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Kicking
Published in Paul Grimshaw, Michael Cole, Adrian Burden, Neil Fowler, Instant Notes in Sport and Exercise Biomechanics, 2019
In situations where the ACL is completely ruptured, it is typically necessary to surgically repair the damaged structures using either a graft derived from the athlete’s semi-membranous or patella tendon (autograft), from other human donors (allograft) or from a non-biological artificial source. Reconstruction using a semi-membranous or patella tendon autograft is generally the preferred option and despite each graft type having its own disadvantages, both have been shown to be capable of restoring knee stability to a degree that allows an athlete to return to play. If a surgeon does not consider the ACL to be partially or completely ruptured, non-operative treatments such as knee braces, anti-inflammatory injections and/or physiotherapy aimed at strengthening the quadriceps and hamstring muscle groups may be prescribed. However, in many cases, those who initially receive non-operative treatments become candidates for surgical reconstruction or repair, which has led to considerable debate about the effectiveness of non-operative therapies.
Biomechanical topics in soft tissues
Published in Benjamin Loret, Fernando M. F. Simões, Biomechanical Aspects of Soft Tissues, 2017
Benjamin Loret, Fernando M. F. Simões
In fact, the knee is stabilized by ligaments and tendons: - ligaments connect bones together, in this case, femur and tibia. The medial collateral and lateral collateral ligaments minimize lateral motion. The anterior cruciate ligament (ACL) inserts in the posterior face of the femur and in the upper anterior face of the tibia and the posterior cruciate ligament (PCL) joints the posterior face of the tibia and the lower face of the femur. This inclination allows for some rotation of the bones in the sagittal plane but prevents forward and backward relative translation of the tibia and femur;- tendons attach muscles to bones. The patellar tendon links the muscles of the thigh to the patella and inserts in the front of the tibia. Similarly, the hamstring muscles attach to the back of the tibia through tendons.
Electromyographic activity of quadriceps muscles during eccentric squat exercises: implications for exercise selection in patellar tendinopathy
Published in Research in Sports Medicine, 2021
Sevim Acaröz Candan, Hasan Sözen, Erdal Arı
The eccentric squat is the main component of rehabilitation programs to recover pain and athletic functionality in athletes with patellar tendinopathy (PT) (Rodriguez-Merchan, 2013; Visnes & Bahr, 2007). Patellar tendinopathy is one of the most extensive painful overuse injuries during the sporting performance and is characterized by degenerative changes of the patellar tendon without inflammation (Khan et al., 1996; Maffulli et al., 2004). Prevalence of PT is high in sports which required high exertions of speed and power for the knee extensors, such as basketball, volleyball, and football due to particularly cutting, sudden acceleration, and jumping movements (Fredberg & Bolvig, 1999; Lian et al., 2005). Patellar tendinopathy prevalence changes approximately between 14% and 45% among elite athletes competing in different sports branches (Lian et al., 2005). Consequences of PT may lead to rupture of the tendon and if it becomes chronic, decreases in athletic performance or even disruption of sports career (Peers & Lysens, 2005).
Low prevalence of patellar tendon abnormality and low incidence of patellar tendinopathy in female collegiate volleyball players
Published in Research in Sports Medicine, 2020
Marcey Keefer Hutchison, Christopher Patterson, Tyler Cuddeford, Robert Dudley, Eric Sorenson, Jason Brumitt
Identifying athletes at risk for developing patellar tendinopathy is warranted. In the United States, there are several levels of competition at the collegiate level [e.g. National Collegiate Athletic Association (NCAA) and National Association of Intercollegiate Athletics (NAIA)]. Most athletes, except for those competing at the NCAA Division I level report to their team in August after having been off-campus for the summer months. Coaches and sports medicine professionals have a limited number of weeks to prepare their athletes for their first competition (National Collegiate Athletic Association, 2019). Screening athletes when they return back to campus may help identify athletes at risk for injury. Diagnostic ultrasound imaging of the patellar tendon may be used as a screening tool to identify athletes who present with a patellar tendon abnormality (Figure 1(a,b)). The presence of a patellar tendon abnormality is not always associated with symptoms; however, there is evidence that the presence of an abnormality increases the risk of developing symptomatic patellar tendinopathy (Cook et al., 2000a). Cook et al. reported a 4.2 times greater risk of elite basketball players (age range 14–18 y) developing symptoms when they presented at baseline testing with an asymptomatic patellar tendon abnormality (i.e., presence of a hypoechoic region) (Cook et al., 2000a). Subsequent studies supported the aforementioned association between symptom onset and tendon imaging at the start of the season (Gisslen, Gyulai, Nordstrom, & Alfredson, 2007; Visnes, Tegnander, & Bahr, 2015). Visnes et al. (2015) reported the presence of a hypoechoic region in an asymptomatic male or female elite teenage VB at baseline was associated with a 3.3 times greater risk of developing patellar tendinopathy. The risk of developing patellar tendinopathy was low in junior VB players (n = 22; mean age 16 y) who started the season with normal clinical and diagnostic ultrasound findings (Gisslen et al., 2007).
Investigating Achilles and patellar tendinopathy prevalence in elite athletics
Published in Research in Sports Medicine, 2018
Ina Janssen, Henk van der Worp, Sjoerd Hensing, Johannes Zwerver
An online questionnaire was designed and sent out between April and May 2015 to collect 6 months of retrospective training and injury information, previously shown to be a valid time for collecting injury history (Gabbe, Finch, Bennell, & Wajswelner, 2003), in the following categories: Respondent characteristics: Gender, date of birth, height, body mass, foot type based on a picture (Figure 1(a)), and whether they wore orthotics in their training shoes.Training history: Competition discipline/event, number of years competing at the senior national championships, total training hours, strength training hours, and flexibility training hours per week, self-reported muscle flexibility of the quadriceps, hamstrings, and calves were reported as feeling normal, stiff, or flexible (Morton et al. 2015).Achilles tendon pain: Whether they currently had Achilles pain, whether they had Achilles pain in the last 6 months, or whether they have previously been diagnosed with Achilles tendinopathy, duration and location of the pain (insertional or mid-portion tendinopathy; see Figure 1(b)), which leg was affected, and whether a physiotherapist or physician had diagnosed Achilles tendinopathy. Subjective answers regarding which movement caused the most pain, whether the pain affected their performance, or whether the pain increased during heavy training weeks were also collected. Participants were classified as having Achilles tendinopathy if they indicated having Achilles pain and/or if they reported being diagnosed as such by a physiotherapist or physician. Participants with current Achilles pain or who had experienced Achilles pain in the last 6 months completed the VISA-A questionnaire (Robinson et al., 2001) to indicate the severity of the Achilles pain, function and sports participation (score 0–100; 0 = most severe complaints, 100 = no complaints).Patellar tendon pain: Whether they currently had knee pain, whether they had knee pain in the last 6 months, or whether they have previously been diagnosed with patellar tendinopathy, duration and location of the pain on a self-administered pain map (see Figure 1(c) (van der Worp et al., 2012)) which leg was affected, and whether a physiotherapist or physician had diagnosed patellar tendinopathy. Participants also answered questions regarding which movement caused the most pain, whether the pain affected their performance, or whether the pain increased during heavy training weeks. Participants were classified as having patellar tendinopathy if they indicated having pain on the inferior or superior poles of the patella (Figure 1(c, parts E,F)) and/or if they were diagnosed as such by a physiotherapist or physician. Participants with current patellar tendinopathy or who sustained patellar tendinopathy in the last 6 months completed the VISA-P questionnaire (Visentini et al., 1998) (score 0–100; 0 = most severe complaints, 100 = no complaints).