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Intrinsic Risk Factors for the Development of Patellar Tendinitis in an Athletic Population

A Two-Year Prospective Study

Erik Witvrouw, PT, PhD^,,, Johan Bellemans, MD, PhD, Roeland Lysens, MD, PhD, Lieven Danneels, PT and Dirk Cambier, PT, PhD

Department of Physical Therapy, Faculty of Medicine, University of Gent, Gent, Belgium
Faculty of Physical Therapy & Rehabilitation Sciences, Catholic University of Leuven, Leuven, Belgium

Presented at the 26th annual meeting of the AOSSM, Sun Valley, Idaho, June 2000.

Address correspondence and reprint requests to Erik Witvrouw, PT, PhD, Gent University Hospital, Faculty of Medicine, Department of Rehabilitation Sciences and Physiotherapy, De Pintelaan 185, 9000 Gent, Belgium

Retrospective studies have suggested various factors that might cause a disposition to develop patellar tendinitis, but no prospective data exist to determine any relationships. The purpose of this study was to determine the intrinsic risk factors for the development of patellar tendinitis in an athletic population. Before the study, 138 male and female students of physical education were evaluated for anthropometric variables, leg alignment characteristics, and muscle tightness and strength parameters. During the 2-year study, 19 of the 138 students developed patellar tendinitis. In all cases the diagnosis was confirmed by the presence of a hypoechogenic nodular lesion in the proximal region of the patellar tendon. Univariate and stepwise discriminant function analyses were performed comparing the various measurements. These analyses revealed that the only significant determining factor was muscular flexibility, with the patellar tendinitis patients being less flexible in the quadriceps and hamstring muscles (P < 0.05). The results of this study demonstrate that lower flexibility of the quadriceps and hamstring muscles may contribute to the development of patellar tendinitis in an athletic population. Therefore, the prevention of this condition in athletes should be focused on screening for and treating poor quadriceps and hamstring muscle flexibility.

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