This Way Up Mother Established 1973 Unisex Adult Sweater/Jumper

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Cook JL, Khan KM, Harcourt PR, Kiss ZS, Fehrmann MW, Griffiths L, et al. (1998) Patellar tendon ultrasonography in asymptomatic active athletes reveals hypoechoic regions: a study of 320 tendons. Clin J Sport Med. 8:73–77. Kannus P, Józsa L. (1991) Histopathological changes preceding spontaneous rupture of a tendon: a controlled study of 891 patients. J Bone Joint Surg. (Am) 73:1507–1525. Holmich P, Uhrskou P, Ulnits L, Kanstrup IL, Nielsen MB, Bjerg AM, et al. (1999) Effectiveness of active physical training as treatment for long-standing adductor-related groin pain in athletes: randomised trial. Lancet. 353:439–453.

Siwek CW, Rao JP. (1981) Ruptures of the extensor mechanism of the knee joint. J Bone Joint Surg. (Am) 63:932–937. Multiple theories have been proposed for the pathogenesis of patellar tendinopathy, mechanical, vascular, and impingement related. However, the chronic overload theory is the most commonly reported. Repetitive overload on the knee extensor tendons will cause it to weaken progressively, eventually leading to failure. Microscopic failure occurs within the tendon at high loads and eventually leads to alterations at the cellular level, which undermine its mechanical properties. Tendon micro-trauma may cause individual fibril degeneration due to stress across the tendon. As the fibril degeneration becomes ongoing, chronic tendinopathy will ensue. [10] Fyfe I, Stanish WD. (1992) The use of eccentric training and stretching in the treatment and prevention of tendon injuries. Clin Sports Med. 11:601–624.

Hägglund M, Zwerver J, Ekstrand J (2011) Epidemiology of patellar tendinopathy in elite male soccer players. Am J Sports Med 39(9):1906–1911, Epub 2011 Jun 3 Khan KM, Bonar F, Desmond PM, Cook JL, Young DA, Visentini PJ, et al. (1996) Patellar tendinosis (jumper’s knee): findings at histopathologic examination, US and MR imaging. Radiology. 200:821–827. Raatikainen T, Karpakka J, Puranen J, Orava S. (1994) Operative treatment of partial rupture of the patellar ligament. a study of 138 cases. Int J Sports Med. 15:46–49.

Levy M, Goldstein J, Rosner M. (1987) A method of repair for quadriceps ten-don or patellar ligament (tendon) ruptures without cast immobilization: preliminary report. Clin Orthop. 218:297–301. Nordin M, Frankel VH. (1989) Biomechanics of the knee. In: Nordin M, Frankel VH, eds. Basic Biomechanics of the Musculoskeletal System. 2nd ed. Philadelphia: Lea & Febiger; 115–134. Davies SG, Baudouin CJ, King JD, et al. (1991) Ultrasound, computed tomography and magnetic resonance imaging in patellar tendinitis. Clin Radiol. 43:52–56. Patellar tendinopathy is mainly a clinical diagnosis made through a detailed history and meticulous physical examination. Appropriate questions which will cue in the diagnosis: Sport practiced, schedule of practice and competition, which position the athlete plays, and level of performance. The patient will usually complain of well-localized pain and tenderness on the inferior tip of the patella. [12] [2] Yu JS, Popp JE, Kaeding CC, Lucas J. (1995) Correlation of MR imaging and pathologic findings in athletes undergoing surgery for chronic patellar tendinitis. Am J Roentgenol. 165:115–118.Examination of the knee might reveal a localized swelling overlying the patellar tendon, which is tender to palpate. In addition, the following signs have been described;Basset's sign, "passive extension – flexion sign," wherethe examiner palpates the anterior aspect of the fully extended knee and identifies the highest tender point, which is usually at the inferior pole of the patella and the proximal part of the patellar tendon. The examination is repeated at 90 degrees of knee flexion, and the sign is positive when there is a marked reduction in tenderness to palpation in the flexed knee position. The other sign is the "standing active quadriceps sign," where the whole patellar tendon is palpated while the patient is standing, and the examination is repeated while the patient is standing on the involved extremity with the knee in 30 degrees of flexion.Similarly, the sign is positive if there is a marked reduction in tenderness to palpation while the quadriceps muscle is contracted.The concept behind these signs was explained in a cadaveric study that showed when the quadriceps muscle is tensioned, as, in 90 degrees of knee flexion, the deep fibers of the tendon do not deformto anterior palpation. [15] Rolf C, Movin T, Engstrom B, Jacobs LD, Beauchard C, Le-Liboux A. (1997) An open, randomized study of ketoprofen in patients in surgery for Achilles or Patellar tendinopathy. J Rheumatol. 24:1595–1598. Burks RT, Edelson RH. (1994) Allograft reconstruction of the patellar ligament: A case report. J Bone Joint Surg. (Am) 76:1077–1079. Webb LX, Toby EB. (1986) Bilateral rupture of the patella tendon in an otherwise healthy male patient following minor trauma. J Trauma. 26:1045–1048.

Khan KM, Visentini PJ, Kiss ZS, Desmond PM, Coleman BD, Cook JL, et al. (1999) Correlation of US and MR imaging with clinical outcome after open patellar tenotomy: prospective and retrospective studies. Clin J Sport Med. 9:129–137. Cook JL, Khan KM, Kiss ZS, Purdam C, Griffiths L. (2000) Prospective imaging study of asymptomatic patellar tendinipathy in elite junior basketball players. J Ultrasound Med. 19:473–479.Takebe K, Hirohata K. (1985) Old rupture of the patellar tendon: A case report. Clin Orthop. 196:253–255. Karlsson J, Lundin O, Lossing IW, Peterson L (1991) Partial rupture of the patellar ligament. Results after operative treatment. Am J Sports Med 19(4):403–408 Shrier I, Matheson GO, Kohl HW. (1996) Achilles tendonitis: are corticosteroid injections useful or harmful. Clin J Sport Med. 6:245–250. Fredberg U. (1997) Local corticosteroid injection in sport: a review of literature and guidelines for treatment. Scand J Med Sci Sport. 7:131–139. Fredberg U, Bolvig L, Andersen NT (2008) Prophylactic training in asymptomatic soccer players with ultrasonographic abnormalities in Achilles and patellar tendons: the Danish Super League Study. Am J Sports Med 36(3):451–460, Epub 2007 Dec 13