Jump-landing mechanics in patellar tendinopathy in elite youth basketballers.

Patellar tendinopathy (PT) is a leading cause of morbidity in jump-landing athletes. Landing mechanics are identified as a factor associated with PT and/or patellar tendon abnormality. This study aimed to identify key jump-landing variables associated with PT. Thirty-six junior elite basketball players (men n = 18, women n = 18) were recruited from a Basketball Australia development camp. Three-dimensional (3D) kinematic and ground reaction force (GRF) data during a stop-jump task were collected as well as ultrasound scans of the patellar tendons and recall history of training load data. Mixed-model factorial analyses of variance were used to determine any significant between-group differences. Of the 23 participants included for statistical analyses, 11 had normal bilateral patellar tendons (controls) and eight reported PT (currently symptomatic); however, the four participants categorized as asymptomatic with patellar tendon abnormality on diagnostic imaging were excluded from statistical analyses due to their small sample size. Athletes with PT displayed a similar knee flexion angle at initial foot-ground contact (IC) and hip extension strategy during a stop-jump horizontal landing. Despite a similar kinematic technique, athletes with PT utilized a strategy of a longer stance duration phase from IC to peak force. This strategy did not lead to those athletes with PT decreasing their peak vertical GRF nor patellar tendon force during landing but enabled these athletes to land with a lower rate of loading (control 59.2 ± 39.3 vs. PT 29.4 ± 33.7 BW.s-1). Athletes with PT still reported significantly reduced training volume (control 4.9 ± 1.8 vs PT 1.8 ± 1.1 sessions/wk; total training time/wk control 2.4 ± 1.0 vs PT 1.4 ± 1.1 h/wk).

Nearly 40% of adolescent athletes report anterior knee pain regardless of maturation status, age, sex or sport played.

OBJECTIVE: To report point prevalence of anterior knee pain (AKP) in adolescent athletes by (1) maturation status, (2) chronological age, (3) sex, and (4) primary sport. DESIGN: Cross-sectional. METHODS: Male and female participants aged 11-15 years were recruited from specialised sports programs for basketball, volleyball, Australian Rules Football and tennis. Standing height, sitting height, and body mass were measured and used to calculate maturity status. Past injury history, self-reported physical activity, and Victorian Institute of Sport Assessment Questionnaire Patellar Tendon (VISA-P) questionnaires were completed. Anterior knee pain was defined as any pain experienced on the anterior surface of the knee and recorded using a visual analogue scale (VAS). A single leg decline squat (SLDS) was performed for provocation of AKP. RESULTS: Two hundred and seventeen male and female adolescent athletes participated in this study. Twenty participants were excluded from data analysis. Point prevalence of AKP was 39% (N = 76). Average self-reported physical activity/week was 7.9 ± 4.1 h of their specialised sport and 2.0 ± 2.0 h of other physical activity/week. Maturation status, chronological age, sex nor primary sporting program was statistically significant in explaining the presence or absence of AKP. CONCLUSION: Due to the right-skewed maturation sample, the authors cannot state conclusively that maturation status was not associated with AKP. Nearly 40% of this cohort reported AKP during a pain provocation test. The presence of AKP was not explained by maturation status, age, sex or primary sport program. Given the chronic nature of AKP and future morbidity reported, this high prevalence provides rationale for intervention or prevention studies targeting younger athletes.

Thirty-seven jump-landing biomechanical variables are associated with asymptomatic patellar tendon abnormality and patellar tendinopathy: A systematic review.

OBJECTIVE: To identify studies that report three-dimensional (3D) biomechanical analysis of jump-landing tasks in relation to athletes with current patellar tendinopathy (PT), and/or asymptomatic with history of PT or patellar tendon abnormality (PTA) on diagnostic imaging. METHODS: Five electronic databases were searched. Included articles were required to: (1) investigate the 3D biomechanics of a jump-landing task; (2) be cross-sectional or longitudinal in design; and (3) include participants that had symptomatic PT, were asymptomatic with a history of PT, asymptomatic with PTA on diagnostic imaging and/or asymptomatic with an unknown pathology or PT history. RESULTS: Thirty-seven statistically significant jump-landing variables were associated with PT, history of PT and/or PTA. The only consistent variable that could be replicated between studies was knee flexion angle at initial foot-ground contact (IC) and an altered hip flexion/extension strategy during a horizontal land phase of a vertical stop-jump. CONCLUSION: Isolated vertical landings or take-offs alone may not be sensitive enough to identify key jump-landing variables associated with PT, thus clinicians and researchers should incorporate a whole jump-landing task with a horizontal landing component. Sagital plane hip and knee kinematics in a horizontal landing phase appear to provide the most valuable information for evaluating those with PT.