A Functional High-Load Exercise Intervention for the Patellar Tendon Reduces Tendon Pain Prevalence During a Competitive Season in Adolescent Handball Players
Imbalances of muscle strength and tendon stiffness may increase the risk for patellar tendinopathy in growing athletes. The present study investigated if a functional high-load exercise intervention, designed to facilitate tendon adaptation and reduce muscle-tendon imbalances, may prevent patellar t...
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Frontiers Media S.A.
2021-03-01
|
Series: | Frontiers in Physiology |
Subjects: | |
Online Access: | https://www.frontiersin.org/articles/10.3389/fphys.2021.626225/full |
id |
doaj-73913512e1704359884d651e27398874 |
---|---|
record_format |
Article |
spelling |
doaj-73913512e1704359884d651e273988742021-03-10T04:37:07ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2021-03-011210.3389/fphys.2021.626225626225A Functional High-Load Exercise Intervention for the Patellar Tendon Reduces Tendon Pain Prevalence During a Competitive Season in Adolescent Handball PlayersFalk Mersmann0Falk Mersmann1Gunnar Laube2Gunnar Laube3Robert Marzilger4Robert Marzilger5Sebastian Bohm6Sebastian Bohm7Arno Schroll8Arno Schroll9Adamantios Arampatzis10Adamantios Arampatzis11Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, GermanyBerlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, GermanyBerlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, GermanyBerlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, GermanyBerlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, GermanyBerlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, GermanyDepartment of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, GermanyBerlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, GermanyImbalances of muscle strength and tendon stiffness may increase the risk for patellar tendinopathy in growing athletes. The present study investigated if a functional high-load exercise intervention, designed to facilitate tendon adaptation and reduce muscle-tendon imbalances, may prevent patellar tendon pain in adolescent male handball players (12–14 years). Tendon pain prevalence (using VISA-P scores), knee extensor strength, vastus lateralis (VL) architecture and patellar tendon mechanical properties were measured at four measurement time points (M1–M4) over a season. The control group (CON; n = 18; age 13.1 ± 0.7 yrs, height 170 ± 8 cm, mass 58 ± 10 kg) followed the usual strength training plan, including muscular endurance and explosive strength components. In the experimental group (EXP; n = 16; 13.1 ± 0.6 yrs, 169 ± 11 cm, 58 ± 16 kg), two sessions per week with functional high-load exercises for the patellar tendon were integrated in the strength training schedule, aiming to provide repetitive high-intensity loading of at least 3 s loading duration per repetition. While in the control group 30% of the athletes reported a clinically significant aggravation of symptoms, all players in the experimental group remained or became pain-free at M2 until the end of the season. There was a similar increase of strength (normalized to body mass; CON: 3.1%, d = 0.22; EXP: 6.8%, d = 0.47; p = 0.04) and VL thickness (CON: 4.8%, d = 0.28; EXP: 5.7%, d = 0.32; p < 0.001) in both groups, but no significant changes of tendon stiffness or maximum tendon strain. Further, both groups demonstrated similar fluctuations of tendon strain over time. We conclude that functional high-load exercises can reduce the prevalence of patellar tendon pain in adolescent athletes even without a reduction of tendon strain.https://www.frontiersin.org/articles/10.3389/fphys.2021.626225/fulltendinopathypreventionmuscle-tendon imbalancematurationloading |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Falk Mersmann Falk Mersmann Gunnar Laube Gunnar Laube Robert Marzilger Robert Marzilger Sebastian Bohm Sebastian Bohm Arno Schroll Arno Schroll Adamantios Arampatzis Adamantios Arampatzis |
spellingShingle |
Falk Mersmann Falk Mersmann Gunnar Laube Gunnar Laube Robert Marzilger Robert Marzilger Sebastian Bohm Sebastian Bohm Arno Schroll Arno Schroll Adamantios Arampatzis Adamantios Arampatzis A Functional High-Load Exercise Intervention for the Patellar Tendon Reduces Tendon Pain Prevalence During a Competitive Season in Adolescent Handball Players Frontiers in Physiology tendinopathy prevention muscle-tendon imbalance maturation loading |
author_facet |
Falk Mersmann Falk Mersmann Gunnar Laube Gunnar Laube Robert Marzilger Robert Marzilger Sebastian Bohm Sebastian Bohm Arno Schroll Arno Schroll Adamantios Arampatzis Adamantios Arampatzis |
author_sort |
Falk Mersmann |
title |
A Functional High-Load Exercise Intervention for the Patellar Tendon Reduces Tendon Pain Prevalence During a Competitive Season in Adolescent Handball Players |
title_short |
A Functional High-Load Exercise Intervention for the Patellar Tendon Reduces Tendon Pain Prevalence During a Competitive Season in Adolescent Handball Players |
title_full |
A Functional High-Load Exercise Intervention for the Patellar Tendon Reduces Tendon Pain Prevalence During a Competitive Season in Adolescent Handball Players |
title_fullStr |
A Functional High-Load Exercise Intervention for the Patellar Tendon Reduces Tendon Pain Prevalence During a Competitive Season in Adolescent Handball Players |
title_full_unstemmed |
A Functional High-Load Exercise Intervention for the Patellar Tendon Reduces Tendon Pain Prevalence During a Competitive Season in Adolescent Handball Players |
title_sort |
functional high-load exercise intervention for the patellar tendon reduces tendon pain prevalence during a competitive season in adolescent handball players |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Physiology |
issn |
1664-042X |
publishDate |
2021-03-01 |
description |
Imbalances of muscle strength and tendon stiffness may increase the risk for patellar tendinopathy in growing athletes. The present study investigated if a functional high-load exercise intervention, designed to facilitate tendon adaptation and reduce muscle-tendon imbalances, may prevent patellar tendon pain in adolescent male handball players (12–14 years). Tendon pain prevalence (using VISA-P scores), knee extensor strength, vastus lateralis (VL) architecture and patellar tendon mechanical properties were measured at four measurement time points (M1–M4) over a season. The control group (CON; n = 18; age 13.1 ± 0.7 yrs, height 170 ± 8 cm, mass 58 ± 10 kg) followed the usual strength training plan, including muscular endurance and explosive strength components. In the experimental group (EXP; n = 16; 13.1 ± 0.6 yrs, 169 ± 11 cm, 58 ± 16 kg), two sessions per week with functional high-load exercises for the patellar tendon were integrated in the strength training schedule, aiming to provide repetitive high-intensity loading of at least 3 s loading duration per repetition. While in the control group 30% of the athletes reported a clinically significant aggravation of symptoms, all players in the experimental group remained or became pain-free at M2 until the end of the season. There was a similar increase of strength (normalized to body mass; CON: 3.1%, d = 0.22; EXP: 6.8%, d = 0.47; p = 0.04) and VL thickness (CON: 4.8%, d = 0.28; EXP: 5.7%, d = 0.32; p < 0.001) in both groups, but no significant changes of tendon stiffness or maximum tendon strain. Further, both groups demonstrated similar fluctuations of tendon strain over time. We conclude that functional high-load exercises can reduce the prevalence of patellar tendon pain in adolescent athletes even without a reduction of tendon strain. |
topic |
tendinopathy prevention muscle-tendon imbalance maturation loading |
url |
https://www.frontiersin.org/articles/10.3389/fphys.2021.626225/full |
work_keys_str_mv |
AT falkmersmann afunctionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT falkmersmann afunctionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT gunnarlaube afunctionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT gunnarlaube afunctionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT robertmarzilger afunctionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT robertmarzilger afunctionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT sebastianbohm afunctionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT sebastianbohm afunctionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT arnoschroll afunctionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT arnoschroll afunctionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT adamantiosarampatzis afunctionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT adamantiosarampatzis afunctionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT falkmersmann functionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT falkmersmann functionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT gunnarlaube functionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT gunnarlaube functionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT robertmarzilger functionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT robertmarzilger functionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT sebastianbohm functionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT sebastianbohm functionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT arnoschroll functionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT arnoschroll functionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT adamantiosarampatzis functionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers AT adamantiosarampatzis functionalhighloadexerciseinterventionforthepatellartendonreducestendonpainprevalenceduringacompetitiveseasoninadolescenthandballplayers |
_version_ |
1724227043515695104 |