Overuse injuries of the extensor mechanism in athletes

Tendinopatia patelar

“…O achado clínico mais consistente é a dor à palpação do pólo inferior da patela (25)(26)(27) ; entretanto, esse teste é influenciado pela posição do joelho. Com o joelho flexionado a 90º, o tendão é colocado sob tensão e a dor diminui significativamente, podendo até desaparecer.…”

“…Não há consenso na literatura sobre qual técnica cirúrgica usar. Há alguns tipos de cirurgia descritos: excisão de áreas degenerativas do tendão, debridamento artroscópico, reparo de defeitos macroscópicos, múltiplas tenotomias longitudinais, perfurações do pólo inferior da patela, realinhamento da tuberosidade anterior da patela, perfurações percutâneas no tendão e tenotomias longitudinais percutâneas (25,27) . Os resultados clínicos pós-cirúrgicos podem ser maus em 15 a 25%, devido à recorrência e à persistência da dor.…”

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

“…Furthermore, Herzog et al (19) showed that the peak torque in the knee joint was kept approximately constant after successive raisings starting from 40% of the peak load during the squat exercise, while in the hip and ankle joints it was detected a raise in the torque generated. These results seem to indicate that despite the extensor musculature is considered the major generator of strength to the jump (5,6) , the variations in the load or training volume may also lead to a raise in the ability to generate strength in the flexor muscles. 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.…”

“…One limitation in this study was not to assess the peak work and peak torque variables normalized by the body mass of the flexor and extensor of the knee at 60 and 300 o /s in an eccentric mode, the agonist/antagonist ratio at both velocities, and the muscle fatigue index of the flexor and extensor of the knee, once the jump, a basic activity to the volleyball practice consists of eccentric contraction followed by a concentric contraction (5,6,15) . This protocol was not used, as several athletes were able to generate eccentric torques higher to that produced by the dynamometer, thus disabling to conduct the tests.…”

“…This basis of the sports demands two main functions from the extensor mechanism: the accelerating function with a concentric contraction, such as the impulsion phase in a jump; and the decelerating function with an eccentric contraction observed in the phase of landing (6) . Due to such demand on the extensor mechanism, imbalances between the extensor and flexor muscles may be present, causing an overloading to the muscletendinous structures around the knees joint (6,7) .…”