Patellar Tendinopathy

Patellar tendinopathy (PT) has a high prevalence in sports that involve repetitive jumping actions such as basketball and volleyball; the constant storage and release of energy from the patellar tendons without adequate periods of rest gradually induces pathology.

Successful treatment and prevention of patellar tendinopathy can be accomplished only with an extensive understanding of the multitude of risk factors that are commonly associated with the condition.

In addition to this, it is important to gain knowledge about the biomechanics behind the movements involved in the aforementioned sports, particularly the jumping motion, and how this relates to patellar tendinopathy.

This becomes even more essential when considering the implications such a condition can have on an athlete’s career; with symptoms lasting for a considerable duration, the athlete is unable to return to sports or in some cases, may even be forced to retire from the game.

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While reviewing literature that examined the relation between patellar tendinopathy and take-off/landing kinematics, Henk van der Worp, from the Center for Sports Medicine at the University of Groningen, concluded that horizontal landing after forward acceleration poses a significant threat for developing the condition compared to the take-off technique.

The author also established that risk factors for developing PT are joint flexion angles at touchdown that reduce the available range of motion, small post-touchdown range of motion in the joints and high post-touchdown joint angular velocities.

Based on these findings, experts such as trainers and coaches can employ a more flexible jumping pattern, with a large post-touchdown range of motion and landing time to reduce the risk of developing patellar tendinopathy.

In a separate study, van der Worp also determined nine intrinsic risk factors that have some evidence in literature for an association with PT namely, weight, body mass index, waist-to-hip ratio, leg length difference, foot arch height, quadriceps strength and flexibility, hamstring flexibility and vertical jump performance.

The prevalence of underlying biomechanical disparities increases the likelihood of an individual developing anterior knee pain because of the compensatory abnormalities and postural misalignments associated with foot posture problems.

The onset of biomechanical imbalances triggered by an unhealthy foot posture, such as an increased Q-angle, causes a misalignment in the patellofemoral joint leading to abnormal tracking of the patella.

The ineffectiveness of the foot function when combined with the aberrant tracking of the patella creates excessive forces in the region which can gradually cause chronic inflammation and joint degeneration leading to pathologies such as patellar tendinopathy.

MASS4D® foot orthotics support the foot in a functionally corrected posture to decrease these compensatory movements such as decreasing internal tibial and femoral rotation.

This helps in reducing torsional stresses to the quadriceps and leads to a decreased Q-angle to curb the lateral tracking of the patella and to promote healthy functioning of the patellar tendons. 

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Related Links
Musculoskeletal Injuries in Volleyball
Treating Hamstring Injuries with Orthotics
Malalignment Syndrome

References:

1. van der Worp, H., de Poel, H. J., Diercks, R. L., van den Akker-Scheek, I., Zwerver, J. (2014) Jumper’s Knee or Lander’s Knee? A Systematic Review of the Relation between Jump Biomechanics and Patellar Tendinopathy. International Journal of Sports Medicine: February 2014, Vol. 35, No. 8, pp. 714-722. DOI: 10.1055/s-0033-1358674
2. van der Worp, H., van Ark, M., Roerink, S., Pepping, G., van den Akker-Scheek, I., Zwerver, J. (2011) Risk Factors for Patellar Tendinopathy: A Systematic Review of the Literature. British Journal of Sports Medicine: March 2011, Vol. 45, pp. 446-452. doi:10.1136/bjsm.2011.084079

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