Patellar Tendinopathy Risk Profiles and the Evidence for Treatment

Luciana presents her PhD study of jumping athletes, 59 with patellar tendinopathy and 133 without. CART analysis found a risk profile of moderate hip passive stiffness, higher foot varus alignment and weak hip external rotators, while the same variables with stronger hip external rotators formed a protective profile. The cutoff points lead directly to interventions: hip stiffness work, foot orthoses and hip external rotator strengthening. A tailored program for volleyball and basketball athletes, supported by warm-up banners, cut incidence by 51%. A 2019 systematic review of nine studies found only low to very low certainty evidence for exercise, dry needling and iontophoresis, and shock wave therapy was not better than control. A survey of 121 Brazilian sports physiotherapists is then compared against grades of recommendation from A to F, with quadriceps concentric, isometric and eccentric exercise best supported, and concern that many do not use concentric exercise. The class closes on combining evidence with clinical reasoning and considering the whole kinetic chain.