Int J Sports Med 2014; 35(08): 714-722
DOI: 10.1055/s-0033-1358674
Review
© Georg Thieme Verlag KG Stuttgart · New York

Jumper’s Knee or Lander’s Knee? A Systematic Review of the Relation between Jump Biomechanics and Patellar Tendinopathy

H. Van der Worp
1   University of Groningen, University Medical Center, Center for Sports Medicine, Groningen, Netherlands
,
H. J. de Poel
2   University of Groningen, University Medical Center, Center for Human Movement Sciences, Groningen, Netherlands
,
R. L. Diercks
1   University of Groningen, University Medical Center, Center for Sports Medicine, Groningen, Netherlands
,
I. van den Akker-Scheek
1   University of Groningen, University Medical Center, Center for Sports Medicine, Groningen, Netherlands
,
J. Zwerver
1   University of Groningen, University Medical Center, Center for Sports Medicine, Groningen, Netherlands
› Author Affiliations
Further Information

Publication History



accepted after revision 08 October 2013

Publication Date:
27 February 2014 (online)

Abstract

Patellar tendinopathy (jumper’s knee) is a common injury in sports that comprise jump actions. This article systematically reviews the literature examining the relation between patellar tendinopathy and take-off and landing kinematics in order to uncover risk factors and potential prevention strategies. A systematic search of the Pubmed, Embase and Amed databases was performed to identify studies that reported kinematics of sport specific jumps in relation to patellar tendinopathy. A quantitative analysis was performed on 4 indentified studies. Differences were found only between controls and asymptomatic subjects with patellar tendon abnormalities. Most differences were found during horizontal landing after forward acceleration. A synthesis of the literature suggests that horizontal landing poses the greatest threat for developing patellar tendinopathy. A stiff movement pattern with a small post-touchdown range of motion and short landing time is associated with the onset of patellar tendinopathy. Accordingly, employing a flexible landing pattern seems to be an expedient strategy for reducing the risk for (re-) developing patellar tendinopathy. Together, these findings indicate that improving kinetic chain functioning, performing eccentric exercises and changing landing patterns are potential tools for preventive and/or therapeutic purposes.

 
  • References

  • 1 Backman LJ, Danielson P. Low range of ankle dorsiflexion predisposes for patellar tendinopathy in junior elite basketball players: A 1-year prospective study. Am J Sports Med 2011; 39: 2626-2633
  • 2 Bisseling RW, Hof AL, Bredeweg SW, Zwerver J, Mulder T. Are the take-off and landing phase dynamics of the volleyball spike jump related to patellar tendinopathy?. Br J Sports Med 2008; 42: 483-489
  • 3 Blazina ME, Kerlan RK, Jobe FW, Carter VS, Carlson GJ. Jumper’s knee. Orthop Clin North Am 1973; 4: 665-678
  • 4 Butler RJ, Crowell 3rd HP, Davis IM. Lower extremity stiffness: Implications for performance and injury. Clin Biomech 2003; 18: 511-517
  • 5 Edwards S, Steele JR, Cook JL, Purdam CR, McGhee DE, Munro BJ. Characterizing patellar tendon loading during the landing phases of a stop-jump task. Scand J Med Sci Sports 2012; 22: 2-11
  • 6 Edwards S, Steele JR, McGhee DE, Beattie S, Purdam C, Cook JL. Landing strategies of athletes with an asymptomatic patellar tendon abnormality. Med Sci Sports Exerc 2010; 42: 2072-2080
  • 7 Elvin N, Elvin A, Scheffer C, Arnoczky S, Dillon E, Erasmus PJ. A preliminary study of patellar tendon torques during jumping. J Appl Biomech 2009; 25: 360
  • 8 Finch C. A new framework for research leading to sports injury prevention. J Sci Med Sport 2006; 9: 3-9
  • 9 Fredberg U, Bolvig L, Andersen NT. Prophylactic training in asymptomatic soccer players with ultrasonographic abnormalities in Achilles and patellar tendons – the Danish super league study. Am J Sports Med 2008; 36: 451-460
  • 10 Gaida JE, Cook J. Treatment options for patellar tendinopathy: Critical review. Curr Sports Med Rep 2011; 10: 249-254
  • 11 Hughes G, Watkins J. Lower limb coordination and stiffness during landing from volleyball block jumps. Res Sports Med 2008; 16: 138-154
  • 12 Kettunen JA, Kvist M, Alanen E, Kujala UM. Long-term prognosis for jumper’s knee in male athletes – A prospective follow-up study. Am J Sports Med 2002; 30: 689-692
  • 13 Khan KM, Cook JL, Kiss ZS, Visentini PJ, Fehrmann MW, Harcourt PR, Tress BW, Wark JD. Patellar tendon ultrasonography and jumper’s knee in female basketball players: A longitudinal study. Clin J Sport Med 1997; 7: 199-206
  • 14 Kountouris A, Cook J. Rehabilitation of Achilles and patellar tendinopathies. Best Pract Res Clin Rheumatol 2007; 21: 295-316
  • 15 Kraemer R, Knobloch K. A soccer-specific balance training program for hamstring muscle and patellar and Achilles tendon injuries an intervention study in premier league female soccer. Am J Sports Med 2009; 37: 1384-1393
  • 16 Lian O, Engebretsen L, Ovrebo RV, Bahr R. Characteristics of the leg extensors in male volleyball players with jumper’s knee. Am J Sports Med 1996; 24: 380-385
  • 17 Lian OB, Engebretsen L, Bahr R. Prevalence of jumper’s knee among elite athletes from different sports – A cross-sectional study. Am J Sports Med 2005; 33: 561-567
  • 18 Malliaras P, Cook JL, Kent P. Reduced ankle dorsiflexion range may increase the risk of patellar tendon injury among volleyball players. J Sci Med Sport 2006; 9: 304-309
  • 19 Milner CE, Fairbrother JT, Srivatsan A, Zhang S. Simple verbal instruction improves knee biomechanics during landing in female athletes. Knee 2012; 19: 399-403
  • 20 Munteanu SE, Barton CJ. Lower limb biomechanics during running in individuals with Achilles tendinopathy: A systematic review. J Foot Ankle Res 2011; 4: 15
  • 21 Onate JA, Guskiewicz KM, Marshall SW, Giuliani C, Yu B, Garrett WE. Instruction of jump-landing technique using videotape feedback: Altering lower extremity motion patterns. Am J Sports Med 2005; 33: 831-842
  • 22 Rees JD, Maffulli N, Cook J. Management of tendinopathy. Am J Sports Med 2009; 37: 1855-1867
  • 23 Richards DP, Ajemian SV, Wiley JP, Brunet JA, Zernicke RF. Relation between ankle joint dynamics and patellar tendinopathy in elite volleyball players. Clin J Sport Med 2002; 12: 266-272
  • 24 Richards DP, Ajemian SV, Wiley JP, Zernicke RF. Knee joint dynamics predict patellar tendinitis in elite volleyball players. Am J Sports Med 1996; 24: 676-683
  • 25 Romero-Rodriguez D, Gual G, Tesch PA. Efficacy of an inertial resistance training paradigm in the treatment of patellar tendinopathy in athletes: A case-series study. Phys Ther Sport 2011; 12: 43-48
  • 26 Siegmund JA, Huxel KC, Swanik CB. Compensatory mechanisms in basketball players with jumper’s knee. J Sport Rehabil 2008; 17: 358-371
  • 27 Sorenson SC, Arya S, Souza RB, Pollard CD, Salem GJ, Kulig K. Knee extensor dynamics in the volleyball approach jump: The influence of patellar tendinopathy. J Orthop Sports Phys Ther 2010; 40: 568-576
  • 28 van der Worp H, van Ark M, Roerink S, Pepping GJ, van den Akker-Scheek I, Zwerver J. Risk factors for patellar tendinopathy: A systematic review of the literature. Br J Sports Med 2011; 45: 446-452
  • 29 van der Worp H, Zwerver J, Kuijer PP, Frings-Dresen MH, van den Akker-Scheek I. The impact of physically demanding work of basketball and volleyball players on the risk for patellar tendinopathy and on work limitations. J Back Musculoskelet Rehabil 2011; 24: 49-55
  • 30 Visnes H, Bahr R. Training volume and body composition as risk factors for developing jumper’s knee among young elite volleyball players. Scand J Med Sci Sports 2012; DOI: 10.1111/j.1600-0838.2011.01430.x.
  • 31 Visnes H, Bahr R. The evolution of eccentric training as treatment for patellar tendinopathy (jumper’s knee): A critical review of exercise programmes. Br J Sports Med 2007; 41: 217-223
  • 32 Witvrouw E, Bellemans J, Lysens R, Danneels L, Cambier D. Intrinsic risk factors for the development of patellar tendinitis in an athletic population – A two-year prospective study. Am J Sports Med 2001; 29: 190-195
  • 33 Yeow CH, Lee PV, Goh JC. Non-linear flexion relationships of the knee with the hip and ankle, and their relative postures during landing. Knee 2011; 18: 323-328
  • 34 Yu JS, Popp JE, Kaeding CC, Lucas J. Correlation of MR imaging and pathologic findings in athletes undergoing surgery for chronic patellar tendinitis. Am J Roentgenol 1995; 165: 115-118
  • 35 Zwerver J, Bredeweg SW, van den Akker-Scheek I. Prevalence of jumper’s knee among nonelite athletes from different sports: A cross-sectional survey. Am J Sports Med 2011; 39: 1984-1988