Stay in the Game: Advanced Tendon Health Strategies for Volleyball Athletes

Patellar tendon health is essential for volleyball players. Knee issues, especially patellar tendinopathy (PT), are prevalent, affecting 14% of non-elite and 45% of elite athletes. Male players are nearly twice as likely to experience PT compared to female players. This condition can significantly hinder an athlete’s performance, making effective prevention crucial.

Study Insights

A study by Lucas Maciel Rabello, Hans Zwerver, Roy E. Stewart, Inge van den Akker-Scheek, and Michel Brink at the University Medical Center Groningen investigated the impact of training load on patellar tendon structure in volleyball players. Over a 7-week preseason, the study tracked 18 elite male players, analyzing training loads and tendon structure using Ultrasound Tissue Characterization (UTC).

Key Findings on Patellar Tendon Structure

Monitoring Training Load

Throughout the 7 weeks, researchers closely monitored training volume, jump frequency, and the players’ perceived exertion (RPE). On average, players spent 615 minutes per week on training and matches, with an RPE of 13.9 and a jump frequency of 269. Consequently, significant variations in weekly load parameters were observed, highlighting the importance of detailed load monitoring.

Tendon Structure Analysis

Using UTC, changes in patellar tendon structure were identified through four echo types, indicating different levels of tendon stability. Echo type I denotes the most stable structures, while echo type IV represents the least stable, amorphous structures.

Results

Tendon Response to Load

Higher weekly training volume and load led to a decrease in stable echo type I and an increase in less stable echo types on the dominant side. This finding suggests that patellar tendon structure adapts to increased load, potentially indicating early signs of tendinopathy. In contrast, the non-dominant side showed no significant changes.

Importance of Baseline and Load Variation

This study considered the variation in load over the study period and the baseline UTC measurement. This approach is crucial because changes in load might influence tendon structure and increase the risk of overuse injuries like PT. Additionally, the baseline measurement helps account for the tendon structure before preseason loading.

Practical Implications for Coaches and Medical Professionals

Tailored Training Programs

The findings highlight the need for individualized training programs. Monitoring both external and internal loads helps design training schedules that optimize tendon health and minimize the risk of tendinopathy. For example, even an extra training hour or set per week can significantly increase the risk of PT.

Early Detection and Prevention

UTC imaging provides a detailed view of tendon health, enabling early detection of maladaptive changes. Regular monitoring can prevent the progression of tendinopathy by adjusting training loads before significant damage occurs.

Study Limitations and Future Directions

The study included athletes with and without previous or current symptoms, which might affect the response to load. Also load performed the day before UTC measurements might influence results, although measurements were taken at the week’s start to minimize this. Future research should explore the impact of jump height and single- versus double-leg jumps on tendon load.

Enhancing Athlete Performance and Longevity

This study highlights how patellar tendon structure in volleyball players responds to training load. By integrating advanced imaging techniques like UTC, coaches and medical professionals can better manage tendon health, enhancing athletic performance and longevity. Understanding the factors contributing to PT and precise load monitoring can lead to more effective prevention and treatment strategies.