Deficits of Calf Muscles Strength and Rate of Force Development After Achilles Tendon Rupture

Vaida Aleknavičiūtė-Ablonskė,Agnė Savenkovienė,Albertas Skurvydas

doi:10.21277/sw.v2i8.386

Abstract

Many studies, investigating biomechanical properties of plantar flexors muscle-tendon unit after ATR surgery, reported an incomplete calf muscle contractile functional recovery. However, these studies only investigated the plantar flexors muscle function failing to provide information about the adaptive changes in motor strategy. In fact, the development of adaptive changes in motor strategies, due to both mechanical and neural factors, may result in pathological musculoskeletal conditions over the long term. Understanding physiological calf muscle changes due to long-term immobilization may help prevent Achilles tendon re-rupture cases.

Highlights

The Achilles tendon is the thickest and the strongest tendon in the human body (Maffulli, Oliva, & Ronga, 2013; Wang, Chiang, Chen, Shih, Huang, & Jiang, 2013; Bressel & Mc Nair, 2001)
The present study results show that over one year of unilateral Achilles tendon rupture (ATR) surgery, (1) plantar flexion muscle isometric maximal voluntary contraction (MVC) and rate of force development (RFD) torque, and dorsiflexion muscle isometric MVC and RFD torque increased in UIL and injured leg (IL), differences remain between (2) UIL and IL and in calf muscle isometric MVC and RFD torque
We studied calf muscle isometric MVC torque to understand the remaining functional deficits in 12 months’ post-surgery period, following subjects after unilateral ATR surgery

Summary

Introduction

The Achilles tendon is the thickest and the strongest tendon in the human body (Maffulli, Oliva, & Ronga, 2013; Wang, Chiang, Chen, Shih, Huang, & Jiang, 2013; Bressel & Mc Nair, 2001). It is established that acceleration/deceleration mechanism explains 90% of all cases of Achilles tendon rupture (ATR) (Arnold, Hamner, Seth, Millard, & Delp, 2013; Maffulli et al, 2013; Finni, Hodgson, Lai, & Edgreto, 2006). After ATR, muscle strength and functional ability decrease (Horstamann, Lukas, Merk, Brauner, & Mündermann, 2012) and neural and mechanical transduction in the muscle – tendon unit are decreased (Doral, Alam, Bozkurt, Thurnan, Atay, Donmez, & Maffulli, 2010; Smigielski, 2008). Horstamann (2012) and colleagues have shown that plantar flexion muscle strength remains reduced for 10 years after ATR surgery. This is associated with muscle atrophy, and with the smaller cross-sectional area of the repaired tendon.

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Conclusion