Influence of Age and Pathology on Achilles Tendon Properties During a Single-leg Jump

 

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Abstract

Prevalence of Achilles tendinopathy increases with age leading to a weaker tendon with predisposition to rupture. Conclusive evidence of the influence of age and pathology on Achilles tendon (AT) properties remains limited, as previous studies are based on standardized isometric conditions. The study investigates the influence of age and pathology on AT properties during single-leg vertical jump (SLVJ). 10 children (C), 10 asymptomatic adults (A), and 10 tendinopathic patients (T) were included. AT elongation [mm] from rest to maximal displacement during a SLVJ on a force-plate was sonographically assessed. AT compliance [mm/N]) and strain [%] was calculated by dividing elongation by peak ground reaction force [N] and length, respectively. One-way ANOVA followed by Bonferroni post-hoc correction (α=0.05) were used to compare C with A and A with T. AT elongation (p=0.004), compliance (p=0.001), and strain were found to be statistically significant higher in C (27±3 mm, 0.026±0.006 [mm/N], 13±2%) compared to A (21±4 mm, 0.017±0.005 [mm/N], 10±2%). No statistically significant differences (p≥0.05) was found between A and T (25±5 mm, 0.019±0.004 [mm/N], 12±3%). During SLVJ, tendon responded differently in regards to age and pathology with children having the most compliant AT. Higher compliance found in healthy tendons might be considered as a protective factor against load-related injuries.

• References

• 1 Arya S, Kulig K. Tendinopathy alters mechanical and material properties of the Achilles tendon. J Appl Physiol 2010; 108: 670-675
  CrossrefPubMedGoogle Scholar
• 2 Butler DL, Grood ES, Noyes FR, Zernicke RF. Biomechanics of ligaments and tendons. Exerc Sport Sci Rev 1978; 6: 125-181
  PubMedGoogle Scholar
• 3 Cassel M, Baur H, Hirschmuller A, Carlsohn A, Frohlich K, Mayer F. Prevalence of Achilles and patellar tendinopathy and their association to intratendinous changes in adolescent athletes. Scand J Med Sci Sports 2015; 25: e310-e318
  CrossrefPubMedGoogle Scholar
• 4 Child S, Bryant AL, Clark RA, Crossley KM. Mechanical properties of the Achilles tendon aponeurosis are altered in athletes with Achilles tendinopathy. Am J Sports Med 2010; 38: 1885-1893
  CrossrefPubMedGoogle Scholar
• 5 Cook JL, Purdam CR. Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy. Br J Sports Med 2009; 43: 409-416
  CrossrefPubMedGoogle Scholar
• 6 Erdemir A, McLean S, Herzog W, van den Bogert AJ. Model-based estimation of muscle forces exerted during movements. Clin Biomech 2007; 22: 131-154
  CrossrefPubMedGoogle Scholar
• 7 Fahlstrom M, Lorentzon R, Alfredson H. Painful conditions in the Achilles tendon region in elite badminton players. Am J Sports Med 2002; 30: 51-54
  CrossrefPubMedGoogle Scholar
• 8 Fahlstrom M, Lorentzon R, Alfredson H. Painful conditions in the Achilles tendon region: a common problem in middle-aged competitive badminton players. Knee Surg Sports Traumatol Arthrosc 2002; 10: 57-60
  CrossrefPubMedGoogle Scholar
• 9 Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007; 39: 175-191
  CrossrefPubMedGoogle Scholar
• 10 Finni T, Komi PV, Lukkariniemi J. Achilles tendon loading during walking: application of a novel optic fiber technique. Eur J Appl Physiol 1998; 77: 289-291
  CrossrefPubMedGoogle Scholar
• 11 Harriss DJ, Atkinson G. Ethical Standards in Sport and Exercise Science Research: 2016 Update. Int J Sports Med 2015; 36: 1121-1124
  Google Scholar
• 12 Heinemeier KM, Kjaer M. In vivo investigation of tendon responses to mechanical loading. J Musculoskelet Neuronal Interact 2011; 11: 115-123
  PubMedGoogle Scholar
• 13 Hirschmuller A, Frey V, Deibert P, Konstantinidis L, Mayer F, Sudkamp N, Helwig P. Achilles tendon power Doppler sonography in 953 long distance runners – a cross sectional study. Ultraschall Med 2010; 31: 387-393
  Article in Thieme ConnectPubMedGoogle Scholar
• 14 Intziegianni K, Cassel M, Froehlich K, Engel T, Mayer F. Measuring Achilles Tendon Length: A simple and Reliable Method. Sports Orthop Traumatol 2015; 31: 260-266
  PubMedGoogle Scholar
• 15 Intziegianni K, Cassel M, König N, Müller S, Fröhlich K, Mayer F. Ultrasonography for the assessment of the structural properties of the Achilles tendon in asymptomatic individuals: An intra-rater reproducibility study. Isokin Exerc Sci 2015; 23: 263-270
  PubMedGoogle Scholar
• 16 Iversen JV, Bartels EM, Langberg H. The Victorian institute of sports assessment – Achilles questionnaire (visa-a) – a reliable tool for measuring Achilles tendinopathy. Int J Sports Phys Ther 2012; 7: 76-84
  PubMedGoogle Scholar
• 17 Johansson C. Injuries in elite orienteers. Am J Sports Med 1986; 14: 410-415
  CrossrefPubMedGoogle Scholar
• 18 Kader D, Saxena A, Movin T, Maffulli N. Achilles tendinopathy: some aspects of basic science and clinical management. Br J Sports Med 2002; 36: 239-249
  CrossrefPubMedGoogle Scholar
• 19 Kjaer M. Role of extracellular matrix in adaptation of tendon and skeletal muscle to mechanical loading. Physiol Rev 2004; 84: 649-698
  CrossrefPubMedGoogle Scholar
• 20 Komi PV. Relevance of in vivo force measurements to human biomechanics. J Biomech 1990; 23 (Suppl. 01) 23-34
  CrossrefPubMedGoogle Scholar
• 21 Komi PV, Fukashiro S, Jarvinen M. Biomechanical loading of Achilles tendon during normal locomotion. Clin Sports Med 1992; 11: 521-531
  PubMedGoogle Scholar
• 22 Kubo K, Kanehisa H, Kawakami Y, Fukanaga T. Growth changes in the elastic properties of human tendon structures. Int J Sports Med 2001; 22: 138-143
  Article in Thieme ConnectPubMedGoogle Scholar
• 23 Kvist M. Achilles tendon injuries in athletes. Ann Chir Gynaecol 1991; 80: 188-201
  PubMedGoogle Scholar
• 24 Kvist M. Achilles tendon injuries in athletes. Sports Med 1994; 18: 173-201
  CrossrefPubMedGoogle Scholar
• 25 Leppilahti J, Orava S, Karpakka J, Takala T. Overuse injuries of the Achilles tendon. Ann Chir Gynaecol 1991; 80: 202-207
  PubMedGoogle Scholar
• 26 Lysholm J, Wiklander J. Injuries in runners. Am J Sports Med 1987; 15: 168-171
  CrossrefPubMedGoogle Scholar
• 27 Maffulli N, Sharma P, Luscombe KL. Achilles tendinopathy: aetiology and management. J R Soc Med 2004; 97: 472-476
  CrossrefPubMedGoogle Scholar
• 28 Maganaris CN. Tensile properties of in vivo human tendinous tissue. J Biomech 2002; 35: 1019-1027
  CrossrefPubMedGoogle Scholar
• 29 Malliaras P, Voss C, Garau G, Richards P, Maffulli N. Achilles tendon shape and echogenicity on ultrasound among active badminton players. Scand J Med Sci Sports 2012; 22: 149-155
  CrossrefPubMedGoogle Scholar
• 30 Muramatsu T, Muraoka T, Takeshita D, Kawakami Y, Hirano Y, Fukunaga T. Mechanical properties of tendon and aponeurosis of human gastrocnemius muscle in vivo. J Appl Physiol 2001; 90: 1671-1678
  CrossrefPubMedGoogle Scholar
• 31 O’Brien TD, Reeves ND, Baltzopoulos V, Jones DA, Maganaris CN. Mechanical properties of the patellar tendon in adults and children. J Biomech 2010; 43: 1190-1195
  CrossrefPubMedGoogle Scholar
• 32 Paavola M, Kannus P, Jarvinen TA, Khan K, Jozsa L, Jarvinen M. Achilles tendinopathy. J Bone Joint Surg Am. 2002; 84-A: 2062-2076
  PubMedGoogle Scholar
• 33 Pang BS, Ying M. Sonographic measurement of Achilles tendons in asymptomatic subjects: variation with age, body height, and dominance of ankle. J Ultrasound Med 2006; 25: 1291-1296
  CrossrefPubMedGoogle Scholar
• 34 Riley G. The pathogenesis of tendinopathy. A molecular perspective. Rheumatology (Oxford) 2004; 43: 131-142
  CrossrefPubMedGoogle Scholar
• 35 Rolf C, Movin T. Etiology, histopathology, and outcome of surgery in achillodynia. Foot Ankle Int 1997; 18: 565-569
  CrossrefPubMedGoogle Scholar
• 36 Sharma P, Maffulli N. Tendon injury and tendinopathy: healing and repair. J Bone Joint Surg Am 2005; 87: 187-202
  CrossrefPubMedGoogle Scholar
• 37 Wang JH. Mechanobiology of tendon. J Biomech 2006; 39: 1563-1582
  CrossrefPubMedGoogle Scholar
• 38 Wang JH, Iosifidis MI, Fu FH. Biomechanical basis for tendinopathy. Clin Orthop Relat Res 2006; 443: 320-332
  CrossrefPubMedGoogle Scholar
• 39 Waugh CM, Blazevich AJ, Fath F, Korff T. Age-related changes in mechanical properties of the Achilles tendon. J Anat 2012; 220: 144-155
  CrossrefPubMedGoogle Scholar