Abstract
BackgroundOver the past thirty years, there has been dramatic increase in incidence of Achilles tendon rupture in the athletic population. The purpose of this study was to compare the lower extremity mechanics of Achilles tendon ruptured runners with healthy controls.MethodsThe participants with a past history of an Achilles tendon repair (n = 11) and healthy control (n = 11) subgroups were matched on sex, age, type of regular physical activity, mass, height, footfall pattern and lateral dominancy. Running kinetics and kinematics of the ankle, knee and hip were recorded using a high-speed motion capture system interfaced with a force platform. Achilles tendon length was measured using ultrasonography. Main outcome measures were lower extremity joint angles and moments during stance phase of running and Achilles tendon lengths.ResultsAthletes from Achilles tendon group had an affected gastro-soleus complex. Athletes with history of Achilles tendon rupture had reduced ankle range of motion during second half of the stance phase of running (Δ7.6°), an overextended knee during initial contact (Δ5.2°) and increased affected knee range of motion (Δ4.4°) during the first half of stance phase on their affected limb compared to the healthy control group. There was a 22% increase in the maximal hip joint moment on contralateral side of the Achilles tendon group compared to the healthy controls.ConclusionThese results suggest a compensation mechanism, relatively extended knee at initial ground contact against the deficit in the muscle-tendon complex of the triceps surae. Overextension during sporting activities may place the knee at risk for further injury. Avoidance of AT lengthening and plantarflexion strength deficit after surgery and during rehabilitation might help to manage AT rupture since these factors may be responsible for altered running kinematics.
Highlights
Over the past thirty years, there has been dramatic increase in incidence of Achilles tendon rupture in the athletic population
This study indicated that the individuals with history of Achilles tendon (AT) rupture have reduced ankle range of motion during push-off phase of stance, reduced knee flexion during initial contact and an increased knee range of motion during the weight acceptance phase of stance on their affected limb compared to the healthy control group
These results suggest a compensation mechanism, overextending the knee at initial ground contact, against the deficit in the muscle-tendon complex of the triceps surae
Summary
Over the past thirty years, there has been dramatic increase in incidence of Achilles tendon rupture in the athletic population. Over the past thirty years, there has been dramatic increase in incidence of AT rupture (from 2 to 22 per 100,000 personyears) primarily in the athletic population [2, 3]. Evidence has been reported that individuals with a history of AT rupture have decreased ankle joint proprioception, decreased plantar flexor muscle volume, increased AT length and affected AT stiffness [6,7,8]. The changes in mechanical, anatomical and/or neuromuscular properties of the triceps surae lead to Achilles tendon weakness in a plantar flexed position [9], an increase plantar flexor muscle activity during locomotion [10] and reduced plantar flexor endurance even several years after rupture [11]. Athletes with a previous AT rupture were 176
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