Region-Specific Tendon Properties and Patellar Tendinopathy: A Wider Understanding
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REVIEW ARTICLE
Region-Specific Tendon Properties and Patellar Tendinopathy: A Wider Understanding Stephen John Pearson • Syed Robiul Hussain
Ó Springer International Publishing Switzerland 2014
Abstract Patellar tendinopathy is a common painful musculoskeletal disorder with a very high prevalence in the athletic population that can severely limit or even end an athletic career. To date, the underlying pathophysiology leading to the condition remains poorly understood, although reports suggesting that patellar tendinopathy most frequently concerns the proximal posterior region of the tendon has prompted some researchers to examine regionspecific tendon properties for a better understanding of the etiology and potential risk factors associated with the condition. However, to date, research concerning the in vivo region-specific tendon properties in relation to patellar tendinopathy is very scarce, perhaps due to the lack of validated techniques that can determine such properties in vivo. In recent years, a technique has been developed involving an automated tendon-tracking program that appears to be very useful in the determination of regionspecific tendon properties in vivo. In terms of regional variations in tendon properties, previous research has demonstrated differences in structural, mechanical, and biochemical properties between the discrete regions of the patellar tendon, but the extent to which these regional variations contribute to patellar tendinopathy remains elusive. In addition, with respect to treatment strategies for patellar tendinopathy, previous research has utilized a wide range of interventions, but the use of eccentric exercise (EE) and/or heavy-slow resistance (HSR) training appear to be most promising. However, the optimal program design variables of EE and HSR training that induce the most favorable effects are yet to be determined. This review S. J. Pearson (&) S. R. Hussain Centre for Health, Sport and Rehabilitation Sciences Research, University of Salford, Manchester M6 6PU, UK e-mail: [email protected]
article provides a detailed discussion of all of the above to allow a better understanding of the etiology and potential risk factors associated with the condition as well as the most effective treatment strategies. First, a comprehensive literature review is provided with respect to region-specific structural, mechanical, and biochemical properties, in association with patellar tendinopathy. Second, the automated tendon-tracking methodology is outlined to assist future researchers in the determination of region-specific tendon properties. Finally, potential treatment strategies are discussed, particularly with regards to the use of EE and HSR training for the management of patellar tendinopathy.
1 Background Patellar tendinopathy is a common degenerative musculoskeletal disorder that affects athletes in a wide range of sports, particularly those associated with explosive jumping [1–3]. For instance, its prevalence has been reported to be 44.6 % in elite volleyball players [2
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