Sporcularda Patellar Tendinopati için Güncel Tedavi Yaklaşımları

Abstract

Patellar tendinopati (PT), özellikle sıçrama sporlarıyla uğraşan sporcuları etkileyen ağrılı bir kas-iskelet sistemi rahatsızlığıdır. PT semptomlarının yönetimi zordur ve spor ile fiziksel aktivite katılımını olumsuz etkiler. PT'nin iyileşme oranı tatmin edici değildir; iyileşme süresi uzundur ve nüks oranı yüksektir. Bu nedenle, sporcuların kısıtlanmış spor katılımını iyileştirmek amacıyla rehabilitasyon programlarının etkin bir şekilde yönetilmesi önemlidir. Bu derlemenin amacı, sporcularda PT’nin klinik tanısı, değerlendirilmesi ve yönetimine ilişkin mevcut kanıtları bir araya getirerek klinisyenlere rehberlik etmektir. Yüklenme, özellikle enerji depolayan tendonlar için olduğu gibi PT için de rehabilitasyonun en önemli parçasıdır. Rehabilitasyonda öncelik, ağrı veya yapısal iyileşmeden önce fonksiyonun yeniden kazandırılmasıdır. Egzersiz, tendonu fonksiyonuna uygun şekilde yüklemenin tek yolu olduğundan, PT için en yüksek kanıt düzeyine sahip birincil tedavi stratejisidir. Şok dalga tedavisi, spor bandajlaması ve kuru iğneleme gibi diğer yöntemler yardımcı tedavi olarak faydalı olabilir, ancak bu yöntemlere dair kanıtlar sınırlıdır. PT’ye sahip sporcular, diğer diz problemlerine sahip olanlara göre spora iki kat daha fazla devam etmektedir; ancak iyileşme süreçlerinden daha az memnundurlar. Uygun egzersizlerle yüklenme yönetimi, PT’li sporcuların kısıtlanmış spor katılımını iyileştirmek için en güçlü kanıt düzeyine sahip yaklaşımdır.

Keywords

• sporcular
• egzersiz
• diz
• rehabiltiasyon
• tendinopati

Current Management Approaches for Patellar Tendinopathy in Athletes

Abstract

Patellar tendinopathy (PT) is a painful musculoskeletal condition that particularly affects athletes participating in jumping sports. Symptoms of PT are difficult to manage, affect sports and physical activity participation. The recovery rate of PT is not satisfactory, with long recovery times and a high recurrence rate. Thus, it is important to manage rehabilitation programs to improve athletes’ compromised sports participation. The aim of this review is to combine and present available evidence to guide clinicians in key elements of clinical diagnosis, examination and management of PT in athletes. Loading is the most important part of rehabilitation, especially for energy storing tendons like PT. Function is the primary focus of rehabilitation, before pain or structural recovery. Exercise is the primary treatment strategy with the highest evidence level for PT as it is the only way to load the tendon in line with its function. Other modalities such as extracorporeal shockwave therapy, sports taping and dry needling may be beneficial as adjunct therapies, but evidence is limited. Athletes with PT play their sports twice as much as those with other knee problems, yet they are less satisfied with their recovery. Loading management with appropriate exercises is the best approach with a strong level of evidence for treating PT in athletes to improve athletes’ compromised sports participation.

Keywords

• athletes
• exercise
• knee
• rehabilitation
• tendinopathy

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