Knee Joint Dynamics Predict Patellar Tendinitis in Elite Volleyball Players

Abstract

We quantified the lower extremity dynamics developed during the volleyball spike and block jumps to find out if predictive relations exist between jump dynamics and patellar tendinitis. Lower extremity movement biomechanics were analyzed for 10 members of the 1994 Canadian Men's National Volleyball Team (all right-handed hitters). Based on physical examination, 3 of the 10 players had patellar tendon pain associated with patellar tendinitis at the time of testing. In masked biomechanical and logistic regression analyses, we discovered that the vertical ground-reaction force during the take-off phase of both spike and block jumps was a significant predictor of patellar tendinitis-correctly predicting the presence or absence of patellar tendinitis in 8 of 10 players. Deepest knee flexion angle (during landing from the spike jump) predicted 10 of 10 cases correctly for the left knee. The external tibial torsional moment (during the takeoff for the right knee with the spike jump and for the left knee with the block jump) was also a significant predictor of tendinitis. In these players, the likelihood of patellar tendon pain was significantly related to high forces and rates of loading in the knee extensor mechanism, combined with large external tibial torsional moments and deep knee flexion angles.

Avaliação muscular isocinética da articulação do joelho em atletas das seleções brasileiras infanto e juvenil de voleibol masculino

“…According to these data, differences found in the present study may be related to a higher training volume of the Under 21 category Another factor that may be related to the significant difference between the Under 19-Under 21 and Under 21 categories found in the peak work variable normalized by the body mass of the flexor of the knee may be a change in the training methodology, as only athletes from the under 21 category had been submitted to some specific work giving priority to the flexor of the knee. Besides, many athletes assessed in this study had already suffered injuries related to the knee joint (Under 21 = 31.3%, and Under 19-Under 21 = 17.3% -data yet to be published) what is in agreement to the data found in the literature (1,4,5,8,9) . Thus, it is possible that before the presence of injuries, athletes have developed compensatory strategies to keep their performance level, as a way to give priority to the flexor muscles as the momentum generator to the jump.…”

“…The possible causal factors for such difference in the flexor work between limbs in the under 21 category may be characteristic of the jump in which the strength generated and absorbed, respectively in the impulsion and landing can be uneven between lower limbs due to the specific characteristic of the sports attack movement (20) . The methods used to attain the agonist/antagonist ratio are widely discussed in the literature (4,21) . Traditionally, the agonist/antagonist ratio is calculated as the ratio between the peak values of the concentric torque of the flexor muscles, and the concentric peak torque of the extensor of the knee.…”

“…Thus one of the training goals to perform higher vertical jumps. The resistance training as well stretch-shortening cycle exercises has been used to attains this goal (1,4) .…”

“…Some authors mention the knee joint injuries as one of the major causes for the absence occurrences in this sport (1,(8)(9)(10) . Ferretti et al report a higher than 40% incidence in the patellar tendinopathy in the elite players, and this injury is the main cause of anterior pain in knee joint (2,4) ; the increase the likelihood of muscle and/or joint injuries has been clinically pointed out as consequence of abnormal torque differences between the agonist/antagonist and/or contralateral muscle groups (11) . Another factor related to the increase in overload of muscle-tendinous structures of the knee joint may be the increasing training intensity and volume in players from different categories.…”

Tendinopatia patelar

“…A correção da biomecânica da aterrissagem após o salto pode diminuir o estresse no joelho (44) . É importante distribuir a força aplicada ao joelho entre o tornozelo, a perna e o quadril.…”