Interventions for prevention and in-season management of patellar tendinopathy in athletes: A scoping review

Burton, Ian

doi:10.1016/j.ptsp.2022.03.002

Cited by 10 publications

(7 citation statements)

References 72 publications

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“…The three groups similarly improving their pain over time, both at rest (before and after intervention) and during a functional provocative test, might reflect different effects. On the one hand, these findings might only indicate a direct positive effect of eccentric exercise on tendon pain, as previously reported ( 29 ). Furthermore, it is unlikely that there was no effect at all from the PNE intervention on pain, as previous studies have found a pain reduction effect in tendinopathies ( 18 ).…”

Section: Discussionsupporting

confidence: 66%

Placebo and nocebo effects of percutaneous needle electrolysis and dry-needling: an intra and inter-treatment sessions analysis of a three-arm randomized double-blinded controlled trial in patients with patellar tendinopathy

Doménech-García,

Pecos-Martín,

Blasco-Abadía

et al. 2024

Front. Med.

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ObjectiveThis study aimed to investigate the influence of potential placebo and nocebo effects on pain perception of percutaneous needle electrolysis (PNE) in individuals with patellar tendinopathy.MethodsIn this secondary analysis of a three-arm randomized double-blinded controlled trial, intra and inter-session pain perception data from 48 sporting participants with patellar tendinopathy between 18 and 45 years were investigated. Participants were divided into 3 parallel groups: “no-sham group” [PNE intervention], “single-sham group” [sham PNE by using dry needling], and “double-sham group” [sham PNE by using sham needles]. Every group received 4 sessions of the needling therapies targeting the patellar tendon over 8 weeks and was instructed to perform a unilateral eccentric exercise program of the quadriceps muscle on the affected side. Clinical and needle-related pain was assessed before, during, and after each treatment session using a visual analog scale.ResultsNo differences were found between groups intra- or inter-session in terms of pain reduction (P = 0.424) despite clinical pain decreased in all groups since the first treatment session (P < 0.001). Furthermore, although the double-sham group showed a lower percentage of participants reporting needle-related pain during needle intervention (P = 0.005), the needle-related pain intensity after needle intervention was similar between groups (P = 0.682). Moreover, there were no group differences for the duration of pain sensation after any needle intervention (P = 0.184), extending in many cases beyond 24 h.ConclusionNeedling therapies for individuals with patellar tendinopathy are prone to elicit placebo effects regarding clinical pain and nocebo effects regarding needling-related pain. Clinicians and physical therapists treating musculoskeletal pain conditions should consider the added value and potential mechanisms of action before routinely using needle techniques.

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Section: Discussionsupporting

confidence: 66%

Placebo and nocebo effects of percutaneous needle electrolysis and dry-needling: an intra and inter-treatment sessions analysis of a three-arm randomized double-blinded controlled trial in patients with patellar tendinopathy

Doménech-García,

Pecos-Martín,

Blasco-Abadía

et al. 2024

Front. Med.

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“…The three groups similarly improving their pain over time, both at rest (before and after intervention) and during a functional provocative test, might reflect different effects. On the one hand, these findings might only indicate a direct positive effect of eccentric exercise on tendon pain, as previously reported (29). Furthermore, it is unlikely that there was no effect at all from the PNE intervention on pain, as previous studies have found a pain reduction effect in tendinopathies (18).…”

Section: Contextual Effects In Clinical Tendon Painsupporting

confidence: 49%

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“…The single-leg decline squat is the most common exercise used at the beginning of rehabilitation to treat patellar tendinopathy patients (8)(9)(10)(11)(12)(13)(14). Some authors even consider the eccentric training, using the single-leg decline squat, the gold standard first-line management approach for patellar tendinopathy, mostly due to this exercise having the largest body of evidence supporting its effects (41,42). However, several authors have shown that improvements in pain and function in tendinopathy patients occur with progressive loading protocols regardless of contraction type (11,15,18,19), and there is no convincing evidence that isolated eccentric exercises are superior to other loading therapies (15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

Patellar Tendon Load Progression during Rehabilitation Exercises: Implications for the Treatment of Patellar Tendon Injuries

SCATTONE SILVA,

SONG,

HULLFISH

et al. 2023

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose To evaluate patellar tendon loading profiles (loading index, based on loading peak, loading impulse, and loading rate) of rehabilitation exercises to develop clinical guidelines to incrementally increase the rate and magnitude of patellar tendon loading during rehabilitation. Methods Twenty healthy adults (10 females/10 males, 25.9 ± 5.7 years) performed 35 rehabilitation exercises, including different variations of squats, lunge, jumps, hops, landings, running, and sports specific tasks. Kinematic and kinetic data were collected and a patellar tendon loading index was determined for each exercise using a weighted sum of loading peak, loading rate, and cumulative loading impulse. Then, the exercises were ranked, according to the loading index, into tier 1 (loading index≤0.33), tier 2 (0.33 < loading index<0.66), and tier 3 (loading index≥0.66). Results The single-leg decline squat showed the highest loading index (0.747). Other tier 3 exercises included single-leg forward hop (0.666), single-leg countermovement jump (0.711), and running cut (0.725). The Spanish squat was categorized as a tier 2 exercise (0.563), as was running (0.612), double-leg countermovement jump (0.610), single-leg drop vertical jump (0.599), single-leg full squat (0.580), double-leg drop vertical jump (0.563), lunge (0.471), double-leg full squat (0.428), single-leg 60° squat (0.411), and the Bulgarian squat (0.406). Tier 1 exercises included 20 cm step up (0.187), 20 cm step down (0.288), 30 cm step up (0.321), and double-leg 60° squat (0.224). Conclusions Three patellar tendon loading tiers were established based on a combination of loading peak, loading impulse, and loading rate. Clinicians may use these loading tiers as a guide to progressively increase patellar tendon loading during the rehabilitation of patients with patellar tendon disorders and after anterior cruciate ligament reconstruction using the bone patellar tendon bone graft.

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Interventions for prevention and in-season management of patellar tendinopathy in athletes: A scoping review

Cited by 10 publications

References 72 publications

Placebo and nocebo effects of percutaneous needle electrolysis and dry-needling: an intra and inter-treatment sessions analysis of a three-arm randomized double-blinded controlled trial in patients with patellar tendinopathy

Placebo and nocebo effects of percutaneous needle electrolysis and dry-needling: an intra and inter-treatment sessions analysis of a three-arm randomized double-blinded controlled trial in patients with patellar tendinopathy

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Patellar Tendon Load Progression during Rehabilitation Exercises: Implications for the Treatment of Patellar Tendon Injuries

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