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Measurements of kinetic and dynamic changes in the lower extremities during volleyball spike and block jumps were made in order to predict patellar tendinitis in elite volleyball players. The study group consisted of ten members of the Canadian Men's National Volleyball Team, mean age 23.2 years. All were right handed and performed spikes with their right hands. They were given medical interviews and physical examinations focusing on detecting patellar tendinitis. They performed a series of simulated volleyball spike and block jumps while on a force platform. High speed video recordings were made of the lower extremities to which reflective markers were attached. Motions of the hips, knees, and ankles were determined from the tapes. Ground reaction forces generated during the jump takeoffs and landings and the contact/foot center of pressure were recorded. The data were used to calculate the maximum vertical ground reaction force and its time derivative, the knee flexion/extension moment and its time derivative, the knee adduction (varus) moment, the knee abduction (valgus) moment, the internal and external torsional moments about the longitudinal axis of the tibia, the knee flexion angle, the knee adduction (varus) angle, the knee abduction (valgus) angle, and the tibial internal and external rotation angles. Associations between the kinematic and dynamic parameters and the risk of developing patellar tendinitis, dichotomously expressed as existing patellar tendon pain versus no pain, were assessed by logistic regression techniques. Six volleyball players had a history of patellar tendinitis which was clinically confirmed in three cases. Vertical ground reaction forces during the take/off phase of both spike and block jumps predicted the presence or absence of patellar tendinitis in the right knee of eight of the 10 players. The peak vertical ground reaction force of the right limb during the block jump take/off predicted the presence or absence of patellar tendinitis of the right limb in nine subjects. The maximum angle for left knee flexion during the spike jump landing correctly predicted the presence or absence of patellar tendinitis of the left knee of all ten subjects. The authors conclude that in this group of elite volleyball players, high forces and loading rates in the knee extensor mechanism combined with large external tibial torsional moments and deep knee flexion angles are significant risk factors for patellar tendinitis.
American Journal of Sports Medicine, 24(5):676-683, 1996. (48 references)
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