendinopathy and 30 controls completed drop jumps with and without patellar tendon straps. Wearing the strap, tendinopathy participants demonstrated significantly decreased pain and reduced knee adductor moment; all participants displayed significantly decreased anterior ground reaction force while wearing a strap. Patellar tendon strapping may reduce pain due to alterations in direction and magnitude of loading.

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Association of Ankle Dorsiflexion and Landing Forces in Jumping Athletes

Sports Health A Multidisciplinary Approach ◽

10.1177/19417381211063456 ◽

2021 ◽

pp. 194173812110634

Author(s):

Adalberto Felipe Martinez ◽

Rodrigo Scattone Silva ◽

Bruna Lopes Ferreira Paschoal ◽

Laura Ledo Antunes Souza ◽

Fábio Viadanna Serrão

Keyword(s):

Patellar Tendon ◽

Loading Rate ◽

Reaction Force ◽

Ankle Dorsiflexion ◽

Patellar Tendinopathy ◽

Plantar Flexor ◽

Vertical Ground Reaction Force ◽

Level Of Evidence ◽

Ankle Kinematics ◽

Tendon Force

Background: Dorsiflexion range of motion restriction has been associated with patellar tendinopathy, but the mechanisms of how dorsiflexion restriction could contribute to knee overload remain unknown. Hypothesis: Peak ankle dorsiflexion and ankle dorsiflexion excursion are negatively associated with peak vertical ground-reaction force (vGRF) and loading rate, and with peak patellar tendon force and loading rate, and positively associated with peak ankle plantar flexor moment. Study Design: Cross-sectional study. Level of Evidence: Level 4. Methods: Kinematic and kinetic data of 26 healthy recreational jumping athletes were measured during a single-leg drop vertical jump. Pearson’s correlation coefficients were calculated to establish the association between peak ankle dorsiflexion and ankle dorsiflexion excursion with peak vGRF and vGRF loading rate, with peak patellar tendon force and patellar tendon force loading rate, and with peak ankle plantar flexor moment. Results: Ankle dorsiflexion excursion negatively correlated with peak vGRF loading rate ( r = −0.49; P = 0.011) and positively correlated with peak ankle flexor plantar moment ( r = 0.52; P = 0.006). In addition, there was a positive correlation between peak ankle dorsiflexion and peak vGRF ( r = 0.39; P = 0.05). Conclusion: Ankle kinematics are associated with vGRF loading rate, ankle flexor plantar moment and peak vGRF influencing knee loads, but no association was observed between ankle kinematics and patellar tendon loads. Clinical Relevance: These results suggest that increasing ankle dorsiflexion excursion may be an important strategy to reduce lower limb loads during landings but should not be viewed as the main factor for reducing patellar tendon force.

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Relationship between the anteroposterior diameter of the patellar tendon. Pain and functionality in volleyball players

Revista Fisioterapia Invasiva ◽

10.1055/s-0039-3401888 ◽

2019 ◽

Vol 02 (02) ◽

pp. 067-067

Author(s):

Calvo Gonell A. ◽

Macia Soler L. ◽

Moncho J.

Keyword(s):

Patellar Tendon ◽

Sports Injuries ◽

Cross Sectional Study ◽

Musculoskeletal Ultrasound ◽

Patellar Tendinopathy ◽

Ground Substance ◽

Linear Regression Models ◽

Cross Sectional ◽

Anteroposterior Diameter ◽

Volleyball Players

Abstract Introduction and Aim Overuse injuries in volleyball represent between 50% and 80% of total injuries, of which, 80% are patellar tendinopathies. Volleyball is the sport with the greatest prevalence of patellar tendinopathy, estimated at 44.6%, followed by basketball with 31.9%. The tendon thickness bears a close and direct relationship with abnormal and diffuse images with accumulation of ground substance, and affecting both sexes, although less marked in women. Aim To determine whether the antero-posterior diameter of the patellar tendon in volleyball players is associated with a greater sensation of pain and reduced functionality. Material and Methods An observational, descriptive, cross-sectional study on volleyball players. The scores on the VISA-P scale, the visual analog scale (VAS) and, using musculoskeletal ultrasound, the anteroposterior diameter of the patellar tendon at 5 and 10 mm distal to the inferior pole of the patella. Multiple linear regression models were constructed to adjust the effect of the anteroposterior diameter on the VAS and the VISA-P scores. Results The final sample comprised 112 players. The anteroposterior diameter was greater in men and was significantly associated with scores on the VAS and the VISA-P for both tendons, and therefore, the greater the score of the diameter, the greater the score on the VAS and the lesser the score on the VISA-P. Conclusions The measurement of the antero-posterior diameter of the patellar tendon using musculoskeletal ultrasound may be useful for the prevention of sports injuries in volleyball players, as it is significantly associated with a greater perception of pain and reduced functionality.

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