Abstract
ObjectivesThe objective of the current cross-sectional study was to examine Achilles tendon transverse stiffness in a group of recreational runners with Achilles tendinopathy, in comparison to an asymptomatic group of runners with similar training history. We also aimed to determine the between-week intra-individual reliability of this measurement technique.DesignCross-sectional cohort study.MethodsA hand-held dynamometer was used to assess the transverse stiffness of the Achilles tendon (AT) in twenty-five recreational runners. In ten people with midportion Achilles tendinopathy (5 men, 5 women), measurements were taken directly over the most symptomatic location. In 15 people who were free of AT symptoms (7 men, 8 women), measurements were taken at an equivalent location on the tendon. Participants returned after one week to determine measurement reliability (intra-class correlation coefficient/ICC and minimum detectable change/MDC95). We also collected information about people’s tendon loading activities, tendon thickness (ultrasound mesaurement), and symptoms (Victorian Institute of Sports Assessment–Achilles / VISA-A score).ResultsThe AT transverse stiffness was lower in people with Achilles tendinopathy (777 N/m ± 86) compared to those who were asymptomatic (873 N/m ± 72) (p < 0.05). AT transverse stiffness was negatively correlated with age and tendon thickness, and positively correlated with VISA-A score and waist circumference. Reliability was good, with ICC of 0.81 in people with tendinopathy and 0.80 in healthy controls, and an MDC95 of 118 and 87N/m in these two respective groups.ConclusionsTransverse Achilles tendon stiffness can be reliably measured in people with midportion Achilles tendinopathy, and appears to be lower in people who are older, more symptomatic, and with more extensive tendon thickening. The potential clinical utility of monitoring tendon stiffness in the management of tendon injuries merits further study.
Highlights
We recently assessed the feasibility of measuring the transverse stiffness of the Achilles and patellar tendons.[1]
The Achilles tendon (AT) transverse stiffness was lower in people with Achilles tendinopathy (777 N/m ± 86) compared to those who were asymptomatic (873 N/m ± 72) (p < 0.05)
AT transverse stiffness was negatively correlated with age and tendon thickness, and positively correlated with VISA-A score and waist circumference
Summary
We recently assessed the feasibility of measuring the transverse stiffness (kTR) of the Achilles and patellar tendons.[1]. In a field study of 66 recreational runners, men displayed stiffer tendons than women, and more highly trained individuals had increased Achilles stiffness compared to those who were less highly trained These results encouraged us to explore the potential utility of measuring Achilles tendon transverse stiffness in people with symptomatic tendinopathy. Using shear-wave elastography, Coombes et al found that transverse Achilles tendon stiffness was reduced in the tendinopathic Achilles compared to healthy tendon, indicating that the symptomatic Achilles tissue was softer (more compliant) in the painful region [7]. A deficit in tissue load tolerance could contribute to a scenario of failed healing and repeated provocation of nociception (mechanical hyperalgesia)
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