Background Patellar tendinopathy is the most common overuse knee injury in volleyball, with men reporting more than twice the injury prevalence than women. However, whether between-sex variations in landing technique account for differences in patellar tendon loading is unknown.

Objective Our objective was to compare the landing technique and patellar tendon loading in male and female volleyball players. We hypothesised that males would display differences in landing technique and generate higher patellar tendon loading due to having a higher jump height than the females.

Design Controlled laboratory study.

Setting A regulation height volleyball net and mounted volleyball were used to simulate volleyball court conditions.

Participants Forty male and female volleyball players volunteered for this study. Participants were excluded if they were injured at the time of testing, had a history of lower limb surgery, equilibrium disorders, or orthopaedic or neurologic conditions that could influence their landing biomechanics.

Risk factor assessment Independent t-tests were used to identify whether there were any between-sex differences in all 20 males and 20 females, or 13 males and 13 females matched for jump height.

Main outcome measurements Three-dimensional lower limb kinematics were calculated to characterise landing technique. Patellar tendon loading was characterised by peak patellar tendon force and patellar tendon force loading rate.

Results Males landed from a higher height (P<.001), displayed differences in landing kinematics (P<.05), and experienced higher patellar tendon loading (P=.002), than female players. These differences, however, dissipated when the participants were matched for jump height.

Conclusions Jump height is the critical factor affecting patellar tendon loading, whereby a higher jump height is associated with higher patellar tendon loading, irrespective of sex. The between-sex disparity in patellar tendinopathy may, therefore, be due to males landing from greater heights causing higher patellar tendon loading, rather than being sex-related differences in landing technique.