A Lower Limb Assessment Tool for Athletes at Risk of Developing Patellar Tendinopathy

MANN, KERRY J.; EDWARDS, SUZI; DRINKWATER, ERIC J.; BIRD, STEPHEN P.

Medicine & Science in Sports & Exercise: March 2013 - Volume 45 - Issue 3 - p 527–533
doi: 10.1249/MSS.0b013e318275e0f2
Applied Sciences

Purpose: Patellar tendon abnormality (PTA) on diagnostic imaging is part of the diagnostic criteria for patellar tendinopathy. PTA and altered landing strategies are primary risk factors that increase the likelihood of asymptomatic athletes developing patellar tendinopathy. Therefore, the aim of this study was to examine the risk factors that are predictors of the presence and severity of a PTA in junior pre-elite athletes.

Methods: Ten junior pre-elite male basketball athletes with a PTA were matched with 10 athletes with normal patellar tendons. Participants had patellar tendon morphology, Victorian Institute of Sport Assessment (VISA) score, body composition, lower limb flexibility, and maximum vertical jump height measured before performing five successful stop–jump tasks. During each stop–jump task, both two-dimensional and three-dimensional kinematics and ground reaction forces were recorded. Multiple regression analyses were used to identify factors for estimating PTA presence and severity, and discriminate analysis was used to classify PTA presence.

Results: Sixty-eight percent of variance for presence of a PTA was accounted for by hip joint range of motion (ROM) and knee joint angle at initial foot–ground contact (IC) during stop–jump task and quadriceps flexibility, whereas hip joint ROM during stop-jump task and VISA score accounted for 62% of variance for PTA severity. Prediction of the presence of a PTA was achieved with 95% accuracy and 95% cross-validation.

Conclusions: An easily implemented, reliable, and valid movement screening tool composed of three criteria enables coaches and/or clinicians to predict the presence and severity of a PTA in asymptomatic athletes. This enables identification of asymptomatic athletes at higher risk of developing patellar tendinopathy, which allows the development of effective preventative measures to aid in the reduction of patellar tendinopathy injury prevalence.

School of Human Movement Studies, Charles Sturt University, Bathurst, New South Wales, AUSTRALIA

Address for correspondence: Dr. Suzi Edwards, School of Human Movement Studies, Charles Sturt University, Panorama Ave., Bathurst, NSW 2795, Australia; E-mail: suzedwards@csu.edu.au.

Submitted for publication May 2012.

Accepted for publication September 2012.

© 2013 American College of Sports Medicine