(13) KNEE JOINT ADAPTATIONS IN WOMEN VOLLEYBALL ATHLETES IN RESPONSE TO A 12–WEEK COMPETITIVE SEASON

Introduction: Patellofemoral Pain Syndrome (PFPS) is common in athletes from high-impact sports. The Victorian Institute of Sport Assessment-Patella (VISA-P) is a self-reporting clinical tool to assess PFPS, which can be used with magnetic resonance imaging (MRI) for diagnostic purposes. PFPS symptoms can increase with increased athlete workloads (WL), emphasizing the need for load monitoring in high impact sports. Purpose: To examine how changes in MRI scans of the dominant knee joint pre- and post-season relate to changes in VISA-P scores, athlete WL, and neuromuscular performance. To examine how changes in MRI scans of the dominant knee joint pre- and post-season relate to changes in VISA-P scores, athlete WL, and neuromuscular performance. Methods: Seven National Collegiate Athletic Association (NCAA) Division I women volleyball (VB) athletes (mean ± SD; age: 19.59 ± 1.50 yrs, height: 177.52 ± 4.47 cm, weight: 77.86 ± 6.53 kg, %bodyfat: 30.03 ± 4.05) were monitored pre- and post-season (12 weeks) with MRI scans of the dominant knee, VISA-P surveys, and neuromuscular performance (countermovement jump (CMJ)). MRI measures included Insall-Salvati (IS) ratio (position of patella in relation to the tibia) and suclus angle (SA) (angle between the lateral and medial facies patellaris femoris). CMJ jump height (JH), reactive strength index modified (RSImod), and peak power (PP) were analyzed pre- and post-season. Athlete load was collected via an inertial measurement unit (IMU) worn at the waist during practices and matches. IMU jump count (JC) and elevated landings (EL) were summed for the entirety of the season. Pearson correlation coefficients determined relationships between MRI, VISA-P, JC, EL, JH, RSImod, PP, and VB position ((Libero (L) = 1, Middle Blocker (MB) = 2, Outside Hitter (OH) = 1, Right Side Hitter (RSH) = 1, Setter (S) = 2). A MANOVA assessed differences between MRI, VISA-P, JC, EL, JH, RSImod, PP, and VB position across timepoints, enabling examination of the overall effect of time. ANOVA tests were performed to investigate the specific effects of timepoint on each variable. Statistical significance was set at p > 0.05. Results: Pearson correlation analysis revealed relationships (p < 0.05) between VISA-P, PP, EL, and IS (Fig 1). Further, SA showed significant correlations with JC and EL. VB position was related to IS (p < 0.05). MANOVA results indicated significant difference in timepoints across variables (p < 0.05). Subsequent individual ANOVAs demonstrated that SA was significantly related to time. Conclusions: Results highlight the importance of considering subjective and objective measures in monitoring and managing athlete health and performance over time in high-impact sports. Specifically, factors like SA are critical in providing objective insight into patellar alignment and tracking, which if altered increase stress on the knee and incidence of PFPS. Practical Applications: By addressing structural risks early through adjustments in WL, sports medicine practitioners can reduce injuries that might cause long-term performance setbacks and reduced training capacity. Acknowledgements: Effort sponsored by the Government under Other Transactions Number HT9425-24-9-0019