Mersmann Falk, Laube Gunnar, Marzilger Robert, Bohm Sebastian, Schroll Arno, Arampatzis Adamantios
Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Berlin, Germany.
Berlin School of Movement Science, Humboldt-Universität zu Berlin, Berlin, Germany.
Front Physiol. 2021 Mar 10;12:626225. doi: 10.3389/fphys.2021.626225. eCollection 2021.
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; = 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; = 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%, = 0.22; EXP: 6.8%, = 0.47; = 0.04) and VL thickness (CON: 4.8%, = 0.28; EXP: 5.7%, = 0.32; < 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.
肌肉力量和肌腱刚度的失衡可能会增加成长中的运动员患髌腱病的风险。本研究调查了一种旨在促进肌腱适应并减少肌肉 - 肌腱失衡的功能性高负荷运动干预措施，是否可以预防青少年男性手球运动员（12 - 14岁）的髌腱疼痛。在一个赛季的四个测量时间点（M1 - M4）测量了肌腱疼痛患病率（使用VISA - P评分）、膝关节伸肌力量、股外侧肌（VL）结构和髌腱力学性能。对照组（CON；n = 18；年龄13.1±0.7岁，身高170±8厘米，体重58±10千克）遵循常规力量训练计划，包括肌肉耐力和爆发力训练部分。实验组（EXP；n = 16；13.1±0.6岁，169±11厘米，58±16千克）在力量训练计划中每周整合两次针对髌腱的功能性高负荷运动，旨在每次重复提供至少3秒加载持续时间的重复性高强度负荷。对照组中有30%的运动员报告症状出现临床上显著加重，而实验组的所有运动员在M2时直至赛季结束都保持无痛或疼痛消失。两组的力量（按体重归一化；CON：3.1%，p = 0.22；EXP：6.8%，p = 0.47；p = 0.04）和VL厚度（CON：4.8%，p = 0.28；EXP：5.7%，p = 0.32；p < 0.001）均有相似的增加，但肌腱刚度或最大肌腱应变无显著变化。此外，两组的肌腱应变随时间均呈现相似的波动。我们得出结论，功能性高负荷运动可以降低青少年运动员髌腱疼痛的患病率，即使肌腱应变没有降低。
