Medical results of preparticipation examination in adolescent athletes

Mayer, Frank; Bonaventura, Klaus; Cassel, Michael; Mueller, Steffen; Weber, Josefine; Scharhag-Rosenberger, Friederike; Carlsohn, Anja; Baur, Heiner; Scharhag, Juergen

doi:10.1136/bjsports-2011-090966

Cited by 30 publications

(22 citation statements)

References 38 publications

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“…The examinations of the Achilles tendons were investigated in a prone position with the feet hanging over the edge of the examination table with ankles passively flexed at 90°while the examination of patellar tendons were carried out in a supine position with 30°knee flexion. The thickness of both Achilles and Patella tendons was measured by use of longitudinal scans at a reference point of 2 cm proximal to the calcaneal insertion and 2 cm distal of the inferior patella pole (Cassel et al, 2012). Furthermore, the thickest part of the Achilles tendons "midportion area" was examined in a second longitudinal scan.…”

Section: Measurement Proceduresmentioning

confidence: 99%

Prevalence ofAchilles and patellar tendinopathy and their association to intratendinous changes in adolescent athletes

Cassel

Baur

Hirschmüller

et al. 2014

Scandinavian Med Sci Sports

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Achilles (AT) and patellar tendons (PT) are commonly affected by tendinopathy in adult athletes but prevalence of symptoms and morphological changes in adolescents is unclear. The study aimed to determine prevalence of tendinopathy and intratendinous changes in ATs and PTs of adolescent athletes. A total of 760 adolescent athletes (13.0 ± 1.9 years; 160 ± 13 cm; 50 ± 14 kg) were examined. History, local clinical examination, and longitudinal Doppler ultrasound analysis for both ATs and PTs were performed including identification of intratendinous echoic changes and vascularization. Diagnosis of tendinopathy was complied clinically in case of positive history of tendon pain and tendon pain on palpation. Achilles tendinopathy was diagnosed in 1.8% and patellar tendinopathy in 5.8%. Vascularizations were visible in 3.0% of ATs and 11.4% of PTs, hypoechogenicities in 0.7% and 3.2% as well as hyperechogenicities in 0% and 0.3%, respectively. Vascularizations and hypoechogenicities were statistically significantly more often in males than in females (P ≤ 0.02). Subjects with patellar tendinopathy had higher prevalence of structural intratendinous changes than those without PT symptoms (P ≤ 0.001). In adolescent athletes, patellar tendinopathy is three times more frequent compared with Achilles tendinopathy. Longitudinal studies are necessary to investigate physiological or pathological origin of vascularizations and its predictive value in development of tendinopathy.

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Section: Measurement Proceduresmentioning

confidence: 99%

Prevalence ofAchilles and patellar tendinopathy and their association to intratendinous changes in adolescent athletes

Cassel

Baur

Hirschmüller

et al. 2014

Scandinavian Med Sci Sports

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“…Preparticipation examinations and annual health examinations took place at the university outpatient clinic [27]. Examinations for recreational subjects were done in a secondary school nearby the university by use of the same portable ultrasound equipment.…”

Section: Measurement Proceduresmentioning

confidence: 99%

Tendon Adaptation to Sport-specific Loading in Adolescent Athletes

et al. 2015

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Tendon adaptation due to mechanical loading is controversially discussed. However, data concerning the development of tendon thickness in adolescent athletes is sparse. The purpose of this study was to examine possible differences in Achilles (AT) and patellar tendon (PT) thickness in adolescent athletes while considering age, gender and sport-specific loading. In 500 adolescent competitive athletes of 16 different sports and 40 recreational controls both ATs and PTs were sonographically measured. Subjects were divided into 2 age groups (< 13; ≥ 13 years) and 6 sport type categories (ball, combat, and water sports, combined disciplines, cycling, controls). In addition, 3 risk groups (low, moderate, high) were created according to the athlete's risk of developing tendinopathy. AT and PT thickness did not significantly differ between age groups (AT/PT:<13: 5.4±0.7 mm/3.6±0.5 mm;≥13: 5.3±0.7 mm/3.6±0.5 mm). In both age groups males presented higher tendon thickness than females (p<0.001). AT thickness was highest in ball sports/cyclists and lowest in controls (p≤0.002). PT thickness was greatest in water sports and lowest in controls (p=0.02). High risk athletes presented slightly higher AT thickness compared to the low risk group (p=0.03). Increased AT and PT thickness in certain sport types compared to controls supports the hypothesis of structural tendon adaptation due to sport-specific loading.

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“…In a preparticipation examination before entrance to an elite sports school, a total of 168 adolescent athletes were recruited [22]. In addition, 28 recreationally-active control subjects from a local secondary school were enrolled in the study.…”

Section: Participantsmentioning

confidence: 99%

“…Furthermore, the prevalence (M1) as well as the incidence (M2) of intratendinous alterations in adolescent elite athletes and recreationally-active controls was analyzed. Preparticipation (M1) and annual health examinations (M2) took place at the University Outpatient Clinic, Olympic Centre, responsible for adolescent athletes' medical care [3,22]. M2 took place either within annual health examinations or, in cases of an earlier acute orthopedic presentation of the athlete with AT or PT tendinopathy, to the Outpatient Clinic.…”

Section: Measurement Proceduresmentioning

confidence: 99%

Incidence of Achilles and Patellar Tendinopathy in Adolescent Elite Athletes

et al. 2018

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The study investigated the incidence of Achilles and patellar tendinopathy in adolescent elite athletes and non-athletic controls. Furthermore, predictive and associated factors for tendinopathy development were analyzed. The prospective study consisted of two measurement days (M1/M2) with an interval of 3.2±0.9 years. 157 athletes (12.1±0.7 years) and 25 controls (13.3±0.6 years) without Achilles/patellar tendinopathy were included at M1. Clinical and ultrasound examinations of both Achilles (AT) and patellar tendons (PT) were performed. Main outcome measures were incidence tendinopathy and structural intratendinous alterations (hypo-/hyperechogenicity, vascularization) at M2 [%]. Incidence of Achilles tendinopathy was 1% in athletes and 0% in controls. Patellar tendinopathy was more frequent in athletes (13%) than in controls (4%). Incidence of intratendinous alterations in ATs was 1-2% in athletes and 0% in controls, whereas in PTs it was 4-6% in both groups (p>0.05). Intratendinous alterations at M2 were associated with patellar tendinopathy in athletes (p≤0.01). Intratendinous alterations at M1, anthropometric data, training amount, sports or sex did not predict tendinopathy development (p>0.05). Incidence of tendinopathy and intratendinous alterations in adolescent athletes is low in ATs and more common in PTs. Development of intratendinous alterations in PT is associated with tendinopathy. However, predictive factors could not be identified.

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Medical results of preparticipation examination in adolescent athletes

Cited by 30 publications

References 38 publications

Prevalence ofAchilles and patellar tendinopathy and their association to intratendinous changes in adolescent athletes

Prevalence ofAchilles and patellar tendinopathy and their association to intratendinous changes in adolescent athletes

Tendon Adaptation to Sport-specific Loading in Adolescent Athletes

Incidence of Achilles and Patellar Tendinopathy in Adolescent Elite Athletes

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