An integrated management model for patellar tendinopathy
Introduction Patellar tendinopathy (PT) is a common chronic pathology of the knee. Elite athletes are especially affected by PT with a prevalence rate of 13%-20%. PT is related to overloading of the patellar tendon and can affect athletes in a variety of sporting codes, resulting in pain and functional impairment. Even with contemporary treatment, almost all athletes experience long lasting symptoms, which makes PT management challenging and highlights the necessity for continuous research. Aim The main aim of this research study was to formulate an integrated management model for PT based on existing sport management models and supplemented with results from this study. Methodology The study was conducted in three stages, including a systematic review, focussing on the intrinsic and extrinsic causative factors and rehabilitation of PT; an e-Delphi survey to formulate a draft rehabilitation framework for PT; and a 12-week exploratory pre-test, post-test clinical testing of the Delphi-based rehabilitation framework amongst elite rugby players of a South African rugby union. Results and discussion Three core elements for the management of PT are identified in this study and include risk factor identification, prevention, and rehabilitation. Sub-components are linked to each of these core elements, where risk factor identification is linked to intrinsic and extrinsic causative factors, prevention is linked to assessment and preventative strategies and rehabilitation is linked to load tolerance, functionality, individualisation, the use of relevant outcomes measures and educational strategies. The model thus enables both a systematic approach to the management of PT through the core elements, and a flexible approach through the variation in the application of these elements in the clinical context. Conclusion The proposed integrated management model for PT provides a singular, structured, yet flexible model as a modernistic platform for the management of PT and a basis for further PT research.