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No Effect of Eccentric Training on Jumper's Knee in Volleyball Players During the Competitive Season: A Randomized Clinical Trial

Visnes, Håvard Stud Med, PT*; Hoksrud, Aasne Stud Med*; Cook, Jill PT, PhD; Bahr, Roald MD, PhD*

Clinical Journal of Sport Medicine: July 2005 - Volume 15 - Issue 4 - p 227-234
doi: 10.1097/01.jsm.0000168073.82121.20
Original Research: Original Article

Background: The effect of surgery on patellar tendinopathy (jumper's knee) is questionable, and conservative treatment protocols have not been properly documented.

Purpose: The aim of this study was to investigate the effect of a newly developed eccentric training program for patellar tendinopathy in volleyball players during the competitive season.

Study Design: Randomized clinical trial.

Methods: Patients were recruited from male and female elite volleyball teams in Norway, and the diagnosis was based on clinical examination alone. Of 51 players diagnosed with patellar tendinopathy, 29 could be included in the study. The training group (n = 13) performed squats on a 25° decline board as a home exercise program (3 × 15 repetitions twice daily) for a 12-week intervention period during the final half of the competitive season. The eccentric (downward) component was done on the affected leg. The control group (n = 16) trained as usual. The primary outcome was a symptom-based questionnaire developed specifically for patellar tendinopathy (Victorian Institute of Sport Assessment score), and patients were followed up before and after the intervention period, as well as after 6 and 30 weeks. All subjects self-recorded training to document their activity level (eccentric training, volleyball training, matches, other training).

Results: There was no change in Victorian Institute of Sport Assessment score during the intervention period in the training (pre, 71.1 ± 11.3; post, 70.2 ± 15.4) or control group (pre, 76.4 ± 12.1; post, 75.4 ± 16.7), nor was there any change during the follow-up period at 6 weeks or 6 months. The training group completed 8.2 ± 4.6 weekly sessions of eccentric training during the intervention period (59% of the recommended volume), and there was no difference between groups in training or competition load.

Conclusion: There was no effect on knee function from a 12-week program with eccentric training among a group of volleyball players with patellar tendinopathy who continued to train and compete during the treatment period. Whether the training would be effective if the patients did not participate in sports activity is not known.

From the *Oslo Sports Trauma Research Center, University of Sport and Physical Education, Oslo, Norway; and the †Faculty of Sciences, School of physiotherapy, La Trobe University, Bundoora, Victoria, Australia.

Received for publication May 2004; accepted March 2005.

Reprints: Roald Bahr, MD, PhD, Oslo Sports Trauma Research Center, University of Sport and Physical Education, P.O. Box 4014, Ullevaal Stadion, 0806 Oslo, Norway (e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.