Self-reported bio-psycho-social factors partially distinguish patellar tendinopathy from other knee problems and explain patellar tendinopathy severity in jumping athletes: A case-control study.

OBJECTIVE: To determine what combinations of self-reported factors distinguish patellar tendinopathy (PT) from other knee problems, and explain PT severity variance. DESIGN: Case-control study. SETTING: Social media, private practice and National Health Service. PARTICIPANTS: An international sample of jumping athletes diagnosed with either PT (n = 132; 30.7 ± 8.9 years; 80 males; VISA-P = 61.6 ± 16.0) or another musculoskeletal knee condition (n = 89; 31.8 ± 9.9 years; 47 males; VISA-P = 62.9 ± 21.2) by a clinician in the last 6 months. MAIN OUTCOME MEASURES: We considered clinical diagnosis (case = having PT vs control = having other knee problems) as the dependent variable. Severity and sporting impact were defined by VISA-P and availability, respectively. RESULTS: A model comprising seven factors distinguished PT from other knee problems; training duration (OR = 1.10), sport type (OR = 2.31), injured side (OR = 2.28), pain onset (OR = 1.97), morning pain (OR = 1.89), condition acceptability (OR = 0.39) and swelling (OR = 0.37). Sports-specific function (OR = 1.02) and player level (OR = 4.11) explained sporting availability. 44% of PT severity variance was explained by quality of life (ß = 0.32), sports-specific function (ß = 0.38) and age (ß = -0.17). CONCLUSION: Sports-specific, biomedical and psychological factors partially distinguish PT from other knee problems. Availability is mainly explained by sports-specific factors, while psychosocial factors impact on severity. Adding sports-specific and bio-psycho-social factors into assessments could help better identification and management of jumping athletes with PT.

Theraband Applications for Improved Upper Extremity Wall-Slide Exercises.

CONTEXT: The wall-slide exercise is commonly used in clinic and research settings. Theraband positioning variations for hip exercises have been investigated and used, but Theraband positioning variations for upper extremity wall-slide exercises, although not commonly used, have not been examined. OBJECTIVE: To evaluate the effect of different Theraband positions (elbow and wrist) on the activation of the scapular and shoulder muscles in wall-slide exercises and compare these variations with each other and with regular wall-slide exercises for the upper limbs. DESIGN: Descriptive laboratory study. SETTING: University laboratory. PATIENTS OR OTHER PARTICIPANTS: A total of 20 participants (age = 23.8 ± 3 years, height = 176.5 ± 8.14 cm, mass = 75.3 ± 12.03 kg, body mass index = 24.23 ± 4.03) with healthy shoulders. INTERVENTION(S): Participants performed wall-slide exercises (regular and 2 variations: Theraband at the elbow and Theraband at the wrist) in randomized order. MAIN OUTCOME MEASURE(S): Surface electromyographic activity of the trapezius (upper trapezius [UT], middle trapezius [MT], and lower trapezius [LT]), infraspinatus, middle deltoid (MD), and serratus anterior (SA) muscles. RESULTS: Regular wall-slide exercises elicited low activity in the MD and moderate activity in the SA muscles (32% of maximal voluntary isometric contraction [MVIC] in the SA), whereas the Theraband-at-elbow and Theraband-at-wrist variations elicited low activity in the MT, LT, infraspinatus, and MD muscles and moderate activity in the SA muscle (46% and 34% of MVIC in the SA, respectively). The UT activation was absent to minimal (classified as 0% to 15% of MVIC) in all wall-slide exercise variations. The Theraband-at-wrist variation produced lower UT:MT, UT:LT, and UT:SA levels compared with the regular wall-slide exercise and Theraband-at-elbow variation. CONCLUSIONS: In shoulder rehabilitation, clinicians desiring to activate the scapular stabilization muscles should consider using the Theraband-at-wrist variation. Those seeking more shoulder-abduction activation and less scapular stabilization should consider using the Theraband-at-elbow variation of the upper extremity wall-slide exercise.