Cuddeford Tyler, Brumitt Jason
College of Physical Therapy, George Fox University, Newberg, OR, USA.
Int J Sports Phys Ther. 2020 Dec;15(6):1184-1195. doi: 10.26603/ijspt20201184.
Patellar tendinopathy is an overuse injury experienced primarily by athletes; especially athletes who participate in sports that involve frequent jumping. Therapeutic exercise is the primary conservative treatment for patients with this condition. However, some patients with patellar tendinopathy may be unable to tolerate the loading that occurs during exercise. The use of blood flow restriction (BFR) therapy for patients with patellar tendinopathy may allow the athlete to exercise with a lower load while still experiencing the physiological benefits associated with training at a higher intensity. The purpose of this case report was to detail the outcomes from a rehabilitation program utilizing BFR for two collegiate decathletes with patellar tendinopathy.
Case ReportCase Descriptions and Interventions: Two NCAA Division III freshmen collegiate decathletes with a history of left knee pain prior to college and who had been complaining of increasing pain during the initial month of track practices. Findings from the musculoskeletal examinations included left sided lower extremity weakness, pain during functional testing, pain when palpating the left patellar tendon, and VISA-P scores less than 80. Ultrasound imaging at baseline revealed thickened tendons on the left with hypoechoic regions. Both athletes participated in 20 therapy sessions consisting of therapeutic exercises performed with BFR.
Both athletes experienced improvements in pain scores, increases in lower extremity strength, improved functional test performance, higher VISA-P scores, and improvements in tendon size and appearance as measured by diagnostic ultrasound.
Both athletes experienced improvements with the BFR-based therapeutic exercise program and were able to compete throughout the track season. The use of BFR may allow patients who are unable to tolerate exercise due to pain an alternative approach during rehabilitation. Future research should compare therapeutic exercise programs for this condition with and without BFR.
Level V.
髌腱炎是一种主要发生在运动员身上的过度使用性损伤，尤其是那些参加频繁跳跃运动的运动员。治疗性运动是这种疾病患者的主要保守治疗方法。然而，一些髌腱炎患者可能无法耐受运动过程中产生的负荷。对髌腱炎患者使用血流限制（BFR）疗法，可能使运动员能够以较低负荷进行运动，同时仍能获得与高强度训练相关的生理益处。本病例报告的目的是详细介绍一项针对两名患有髌腱炎的大学十项全能运动员采用BFR的康复计划的结果。
病例报告
两名美国大学体育协会（NCAA）第三分部的大学新生十项全能运动员，在大学之前有左膝疼痛病史，且在田径训练的第一个月一直抱怨疼痛加剧。肌肉骨骼检查结果包括左侧下肢无力、功能测试时疼痛、触诊左髌腱时疼痛以及VISA-P评分低于80分。基线超声成像显示左侧肌腱增厚并有低回声区域。两名运动员都参加了20次治疗课程，包括在BFR状态下进行的治疗性运动。
两名运动员在疼痛评分、下肢力量增加、功能测试表现改善、VISA-P评分提高以及通过诊断超声测量的肌腱大小和外观改善等方面均有改善。
两名运动员通过基于BFR的治疗性运动计划均有改善，并能够在整个田径赛季中参赛。BFR的使用可能为因疼痛而无法耐受运动的患者在康复过程中提供一种替代方法。未来的研究应该比较有和没有BFR的针对这种疾病的治疗性运动计划。
V级
