Sport-discipline and age-related differences in knee extensor musculotendinous morphology and function.
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- Record sourced from PubMed, PMID 42430869.
- Also identified by DOI 10.1016/j.knee.2026.104562.
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Abstract
BACKGROUND: Sport-specific mechanical demands and progression from youth to elite competition may influence musculotendinous morphology and function, that potentially contribute to knee pain and injury in athletes. The objective of this study was to assess sport- and age-related differences in the knee extensor musculotendinous morphology and function, and self-reported knee pain and injury incidence in competitive athletes. METHODS: A total of ninety male athletes volunteered for the present study: cyclists (CY), basketball players (BP), and ice hockey-players (IH), with 15 youth (U19 teams - 17.3 ± 1.1 years) and 15 elite men (27.2 ± 3.8 years) per discipline. Muscle thickness (vastus lateralis, rectus femoris, vastus medialis) and patellar tendon cross-sectional area (CSA) were assessed with ultrasonography. Maximal isometric and isokinetic torque, and countermovement jump (CMJ) height were measured. Anterior knee pain (AKP) and knee injury history (KIJ) were collected via structured interviews. Data were analyzed using a two‑way ANOVA with discipline and age category as between‑subject factors. RESULTS: A discipline × age interaction was observed for quadriceps muscle size (QMS) (p = 0.01). Elite athletes showed larger muscles than youth and CY had smaller absolute QMS but higher body-mass-normalized values than BP and IH (p < 0.05). Muscle and tendon size and maximal torque were greater in elite athletes (p < 0.03), but differences disappeared when normalized for body mass. CY displayed lower patellar tendon stress and CMJ height than BP and IH (p < 0.05). Elite athletes reported higher AKP and KIJ than youth (p ≤ 0.05). CONCLUSION: Cycling was associated with a greater muscle size-to-body mass ratio, yet lower tendon stress, whereas basketball and ice hockey were associated with superior explosive performance. Despite proportional scaling from youth to elite suggesting a coordinated muscle-tendon development, elite athletes suffer more from knee pain and injury rates.