Tendinopathy alters mechanical and material properties of the Achilles tendon

Arya, Shruti; Kulig, Kornelia

doi:10.1152/japplphysiol.00259.2009

Cited by 332 publications

(345 citation statements)

References 33 publications

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“…During SSC tasks, elongation of the TA occurs in the presence of a 'quasi-isometric' plantarflexion contraction 18 . However, it has been reported that AT is associated with reduced tendon stiffness 19,20 , so the increased stretch amplitude may be viewed as an indicator of reduced tendon stiffness.…”

Section: Discussionmentioning

confidence: 99%

Achilles tendinopathy alters stretch shortening cycle behaviour during a sub-maximal hopping task

Debenham

Travers

Gibson

et al. 2016

Journal of Science and Medicine in Sport

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ObjectivesTo describe stretch shortening cycle behaviour of the ankle and lower limb in patients with Achilles tendinopathy (AT) and establish differences with healthy volunteers. DesignBetween-subjects case-controlled MethodsFifteen patients with AT (mean age 41.2 ± 12.7 years) and eleven healthy volunteers (CON) (mean age 23.2 ± 6.7 years) performed sub-maximal single-limb hopping on a custom built sledge-jump system. Using 3D motion analysis and surface EMG, temporal kinematic (lower limb stiffness, ankle angle at 80 ms pre-contact, ankle angle at contact, peak ankle angle, ankle stretch amplitude) and EMG measures (onset, offset and peak times relative to contact) were captured. Data between AT and CON were compared statistically using a linear mixed model. ResultsPatients with AT exhibited significantly increased lower limb stiffness when compared to healthy volunteers (p<0.001) and their hopping range was shifted towards a more dorsiflexed position (p<0.001). Furthermore, ankle stretch amplitude was greater in AT compared with healthy volunteers (p<.001). A delay in muscle activity was also observed; soleus onset (p<.001), tibialis anterior peak (p=0.026) and tibialis anterior offset (p<.001) were all delayed in AT compared with CON. ConclusionsThese findings indicate that patients with AT exhibit altered stretch-shortening cycle behaviour during sub-maximal hopping when compared with healthy volunteers. Patients with AT hop with greater lower limb stiffness, in a greater degree of ankle dorsiflexion and have a greater stretch amplitude.Likewise, delayed muscle activity is evident. These findings have implications in terms of informing the understanding of the pathoaetiology and management of AT.3

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Section: Discussionmentioning

confidence: 99%

Achilles tendinopathy alters stretch shortening cycle behaviour during a sub-maximal hopping task

Debenham

Travers

Gibson

et al. 2016

Journal of Science and Medicine in Sport

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“…10 While this investigation did not directly measure patellar tendon strain or mechanical stiffness, reduced energy absorption during the eccentric countermovement is theoretically consistent with the behavior of a material with reduced resistance to elastic deformation. In a study of Achilles tendinopathy, Arya and Kulig 4 reported reduced in vivo mechanical stiffness in pathological tendons compared to those of control subjects. In a case study of a running task, this paralleled reductions in ankle joint torsional stiffness, with a concomitant increase in knee joint stiffness.…”

Section: Knee Joint Kinetics and Kinematicsmentioning

confidence: 99%

Knee Extensor Dynamics in the Volleyball Approach Jump: The Influence of Patellar Tendinopathy

Sorenson¹,

Arya²,

Souza³

et al. 2010

Journal of Orthopaedic & Sports Physical Therapy

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Study Design Controlled laboratory study using a cross-sectional design. Objectives To evaluate knee joint dynamics in elite volleyball players with and without a history of patellar tendinopathy, focusing on mechanical energy absorption and generation. We hypothesized that tendinopathy would be associated with reduced net joint work and net joint power. Background Patellar tendinopathy is a common, debilitating injury affecting competitive volleyball players. Methods Thirteen elite male players with and without a history of patellar tendinopathy (mean ± SD age, 27 ± 7 years) performed maximum-effort volleyball approach jumps. Sagittal plane knee joint kinematics, kinetics, and energetics were quantified in the lead limb, using data obtained from a force platform and an 8-camera motion analysis system. Vertical ground reaction forces and pelvis vertical velocity at takeoff were examined. Independent sample t tests were used to evaluate group differences (α = .05). Results The tendinopathy group, compared to controls, demonstrated significant reductions (approximately 30%) in net joint work and net joint power during the eccentric phase of the jump, with no differences in the concentric phase. Positive-to-negative net joint work and net joint power ratios were significantly higher in the tendinopathy group, which had a net joint work ratio of 1.00 (95% CI: 0.77, 1.24) versus 0.76 (95% CI: 0.64, 0.88) for controls, and a net joint power ratio of 1.62 (95% CI: 1.15, 2.10) versus 1.00 (95% CI: 0.80, 1.21) for controls. There were no significant differences in net joint moment, angular velocity, or range of motion. Peak vertical ground reaction forces were lower for the tendinopathy group, while average vertical ground reaction forces and pelvis vertical velocity were similar. Conclusions Patellar tendinopathy is associated with differences in sagittal plane mechanical energy absorption at the knee during maximum-effort volleyball approach jumps. Net joint work and net joint power may help define underlying mechanisms, adaptive effects, or rehabilitative strategies for individuals with patellar tendinopathy. J Orthop Sports Phys Ther 2010;40(9):568–576. doi:10.2519/jospt.2010.3313

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“…The participant's ankle was moved in the sagittal plane from 10° of plantar flexion to 10° of dorsiflexion at a rate of 5°/s, and the passive plantar flexion torque was recorded at a rate of 1000 Hz. Similar to previous studies, 5,8,18 ultrasound imaging was used to track the linear displacement of the gastrocnemius muscle-Achilles tendon junction (MTJ), with the probe at a fixed point on the calf (FIGURES 2B and 2C). A first set of 6 rotations was used for preconditioning, followed by a second set of 6 rotations, from which images were used to calculate tendon mechanical properties.…”

Section: Tendon Mechanical Propertiesmentioning

confidence: 99%

Altered Tendon Characteristics and Mechanical Properties Associated With Insertional Achilles Tendinopathy

Chimenti¹,

Flemister²,

Tome³

et al. 2014

J Orthop Sports Phys Ther

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A cross-sectional image was obtained 2 cm proximal to the tendon insertion. Echogenicity was quantified as the mean grayscale value for the central 1 cm of the entire depth of the tendon cross-section (FIGURES 1C and 1D). The grayscale value for a pixel could range from 0 (black) to 255 (white). The mean grayscale value for all pixels in the region of interest was quantified using ImageJ, with a lower value indicating greater pathology. All ultrasound images had the same gain setting of 56 and were collected at a 3-cm depth, so that differences in ultrasound settings would not influence the mean grayscale values between participants. Tendon Mechanical PropertiesThe combination of ultrasound imaging and dynamometry was used to measure tendon mechanical properties (strain, stiffness). Each participant's ankle was positioned and secured in a Biodex System 4 (Biodex Medical Systems, Inc, Shirley, NY) in sitting, with the seatback reclined to 45°, the chair height adjusted so that the tibia was parallel to the floor, and the hip in neutral adduction/abduction (FIGURE 2A). The participant's ankle was moved in the sagittal plane from 10° of plantar flexion to 10° of dorsiflexion at a rate of 5°/s, and the passive plantar flexion torque was recorded at a rate of 1000 Hz. Similar to previous studies, 5,8,18 ultrasound imaging was used to track the linear displacement of the gastrocnemius muscle-Achilles tendon junction (MTJ), with the probe at a fixed point on the calf (FIGURES 2B and 2C). A first set of 6 rotations was used for preconditioning, followed by a second set of 6 rotations, from which images were used to calculate tendon mechanical properties. B-mode ultrasound images were collected when the ankle was in (1) 10° of plantar flexion at the start and end of the second set and (2) 10° of dorsiflexion during the third, fourth, and fifth repetitions. The location of the MTJ in each ankle position was averaged, so that distance between the MTJ locations in 10° of plantar flexion and 10° of dorsiflexion could be calculated. A video was taken on the second repetition to confirm that the images captured the full range of MTJ displacement. Passive torque values from the third, fourth, and fifth repetitions of the second set were used for analysis. Participants were instructed to relax as the foot plate moved the ankle. To ensure that the condition was passive, the activity of the medial gastrocnemius and the anterior tibialis muscles was monitored by a 2-channel Bagnoli desktop electromyography system (Delsys Inc, Natick, MA). Single-differential surface electrodes (input impedance greater than 1015 Ω // 0.2 pF; common-mode rejection ratio, -92 dB; noise, 1.2 μV; preamplifier gain, 10 V/V  1%) were used. The contact material was 99.9% Ag, in the shape of 2 bars with contact dimensions of 10 × 1 mm and spaced 1 cm apart. The electrodes were placed over the motor point of the medial gastrocnemius and the anterior tibialis muscles. The raw electromyography signal was viewed using a 2-channel digitizing oscilloscope (Tektr...

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Tendinopathy alters mechanical and material properties of the Achilles tendon

Cited by 332 publications

References 33 publications

Achilles tendinopathy alters stretch shortening cycle behaviour during a sub-maximal hopping task

Achilles tendinopathy alters stretch shortening cycle behaviour during a sub-maximal hopping task

Knee Extensor Dynamics in the Volleyball Approach Jump: The Influence of Patellar Tendinopathy

Altered Tendon Characteristics and Mechanical Properties Associated With Insertional Achilles Tendinopathy

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