International Athletes Research Articles

Young athletes’ mental well-being is associated with smartphone social networking application usage and moderated by performance level and app type

Smartphones and social media have become an integral part of human daily life and they influence mental well-being. These accounts have been researched in the general population, but not in athletes. This is critical given enhanced physical and emotional stressors in athletes versus non-athletes. Therefore, we here studied intra- and interindividual relationships of four social media sites (WhatsApp, TikTok, Instagram, and Snapchat) with mood, stress, recovery, and sleep using log-based media usage tracking as an objective measure in 53 competitive athletes aged 12–27 years. Multilevel modeling revealed that intraindividual TikTok usage negatively predicted sleep (β = −0.10, p = 0.040) and recovery (β = −0.15, p < 0.002), and positively predicted stress (β = 0.12, p = 0.018). Interindividual Instagram usage predicted feelings of calmness (β = 0.27, p = 0.029) and valence (β = 0.20, p = 0.043). Intriguingly, competition level moderated the usage outcomes of all four apps: Athletes on low performance levels showed lower mental well-being when using social media longer, yet in national and international athletes the strength of these relationships was weaker or even reversed. Our study unravels social media usage associations with mental well-being to vary as a function of performance level and provides findings on intra- and interindividual effects of critical importance to inform future population-tailored and expedient interventions.

Injury Characteristics Among Japanese International Athletes: Report on the Pre-competition Medical Check-Up Data of the Japanese Olympic Committee

Injury Characteristics Among Japanese International Athletes: Report on the Pre-competition Medical Check-Up Data of the Japanese Olympic Committee

Capitalizing on sport labor migration: The role of ethnic capitalism in the discriminatory, regulatory, and exploitative environment for international college athletes in the United States

International college athletes (ICAs) are integral to the National Collegiate Athletic Association (NCAA) and lie at a particular social location as they are international students and college sport laborers. However, little research examines the discriminatory regulations toward ICAs by the NCAA, its member institutions, and the US federal government. Recent court rulings that permit college athletes to monetize their name, image, and likeness (NIL) do not benefit ICAs because of outdated and exclusionary restrictions imposed by federal immigration policies, visa laws, and US tax laws, which prohibit ICAs from having equitable rights, building their personal brand and professional careers. To examine the discrimination, regulation, and exploitation of ICAs by the US federal government and the NCAA, we apply the theory of ethnic capitalism, which highlights the marginalization of groups based on their ethnicity and national origin. In this setting, ICAs are treated as bodies of athletic labor, recruited for institutional gain and athletic program reputation to benefit US higher education institutions (HEIs). To conclude, we propose the need for the NCAA and its member institutions to treat ICAs equitably and include, support, and advocate for them, specifically regarding their inclusion in NIL on US lands.

Educating and promoting athletes’ health protection through infographics on injury and illness prevention during an international competition: a prospective study during the 2024 European Athletics Championships

ObjectiveTo investigate the feasibility, perceived relevance and usefulness of providing injury and illness prevention information through infographics to athletes and medical teams before and during an international athletics championship, and...

A study on the grey relation analysis between the overall performance and individual event scores of international elite trampolinists.

This study applied grey relational analysis to assess the relationship between individual trampoline event scores and overall performance of top male and female athletes in the 2020 Tokyo Olympics. Analyzing execution, horizontal, difficulty, timing of flight, and total scores, results showed males excelled significantly in difficulty, timing, and overall performance, while execution and horizontal scores were comparable. For males, timing of flight (excluding outliers) had the greatest influence on total score, followed by difficulty and execution. In females, difficulty dominated, followed by timing and horizontal, with execution least impactful. The study highlighted the primary roles of timing and difficulty scores in overall trampoline performance, with gender variations in score contributions. The findings illuminated the interplay of score components, offering a theoretical framework for targeted trampoline training. For international athletes, key considerations included boosting height index for a robust trampoline foundation; tailoring difficulty levels to athletes' abilities while adhering to scoring rules, without sacrificing technical prowess; and sustaining training to refine quality and stability of routines.

Leaders beyond sport: an exploratory comparative analysis of international and domestic college athletes’ leadership competencies

PurposeThe purpose of this study was to explore the leadership competencies of the National Collegiate Athletic Association (NCAA) college athletes and assess the potential differences between domestic and international college athletes.Design/methodology/approachA quantitative, non-experimental research design was employed, including the use of an electronic survey to collect data. Survey research allows for extensive data management and a quick data collection method (Creswell &amp; Creswell, 2018). The survey was conducted using online Qualtrics software, which allowed convenience in administration, maintenance, nationwide distribution and data export and analysis.FindingsThe findings of this study suggest that domestic college athletes develop greater leadership competencies than their international peers.Practical implicationsThe study implications include both practical and academic contributions. The research in the area of leadership development in college athletes has been growing. Previous research has focused on the benefits of the leadership development (Lewis, 2023); however, minimal research has been dedicated to exploring actual leadership constructs within the college athlete population. Moreover, this study focused on the differences between domestic and international college athletes’ leadership constructs. International college athletes go through additional challenges while balancing the academic part of being college athletes (Ridpath, Rudd, &amp; Stokowski, 2020).Originality/valueMinimal research has been dedicated to exploring actual leadership constructs within the student-athlete population. This study is the first study that explored leadership constructs from the quantitative lens and focusing on both domestic and international student-athletes. The literature on international student-athletes mainly focuses on the motivation arriving to the United States of America (Love &amp; Kim, 2011) and their transitional experiences (Popp, Pierce, &amp; Hums, 2011; Jolly, Stokowski, Paule-Koba, Arthur-Banning, &amp; Fridley, 2022). However, limited literature focuses on the preparation of international student-athlete for life beyond their sport.

Arterial blood pressure regulation during prolonged isometric exercise in artistic gymnastic athletes compared to controls.

The aim of this cross-sectional study was to examine the baroreflex sensitivity alterations in regulating arterial blood pressure during prolonged isometric exercise at different intensities in elite artistic gymnastic athletes compared to non-athletes. Fourteen young males participated in the study; 7 international level artistic gymnastics athletes and 7 physically active students inexperienced to isometric or resistance training. On two occasions, both groups performed 3 minutes of isometric handgrip exercise either at 30% or 50% of maximum voluntary contraction (MVC), in a randomized order. Force production, arterial blood pressure and baroreflex sensitivity through finger plethysmograph were continuously recorded. At rest, arterial blood pressure was normal in both groups (systolic blood pressure [SBP], athletes [A]: 128±9.0 mmHg, non-athletes [NA]: 130±7.2 mmHg, P=0.62; DIA, A: 75.6±5.2, NA: 78.5±4.6, P=0.31) but baroreflex sensitivity (BRS) was higher in athletes than in non-athletes (A: 16.6±7.4, NA: 12.0±7.9, P=0.02). During prolonged isometric exercise at 30% MVC, blood pressure was similar between groups (SBP, A: 176.9±16 mmHg vs. NA: 189.5±15.1 mmHg P=0.9, diastolic blood pressure [DBP], A: 108±11 mmHg vs. NA: 118±11 mmHg, P=0.6) and BRS was still higher in athletes (A: 13.28±5.75 ms/mmHg vs. NA: 6.72±3.83, P=0.04), whereas at 50% MVC, blood pressure was lower in the athletes compared to the control group (SBP, A: 182.5±15 mmHg vs. NA: 222.1±19.3 mmHg, P=0.001; DBP A: 115±14 mmHg vs. NA: 141±20 mmHg, P=0.02,without statistically significant difference in BRS between groups (A: 7.39±5.34 ms/mmHg vs. NA: 3.9±1.73 ms/mmHg, P=0.44). The results of our cross-sectional study revealed that after years of exposure in high amounts of training loads, baroreflex sensitivity is increased in healthy athletes probably in order to prevent excessive increases in blood pressure during exercise.

Superstars Really Are Scarce: Shohei Ohtani and Baseball Attendance

We estimate the superstar effects in Major League Baseball, focusing on a particularly unique international athlete, Shohei Ohtani, using a fixed effects panel regression with multiway clustering. Ohtani’s scarce talent as both a pitcher and a hitter provides the potential to have outsized influence on demand at home (superstar effect) and away (superstar externality) games, providing new marketing opportunities for the league. We compare Ohtani’s impact on attendance with other top pitchers, particularly after large attendance drops attributed to the COVID-19 pandemic, suggesting that his superstardom played a key role in bringing fans back to baseball games. Results revealed a large attendance externality, especially after the pandemic, that increased away attendance by up to 40% in 2021 specifically (and up to 20% overall). We propose that Ohtani provides an opportunity for Major League Baseball to leverage a recognizable face of baseball and leverage superstar value that was previously shown to be in decline.

“Navigating a Path Beyond the Finish Line” — How Can Post-Retirement Support Enhance the Transition for Athletes After Retirement in China?

This paper investigates the post-retirement challenges faced by Chinese athletes and proposes solutions to improve their career transitions. Despite government efforts, many Chinese athletes—primarily from economically disadvantaged families—continue to struggle with inadequate education, health issues, and limited employment opportunities. This study analyzes existing research and benchmarks international athlete transition systems, seeking ways to improve China’s current approach. By comparing China’s system with those in other countries, the findings highlight the need for comprehensive education, better healthcare, and enhanced employment opportunities for retired athletes. Key recommendations include providing short-term pre-retirement training focused on life after sports, improving long-term educational preparation, and encouraging athletes to develop intellectual property and foster a positive public image for external financial stability. In addition, government policies should be improved to offer more appropriate job opportunities and stronger post-retirement support. By refining the current athlete retirement system, this paper aims to facilitate a smoother transition for athletes as they navigate beyond their sports careers.

Transcultural adaptation and validation of the 4-Domain Sports PROM into Italian

ObjectivesThis work aims to evaluate and validate the process of cross-cultural adaptation and validation of the 4-Domain Sports PROM (4-DSP) into Italian, assessing its understandability and reproducibility in all questionnaire domains for Italian-speaking patients. MethodsCross-sectional study, level of evidence II. The questionnaire was self-administered by 100 patients (80 males and 20 females) who had undergone anterior cruciate ligament (ACL) reconstruction and had a one-year minimum follow-up. The mean age and standard deviation (SD) was 31.20 ​± ​12.65 years. According to their level of sports participation, 51% were recreational, 31% were regional, 12% were national, and 6% were international athletes. All patients filled in the 4-DSP questionnaire without direct supervision of their trainer/coach or researcher. All data were collected and processed anonymously. The translation and cultural adaptation of the 4-DSP involved six phases: (1) translation, (2) synthesis, (3) back-translation, (4) pre-test, (5) expert committee review and (6) final version approval by the author of the original version for publication. ResultsThe cross-cultural validation of the questionnaire 4-DSP into Italian presented a global Cronbach's alpha of 0.65, Conceptual equivalence to translation and relevance were 99.09% and 99.81%, respectively, and the percentage of agreement was 99.09%. ConclusionThe cross-culturally validated version of the 4-DSP into Italian proved to be adequately understandable and reproducible in all questionnaire domains and can be safely and reliably used in Italian-speaking patients. Level of evidenceStudy level II.

Swedish elite athletes’ experiences of psychotherapy for mental health concerns provided by licensed psychologists and psychotherapists: a qualitative study

This study explores elite athletes’ experiences of psychotherapy administered by Swedish licensed psychologists or psychotherapists with and without specialisation in elite sports, addressing the research question: What do elite athletes...

Bone stress injuries in athletics (track and field) championships: findings from a prospective injury surveillance conducted across 24 international championships with 29,147 registered athletes

BackgroundAthletics (track and field) athletes are prone to develop bone stress injuries (BSIs) but epidemiological data on BSIs from top-level sports events are scarce.ObjectiveTo describe the incidence and characteristics of BSIs during 24 international athletics championships held from 2007 to 2023.MethodsBSI-related data were prospectively collected during 24 international athletics championships, including the Olympic Games (n = 3), World Outdoor Championships (n = 4), European Outdoor Championships (n = 6), World Indoor Championships (n = 3) and European Indoor Championships (n = 8). Descriptive and comparative statistics were used to assess the epidemiological characteristics of BSIs.ResultsBSIs accounted for 1.5% of all reported injuries (n = 36; 1.2 per 1000 registered athletes (95%CI 0.8 to 1.6)). No significant difference of BSI incidence was detected between female (2.0 per 1000 athletes (95%CI: 0.9 to 2.3)) and male athletes (0.9 per 1000 athletes (95%CI: 0.4 to 1.4)) (relative risk (RR) = 1.73, 95%CI: 0.88 to 3.40). BSI incidence was significantly higher during outdoor championships (1.6 per 1000 registered athletes (95%CI: 1.0 to 2.1)) as compared to indoor championships (0.2 per 1000 registered athletes (95%CI: 0.0 to 0.5)) (RR = 10.4, 95%CI: 1.43 to 76.0). Most BSIs were sustained in the foot (n = 50%) or leg (n = 33%). BSIs were reported in athletes participating in endurance disciplines (52.8%) or in explosive disciplines (47.2%).ConclusionsBSIs represent a small portion of injuries sustained during international athletics championships. Collective results suggest that injury rates are higher in outdoor competitions as compared to indoor competitions. The most common injury locations comprise the foot and leg.Clinical Trial NumberNot applicable.

Sport and longevity: an observational study of international athletes.

The human lifespan is influenced by various factors, with physical activity being a significant contributor. Despite the clear benefit of exercise on health and longevity, the association between different types of sports and lifespan is yet to be considered. Accordingly, we aimed to study this association in a large international cohort of former athletes using a robust linear regression model. We collected data on athletes from public sources, accumulating a total of 95,210 observations, 95.5% of which were accounted for by males. The dataset represented athletes born between 1862 and 2002 from 183 countries across 44 sports disciplines. We calculated the change in lifespan by measuring the difference in age between athletes and the corresponding reference populations, while accounting for variations caused by sex, year of death, and country. The results revealed that various sports impacted lifespan differently, with male athletes being more likely to experience benefits from sports than female athletes. Among male athletes, pole vaulting and gymnastics were linked to the highest extension in lifespan (8.4years, 95% CI [6.8, 9.9] and 8.2years, 95% CI [7.4, 9], respectively), while volleyball and sumo wrestling were the most negatively associated with lifespan (- 5.4years, 95% CI [- 7, - 3.8]; - 9.8years, 95% CI [- 11, - 8.6], respectively). The association between lifespan and popular team sports in males was positive for cricket, rowing, baseball, water polo, Australian rules, hurling, lacrosse, field hockey, minimal for rugby, canoeing and kayaking, basketball, gridiron football, and football (soccer), and negative for handball and volleyball. Racquet sports (i.e., tennis and badminton) exhibited a consistent and positive association in both male and female athletes, as shown by an extended lifespan of up to 5.7years in males (95% CI [5, 6.5]) and 2.8years in females (95% CI [1.8, 3.9]). Although lacking conclusive evidence, we theorize that the observed results may be attributed to the aerobic and anaerobic characteristics of each sport, with mixed sports yielding the maximum benefits for the lifespan. While results from female athletes should be cautiously interpreted, our study highlights the complex interplay between sports and lifespan and contributes to the growing body of knowledge on the multifaceted relationship between physical activity and human longevity.

Evaluation of the impact of team play in 3˟3 basketball on the development of dexterity in international military pentathlon cadet athletes

Evaluation of the impact of team play in 3˟3 basketball on the development of dexterity in international military pentathlon cadet athletes

Physical and Physiological Characteristics of Elite CrossFit Athletes.

Due to little available research on elite CrossFit athletes, the present investigation was undertaken to provide knowledge about their physical and physiological characteristics. Nineteen international level CrossFit athletes (8 men; 11 women) were tested for maximum oxygen consumption (V˙O2max), Wingate, squat 1 repetition maximum (1RM), countermovement jump (CMJ), lower body force-velocity, and body composition (DXA). To provide perspective, the results were compared to sixteen elite-level Alpinists (8 men; 8 women). There was no significant difference in absolute nor relative V˙O2max between the CrossFit and Alpinist men (p = 0.335 and p = 0.279, respectively). The CrossFit women showed similar absolute but higher relative V˙O2max than the Alpinist women (p = 0.055 and p = 0.005, respectively). Mean anaerobic power was higher in both CrossFit men and women (p = 0.021 and p = 0.008, respectively). There were no significant differences in squat 1RM and CMJ for both men and women (p > 0.05). Both CrossFit men and women showed lesser lower body force production (p = 0.043 and p = 0.034, respectively) but higher power (p = 0.009 and p = 0.003, respectively). The CrossFit men and women had a lower fat mass (p = 0.018 and p = 0.002, respectively) and fat percentage (p = 0.027 and p < 0.001, respectively). These observations show that elite CrossFit athletes possess physical and physiological characteristics comparable to world-class Alpinists.

Can the Countermovement Jump or Squat Jump predict the kinematic performance of the rear Bandal Chagi kick?

This study aimed to measure the associative and predictive strength of biomechanical variables of the countermovement jump (CMJ) and squat jump (SJ), and performance of the bandal-chagi kick performed with the dominant (D) rear lower limb in elite Taekwondo Athletes. For this, a total of 27 international level athletes (15 males and 12 females) performed the CMJ and SJ on two force platforms. The bandal-chagi was monitored using a motion capture system (VICON). The main results indicated that non-dominant (ND) Stiffness for the CMJ showed predictive power alone (p=0.048) or in combination with eccentric breaking rating of force development (RFD) (p=0.031) for total hip angular speed. Takeoff peak force/BM for the SJ predicted total time (p=0.002). Concentric RFD/BM predicted total linear foot acceleration, either alone (p=0.001) or with vertical speed at takeoff (p=0.042). The total hip angular acceleration predictor was takeoff peak force D alone (p=0.019) or in combination with peak power/BM (p=0.041). In conclusion, CMJ and SJ tests showed specific associations with TKD kick performance. These analyses in this study indicated that they are good predictors for TKD athletes, producing results consistent with the participants’ levels. Keywords: Martial arts, Biomechanical Phenomena, Time-motion studies, Kinanthropometry, Motion Capture.

Performance pathways in elite middle- and long-distance track and field athletes: The influence of a successful youth

ObjectivesThere is limited information on the performance progression of athletics endurance athletes from junior-to-senior status and the determinants of success in adulthood. This study aimed to quantify the youth-to-senior transition rate, the likelihood of success and the relationship between youth and senior performance amongst world-class athletes competing in middle- and long-distance disciplines. DesignRetrospective design examining public data between 2000 and 2019. MethodsThe performances of 4678 international athletes (45.3 % female) were analysed. World's all-time top 50 athletes were identified for U18 and Senior categories (age ≥ 20 years). Youth-to-senior transition rate and transition probabilities were calculated. Correlations between best U18 and Senior performances were determined to assess the stability of the performance. ResultsThe youth-to-senior transition rate for top U18 athletes was low for males and females (~19 % and 21 %). Nevertheless, the probability of transition to a top senior was ~7 times higher for top U18 athletes than for non-top U18 athletes. The correlations between youth and senior best performances were low-to-high. ConclusionsFew top U18 athletes maintained top world ranking status during their senior careers. Still, they are more likely to become top senior athletes than those who did not perform at the top level in U18. The association between youth and senior performance is stronger when comparing the same discipline or when athletes competed over longer distances in their senior compared to U18 career. Being a successful youth athlete may represent a small advantage for future success, however, it does not guarantee advancement to the senior top level.

The Effects of Resistance Training on Sport-Specific Performance of Elite Athletes: A Systematic Review with Meta-Analysis.

This systematic review examines the influence of resistance training (RT) on the performance outcomes of elite athletes. Adhering to PRISMA guidelines, a comprehensive search across PubMed, Scopus, SPORTDiscus, and Web of Science databases was conducted, considering studies up to November 19, 2023. The inclusion criteria were elite athletes involved in high-level competitions. Studies were categorized by the competitive level among elite athletes, athlete's sex, performance outcomes, and a training modality with subgroup analyses based on these factors. Thirty-five studies involving 777 elite athletes were included. The results of the meta-analysis revealed a large and significant overall effect of RT on sport-specific performance (standardized mean difference, SMD = 1.16, 95% CI: 0.65, 1.66), with substantial heterogeneity (I2 = 84%). Subgroup analyses revealed differential effects based on the competitive level, the type of sport-specific outcomes, and sex. National elite athletes showed more pronounced (large SMD) benefits from RT compared to international elite athletes (small SMD). Global outcomes revealed a medium but non-significant (p > 0.05) SMD, while local outcomes showed a large SMD. Notably, female athletes exhibited a large SMD, though not reaching statistical significance (p > 0.05), probably due to limited study participants. No significant (p > 0.05) differences were found between heavy and light load RT. Resistance training is effective in improving sport-specific performance in elite athletes, with its effectiveness modulated by the competitive level, the type of the performance outcome, and athlete's sex. The findings underscore the need for personalized RT regimens and further research, particularly in female elite athletes, as well as advanced RT methods for international elite athletes.

BIOKINEMATIC CHARACTERISTICS OF THE TRIPLE JUMP TECHNIQUE IN QUALIFIED ATHLETES

The purpose of the study is to investigate the biokinematic characteristics of the triple jump technique in qualified athletes. Material and methods. The technique of the final attempts of qualified triple jumpers during the 2023 World Athletics Championships was analyzed. The following methods were used in the work: analysis and synthesis of scientific and methodological literature, analysis of video materials, methods of mathematical statistics. The video of the final attempts was used, provided for public use by the International Athletics Federation (World Athletics). The attempts were recorded by four video cameras installed on the side of the treadmill at a distance of 2,5 m, the height of the video camera mounted on a tripod was 1,5 m. Two of the four video cameras recorded video at a frequency of 25 frames per second, the other two video cameras recorded video at a frequency of 1300 frames per second. Video analysis of the final attempts and processing of biokinematic parameters of the technique were determined using the Dartfish and Kinovea programs. All statistical data were processed in the statistical analysis program IBM SPSS Statistics version 28.0.1.0. Results. The metric, time, angular, and speed characteristics of the take-off technique are determined; push-off; jump; step; jump for highly skilled triple jumpers. Based on the analysis of the triple jump technique indicators, the optimal biokinematic parameters of the technique that athletes need to have in order to achieve high competitive results were obtained. Conclusions. To achieve high competitive results in the triple jump, the following technical parameters must be used. The take-off speed should reach 10.40 m s-1 or more, the length of the last take-off step should be 2,20-2,40 m; the pace of the last step is 4-5 steps/s. The push-off; from the bar should last 0.100-0.133 s; the push-off; angle reaches 65-70 ̊; the speed of departure of the general center of mass of the body is 9.60 m s-1 and more. The jump should last no more than 0,660 s. During the jump, the high height of the overall center of body mass should be 1.30-1.45 m; upon landing, the speed of the general center of mass of the body is 9,20 m s-1 or more. The second push-off should last 0,160-0,180 s, the push-off angle is 60-65°. The take-off speed of the general center of body mass in a step should be 8,80 m s-1 or more. The optimal step duration is 0.450-0.520 s, step length is 5.20-5.50 m, the maximum height of the overall center of body mass is 1.24-1.30 m; upon landing, the speed of the general center of mass of the body is 8.50 m s-1 or more. The third push-off should last 130-166 s. The push-off angle is 63-70°. The take-off speed of the general center of mass of the body in a jump is from 8 m s-1 and more. The optimal duration of the jump is 0.750-0.780 s; maximum height of the overall center of body mass 1,10-1,22 m; upon landing, the speed of the general center of mass of the body is 7 m s-1 or more. When taking off and landing, the angle in the supporting leg throughout all three jumps should be 163-170 ̊.

Ultrasound- and Doppler-Guided WALANT Arthroscopic Surgery for Patellar Tendinopathy with Partial Rupture in Elite Athletes-A 2-Year Follow-Up of a Prospective Case Series.

Background and Objectives: Patellar tendinopathy is difficult to treat, and when combined with partial rupture, there are additional challenges. The aim of this study was to evaluate the subjective outcome and return-to-sport status after ultrasound (US)- and colour doppler (CD)-guided wide awake local anaesthetic no tourniquet (WALANT) arthroscopic shaving in elite athletes. Material and Methods: Thirty Swedish and international elite athletes (27 males) with a long duration (>1 year) of persistent painful patellar tendinopathy in 35 patellar tendons, not responding to non-surgical treatment, were included. All patients were treated with the same protocol of arthroscopic shaving, including bone removal and debridement of partial rupture, followed by at least 3 months of structured rehabilitation. The VISA-P score and a study-specific questionnaire evaluating physical activity level and subjective satisfaction with the treatment were used for evaluation. Results: At the 2-year follow-up (mean 23, range 8-38 months), 25/30 patients (29/35 tendons) were satisfied with the treatment result and had returned to their pre-injury sport. The mean VISA-P score increased from 37 (range 7-69) before surgery to 80 (range 44-100) after surgery (p < 0.05). There was one drop-out (one tendon). There were no complications. Conclusions: US- and CD-guided WALANT arthroscopic shaving for persistent painful patellar tendinopathy, including bone removal and debridement of partial rupture, followed by structured rehabilitation showed good clinical results in the majority of the elite-level athletes.