What are causes and treatment strategies for patellar-tendinopathy in female runners? (original) (raw)
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Objectives: To explore feasibility of recruitment and retention of runners with patellofemoral pain (PFP), before delivering a step rate intervention. Design: Feasibility study. Setting: Human performance laboratory. Participants: A mixed-sex sample of runners with PFP (n ¼ 11). Main outcome measures: Average/worst pain and the Kujala Scale were recorded pre/post intervention, alongside lower limb kinematics and surface electromyography (sEMG), sampled during a 3 KM treadmill run. Results: Recruitment and retention of a mixed-sex cohort was successful, losing one participant to public healthcare and with kinematic and sEMG data lost from single participants only. Clinically meaningful reductions in average (MD ¼ 2.1, d ¼ 1.7) and worst pain (MD ¼ 3.9, d ¼ 2.0) were observed. Reductions in both peak knee flexion (MD ¼ 3.7 , d ¼ 0.78) and peak hip internal rotation (MD ¼ 5.1 , d ¼ 0.96) were observed, which may provide some mechanistic explanation for the identified effects. An increase in both mean amplitude (d ¼ 0.53) and integral (d ¼ 0.58) were observed for the Vastus Medialis Obliqus (VMO) muscle only, of questionable clinical relevance. Conclusions: Recruitment and retention of a mixed sex PFP cohort to a step rate intervention involving detailed biomechanical measures is feasible. There are indications of both likely efficacy and associated mechanisms. Future studies comparing the efficacy of different running retraining approaches are warranted.
Simplified methods to measure patellar anatomical and biomechanical variables in state level runners
2019
The endeavour of the present study was to establish simplified methods to measure Patellar anatomical and biomechanical variables. 100 state level runners (50 males and 50 females) of age group 18-27 years were selected purposively from various sports academies of Odisha for this study. All the variables were recorded thrice and median value considered as criterion to eradicate error. Selected variables such as patella length, patella breadth, patellar tendon length, patella to patellar tendon ratio, patellar medial to lateral glide, patellar lateral to medial glide, patellar cephal to caudal glide and patellar caudal to cephal glide were measured on each subject following standard techniques. The Results showed highly significant differences (p<0.001) in right patella length, right patella breadth, right patellar tendon length, and statistically significant difference (p<0.05) was seen in right patellar cephal to caudal glide on the right patellar side. However, in the left p...
Etiology of Patellar Tendinopathy in Athletes
Journal of Sport Rehabilitation, 2005
Objective:To review the etiology of patellar tendinopathy as it relates to clinical management of chronic patellar-tendon disease in athletes.Data Sources:Information was gathered from a MEDLINE search of literature in English using the key wordspatellar tendinitis, patellar tendonitis, patellar tendinosis, patellar tendinopathy,andjumper’s knee.Study Selection:All relevant peer-reviewed literature in English was reviewed.Data Synthesis:The etiology of patellar tendinopathy is multifactorial, incorporating both intrinsic and extrinsic factors. Age, muscle flexibility, training program, and knee-joint dynamics have all been associated with patellar tendinopathy. The roles of gender, body morphology, and patellar mobility in patellar tendinopathy are unclear.Conclusions:The pathoetiology of patellar tendinopathy is a complex process that results from both an inflammatory response and degenerative changes. There is a tremendous need for research to improve our understanding of the path...
Applied Sciences, 2022
Patellofemoral pain (PFP) is a common atraumatic knee pathology in runners, with a complex multifactorial aetiology influenced by sex differences. This retrospective case–control study therefore aimed to evaluate lower limb kinetics and kinematics in symptomatic and control male and female runners using musculoskeletal simulation. Lower extremity biomechanics were assessed in 40 runners with PFP (15 females and 25 males) and 40 controls (15 females and 25 males), whilst running at a self-selected velocity. Lower extremity biomechanics were explored using a musculoskeletal simulation approach. Four intergroup comparisons—(1) overall PFP vs. control; (2) male PFP vs. male control; (3) female PFP vs. female control; and (4) male PFP vs. female PFP—were undertaken using linear mixed models. The overall (stress per mile: PFP = 1047.49 and control = 812.93) and female (peak stress: PFP = 13.07 KPa/BW and control = 10.82 KPa/BW) comparisons showed increased patellofemoral joint stress indi...
Clinical features of patellar tendinopathy and their implications for rehabilitation
Journal of Orthopaedic Research, 2007
This study investigated the clinical features of patellar tendinopathy (PT), with focus on individuals with unilateral and bilateral PT. A cross-sectional study design was employed to compare individuals with unilateral (n ¼ 14) or bilateral (n ¼ 13) PT and those without PT (control, n ¼ 31). Features assessed included thigh strength (normalized peak knee extensor torque) and flexibility (sit-and-reach and active knee extension), calf endurance (heel-rise test), ankle flexibility (dorsiflexion), alignment measures (arch height and leg length difference), and functional measures (hop for distance and 6 m hop test). Groups were matched for age and height; however, unilateral and bilateral PT had greater mass with a higher body mass index (BMI) than control. Also, bilateral PT performed more sport hours per week than both unilateral PT and control. Unilateral PT had less thigh strength than control and bilateral PT, whereas bilateral PT had more thigh flexibility than control and unilateral PT. Both unilateral and bilateral PT had altered alignment measures compared to control. Features that predicted symptoms in PT were lower thigh flexibility and strength, whereas those that predicted function were higher thigh strength and lower ankle flexibility. These findings indicate that unilateral and bilateral PT represent distinct entities, and that thigh strength appears particularly important in PT as it predicted both symptoms and function in PT. ß