Background Patellar tendinopathy (PT) has a multifactorial etiology, and many possible risk factors have been described in the literature. Findings are conflicting though, and most research is conducted on elite athletes.

Objective Aim of the current study is to determine risk factors for PT in a large representative sample of volleyball players.

Design Cross-sectional study using an online questionnaire.

Setting Volleyball players of all playing levels.

Participants All volleyball players between ages 18 and 35 years from the Dutch Volleyball Association were invited to complete the questionnaire (n=7750). 1561 volleyball players completed the questionnaire.

Assessment of risk factors The following independent variables were collected: Gender, age, body mass index, waist-to-hip ratio, years playing volleyball, hours of training during the last week, number of games during the last month, average hours of other sports per week, training increase compared to last year, playing surface, playing level and playing position.

Main outcome measurements Presence of symptomatic tendinopathy was the dependent variable.

Results Being male (OR=2.1) and playing at the national level (OR=2.1) were risk factors for PT in volleyball players. Also players that play as outside hitter (OR=2.3) or middle blocker/hitter (OR=2.8) are at a greater risk for PT than those who play as setter.

Conclusions Several potential risk factors for PT were identified. Volleyball players that play as outside hitter or middle block/hitter have the highest odds for PT. Therefore, changing playing position to libero/opposite hitter or setter may be an option in volleyball players with PT.