title: Preventive interventions for tendinopathy: A systematic review.
abstract: OBJECTIVE
  Tendinopathy, the most prevalent tendon disorder which is considered as the clinical diagnosis of pain and dysfunction, is common in sports and its prevalence is ever-increasing. Despite the lack of clarity about risk factors, various preventive interventions for tendinopathy have been investigated. The main objective of this study is to review current preventive interventions for tendinopathy in the major regions: ankle, knee, hip, groin, shoulder and elbow.
  
  
  METHODS
  A systematic literature search was conducted.
  
  
  METHODS
  The PubMed and Embase databases were explored to identify articles that met the inclusion criteria. The included studies were assessed on methodological quality and data was summarized.
  
  
  RESULTS
  Ten articles were included that describe a wide variety of preventive interventions. These were divided into three categories: stretch and exercise interventions, shoe adaptations and other interventions. The methodological quality of the studies was moderate to high. Three out of ten studies showed a significant beneficial result.
  
  
  CONCLUSIONS
  There is limited evidence that a long-term intervention including balance training is effective in the prevention of patellar and Achilles tendinopathy. Shoe adaptations in the form of shock absorbing insoles could have a preventive effect on Achilles tendinopathy. Hormone replacement therapy seems to reduce the risk for structural Achilles tendon changes in active post-menopausal women. No evidence was found for a positive effect of stretching exercises. Prophylactic eccentric training and stretching can increase the risk of injury in asymptomatic players with patellar tendon abnormalities. A limited amount of studies was available and more research is needed on (multifactorial) etiology, risk factors and preventive interventions.
authors.affiliation: Center for Sports Medicine, University Medical Center Groningen, University of Groningen, The Netherlands; Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Janne A
authors.initials: JA
authors.lastname: Peters
authors.affiliation: Center for Sports Medicine, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Johannes
authors.initials: J
authors.lastname: Zwerver
authors.affiliation: Center for Sports Medicine, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Ronald L
authors.initials: RL
authors.lastname: Diercks
authors.affiliation: Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, The Netherlands.
authors.forename: Marije T
authors.initials: MT
authors.lastname: Elferink-Gemser
authors.affiliation: Center for Sports Medicine, University Medical Center Groningen, University of Groningen, The Netherlands. Electronic address: i.scheek@umcg.nl.
authors.forename: Inge
authors.initials: I
authors.lastname: van den Akker-Scheek
mesh_terms: D020249:Hormone Replacement Therapy; D006801:Humans; D052580:Muscle Stretching Exercises; D004856:Postural Balance; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D012775:Shoes; D052256:Tendinopathy / Q000517:prevention & control*
keywords: Intervention studies; Prevention; Systematic review; Tendinopathy