Can we really say getting stronger makes your tendon feel better? No current evidence of a relationship between change in Achilles tendinopathy pain or disability and changes in Triceps Surae structure or function when completing rehabilitation: A systematic review

Murphy, Myles; Travers, Mervyn; Chivers, Paola; Debenham, James; Docking, Sean; Rio, Ebonie; Gibson, William; Ardern, Clare L

doi:10.1016/j.jsams.2023.03.007

Cited by 6 publications

(4 citation statements)

References 47 publications

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“…Our results support a long-standing hypothesis that these test conditions should not be considered interchangeable field-based or clinical measures of calf muscle function in practical settings [8]-form matters. By proxy, this may extend into SLHR interventions and explain why some SLHR interventions have a minimal effect on SLHR repetitions to failure [35] and even clinical improvement. Our results revealed that the scales of measurement within these tests are not equivalent and that Australian football players are biased towards recording a greater number of repetitions during the non-cued SLHR.…”

Section: Discussionmentioning

confidence: 99%

Form Matters—Technical Cues in the Single Leg Heel Raise to Failure Test Significantly Change the Outcome: A Study of Convergent Validity in Australian Football Players

Green,

Coventry,

Pizzari

et al. 2024

BioMed

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Practitioners routinely use the single leg heel raise (SLHR) to quantify calf function in healthy and injured populations. Despite this, approaches vary and the impact of cueing on SLHR performance and results interpretation in athletesis unknown. The primary aim of this study was to quantify the level of agreement of the cued versus non-cued SLHR tests. The secondary aim was to explore test outcomes and the potential impact of intrinsic factors. Cued and non-cued SLHR tests were conducted in fifty-one Australian football players (23 women, 28 men). Metronome pacing (60 bpm) and five key cues were included in the cued condition. The level of agreement (Bland–Altman) between tests was measured for capacity (repetitions to failure) and asymmetry. Data from 100 legs were included. The non-cued and cued SLHR tests demonstrated poor agreement in both capacity and asymmetry. More repetitions to failure were performed in the non-cued SLHR [Mean (SD) = 33.9 (10.3) vs. 21.9 (5.3), p < 0.001)], and men had greater capacity (36.8 (10.4) vs. 30.3 (9.2), p < 0.001). During the cued SLHR, older players (age ≥ 30 years: −5.1 repetitions, p = 0.01) and Indigenous players (−3.4 repetitions, p = 0.002) and had reduced calf muscle function. Cueing the SLHR test significantly changes the result—outcomes are not comparable or interchangeable with the commonly used non-cued SLHR. These findings can guide practitioners quantifying calf capacity.

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Section: Discussionmentioning

confidence: 99%

Form Matters—Technical Cues in the Single Leg Heel Raise to Failure Test Significantly Change the Outcome: A Study of Convergent Validity in Australian Football Players

Green,

Coventry,

Pizzari

et al. 2024

BioMed

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“…In a recent systematic review of resistance training protocols for Achilles tendinopathy almost no studies were able to demonstrate a significant improvement in muscle size, endurance or strength after months of resistance training. 2 While it would be simple to say the programmes were poorly prescribed, some trials used what would be considered 'good' strength and conditioning principles. 2 Further, in a separate longitudinal metaanalysis where all included studies reported improvements in pain during the rehabilitation period, a rehabilitative plateau (whereby symptoms tend to stop improving after 12 weeks of resistance training) has been…”

Section: Introductionmentioning

confidence: 99%

“…2 While it would be simple to say the programmes were poorly prescribed, some trials used what would be considered 'good' strength and conditioning principles. 2 Further, in a separate longitudinal metaanalysis where all included studies reported improvements in pain during the rehabilitation period, a rehabilitative plateau (whereby symptoms tend to stop improving after 12 weeks of resistance training) has been…”

Section: Introductionmentioning

confidence: 99%

Maximising neuromuscular performance in people with pain and injury: moving beyond reps and sets to understand the challenges and embrace the complexity

Murphy,

Rio,

Whife

et al. 2024

BMJ Open Sport Exerc Med

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Rehabilitative practice is often criticised for being non-individualised, monotonous and not well aligned with foundational principles that drive continued physiological adaptation(s). However, our understanding of neuromuscular physiology is rapidly increasing and the way we programme rehabilitation is improving. This viewpoint highlights some of the potential considerations around why the adaptations achieved during rehabilitation programmes may be suboptimal. We provide basic, clinician-focused discussion about potential confounding physiological factors, and put forward several exercise-based programming recommendations and novel approaches to consider in contemporary rehabilitative practice. Specifically, we outline several potential mechanisms contributing to poor muscle activation and function that might be present following musculoskeletal injury. However, clinicians require strategies capable of attenuating these impairments to restore proper function. Therefore, we also provide an overview of recommended strength and conditioning guidelines, and novel strategies (such as external pacing and electrical stimulation techniques) that clinicians can consider to potentially improve the efficacy of musculoskeletal rehabilitation.

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“…It has been proposed that pain improvements occur due to improved neuromuscular function with exercise rehabilitation ( 11 ). However, this hypothesis has been challenged in other musculoskeletal conditions, with changes in disability being unrelated to neuromuscular function ( 12 ). Specifically in OA, improvements in muscle function, including strength, are proposed to improve the joint’s capacity to absorb impact forces and thereby reduce joint load ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

Does lower-limb osteoarthritis alter motor cortex descending drive and voluntary activation? A systematic review and meta-analysis

Murphy,

Latella,

Rio

et al. 2023

EFORT Open Reviews

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Purpose The aim of the study was to quantify motor cortex descending drive and voluntary activation (VA) in people with lower-limb OA compared to controls. Methods A systematic review and meta-analysis according to the PRISMA guidelines was carried out. Seven databases were searched until 30 December 2022. Studies assessing VA or responses to transcranial magnetic stimulation (TMS; i.e. motor evoked potential, intracortical facilitation, motor threshold, short-interval intracortical inhibition, and silent period) were included. Study quality was assessed using Joanna Briggs Institute criteria and evidence certainty using GRADE. The meta-analysis was performed using RevMan inverse variance, mixed-effect models. Results Eighteen studies were included, all deemed low-quality. Quadriceps VA was impaired with knee OA compared to healthy controls (standardised mean difference (SMD) = 0.84, 95% CI = −1.12–0.56, low certainty). VA of the more symptomatic limb was impaired (SMD = 0.42, 95% CI = −0.75–0.09, moderate certainty) compared to the other limb in people with hip/knee OA. As only two studies assessed responses to TMS, very low-certainty evidence demonstrated no significant difference between knee OA and healthy controls for motor evoked potential, intracortical facilitation, resting motor threshold or short-interval intracortical inhibition. Conclusions Low-certainty evidence suggests people with knee OA have substantial impairments in VA of their quadriceps muscle when compared to healthy controls. With moderate certainty we conclude that people with hip and knee OA had larger impairments in VA of the quadriceps in their more painful limb compared to their non-affected/other limb.

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Can we really say getting stronger makes your tendon feel better? No current evidence of a relationship between change in Achilles tendinopathy pain or disability and changes in Triceps Surae structure or function when completing rehabilitation: A systematic review

Cited by 6 publications

References 47 publications

Form Matters—Technical Cues in the Single Leg Heel Raise to Failure Test Significantly Change the Outcome: A Study of Convergent Validity in Australian Football Players

Form Matters—Technical Cues in the Single Leg Heel Raise to Failure Test Significantly Change the Outcome: A Study of Convergent Validity in Australian Football Players

Maximising neuromuscular performance in people with pain and injury: moving beyond reps and sets to understand the challenges and embrace the complexity

Does lower-limb osteoarthritis alter motor cortex descending drive and voluntary activation? A systematic review and meta-analysis

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