Achilles tendon structure in distance runners does not change following a competitive season (original) (raw)
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Running a Marathon—Its Influence on Achilles Tendon Structure
Journal of Athletic Training, 2020
Context: Several studies have been conducted to better understand the effect of load on the Achilles tendon structure. However, the effect of a high cumulative load consisting of repetitive cyclic movements, such as those that occur during the running of a marathon, on Achilles tendon structure is not yet clear. Clinicians, coaches, and athletes will benefit from knowledge about the effects of a marathon on the structure of the Achilles tendon. Objective: To investigate the short-term response of the Achilles tendon structure to running a marathon. Design: Case series (prospective). Setting: Sports medicine centers. Patients or Other Participants: Ten male nonelite runners who ran in a marathon. Main Outcomes Measure(s): Tendon structure was assessed before and 2 and 7 days after a marathon using ultrasound tissue characterization (UTC), an imaging tool that quantifies tendon organization in 4 echo types (I-IV). Echo type I represents the most stable echo pattern, and echo type IV, the least stable. Results: At 7 days postmarathon, both the insertional and midportion structure changed significantly. At both sites, the percentage of echo type II increased (insertion P , .01; midportion P ¼ .02) and the percentages of echo types III and IV decreased (type III: insertion P ¼ .01; midportion P ¼ .02; type IV: insertion P ¼ .01; midportion P , .01). Additionally, at the insertion, the percentage of echo type I decreased (P , .01). Conclusions: We observed the effects of running a marathon on the Achilles tendon structure 7 days after the event. Running the marathon combined with the activity performed shortly thereafter might have caused the changes in tendon structure. This result emphasizes the importance of sufficient recovery time after running a marathon to prevent overuse injuries.
Sports
There is a need for clinical indicators that can be used to guide the treatment of Achilles tendon complaints in recreational runners. Diagnostic ultrasound has recently been introduced for clinical decision support in tendon pain management. The aim of this study was to determine whether tendon thickness and morphological changes in the Achilles tendon detected in ultrasound examinations are associated with local symptoms in middle-age recreational long-distance runners. Forty-two Achilles tendons (21 middle-aged runners) were investigated by ultrasound examination measuring tendon thickness and a morphology score indicating tendinosis. The Generalized Estimating Equations method was applied in multiple models of factors associated with reporting a symptomatic tendon. Eleven symptomatic and 31 asymptomatic Achilles tendons were recorded. In the multiple model that used tendon thickness measured 30 mm proximal to the distal insertion, an association was found between thickness and r...
Factors related to intra-tendinous morphology of Achilles tendon in runners
PLOS ONE, 2019
The purpose of this study was to determine and explore factors (age, sex, anthropometry, running and injury/pain history, tendon gross morphology, neovascularization, ankle range of motion, and ankle plantarflexor muscle endurance) related to intra-tendinous morphological alterations of the Achilles tendon in runners. An intra-tendinous morphological change was defined as collagen fiber disorganization detected by a low peak spatial frequency radius (PSFR) obtained from spatial frequency analysis (SFA) techniques in sonography. Ninety-one runners (53 males and 38 females; 37.9 ± 11.6 years) with 8.8 ± 7.3 years of running experience participated. Height, weight, and waist and hip circumferences were recorded. Participants completed a survey about running and injury/pain history and the Victorian Institute of Sport Assessment-Achilles (VISA-A) survey. Heel raise endurance and knee-to-wall composite dorsiflexion were assessed. Brightness-mode (B-mode) sonographic images were captured longitudinally and transversely on the Achilles tendon bilaterally. Sonographic images were analyzed for gross morphology (i.e., cross-sectional area [CSA]), neovascularization, and intra-tendinous morphology (i.e., PSFR) for each participant. The factors associated with altered intra-tendinous morphology of the Achilles tendon were analyzed using a generalized linear mixed model. Multivariate analyses revealed that male sex was significantly associated with a decreased PSFR. Additionally, male sex and the presence of current Achilles tendon pain were found to be significantly related to decreased PSFR using a univariate analysis. Our findings suggested that male sex and presence of current Achilles tendon pain were related to intra-tendinous morphological alterations in the Achilles tendon of runners.
Revista Brasileira de Medicina do Esporte, 2020
Introduction: This study aimed to measure thickness and cross-sectional area of the Achilles tendon (AT), and the range of motion of the ankle joint in dorsiflexion of amateur marathon runners compared to non-active people. Objectives: To analyze the relationship between cross-sectional area and thickness of the Achilles tendon in marathon runners and age, anthropometric characteristics (height and body mass), training habits, running experience, marathon performance, and range of motion in the ankle joint. Methods: Achilles tendon thickness and cross-sectional area were measured using ultrasound images of the left leg in 97 male amateur marathon runners (age 42.0 ± 9.6 years; height 175 ± 6 cm; and body mass 73.7 ± 8.6 kg), and 47 controls (39.9 ± 11.6 years; 176 ± 7 cm; 79.6 ± 16.1 kg). Results: Achilles tendon thickness (4.81 ± 0.77 vs. 4.60 ± 0.66 mm; p = 0.01) and cross-sectional area (60.41 ± 14.36 vs. 53.62 ± 9.90 mm2; p < 0.01) were greater in the marathon runners than in...
Tendon structure quantified using ultrasound imaging differs based on location and training type
Journal of Applied Physiology, 2018
Achilles tendinopathy is 10 times more common among running athletes compared with age-matched peers. Load-induced tendon remodeling and its progression in an at-risk population of developing symptomatic tendinopathy are not well understood. The purpose of this study was to prospectively characterize Achilles and patellar tendon structure in competitive collegiate distance runners over different competitive seasons using quantitative ultrasound imaging. Twenty-two collegiate cross-country runners and eleven controls were examined for this study. Ultrasound images of bilateral Achilles and patellar tendons were obtained near the start and end of the collegiate cross-country season and the conclusion outdoor track season. Collagen organization, mean echogenicity, tendon thickness, and neovascularity were determined using well-established image processing techniques. Achilles tendon collagen was less aligned in runners compared with controls (28% greater) but improved slightly (7% decr...
Achilles tendinopathy in amateur runners: role of adiposity (Tendinopathies and obesity)
Muscles, ligaments and tendons journal, 2012
Obesity is an important risk factor for Achilles tendinopathy, and running is usually carried out to reduce excess body weight. Aim of this study was to evaluate the prevalence of Achilles tendinopathy in young over-weight amateur runners. MALE RUNNERS AND NON RUNNERS WERE RECRUITED AND, IN EACH CATEGORY, DIVIDED IN TWO GROUPS: normal weight, and overweight. Data about Achilles tendon thickness, vascularisation and structural abnormalities were collected using a Power Doppler Ultrasonography device. Achilles tendon thickness was greater in both normal weight or overweight runners, but the difference was significant only in normal weight subjects. In non - runners, thickness was significantly higher only in over-weight subjects. Sonographic abnormalities were significantly prevalent in overweight runners. Running is associated to a physiologic hypertrophy of Achilles tendon in normal weight subjects. Overweight runners may precociously develop tendon abnormalities, due to the increas...
Muscles, ligaments and tendons journal, 2011
The primary aim of this prospective cohort study was to compare the incidence of Achilles tendinopathy symptoms in elite soccer players with and without baseline asymptomatic ultrasound abnormalities. This study also investigated the relationship between baseline tendon thickness and development of symptoms. Using ultrasonography, 18 players were examined in 2009 for the existence of hypoechoicity, paratenon blurring, focal thickening and/or neovascularisation, and anteroposterior tendon thickness was measured. Symptom development during the follow-up period was assessed by interview one year later. Baseline mid-tendon thickness was greater (p=0.041) in tendons that experienced symptoms [median (IQR): 0.53 (0.51-0.55) cm] in the following year than tendons remaining asymptomatic [0.48 (0.45-0.52) cm]. No association between the existence of baseline ultrasound signs and development of symptoms in the following year was observed (Chi-Square: 1.180, p=0.277). A thicker baseline mid-te...
Journal of Applied Physiology, 2005
The prevalence of Achilles tendon (AT) injury is high in various sports, and AT rupture patients have been reported to have a 200-fold risk of sustaining a contralateral rupture. Tendon adaptation to different exercise modes is not fully understood. The present study investigated the structural properties of the AT in male elite athletes that subject their AT to different exercise modes as well as in Achilles rupture patients. Magnetic resonance imaging of the foot and leg, anthropometric measurements, and maximal isometric plantar flexion force were obtained in 6 male AT rupture patients and 25 male elite athletes (kayak/control group n = 9, volleyball n = 8 and endurance running n = 8). AT cross-sectional area (CSA) was normalized to body mass. Runners had a larger normalized AT CSA along the entire length of the tendon compared with the control group ( P < 0.05). The volleyball subjects had a larger normalized CSA compared with the control group ( P < 0.05) in the area of t...