Mentoring Minutes: Patellar Tendinopathy

References and notes:

J Sport Rehabil. 2017 Nov 15:1-22. doi: 10.1123/jsr.2017-0196. [Epub ahead of print]

Clinical Measures and Their Contribution to Dysfunction in Individuals With Patellar Tendinopathy.

Jeon H1, McGrath ML2, Grandgenett N3, Rosen AB4.

  • 30 participants with patellar tendinopathy
  • Purpose of this investigation was to determine if strength, flexibility, and various lower extremity static alignments contributed to self-reported function and influence the severity of patellartendinopathy.
  • Isometric knee extension and flexion strength, hamstring flexibility and alignment measures of rearfoot angle, navicular drop, tibial torsion, q angle, genu recurvatum, pelvic tilt, and leg length differences were assessed. 
  • Significant relationships between questionnaires and BMI, normalized knee extension and flexion strength, q angle and pelvic tilt . Regression models identified thigh musculature strength and supine q angle to have greatest predictability for severity in patient-reported outcomes.

Br J Sports Med. 2015 Oct;49(19):1277-83. doi: 10.1136/bjsports-2014-094386. Epub 2015 May 15.

Isometric exercise induces analgesia and reduces inhibition in patellartendinopathy.

Rio E1, Kidgell D2, Purdam C3, Gaida J4, Moseley GL5, Pearce AJ6, Cook J1.

  • Single resistance training bout of isometric contractions reduced tendon pain immediately for at least 45 min postintervention and increased MVIC. The reduction in pain was paralleled by a reduction in cortical inhibition, providing insight into potential mechanisms. Isometric contractions can be completed without pain for people with PT. The clinical implications are that isometric muscle contractions may be used to reduce pain in people with PT without a reduction in muscle strength.

Br J Sports Med. 2007 Apr;41(4):217-23. Epub 2007 Jan 29.

The evolution of eccentric training as treatment for patellar tendinopathy (jumper's knee): a critical review of exercise programmes.

Visnes H1, Bahr R.

  • 7 articles with a total of 162 patients 
  • Most studies suggest that eccentric training may have a positive effect, but our ability to recommend a specific protocol is limited. The studies available indicate that the treatment programme should include a decline board and should be performed with some level of discomfort, and that athletes should be removed from sports activity. 
  • Most were home-based programmes with twice daily training for 12 weeks
  • Drop squats or slow eccentric movement, squatting on a decline board or level ground, exercising into tendon pain or short of pain, loading the eccentric phase only or both phases, and progressing with speed then loading or simply loading.