Abstract
Background: While there is evidence that tendon adapts to training load, structural alterations in the patellar tendon in response to training loads are still unclear. The aim of this study is to identify changes in patellar tendon structure throughout pre-season and after finalizing the first competitive cycle. Methods: Nineteen professional handball players participated in the aforesaid cross-sectional study, in which patellar tendon scan and counter movement jump (CMJ) performance were conducted. Measurements were taken on the first and last day of pre-season training, and at the end of the first competitive cycle. Results: The results revealed that variation on the tendon structure occurred, mainly at the end of pre-season training; for injured tendons this occurred at the proximal (Right p = 0.02), distal (Right p = 0.01), and (Left p = 0.02) tendon, while changes in healthy tendons occurred at the mid (Left p = 0.01) and distal tendon (Right p = 0.01). At the end of the first competitive cycle, changes were observed in the distal injured tendon (p = 0.02). Conclusion: Patellar tendon shows greater structural change after completing pre-season training than at the end of the first competitive cycle, from which it may be inferred that gradual loading during pre-season training allows the tendon to adapt and potentially decrease the onset of patellar tendinopathy.
Highlights
Patellar tendinopathy remains one of the most frequent pathologies in professional athletes: epidemiology studies report that 44.6% of volleyball players and 31.9% of basketball players suffer from patellar tendinopathy [1]
Changes occurred in all portions of the patellar tendon, proximal and distal tendon showed greater change than mid tendon throughout the pre-season and first competitive cycle
Changes in tendon structure were seen at the end of the first competitive cycle, a mild decrease in healthy tendon and increase in injured tendon was seen
Summary
Patellar tendinopathy remains one of the most frequent pathologies in professional athletes: epidemiology studies report that 44.6% of volleyball players and 31.9% of basketball players suffer from patellar tendinopathy [1]. Notwithstanding, recent studies have demonstrated patellar tendinopathy to be a multifactorial, multi-etiological pathology that is not solely susceptible to being aggravated by jumping mechanisms [4]. Clinical features of patellar tendinopathy include localized pain in the tendon along with decreased athletic performance [5,6]. This concomitance can be explained by patellar tendon sensitivity to load changes, whether short-term or long-term load [7], which in turn usually present structural alterations in the tendon.
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