Introduction Numerous athletes with patellar tendinopathy (PT) use a patellar strap or sports tape during sports aiming to reduce their pain. Despite that theories are suggested about the working mechanisms of these orthoses,2 there is to our knowledge no scientific evidence supporting the use of these orthoses in this common overuse injury. The aim of this study was to investigate the effect of wearing a patellar strap or sports tape on pain in athletes with PT. The secondary aim was to investigate if specific patients’ characteristics are related to the effectiveness of the orthoses.
Methods In a randomised controlled crossover experiment, active athletes with clinically diagnosed PT were included. All participants performed three functional patellar tendon loading tests (single leg decline squat (1x and 10x), counter movement jump (both legs and one leg) and triple hop test) under four different conditions: control, patellar strap, sports tape, and placebo (kinesiotape administered in a non-functional way). The order of the conditions was randomised and balanced between subjects. A visual analogue scale (VAS, 0–100 mm) for pain was used to quantify the amount of pain experienced by the subjects during the tests. A difference of 12 mm was considered clinically relevant.1 A mixed model analysis and a linear regression analysis were used for the data analysis. The study design was previously published.4
Results A total of 97 athletes from different sports (61% male, age 27.0 y (SD 8.1), VISA-P 58.5 (SD 12.7)) were analysed. On the 10x single leg decline squat we found a significant (p < 0.05) median reduction of 14 mm and 13 mm on the VAS pain score in the patellar strap and sports tape condition, compared to control. A reduction of 7 mm and 6 mm compared to placebo was found (p = 0.33 and p = 0.32). A reduction of 11.5 mm (p = 0.06) was found in the patellar strap condition compared to control during the one legged counter movement jump. Females seem to benefit more from wearing sports tape compared to men. No predictors could be identified for the effectiveness of a patellar strap.
Discussion This study shows that in athletes with PT the use of a patellar strap or sports tape results in significant and clinically relevant (>12 mm) lower VAS pain scores during functional tests with high patellar tendon load like the 10 times single leg decline squat. Part of the effect can be a placebo effect, as the placebo condition also caused a reduction in the VAS pain score compared to control. Females seem to benefit more than men from the use of sports tape. As in the current study only the short term effect of the orthoses was investigated, future research should focus on long term effects as these might be different.3 Furthermore, it is very interesting to investigate if the same effects of the orthoses will be found in a sports specific situation and to determine if other factors can predict the effectiveness of wearing orthoses in order to be able to provide the athlete with an evidence based advice on the use of orthoses in PT.
References 1 Kelly. Emergency Medicine Journal. 2001;18: 205–207
2 Lavagnino et al. Sports Health: A Multidisciplinary Approach. 2011;3:296–302
3 Öken et al. Journal of Hand Therapy. 2008;21:63–68
4 Vries de et al. Journal of Physiotherapy. 2013;59:270
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