Comparison of Pain Measures Between Tendons of Elite Basketball Players With Different Sonographic Patterns.

CONTEXT:: The prevalence and negative consequences of the symptoms surrounding patellar tendinopathy constitute an important problem for sports medicine professionals. The identification of potential pain mediators is therefore of major interest in order to improve both the prevention and management of this injury.

OBJECTIVE:: To compare the pain experienced by elite male adult basketball players and patterns of patellar tendon abnormalities. Also, to identify whether structural and vascular sonographic abnormalities (focal area of hypoechogenicity [FAH], thickening [Thk], and neovascularization [NV]) are equal in determining pain perceptions.

DESIGN:: An observational study with professional basketball teams (ACB. Spanish league).

PARTICIPANTS:: 73 male basketball players (mean age 26.8 years).

MAIN OUTCOME MEASURES:: Patellar tendon ultrasonography images. Pain scores were compared between the identified patterns. Multiple regression analysis was used to examine the relative importance of abnormalities.

RESULTS:: Of the 146 tendons, 91 had some degree of sonographic abnormality. Three main patterns were identified: I (one structural abnormality without NV), II (two structural abnormalities without NV) and III (two structural abnormalities and NV). A total of 31 tendons (21.2%) exhibited pattern I, 46 (31.5%) presented pattern II and 13 tendons (8.9%) exhibited pattern III. The mean visual analogue scale, the Victorian institute of sport assessment questionnaire - patellar tendon (VISA-P) scores for pattern III were significantly different (p<0.05) compared to patterns II and I, however the pain pressure threshold (PPT) was not. The NV was significantly associated with worsened scores for all pain measures, however the FAH was only associated with PPT scores.

CONCLUSION:: Patterns of sonographic abnormalities, including NV, demonstrated greater pain. While NV determines scores for the VAS, VISA-P and PPT, the presence of FAH on its own is a determining factor for the PPT. This study suggests that the combination of two or more sonographic abnormalities may help explain pain variations among basketball players.