Patellar tendinopathy in young elite soccer– clinical and sonographical analysis of a German elite soccer academy

Abstract Background The prevalence of patellar tendinopathy is elevated in elite soccer compared to less explosive sports. While the burden of training hours and load is comparably high in youth elite players (age < 23 years), little is known about the prevalence of patellar tendinopathy at this...

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Main Authors: Gerrit Bode, Thorsten Hammer, N. Karvouniaris, M. J. Feucht, L. Konstantinidis, N. P. Südkamp, A. Hirschmüller
Format: Article
Language:English
Published: BMC 2017-08-01
Series:BMC Musculoskeletal Disorders
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12891-017-1690-2
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author Gerrit Bode
Thorsten Hammer
N. Karvouniaris
M. J. Feucht
L. Konstantinidis
N. P. Südkamp
A. Hirschmüller
author_facet Gerrit Bode
Thorsten Hammer
N. Karvouniaris
M. J. Feucht
L. Konstantinidis
N. P. Südkamp
A. Hirschmüller
author_sort Gerrit Bode
collection DOAJ
description Abstract Background The prevalence of patellar tendinopathy is elevated in elite soccer compared to less explosive sports. While the burden of training hours and load is comparably high in youth elite players (age < 23 years), little is known about the prevalence of patellar tendinopathy at this age. There is only little data available on the influence of age, the amount of training, the position on the field, as well as muscular strength, range of motion, or sonographical findings in this age group. The purpose of the present study was to examine the above-mentioned parameters in all age groups of a German youth elite soccer academy. Methods One hundred nineteen male youth soccer players (age 15,97 ± 2,24 years, height 174, 60 ± 10,16 cm, BMI 21, 24 ± 2,65) of the U-13 to U-23 teams were part of the study. Data acquisition included sport specific parameters such as footwear, amount of training hours, leg dominance, history of tendon pathologies, and clinical examination for palpatory pain, indurations, muscular circumference, and range of motion. Subjective complaints were measured with the Victorian Institute of Sport Assessment Patellar (VISA-P) Score. Furthermore, sonographical examinations (Aplio SSA-770A/80; Toshiba, Tokyo, Japan) with 12-MHz multifrequency linear transducers (8–14 MHz) of both patellar tendons were performed with special emphasis on hyper- and hypo echogenic areas, diameter and neovascularization. Results The prevalence of patellar tendinopathies was 13.4%. Seventy-five percent of the players complained of pain of their dominant leg with onset of pain at training in 87.5%. The injured players showed a medium amount of 10.34 ± 3.85 training hours and a medium duration of symptoms of 11.94 ± 18.75 weeks. Two thirds of players with patellar tendinopathy were at the age of 15–17 (Odds ratio 1.89) while no differences between players of the national or regional league were observed. In case of patellar tendinopathy, VISA-P was significantly lower in comparison to healthy players (mean ± SD 76.80 ± 28.56 points vs. 95.85 ± 10.37). The clinical examination revealed local pain at the distal patella, pain at stretching, and thickening of the patellar tendon (p = 0.02). The mean tendon diameter measured 2 cm distally to the patella was 4.10 ± 0.68 mm with a significantly increased diameter of 0.15 mm in case of an underlying tendinopathy (p = 0.00). The incidence of hypo-echogenic areas and neovascularizations was significantly elevated in players with patellar tendon syndrome (PTS) (p = 0.05). Conclusion The prevalence of patellar tendinopathy in youth elite soccer is relatively high in comparison to available data of adult players. Especially players at the age of 15 to 17 are at considerable risk. Tendon thickening, hypo-echogenic areas, and neovascularization are more common in tendons affected by PTS.
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spelling doaj.art-3e3b5c4faaad41feb31c8f958ccb5d742022-12-22T01:05:12ZengBMCBMC Musculoskeletal Disorders1471-24742017-08-011811710.1186/s12891-017-1690-2Patellar tendinopathy in young elite soccer– clinical and sonographical analysis of a German elite soccer academyGerrit Bode0Thorsten Hammer1N. Karvouniaris2M. J. Feucht3L. Konstantinidis4N. P. Südkamp5A. Hirschmüller6Freiburg University Hospital, Clinic of Orthopedic Surgery and TraumatologyFreiburg University Hospital, Clinic of Orthopedic Surgery and TraumatologyFreiburg University Hospital, Clinic of Orthopedic Surgery and TraumatologyFreiburg University Hospital, Clinic of Orthopedic Surgery and TraumatologyFreiburg University Hospital, Clinic of Orthopedic Surgery and TraumatologyFreiburg University Hospital, Clinic of Orthopedic Surgery and TraumatologyFreiburg University Hospital, Clinic of Orthopedic Surgery and TraumatologyAbstract Background The prevalence of patellar tendinopathy is elevated in elite soccer compared to less explosive sports. While the burden of training hours and load is comparably high in youth elite players (age < 23 years), little is known about the prevalence of patellar tendinopathy at this age. There is only little data available on the influence of age, the amount of training, the position on the field, as well as muscular strength, range of motion, or sonographical findings in this age group. The purpose of the present study was to examine the above-mentioned parameters in all age groups of a German youth elite soccer academy. Methods One hundred nineteen male youth soccer players (age 15,97 ± 2,24 years, height 174, 60 ± 10,16 cm, BMI 21, 24 ± 2,65) of the U-13 to U-23 teams were part of the study. Data acquisition included sport specific parameters such as footwear, amount of training hours, leg dominance, history of tendon pathologies, and clinical examination for palpatory pain, indurations, muscular circumference, and range of motion. Subjective complaints were measured with the Victorian Institute of Sport Assessment Patellar (VISA-P) Score. Furthermore, sonographical examinations (Aplio SSA-770A/80; Toshiba, Tokyo, Japan) with 12-MHz multifrequency linear transducers (8–14 MHz) of both patellar tendons were performed with special emphasis on hyper- and hypo echogenic areas, diameter and neovascularization. Results The prevalence of patellar tendinopathies was 13.4%. Seventy-five percent of the players complained of pain of their dominant leg with onset of pain at training in 87.5%. The injured players showed a medium amount of 10.34 ± 3.85 training hours and a medium duration of symptoms of 11.94 ± 18.75 weeks. Two thirds of players with patellar tendinopathy were at the age of 15–17 (Odds ratio 1.89) while no differences between players of the national or regional league were observed. In case of patellar tendinopathy, VISA-P was significantly lower in comparison to healthy players (mean ± SD 76.80 ± 28.56 points vs. 95.85 ± 10.37). The clinical examination revealed local pain at the distal patella, pain at stretching, and thickening of the patellar tendon (p = 0.02). The mean tendon diameter measured 2 cm distally to the patella was 4.10 ± 0.68 mm with a significantly increased diameter of 0.15 mm in case of an underlying tendinopathy (p = 0.00). The incidence of hypo-echogenic areas and neovascularizations was significantly elevated in players with patellar tendon syndrome (PTS) (p = 0.05). Conclusion The prevalence of patellar tendinopathy in youth elite soccer is relatively high in comparison to available data of adult players. Especially players at the age of 15 to 17 are at considerable risk. Tendon thickening, hypo-echogenic areas, and neovascularization are more common in tendons affected by PTS.http://link.springer.com/article/10.1186/s12891-017-1690-2Patellar tendinopathyJumper’s kneeSoccerYouth elite players
spellingShingle Gerrit Bode
Thorsten Hammer
N. Karvouniaris
M. J. Feucht
L. Konstantinidis
N. P. Südkamp
A. Hirschmüller
Patellar tendinopathy in young elite soccer– clinical and sonographical analysis of a German elite soccer academy
BMC Musculoskeletal Disorders
Patellar tendinopathy
Jumper’s knee
Soccer
Youth elite players
title Patellar tendinopathy in young elite soccer– clinical and sonographical analysis of a German elite soccer academy
title_full Patellar tendinopathy in young elite soccer– clinical and sonographical analysis of a German elite soccer academy
title_fullStr Patellar tendinopathy in young elite soccer– clinical and sonographical analysis of a German elite soccer academy
title_full_unstemmed Patellar tendinopathy in young elite soccer– clinical and sonographical analysis of a German elite soccer academy
title_short Patellar tendinopathy in young elite soccer– clinical and sonographical analysis of a German elite soccer academy
title_sort patellar tendinopathy in young elite soccer clinical and sonographical analysis of a german elite soccer academy
topic Patellar tendinopathy
Jumper’s knee
Soccer
Youth elite players
url http://link.springer.com/article/10.1186/s12891-017-1690-2
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