M31972 Rehabilitation in Strength and Conditioning Assignment Sample 2023
1.0 Anatomy and Epidemiology of the injury
Patellar tendinopathy is the primary source of the anterior knee pains that is being characterized by the localized pain to the pole that is an inferiority of the patella. The pain is recognized by the loading and increasing with the demand on the musculature that is extended (Slane, L et al.2018)
. It is notable in the activities that releases and stores in the patellar tendon. The patellar tendinopathy is the basic or primary condition of young athletes, men, who are participating in sports like basketball, athletic jump, volleyball, football, tennis and so on. These types of sports needed repetitive loading of the patellar tendons. The prevalence of this particular condition is seen mostly in the active basketball and volleyball players. Some certain risk factors for the tendinopathy of patellar have been found in various studies. The risk factors are body mass index, weight, training load, gender and many other things that are related with the pressure on patellar (Breda, S. J., et al.2021)
. These particular types of muscles are also called quadriceps muscles. These muscles are connected to the inferior poles of the patellar by some of the common quadriceps tendons with a sesamoid bone of the particular patella. The ligament of the patella connects the bottom to the tibia tuberoses. The forces that are generated from the quadriceps muscles are acting to the patellar as the pulley and it causes the knees to extend. In this particular essay, the main reasons for the injuries, the causes that lead to these types of injuries would be discussed. The rehabilitation program for this particular injury would also be discussed throughout this project. The practical exercises that help to overcome the situations would be discussed throughout this particular project. Then, the guidelines for the players who are suffering from this particular injury having some effective guidelines that would help them to continue their playing in future would be discussed throughout this project.
2.0 The biochemical and physiological underpinnings
A healthy tendon that is mostly composed by the parallel collagen fibers that are packed together and very closely. Collagen is predominantly of the type 1. Some other components of the tendon are proteoglycans, elastin, and some inorganic components. The collagens of the tendon are held together with the components of proteoglycans like Aggrecan and Decorin. These two proteoglycan components help to bind the collagen fibers at some of the specific locations. The tenocytes are the special type of fibroblasts that are joined with the tendons that help to produce the molecules of collagens (Maciel Rabello, L., et al.2019)
. This particular type of tendon also helps to cluster together the formations of the fibrils of collagen. The bundles of fibrils are organized to form the special type of fibers with the tenocytes that are elongated. The cells of this particular thing also help to communicate with each other through the gaps of the junctions. This type of signal gives the abilities to tendons to detect and respond to the load that is mechanical also. Blood vessels run parallel to the fibers of collagen with the tendon and some of the branching transverse anastomosis. There are almost no nerves that supply to the internal tendons but are also adjacent with the tendons. These types of tendons are also helping in ending the response of some particular nerves (Bailey, L., et al. 2019)
. Some tendons are also presented in the junctions between the muscles and the tendons. There are some kind of pathological processes that help to overcome the injuries regarding the tendons. The pathological processes are the reactive tendinopathy, the disrepair of the tendons, the tendinopathy that is degenerative. Load is the primary or basic stimulus that helps to drive the health of the tendon forward and back along to the continued process. The reactive tendinopathy is one of the non-inflammatory proliferative processes or the response in the cells. This kind of injury occurs if the acute tensile is overloaded with pressures. The production of tenocytes and the protein are increased in this particular stage (Ristaniemi, A et al. 2018)
. This leads to the short term adaptation to the tendons in the thick tendons that helps to get the ultimate results of reducing the stresses by increasing the areas of cross sectional or to the areas of compressions. This particular process is completely different from the normal tendon responses of load that also occurs by the multiple suffering of the tendons. Clinically, this particular process happened sometimes with the unaccustomed physical activities. After the direct blows of the tendons like the direct falling of the patellar tendons. The continuous attempt of the tendons that are healing by following some necessary steps that are also reactive might be having greater breakdowns. The numbers of the tendon matrix have already increased the production of proteins. This process also helps to increase the separation and disorganization of collagens. There would be a type of vascular ties and neuronal growths (Coombes, B. K., et al. 2018)
. Clinically, this pathological process is chronically seen to be overloaded for the tendons and appears across the spectrum of the ages and it is also helpful in loading environments. There are some other areas that might also help in the areas of cell death and this particular process is known as the degenerative tendinopathy. The reasons for the death of cells are because of apoptosis, tenocyte exhaustions, traumas and many other things. The large areas of the matrix are being disordered and they are being filled with kinds of vessels, breakdown products, and little collagen. Tendons in this particular clinical process are having some few capacities for the irreversibility of the pathological changes in this particular stage. This particular stage is quite effective for the old age persons.
Along with all these biochemical underpinnings there are several types of physiological underpinnings that the patients who are being suffered from are having. The tenocytes are the special type of fibroblasts that are joined with the tendons that help to produce the molecules of collagens. This particular type of tendon also helps to cluster together the formations of the fibrils of collagen. The bundles of fibrils are organized to form the special type of fibers with the tenocytes that are elongated. The cells of this particular thing also help to communicate with each other through the gaps of the junctions. This type of signal gives the abilities to tendons to detect and respond to the load that is mechanical also. Blood vessels run parallel to the fibers of collagen with the tendon and some of the branching transverse anastomosis. There are almost no nerves that supply to the internal tendons but are also adjacent with the tendons (Schuette, H. B., et al. 2017)
. This leads to the short term adaptation to the tendons in the thick tendons that helps to get the ultimate results of reducing the stresses by increasing the areas of cross sectional or to the areas of compressions. This particular process is completely different from the normal tendon responses of load that also occurs by the multiple suffering of the tendons. Clinically, this particular process happened sometimes with the unaccustomed physical activities. After the direct blows of the tendons like the direct falling of the patellar tendons. The continuous attempt of the tendons that are healing by following some necessary steps that are also reactive might be having greater breakdowns. The tendinopathy of the patellar is one of the strongest diagnoses for the particular patients who are suffering from the severe knee pains. There are two types of clinical features that are very much important: the pain has to be localized to the inferior poles of the particular patellar. The second one is the leads that is related with the pain and during the time of increasing the pain with the demand on the extensors of knees are having the significant activities that helps to store and release the energies in the tendons of patellar. The patients who are suffering from these particular injuries might have various problems (Hunnicutt, J. L et al. 2019)
. This pathological process is chronically seen to be overloaded for the tendons and appears across the spectrum of the ages and it is also helpful in loading environments. There are some other areas that might also help in the areas of cell death and this particular process is known as the degenerative tendinopathy. The reasons for the death of cells are because of apoptosis, tenocyte exhaustions, traumas and many other things. The large areas of the matrix are being disordered and they are being filled with kinds of vessels, breakdown products, and little collagen. Tendons in this particular clinical process are having some few capacities for the irreversibility of the pathological changes in this particular stage. Patients are complaining that they are having pain during prolonged sitting, stairs, squatting and so on (Docking, S. I., et al. 2019)
. These types of complaints are featuring some other types of pathologies that are known as the patellofemoral pains. The pain is rarely experienced during the time of resting. Pain occurred instantly during the time of loading something, and in time of unloading the things pain ceased automatically but slowly. The pain might be improved with the repetitive loading (Alfredson, H. (2018)
. The most significant feature of the tendinopathies is that they are very much dependent on doses. The application process that is practical related to pain might increase when the situation is progressing from the swallow to the deeper squats or might be from the very smaller to greater heights.
3.0 An evidence based rehabilitation program
There are some diagnostic processes or procedures that could help the patients or people from suffering the patellar tendonitis. The first one that would be analyzed in this particular project would be the knee examinations. In this process the energy storage activities could be assessed clinically through the overall examination of jumping and hopping processes (Chen, W., et al. 2019)
. The extremity that is completely lower is significant to identify the relevant deficits of various different parts of the human body. The various different parts of the human body that can be affected by this process. The body parts are knees, hips, ankles, foot regions and so on. There are some other areas that might also help in the areas of cell death and this particular process is known as the degenerative tendinopathy. The reasons for the death of cells are because of apoptosis, tenocyte exhaustions, traumas and many other things (Steinberg, N., et al. 2021)
. The large areas of the matrix are being disordered and they are being filled with kinds of vessels, breakdown products, and little collagen. Tendons in this particular clinical process are having some few capacities for the irreversibility of the pathological changes in this particular stage. Patients are complaining that they are having pain during prolonged sitting, stairs, squatting and so on (Biedert, R. M., et al. 2017)
. These types of complaints are featuring some other types of pathologies that are known as the patellofemoral pains. The pain is rarely experienced during the time of resting. Imaging of patellar tendon does not show the appropriate results of the pain of patellar tendon. Through the pathologies and ultrasound imaging might be present in the asymptomatic individuals. The pain is recognized by the loading and increasing with the demand on the musculature that is extended. It is notable in the activities that releases and stores in the patellar tendon. The patellar tendinopathy is the basic or primary condition of young athletes, men, who are participating in sports like basketball, athletic jump, volleyball, football, tennis and so on (Ueno, H., et al. 2021)
. These types of sports needed repetitive loading of the patellar tendons. The prevalence of this particular condition are seen mostly in the active basketball and volleyball players. Some certain risk factors for the tendinopathy of patellar have been found in various studies. The risk factors are body mass index, weight, training load, gender and many other things that are related with the pressure on patellar. These particular types of muscles are also called quadriceps muscles. The provocation of pain, the swelling of tendons, willingness of the people for returning to the activities are some of the things that the things that helps the people to back into their world. Drugs that are necessary and important for these types of injuries should be non steroidal and anti inflammatory. It would remain controversial both in the chronic and acute stages. The scientists reported the best part of healing of the pain is the soft tissues (Taş, S., et al. 2020)
. A healthy tendon that is mostly composed by the parallel collagen fibers that are packed together and very closely. Collagen is predominantly of the type one. Some other components of the tendon are proteoglycans, elastin, and some inorganic components. The collagens of the tendon are held together with the components of proteoglycans like Aggrecan and Decorin. These two proteoglycan components help to bind the collagen fibers at some of the specific locations (Pearson, S. J., et al. 2017)
. The tenocytes are the special type of fibroblasts that are joined with the tendons that help to produce the molecules of collagens. This particular type of tendon also helps to cluster together the formations of the fibrils of collagen. The bundles of fibrils are organized to form the special type of fibers with the tenocytes that are elongated. Apart from this particular therapy there are some other therapies too. The therapies are the Corticosteroid injections, surgical treatment, treatment of physiotherapy, pain relief; rehabilitation programs, tendon neuron-plastic training, and differential diagnosis are the processes that help to overcome the injuries.
The injections that are above mentioned or the corticosteroids are used to decrease the pains and proliferations of the cells, production of proteins, reactive tendinopathies and so on. The corticosteroid has shown to be reduced down the diameter of tendon after the injections that are pushed in tendons. The surgical treatments are the surgeries for the patients who have painful tendons that are chronic with various outcomes, in which athletes are able to return to their sports with the previous levels (Leong, N. L., et al. 2020)
. Surgeries are considered as the responsible and reasonable options that are failed in the conservative interventions. The physiotherapy management system is also quite helpful in the fields of some specific injuries. This particular process allows the tendons to heal appropriately and have the time for the acute overloading or the exercises that are unaccustomed. These muscles are connected to the inferior poles of the patellar by some of the common quadriceps tendons with a seamed bone of the particular patella. The ligament of the patella connects the bottom to the tibia tuberoses. The forces that are generated from the quadriceps muscles are acting to the patellar as the pulley and it causes the knees to extend. In this particular essay, the main reasons for the injuries, the causes that lead to these types of injuries would be discussed. The rehabilitation program for this particular injury would also be discussed throughout this project. The practical exercises that help to overcome the situations would be discussed throughout this particular project. The physiotherapy management system also helps the athletes to return to the activities properly (Breda, S. J et al. 2020)
. The isometrics are suggested as the analgesic exercise that is possible for the places where isotonic exercises are not possible. Isotonic exercises are not possible everywhere because of fatigue and the high rate of SIN. The systematic reviews have confirmed that the isometric exercises are found to be superior and aerobic and also very much helpful as the exercise of resistance to reduce down the rate of the pain in muscle. The rehabilitation programs are also very important as the exercises are important and the component to reduce downs the pain. It is also very helpful in the management of tendinopathies of patellar. Different kinds of programs are being suggested by the doctors to treat the patella injuries (Lee, W. C., et al. 2020)
. The patellar tendinopathy is the basic or primary condition of young athletes, men, who are participating in sports like basketball, athletic jump, volleyball, football, tennis and so on. These types of sports needed repetitive loading of the patellar tendons. The prevalence of this particular condition are seen mostly in the active basketball and volleyball players. Some certain risk factors for the tendinopathy of patellar have been found in various studies. The risk factors are body mass index, weight, training load, gender and many other things that are related with the pressure on patellar. In this process the energy storage activities could be assessed clinically through the overall examination of jumping and hopping processes (Mascaró, A., et al. 2018)
. The extremity that is completely lower is significant to identify the relevant deficits of various different parts of the human body. The various different parts of the human body that can be affected by this process. The body parts are knees, hips, ankles, foot regions and sxo on. There are some other areas that might also help in the areas of cell death and this particular process is known as the degenerative tendinopathy. The reasons for the death of cells are because of apoptosis, tenocyte exhaustions, traumas and many other things. There are two types of rehabilitation programs namely, Eccentric loading and Eccentric concentric loading. The Eccentric loading has been one of the most dominant rehabilitation approaches that is also very much effective. With the help of all kinds of evidence it is proved that all kinds of loading programs are related to this particular injury (Hong, H. T., et al. 2020)
. Some type of rehabilitation programs are unrealistic and have time frames. This type of rehabilitation program has some characteristics and the characteristics are beliefs of inaccurate news, expectations of pain, recognition of the central sensitization, passive treatments, over reliance abilities. Along with all these positive sides of this type of rehabilitation program there are some negative sides also. The negative sides are that these programs could not recognize the muscle deficits that are isolated. This addresses the kinetic deficits of muscles and these types of programs do not adequately address biomechanics.
4.0 Practical exercise guides
Exercises that are included for this particular disease or to overcome this patellar tendonitis are some kind of leg extensions, pressing of legs, single squatting of legs, split squatting of legs and so on. If the patients who are suffering from patellar tendonitis are doing these types of exercises it would help them to recover from the injuries. Though all these exercises are effective for the patients, they are working very slowly. There are 2 types of exercises that can be used to overcome the injuries of patellar tendonitis. Stage 1 exercises are practiced during the complete days off and stage 2 exercises are being practiced during the rehabilitation programs for the patients. Some other exercises that could be done to overcome the patellar tendonitis are kneeling on one particular knee, with the other leg in a 90 degree angle in front. Leaning forward that refers to bending forward with the knee at front very slight and it should be done by the patient till the stretch is being felt from the hips of the patient to the knee. The stretch should be felt by the patient to the knee down of another leg (Nuhmani, S. (2020)
. These two exercises should be practiced by the patients and hold for thirty seconds. Patients should switch their legs while doing the particular exercises and do not give pressure to one particular leg. Apart from all these things, patients should take the pain killers or the pain relievers that must be prescribed by the expert or the doctors to reduce the pain. Some effective medicines that are prescribed by the doctors in most of the cases that are related to the pain are ibuprofen, naproxen sodium etc. the patients who are suffering from the patellar tendonitis should avoid the activities that lead to the pain. The patient might often be required to practice the sports temporarily and might switch to a sport that has less impact on pain. Patients should use ices or apply ices after the particular activities that cause some types of pain. The patients who are having pain continuously are recommended to continue the exercise at a normal level. If the patients are continuing their exercises and do not take any kind of rest the pain will increase and be more persistent (Stenroth, L., et al. 2019)
. The patients are also recommended by the doctors to take care of the patella and strengthen the knees like, squatting, as it helps to strengthen the quadriceps, hamstrings and gluts. Sit to stand, lunges, lifting something while keeping the legs straight, lifting something using the side portions of the legs, extensions with short arcs, step ups, calf raises and many other things. Step ups are the great things to maintain the strengths of knees, hamstrings and quadriceps. Calf raises are the kind of exercises that help to raise the stabilities and balances. Hamstring curls are the things that help to build the strengths, mobility and reduce the stiffness of the knee joint. The hip bridges are one of the common exercises that improve the alignment of the body, maintain the strengths and stabilities of the knees, hips, core muscles and gluts.
5.0 Return to play guidelines
Returning to play or the field related to sports might be different for each and every individual sport person. This is the thing that completely depends on the type or the characteristics of the sports, the level of participation of the sports person. For returning to the sports the athlete at first has to return to the participation of the sports. The patient has to be ready mentally, physically both for returning to the field again. The athlete who has returned to the sport might not target the earlier performance level from the very first. The athlete has returned to the sport and tries to perform gradually better than the level of pre-injury. Some things that the athlete or the patients who are suffering from the patellar tendonitis have to keep in mind are the safety of the player, the risk factors that are potential are the safety of the other members of the team, the capabilities of the player that are functional, the requirements of the sport from the players, the rules and regulations of the play and for the player who are already injured. There are some other factors that might also have the negative impacts or negative effects on the players as well as the team and the sport. The things are miscommunications, potential litigations, loss of trust and so on. Apart from these, other things that could also affect the sports are the decline in the rate of participation in the sports. Some people have fears of repetitive injuries that would lead to loss of lives. Some people are afraid of taking the risks to join the sports again. Some people might have some other medical complications that grow during the time of pain and the patella tendonitis. For returning to the sports again athletes should attend some small group programs as it would help the athletes to rehabilitate the entire process for the active mode after the surgery and injuries they are having with the lower portion of their body. The treatment of the patient or the sport persons should be customized on the basis of a team. It will help the athletes or the sports person to have motivations and positive environments for back to the field. The treatment of the athletes or the sport persons must include therapeutic exercises, balancing, coordination exercises, conditioning and strengths exercises, the manual therapies that might be include, dry needling, soft tissues mobility, motilities of joints, soft tissues mobilization based on the instruments and equipment that are medically proven and effective for the patients. The solutions of the factors of the athletes or the sport persons who are returning to the field of sports are that the athletes should be involved with the team entirely during the time of rehabilitation. The athletes should create the short term goals that they can attend in the way they are returning to the field again. This would seriously help the patient or the sport persons to feel that the progression is seriously ongoing and they are able to make it again. Last but not the least the mixing up of various kinds of exercises during the time of rehabilitation eradicates boredom of the players and helps to stimulate the motivations in the players.
References
Journal
Slane, L. C., Dandois, F., Bogaerts, S., Vandenneucker, H., & Scheys, L. (2018). Non-uniformity in the healthy patellar tendon is greater in males and similar in different age groups. Journal of biomechanics, 80, 16-22.
Retrieved from: https://www.sciencedirect.com/science/article/am/pii/S0021929018306882 [Retrieved on: 20.12.2021]
Breda, S. J., van der Vlist, A., de Vos, R. J., Krestin, G. P., & Oei, E. H. (2020). The association between patellar tendon stiffness measured with shear-wave elastography and patellar tendinopathy—a case-control study. European Radiology, 30, 5942-5951.
Retrieved from: https://link.springer.com/content/pdf/10.1007/s00330-020-06952-0.pdf [Retrieved on: 20.12.2021]
Maciel Rabello, L., Zwerver, J., Stewart, R. E., van den Akker‐Scheek, I., & Brink, M. S. (2019). Patellar tendon structure responds to load over a 7‐week preseason in elite male volleyball players. Scandinavian journal of medicine & science in sports, 29(7), 992-999.
Retrieved from: https://onlinelibrary.wiley.com/doi/pdf/10.1111/sms.13428 [Retrieved on: 20.12.2021]
Bailey, L., Griffin, J., Elliott, M., Wu, J., Papavasiliou, T., Harner, C., & Lowe, W. (2019). Adductor canal nerve versus femoral nerve blockade for pain control and quadriceps function following anterior cruciate ligament reconstruction with patellar tendon autograft: a prospective randomized trial. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 35(3), 921-929.
Retrieved from: https://www.grupodojoelho.com.br/img/uploads/revistas/1559828227-artigo%20junho.pdf [Retrieved on: 20.12.2021]
Ristaniemi, A., Stenroth, L., Mikkonen, S., & Korhonen, R. K. (2018). Comparison of elastic, viscoelastic and failure tensile material properties of knee ligaments and patellar tendon. Journal of biomechanics, 79, 31-38.
Retrieved from: https://erepo.uef.fi/bitstream/handle/123456789/7108/154081628087578838.pdf?sequence=2&isAllowed=n [Retrieved on: 20.12.2021]
Coombes, B. K., Tucker, K., Vicenzino, B., Vuvan, V., Mellor, R., Heales, L., … & Hug, F. (2018). Achilles and patellar tendinopathy display opposite changes in elastic properties: a shear wave elastography study. Scandinavian journal of medicine & science in sports, 28(3), 1201-1208.
Retrieved from: https://www.researchgate.net/profile/Kylie-Tucker/publication/320192287_Achilles_and_patellar_tendinopathy_display_opposite_changes_in_elastic_properties_A_shear_wave_elastography_study/links/5be0dbde4585150b2ba1ef0c/Achilles-and-patellar-tendinopathy-display-opposite-changes-in-elastic-properties-A-shear-wave-elastography-study.pdf [Retrieved on: 20.12.2021]
Schuette, H. B., Kraeutler, M. J., Houck, D. A., & McCarty, E. C. (2017). Bone–patellar tendon–bone versus hamstring tendon autografts for primary anterior cruciate ligament reconstruction: a systematic review of overlapping meta-analyses. Orthopaedic journal of sports medicine, 5(11), 2325967117736484.
Retrieved from: https://www.researchgate.net/profile/Jelle-Van-Der-List/publication/315511329_Technical_Considerations_for_Patellar_Tendon_Harvest/links/59dddf32a6fdcc276fbd2cb0/Technical-Considerations-for-Patellar-Tendon-Harvest.pdf [Retrieved on: 20.12.2021]
Hunnicutt, J. L., Gregory, C. M., McLeod, M. M., Woolf, S. K., Chapin, R. W., & Slone, H. S. (2019). Quadriceps recovery after anterior cruciate ligament reconstruction with quadriceps tendon versus patellar tendon autografts. Orthopaedic journal of sports medicine, 7(4), 2325967119839786.
Retrieved from: https://journals.sagepub.com/doi/pdf/10.1177/2325967119839786 [Retrieved on: 20.12.2021]
Docking, S. I., Rio, E., Cook, J., Carey, D., & Fortington, L. (2019). Quantification of Achilles and patellar tendon structure on imaging does not enhance ability to predict self-reported symptoms beyond grey-scale ultrasound and previous history. Journal of science and medicine in sport, 22(2), 145-150.
Retrieved from: https://david-carey.github.io/files/%5BJSAMS%5D%20Docking%20-%20Quantification%20of%20Achilles%20and%20patellar%20tendon%20structure%20on%20imaging%20does%20not%20enhance%20ability%20to%20predict%20self-reported%20symptoms.pdf [Retrieved on: 20.12.2021]
Alfredson, H. (2018). Achilles and patellar tendon operations performed in local anestesia. American journal of Anesthesiology and Pain medicine, 1(1), 001-002.
Retrieved from: https://www.diva-portal.org/smash/get/diva2:1273421/FULLTEXT02 [Retrieved on: 20.12.2021]
Chen, W., Li, H., Chen, Y., Jiang, F., Wu, Y., & Chen, S. (2019). Bone–Patellar Tendon–Bone Autografts Versus Hamstring Autografts Using the Same Suspensory Fixations in ACL Reconstruction: A Systematic Review and Meta-analysis. Orthopaedic journal of sports medicine, 7(11), 2325967119885314.
Retrieved from: https://journals.sagepub.com/doi/pdf/10.1177/2325967119885314 [Retrieved on: 20.12.2021]
Steinberg, N., Pantanowitz, M., Funk, S., Svorai Band, S., Waddington, G., Yavnai, N., & Zeev, A. (2021). Can Achilles and patellar tendon structures predict musculoskeletal injuries in combat soldiers?. Scandinavian Journal of Medicine & Science in Sports, 31(1), 205-214.
Retrieved from: https://www.researchgate.net/profile/Nili-Steinberg-2/publication/344128758_Can_Achilles_and_patellar_tendon_structures_predict_musculoskeletal_injuries_in_combat_soldiers/links/5f6df9f292851c14bc94f13e/Can-Achilles-and-patellar-tendon-structures-predict-musculoskeletal-injuries-in-combat-soldiers.pdf [Retrieved on: 20.12.2021]
Biedert, R. M., & Tscholl, P. M. (2017). Patella alta: a comprehensive review of current knowledge. Am J Orthop, 46(06), 290-300.
Retrieved from: https://cdn.mdedge.com/files/s3fs-public/Document/October-2017/ajo046060290.pdf [Retrieved on: 20.12.2021]
Ueno, H., Suga, T., Takao, K., Tanaka, T., Miyake, Y., Kusagawa, Y., … & Isaka, T. (2021). Association between patellar tendon moment arm and running performance in endurance runners. Physiological Reports, 9(15), e14981.
Retrieved from: https://physoc.onlinelibrary.wiley.com/doi/pdfdirect/10.14814/phy2.14981 [Retrieved on: 20.12.2021]
Taş, S., & Aktaş, D. (2020). Menstrual Cycle does not Affect the Mechanical Properties of Muscle and Tendon. Muscles, Ligaments & Tendons Journal (MLTJ), 10(1).
Retrieved from: https://www.researchgate.net/profile/Serkan-Tas/publication/339983271_Menstrual_Cycle_does_not_Affect_the_Mechanical_Properties_of_Muscle_and_Tendon/links/5e70d96da6fdcc2ddcfe2fad/Menstrual-Cycle-does-not-Affect-the-Mechanical-Properties-of-Muscle-and-Tendon.pdf [Retrieved on: 20.12.2021]
Pearson, S. J., Mohammed, A. S., & Hussain, S. R. (2017). Patellar tendon in vivo regional strain with varying knee angle. Journal of biomechanics, 61, 45-50.
Retrieved from: http://usir.salford.ac.uk/id/eprint/42907/1/JOB%20submission%20revised%203%20clean%20copy.pdf [Retrieved on: 20.12.2021]
Leong, N. L., Kator, J. L., Clemens, T. L., James, A., Enamoto‐Iwamoto, M., & Jiang, J. (2020). Tendon and ligament healing and current approaches to tendon and ligament regeneration. Journal of Orthopaedic Research®, 38(1), 7-12.
Retrieved from: https://onlinelibrary.wiley.com/doi/pdf/10.1002/jor.24475[Retrieved on: 20.12.2021]
Breda, S. J., Poot, D. H., Papp, D., de Vries, B. A., Kotek, G., Krestin, G. P., … & Oei, E. H. (2020). Tissue‐specific T2* biomarkers in patellar tendinopathy by subregional quantification using 3D ultrashort echo time MRI. Journal of Magnetic Resonance Imaging, 52(2), 420-430.
Retrieved from: https://onlinelibrary.wiley.com/doi/pdf/10.1002/jmri.27108 [Retrieved on: 20.12.2021]
Lee, W. C., Ng, G. Y. F., Zhang, Z. J., Malliaras, P., Masci, L., & Fu, S. N. (2020). Changes on tendon stiffness and clinical outcomes in athletes are associated with patellar tendinopathy after eccentric exercise. Clinical Journal of Sport Medicine, 30(1), 25-32.
Retrieved from: https://sportdoctorlondon.com/wp-content/uploads/2020/08/publish_changes_on_tendon_stiffness_and_clinical_outcomes.pdf [Retrieved on: 20.12.2021]
Mascaró, A., Cos, M. À., Morral, A., Roig, A., Purdam, C., & Cook, J. (2018). Load management in tendinopathy: Clinical progression for Achilles and patellar tendinopathy. Apunts. Medicina de l’Esport, 53(197), 19-27.
Retrieved from: http://fisiogenomica.com/assets/Blog/pdf/S1886658117300580_S300_en.pdf [Retrieved on: 20.12.2021]
Hong, H. T., Koh, Y. G., Nam, J. H., Kim, P. S., Kwak, Y. H., & Kang, K. T. (2020). Gender differences in patellar positions among the Korean population. Applied Sciences, 10(24), 8842.
Retrieved from: https://www.mdpi.com/2076-3417/10/24/8842/pdf [Retrieved on: 20.12.2021]
Nuhmani, S. (2020). Injection therapies for patellar tendinopathy. The Physician and sportsmedicine, 48(2), 125-130.
Retrieved from: https://www.researchgate.net/profile/Shibili-Nuhmani/publication/335955584_Injection_therapies_for_patellar_tendinopathy/links/5eee53db92851ce9e7f52d1d/Injection-therapies-for-patellar-tendinopathy.pdf [Retrieved on: 20.12.2021]
Stenroth, L., Sefa, S., Arokoski, J., & Töyräs, J. (2019). Does magnetic resonance imaging provide superior reliability for Achilles and Patellar tendon cross-sectional area measurements compared with ultrasound imaging?. Ultrasound in medicine & biology, 45(12), 3186-3198.
Retrieved from: https://helda.helsinki.fi/bitstream/handle/10138/330138/UMB_Stenroth_2019_1.pdf?sequence=1 [Retrieved on: 20.12.2021]
Know more about UniqueSubmission’s other writing services:
