ORIGINAL ARTICLE

Vascularity and pain in the patellar tendon of adult jumping athletes: a 5 month longitudinal study

J L Cook¹, P Malliaras¹, J De Luca², R Ptasznik³, M Morris¹

¹ La Trobe University, Bundoora, Victoria 3083, Australia
² La Trobe Medical Imaging, Bundoora, Victoria, Australia
³ Monash University, Victoria 3800, Australia

Correspondence to:
Correspondence to:
Jill L Cook
La Trobe University, Musculoskeletal Research Centre, School of Physiotherapy, Bundoora, Victoria 3083, Australia; j.cook{at}latrobe.edu.au

Background: This study investigated changes in tendon vascularity in 102 (67 men and 35 women) volleyball players over a 6 month competitive season.

Methods: Athletes were examined with both grey scale ultrasound and standardised colour Doppler settings. Vessel length and pain were measured each month on five separate occasions. Vascular tendons were divided into (i) those that were vascular on all occasions (persistent vascularity) and (ii) those that were vascular on more than two but less than five occasions (intermittent vascularity).

Results: A total of 41 of the 133 abnormal tendons were vascular on two or more occasions. Of these, 16 had persistent vascularity and 25 had intermittent vascularity. There was no significant difference in the prevalence of vascularity between men and women. None of the tendons had a pattern of vascularity over the season that could be clearly interpreted as the onset or resolution of vascularity. Subjects with changes in both tendons were more likely to have persistent vascularity (p = 0.045). Vessels were longer in tendons with persistent vascularity (p<0.000) and pain was significantly greater (p = 0.043) than in tendons with intermittent vascularity. Tendons with intermittent vascularity had similar pain scores on all days, whether or not they had detectable blood flow.

Conclusions: These data suggest that the presence of blood vessels is more likely to be the source of pain than the blood flow in them.

Keywords: neovascularisation; pain; patellar tendinopathy

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Commentary

K Khan⁴

⁴ Department of Family Practice and School of Human Kinetics, Suite 211, University of British Columbia, 2150 Western Parkway, Vancouver, Canada V6T 1V6; kkhan{at}interchange.ubc.ca

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