Advertisement

Jumper’s knee mechanical consequences in professional basketball players: the “Camel’s Back curve”

  • Marc Dauty
  • Pierre Menu
  • Thomas Garraud
  • Olivier Mesland
  • Thibaud Berlivet
  • Benoit Metayer
  • Alban Fouasson-ChaillouxEmail author
Original Article

Abstract

Purpose

Jumper’s knee is characterized by an anterior knee pain during tendon palpation and can be classified in overuse pathologies, secondary to repetitive jumps. The prevalence is high in professional basketball players. It is responsible for an alteration of the motor control inducing a strength deficit of the quadriceps. We aimed to describe an isokinetic curve anomaly, a double-humped curve called “Camel’s Back curve”, consequence of a jumper’s knee history.

Methods

170 Professional basketball players were enrolled (24.8 ± 4.6 years; 91.8 ± 12.0 kg, 194 ± 9.0 cm). All players performed isokinetic tests of the knee extensors on a concentric mode at the angular speed of 60°/s and 180°/s.

Results

43 players had a jumper’s knee history and 35 (81%) had a “Camel’s Back curve” at 60°/s. The sensitivity and the specificity of this curve were 81.3% and 100%, respectively. The minimum torque of strength was decreased from 12 to 18% compared to the 2 maximal peaks. Yet, the strength measured every 5° of ROM was significantly different between the players with “Camel’s Back curve” and those with normal curve.

Conclusions

“Camel’s Back curve” had never been described in that context. It may be secondary to a protective inhibitory mechanism which could alter jumping. The presence of a “Camel’s Back curve” would enable clinicians to adapt physical preparation, knee rehabilitation, and trainings to improve players performances.

Keywords

Patellar tendon Jump Quadriceps Basketball Isokinetic 

Abbreviations

ANOVA

Analysis of variance

LSI

Limb symmetry index

PM&R

Physical medicine and rehabilitation

ROM

Range of motion

Notes

Author contributions

All authors conceived and designed the research protocol, read and approved the final manuscript. MD conducted experiments and analyzed the data. MD and AFC wrote the manuscript.

Compliance with ethical standards

Ethical approval

Applicable institutional and governmental regulations concerning ethics were followed during this research. The data report form was declared to the French data protection authority (Commission Nationale de l’Informatique et des Libertés) and to the Research Department of the University Hospital under the registration number RC18_0025. Since data were collected retrospectively and that patients’ management had not been modified, according to the French law, this study did not need to be approved by a research ethics committee (articles L.1121-1 paragraph 1 and R1121-2, Public Health code).

Conflict of interest

The authors have no conflict of interest to declare.

References

  1. Anderson G, Herrington L (2003) A comparison of eccentric isokinetic torque production and velocity of knee flexion angle during step down in patellofemoral pain syndrome patients and unaffected subjects. Clin Biomech Bristol Avon 18:500–504CrossRefGoogle Scholar
  2. Ayalon M, Barak Y, Rubinstein M (2002) Qualitative analysis of the isokinetic moment curve of the knee extensors. Isokinet Exerc Sci 10:145–151Google Scholar
  3. Bahr R, Holme I (2003) Risk factors for sports injuries—a methodological approach. Br J Sports Med 37:384–392CrossRefGoogle Scholar
  4. Balčiūnas M, Stonkus S, Abrantes C, Sampaio J (2006) Long term effects of different training modalities on power, speed, skill and anaerobic capacity in young male basketball players. J Sports Sci Med 5:163–170Google Scholar
  5. Blazina ME, Kerlan RK, Jobe FW et al (1973) Jumper’s knee. Orthop Clin North Am 4:665–678Google Scholar
  6. Boone J, Bourgois J (2013) Morphological and physiological profile of elite basketball players in Belgian. Int J Sports Physiol Perform 8:630–638CrossRefGoogle Scholar
  7. Chalmers G (2002) Do Golgi tendon organs really inhibit muscle activity at high force levels to save muscles from injury, and adapt with strength training? Sports Biomech 1:239–249.  https://doi.org/10.1080/14763140208522800 CrossRefGoogle Scholar
  8. Clarsen B, Myklebust G, Bahr R (2013) Development and validation of a new method for the registration of overuse injuries in sports injury epidemiology: the Oslo Sports Trauma Research Centre (OSTRC) overuse injury questionnaire. Br J Sports Med 47:495–502.  https://doi.org/10.1136/bjsports-2012-091524 CrossRefGoogle Scholar
  9. Cook JL, Purdam CR (2009) Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med 43:409–416.  https://doi.org/10.1136/bjsm.2008.051193 CrossRefGoogle Scholar
  10. Cook JL, Khan KM, Kiss ZS et al (2001) Asymptomatic hypoechoic regions on patellar tendon ultrasound: a 4-year clinical and ultrasound followup of 46 tendons. Scand J Med Sci Sports 11:321–327CrossRefGoogle Scholar
  11. Cook JL, Rio E, Purdam CR, Docking SI (2016) Revisiting the continuum model of tendon pathology: what is its merit in clinical practice and research? Br J Sports Med 50:1187–1191.  https://doi.org/10.1136/bjsports-2015-095422 CrossRefGoogle Scholar
  12. Croisier JL, Crielaard JM (1999) Exploration isocinétique: analyse des courbes. Ann Réadapt Méd Phys 42:497–502.  https://doi.org/10.1016/S0168-6054(00)87704-1 CrossRefGoogle Scholar
  13. Dauty M, Dupré M, Potiron-Josse M, Dubois C (2007) Identification of mechanical consequences of jumper’s knee by isokinetic torque measurement in elite basketball players. Isokinet Exerc Sci 15:37–41CrossRefGoogle Scholar
  14. Drouin JM, Valovich-mcLeod TC, Shultz SJ et al (2004) Reliability and validity of the Biodex system 3 pro isokinetic dynamometer velocity, torque and position measurements. Eur J Appl Physiol 91:22–29.  https://doi.org/10.1007/s00421-003-0933-0 CrossRefGoogle Scholar
  15. Dvir Z (1991) Clinical applicability of isokinetics: a review. Clin Biomech Bristol Avon 6:133–144.  https://doi.org/10.1016/0268-0033(91)90024-K CrossRefGoogle Scholar
  16. Dvir Z, Halperin N (1992) Patellofemoral pain syndrome: a preliminary model for analysis and interpretation of isokinetic and pain parameters. Clin Biomech Bristol Avon 7:240–246.  https://doi.org/10.1016/S0268-0033(92)90007-Q CrossRefGoogle Scholar
  17. Dvir Z, Shklar A, Halperin N et al (1990) Concentric and eccentric torque variations of the quadriceps femoris in patellofemoral pain syndrome. Clin Biomech Bristol Avon 5:68–72.  https://doi.org/10.1016/0268-0033(90)90040-D CrossRefGoogle Scholar
  18. Gisslèn K, Gyulai C, Söderman K, Alfredson H (2005) High prevalence of jumper’s knee and sonographic changes in Swedish elite junior volleyball players compared to matched controls. Br J Sports Med 39:298–301.  https://doi.org/10.1136/bjsm.2004.014290 CrossRefGoogle Scholar
  19. Grace TG, Sweetser ER, Nelson MA et al (1984) Isokinetic muscle imbalance and knee-joint injuries. A prospective blind study. J Bone Jt Surg Am 66:734–740CrossRefGoogle Scholar
  20. Hadzić V, Erculj F, Bracic M, Dervisević E (2013) Bilateral concentric and eccentric isokinetic strength evaluation of quadriceps and hamstrings in basketball players. Coll Antropol 37:859–865Google Scholar
  21. Impellizzeri FM, Bizzini M, Rampinini E et al (2008) Reliability of isokinetic strength imbalance ratios measured using the Cybex NORM dynamometer. Clin Physiol Funct Imaging 28:113–119.  https://doi.org/10.1111/j.1475-097X.2007.00786.x CrossRefGoogle Scholar
  22. Köklü Y, Alemdaroğlu U, Koçak F et al (2011) Comparison of chosen physical fitness characteristics of Turkish professional basketball players by division and playing position. J Hum Kinet 30:99–106.  https://doi.org/10.2478/v10078-011-0077-y CrossRefGoogle Scholar
  23. Lian OB, Engebretsen L, Bahr R (2005) Prevalence of jumper’s knee among elite athletes from different sports: a cross-sectional study. Am J Sports Med 33:561–567.  https://doi.org/10.1177/0363546504270454 CrossRefGoogle Scholar
  24. Metaxas TI, Koutlianos N, Sendelides T, Mandroukas A (2009) Preseason physiological profile of soccer and basketball players in different divisions. J Strength Cond Res 23:1704–1713.  https://doi.org/10.1519/JSC.0b013e3181b3e0c5 CrossRefGoogle Scholar
  25. Mileusnic MP, Loeb GE (2009) Force estimation from ensembles of Golgi tendon organs. J Neural Eng 6:036001.  https://doi.org/10.1088/1741-2560/6/3/036001 CrossRefGoogle Scholar
  26. Nordgren B, Nordesjö LO, Rauschning W (1983) Isokinetic knee extension strength and pain before and after advancement osteotomy of the tibial tuberosity. Arch Orthop Trauma Surg Arch Orthopadische Unf-Chir 102:95–101CrossRefGoogle Scholar
  27. Rauschning W, Nordesjö LO, Nordgren B (1983) Isokinetic knee extension strength and pain before and after correction of recurrent patellar dislocation. Arch Orthop Trauma Surg Arch Orthopadische Unf-Chir 102:102–106CrossRefGoogle Scholar
  28. Rio E, Kidgell D, Moseley GL et al (2016) Tendon neuroplastic training: changing the way we think about tendon rehabilitation: a narrative review. Br J Sports Med 50:209–215.  https://doi.org/10.1136/bjsports-2015-095215 CrossRefGoogle Scholar
  29. Rochcongar P (2004) Isokinetic thigh muscle strength in sports: a review. Ann Readaptation Med Phys Rev Sci Soc Francaise Reeducation Fonct Readaptation Med Phys 47:274–281.  https://doi.org/10.1016/j.annrmp.2004.05.013 Google Scholar
  30. Rosso F, Bonasia DE, Cottino U et al (2015) Patellar tendon: From tendinopathy to rupture. Asia-Pac J Sports Med Arthrosc Rehabil Technol 2:99–107.  https://doi.org/10.1016/j.asmart.2015.07.001 Google Scholar
  31. Rudavsky A, Cook J (2014) Physiotherapy management of patellar tendinopathy (jumper’s knee). J Physiother 60:122–129.  https://doi.org/10.1016/j.jphys.2014.06.022 CrossRefGoogle Scholar
  32. Schiltz M, Lehance C, Maquet D et al (2009) Explosive strength imbalances in professional basketball players. J Athl Train 44:39–47.  https://doi.org/10.4085/1062-6050-44.1.39 CrossRefGoogle Scholar
  33. Van der Worp H, de Poel HJ, Diercks RL et al (2014) Jumper’s knee or lander’s knee? A systematic review of the relation between jump biomechanics and patellar tendinopathy. Int J Sports Med 35:714–722.  https://doi.org/10.1055/s-0033-1358674 CrossRefGoogle Scholar
  34. Van der Worp H, van der Does HTD, Brink MS et al (2016) Prospective study of the relation between landing biomechanics and jumper’s knee. Int J Sports Med 37:245–250.  https://doi.org/10.1055/s-0035-1555858 Google Scholar
  35. Visentini PJ, Khan KM, Cook JL et al (1998) The VISA score: an index of severity of symptoms in patients with jumper’s knee (patellar tendinosis). Victorian Institute of Sport Tendon Study Group. J Sci Med Sport 1:22–28CrossRefGoogle Scholar
  36. Visnes H, Aandahl H, Bahr R (2013) Jumper’s knee paradox–jumping ability is a risk factor for developing jumper’s knee: a 5-year prospective study. Br J Sports Med 47:503–507.  https://doi.org/10.1136/bjsports-2012-091385 CrossRefGoogle Scholar
  37. Visnes H, Tegnander A, Bahr R (2015) Ultrasound characteristics of the patellar and quadriceps tendons among young elite athletes. Scand J Med Sci Sports 25:205–215.  https://doi.org/10.1111/sms.12191 CrossRefGoogle Scholar
  38. Zakas A, Mandroukas K, Vamvakoudis E et al (1995) Peak torque of quadriceps and hamstring muscles in basketball and soccer players of different divisions. J Sports Med Phys Fitness 35:199–205Google Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Physical Medicine and Rehabilitation DepartmentCHU Nantes, Hôpital Saint JacquesNantes Cedex 03France
  2. 2.Sports Medicine DepartmentCHU Nantes, Hôpital Saint JacquesNantes Cedex 03France
  3. 3.Inserm, UMR 1229, RMeS, Regenerative Medicine and SkeletonUniversité de Nantes, ONIRISNantesFrance
  4. 4.Rheumatologic DepartmentCHU NantesNantes CedexFrance
  5. 5.MPR Locomotrice et Respiratoire, CHU de NantesHôpital St JacquesNantes Cedex 1France

Personalised recommendations