Low range of ankle dorsiflexion predisposes for patellar tendinopathy in junior elite basketball players: a 1-year prospective study.

Backman LJ1, Danielson P.

Abstract

BACKGROUND:

Patellar tendinopathy (PT) is one of the most common reasons for sport-induced pain of the knee. Low ankle dorsiflexion range might predispose for PT because of load-bearing compensation in the patellar tendon.

PURPOSE:

The purpose of this 1-year prospective study was to analyze if a low ankle dorsiflexion range increases the risk of developing PT for basketball players.

STUDY DESIGN:

Cohort study (prognosis); Level of evidence, 2.

METHODS:

Ninety junior elite basketball players were examined for different characteristics and potential risk factors for PT, including ankle dorsiflexion range in the dominant and nondominant leg. Data were collected over a 1-year period and follow-up, including reexamination, was made at the end of the year.

RESULTS:

Seventy-five players met the inclusion criteria. At the follow-up, 12 players (16.0%) had developed unilateral PT. These players were found to have had a significantly lower mean ankle dorsiflexion range at baseline than the healthy players, with a mean difference of -4.7° (P = .038) for the dominant limb and -5.1° (P = .024) for the nondominant limb. Complementary statistical analysis showed that players with dorsiflexion range less than 36.5° had a risk of 18.5% to 29.4% of developing PT within a year, as compared with 1.8% to 2.1% for players with dorsiflexion range greater than 36.5°. Limbs with a history of 2 or more ankle sprains had a slightly less mean ankle dorsiflexion range compared to those with 0 or 1 sprain (mean difference, -1.5° to -2.5°), although this was only statistically significant for nondominant legs.

CONCLUSION:

This study clearly shows that low ankle dorsiflexion range is a risk factor for developing PT in basketball players. In the studied material, an ankle dorsiflexion range of 36.5° was found to be the most appropriate cutoff point for prognostic screening. This might be useful information in identifying at-risk individuals in basketball teams and enabling preventive actions. A history of ankle sprains might contribute to reduced ankle dorsiflexion range.

Analysis By Dr Mark Rathjen PT DPT CSCS
As a Doctor of Physical Therapy, my main goal is always to find the source of your pain. Knee pain can have many causes and manifestations, but its always important to look above and below the levels of the pain. In study above, we see how the lack of ankle flexibility can play a major role in tendonitis of the knee. Countless clinicians would treat the knee, the pain, the symptoms, perhaps working on strengthening, flexibility and balance. IF they are only focusing on the knee OR the hip, they are leaving a key ingredient out of the recipe for complete recovery.
Sometimes where you have pain isn’t the issue, perhaps its just the messenger. The body always should be looked at as a whole.
Customized treatments are tailored to the individual and their needs.