The risk of Jumper's Knee in elite volleyball players: a cross-sectional observational study on the impact of training volume, sex, and playing position

Afonso Manuel Antunes Marques Reis, 2025

Background: 
Jumper's knee, also known as patellar tendinopathy, is a common overuse injury among athletes involved in sports that require repetitive jumping and high-impact activities, such as volleyball. Understanding the risk factors contributing to this injury is essential for implementing effective prevention strategies.
 
Objective: 
The aim of this study is to clinically and ultrasonographically evaluate the patellar tendons of senior volleyball players at national division one in Portugal (>18 years old) and investigate the relationship between weekly training volume (in hours), sex and players’ positions, and the risk of developing jumper's knee.
 
Methods: 
The diagnosis of jumper's knee was clinically determined using a pain questionnaire and confirmed via imaging through ultrasonography of the athletes’ knees. Both tendons of total of 78 athletes were analyzed.
 
Results: 
The analysis revealed that the odds ratio for weekly training volume was 1.37 (p<0.001), indicating a significant positive relationship between training hours and the risk of developing the injury. Male athletes were significantly more likely to develop jumper's knee compared to females, with an odds ratio of 4.41 (p=0.003). Regarding player positions, attackers had an odds ratio of 6.18 (p=0.095), and setters had an odds ratio of 5.81 (p=0.14), both compared to liberos. Although the effects of positions were positive, they did not reach statistical significance.
 
Conclusion: 
The results demonstrate that male athletes and those engaging in higher weekly training volumes are at greater risk of developing jumper's knee. While positions involving greater jumping volume and explosive effort showed a higher odds ratio, these findings did not achieve statistical significance.
 
Keywords: 
jumper’s knee; patellar tendinopathy; risk factors; ultrasonography; sports injuries


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