Tendon Length, Calf Muscle Atrophy, and Strength Deficit After Acute Achilles Tendon Rupture

Heikkinen, Juuso; Lantto, Iikka; Piilonen, Juuso; Flinkkilä, Tapio; Ohtonen, Pasi; Siira, Pertti; Laine, Vesa; Niinimäki, Jaakko; Pajala, Ari; Leppilahti, Juhana

doi:10.2106/jbjs.16.01491

Cited by 117 publications

(152 citation statements)

References 29 publications

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“…Using this imaging approach, we detected a small (3%) decrease in muscle thickness at week 4 that approached statistical significance (P = 0.041). This small decrease in muscle thickness was less than previous reports of muscle atrophy at least 1 year following injury (10,12). Decreases in muscle quality have been associated with age-related muscle deterioration such as sarcopenia (8), but these changes have not been observed in muscle following tendon rupture.…”

Section: Discussionmentioning

confidence: 65%

Gastrocnemius fascicles are shorter and more pennate throughout the first month following acute Achilles tendon rupture

Hullfish

O’Connor

Baxter

2018

Preprint

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1The purpose of this study was to characterize the short-term effects of Achilles tendon 2 ruptures on medial gastrocnemius. We hypothesized that the fascicles of the medial 3 gastrocnemius muscle of the injured Achilles tendon would be shorter and more pennate 4 immediately following the injury and would persist throughout 4 weeks post-injury. B-mode 5 longitudinal ultrasound images of the medial gastrocnemius were acquired in 10 adults who 6 suffered acute Achilles tendon ruptures and were treated non-operatively. Ultrasound images 7 were acquired during the initial clinical visit following injury as well as two and four weeks 8 following this initial clinical visit. Resting muscle structure was characterized by measuring 9 fascicle length, pennation angle, muscle thickness, and muscle echo intensity in both the injured 1 0 and contralateral (control) limbs. Fascicle length was 15% shorter (P < 0.001) and pennation 1 1 angle was 21% greater (P < 0.001) in the injured muscle compared to the uninjured (control) 1 2 muscle at the presentation of injury (week 0). These differences in fascicle length and pennation 1 3 angle persisted throughout the 4 weeks after the injury (P < 0.008). Muscle thickness changes 1 4were not detected at any of the post-injury visits (difference < 4%, P > 0.04). Echo intensity of 1 5 the injured limb was 8% lower at the presentation of the injury and 11% lower (P = 0.008) than 1 6 the contralateral muscle at 2 weeks following injury (P < 0.001) but returned to within 1% by 4 1 7 weeks (P = 0.393). Our results suggest that Achilles tendon ruptures elicit rapid changes in the

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Section: Discussionmentioning

confidence: 65%

Gastrocnemius fascicles are shorter and more pennate throughout the first month following acute Achilles tendon rupture

Hullfish

O’Connor

Baxter

2018

Preprint

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“…From a muscular standpoint, lower muscle volumes in the triceps surae and fatty infiltration of the soleus muscle have been found to relate to decreases in plantar flexor strength . It also seems that the triceps surae musculature is consistently more metabolically active following Achilles tendon rupture .…”

mentioning

confidence: 99%

“…9,10 Also at the tendon level, tendon mechanical properties have been found be altered following rupture [11][12][13][14] and to relate to performance on strength testing 14,15 and walking gait. 12 From a muscular standpoint, lower muscle volumes in the triceps surae [16][17][18] and fatty infiltration of the soleus muscle have been found to relate to decreases in plantar flexor strength. 16 It also seems that the triceps surae musculature is consistently more metabolically active following Achilles tendon rupture.…”

mentioning

confidence: 99%

Lower extremity work along with triceps surae structure and activation is altered with jumping after Achilles tendon repair

Zellers¹,

Marmon²,

Ebrahimi

et al. 2019

Journal Orthopaedic Research

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Achilles tendon rupture leads to long term plantar flexor deficits. The purpose of this study was to describe changes in jumping biomechanics along with triceps surae structure and activation in individuals after Achilles repair. Eleven individuals 1–3 years following Achilles repair and 10 healthy controls were included. Kinetics and kinematics, analyzed using a constituent lower extremity work (CLEW) approach, and muscle activity using surface electromyography (EMG) were collected during a unilateral hopping task. Triceps surae myotendinous structure was assessed using ultrasound imaging. There were no differences in jump height, absolute limb work, or cost of transport between groups. During takeoff, the knee did more (p < 0.001) and ankle did less concentric work (p < 0.001), and lateral gastrocnemius rate of rise was higher (p = 0.02) on the ruptured side. During landing, the knee did more eccentric work (p = 0.033) and lateral gastrocnemius (p = 0.003) and soleus (p = 0.02) activation amplitude prior to landing was higher on the ruptured side. Individuals after Achilles tendon repair shift work toward the knee and alter muscle recruitment. Differences in lateral gastrocnemius activity may indicate that it is well‐situated to generate power during takeoff and assist in landing with the soleus. The lack of change in muscle activity and decreased cross sectional area of the medial gastrocnemius may suggest that this muscle atrophies and does not accommodate to the hopping task. Clinical Significance: Proximal lower extremity strengthening along with emphasizing medial gastrocnemius and soleus activation during the recovery of patients with Achilles tendon repair may be rehabilitative targets for improved jumping performance. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res

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“…[16] Heikkinen ve ark., Aşil tendon rüptür cerrahileri sonrası diğer taraf ile karşılaştırıldığında, etkilenen taraf Aşil tendonunda uzama, gastrocnemius ve soleus kasları kas kütlelerin-de ve plantar fleksiyon kuvvetinde azalma görüldüğünü belirtmişlerdir. [17] Bu nedenle, cerrahi sonrası en erken dönemden itibaren, kas atrofisinin miktarını azaltmak için kuvvetlendirme egzersizlerine başlanmalı-dır. Cerrahi sonrası ilk iki hafta daha güvenli olacağı için, dorsifleksiyon, inversiyon ve eversiyon yönlerinde izometrik egzersizlere başlanmalıdır.…”

Section: Aşi̇l Tendon Onarimi Sonrasi Fonksi̇yonel Rehabi̇li̇tasyonunclassified

Aşil tendon rüptür cerrahisi sonrası fonksiyonel rehabilitasyon

Can¹,

Numanoğlu²

2018

TOTBID

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Tendon Length, Calf Muscle Atrophy, and Strength Deficit After Acute Achilles Tendon Rupture

Abstract: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Cited by 117 publications

References 29 publications

Gastrocnemius fascicles are shorter and more pennate throughout the first month following acute Achilles tendon rupture

Gastrocnemius fascicles are shorter and more pennate throughout the first month following acute Achilles tendon rupture

Lower extremity work along with triceps surae structure and activation is altered with jumping after Achilles tendon repair

Aşil tendon rüptür cerrahisi sonrası fonksiyonel rehabilitasyon

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