Achilles Tendon Length Research Articles

Change in Achilles Tendon Length after Walking on Treadmill with Gradient.

Improving ankle joint contracture is important because stiffness in ankle dorsiflexion can lead to pain, especially when weight-bearing during walking, which tends to concentrate on the forefoot. We hypothesized that the contraction of the gastrocnemius muscle in ankle dorsiflexion would increase the Achilles tendon length and improve the dorsiflexion range of motion. We evaluated the effects of walking with and without a gradient on Achilles tendon length. This study included 23 men who underwent ultrasound imaging to measure the Achilles tendon length while they stood on an inclined table adjusted according to the dorsiflexion angle. Treadmill walking was performed for 10 min with a 10° incline (gradient condition) or without gradient (level condition). The measurements were compared using a paired t-test. In the gradient condition, the range of motion for ankle dorsiflexion was significantly increased after the intervention. In the gradient condition, the Achilles tendon length while standing on an inclined surface was significantly increased after the intervention. Walking under gradient conditions led to the extension of the Achilles tendon in the ankle dorsiflexion position. This was accompanied by contraction of the gastrocnemius muscle, resulting in lengthening of the Achilles tendon. This finding suggests that such interventions may have clinical applications.

ISB clinical biomechanics award winner 2023: Medial gastrocnemius muscle and Achilles tendon interplay during gait in cerebral palsy

BackgroundThe interplay between the medial gastrocnemius muscle and the Achilles tendon is crucial for efficient walking. In cerebral palsy, muscle and tendon remodelling alters the role of contractile and elastic components. The aim was to investigate the length changes of medial gastrocnemius belly and fascicles, and Achilles tendon to understand their interplay to gait propulsion in individuals with cerebral palsy. MethodsTwelve young individuals with cerebral palsy and 12 typically developed peers were assessed during multiple gait cycles using 3D gait analysis combined with a portable ultrasound device. By mapping ultrasound image locations into the shank reference frame, the medial gastrocnemius belly, fascicle, and Achilles tendon lengths were estimated throughout the gait cycle. Participants with cerebral palsy were classified into equinus and non-equinus groups based on their sagittal ankle kinematics. FindingsIn typically developed participants, the Achilles tendon undertook most of the muscle-tendon unit lengthening during stance, whereas in individuals with cerebral palsy, this lengthening was shared between the medial gastrocnemius belly and Achilles tendon, which was more evident in the equinus group. The lengthening behaviour of the medial gastrocnemius fascicles resembled that of the Achilles tendon in cerebral palsy. InterpretationThe findings revealed similar length changes of the medial gastrocnemius fascicles and Achilles tendon, highlighting the enhanced role of the muscle in absorbing energy during stance in cerebral palsy. These results, together with the current knowledge of increased intramuscular stiffness, suggest the exploitation of intramuscular passive forces for such energy absorption.

Effect of the Copenhagen Achilles Rupture Treatment Algorithm (CARTA) on Calf Muscle Volume and Tendon Elongation After Acute Achilles Tendon Rupture: A Predefined Secondary Analysis of the First 60 Patients in a Randomized Controlled Trial.

Surgical treatment of acute Achilles tendon rupture (ATR) lowers the risk of rerupture and may reduce calf atrophy and elongation of the Achilles tendon. The Copenhagen Achilles Rupture Treatment Algorithm (CARTA) was developed to provide individualized treatment selection based on ultrasonographic evaluation of the rupture. In a randomized setup, the present study aimed to investigate whether treatment selection using the CARTA could reduce atrophy and tendon elongation compared with (1) patients treated surgically and (2) patients treated nonsurgically. Randomized controlled trial; Level of evidence, 2. A total of 60 patients with an acute ATR were randomly assigned to receive treatment based on the CARTA (intervention), surgical treatment (control), or nonsurgical treatment (control) in a 1 to 1 to 1 ratio. After 1 year, magnetic resonance imaging of both calves was performed, and muscle volume and Achilles tendon length were measured. Results were presented as the ratio between the affected and the unaffected limbs (ie, limb symmetry index; %). A total of 156 patients were assessed for eligibility, 60 patients were randomized, and 54 patients provided data for the study-19 patients received treatment based on the CARTA (intervention group), 17 patients received nonsurgical treatment (control), and 18 patients received surgical treatment (control). No statistically significant differences were found between the intervention group and the 2 control groups regarding muscle volume and tendon length. No statistically significant differences were found between patients treated surgically and patients treated nonsurgically. Comparison between the affected and the unaffected limb showed statistically significant muscle atrophy (24%-30%) and tendon elongation (soleus, 59%-76%; gastrocnemius, 8%-14%) in the affected limb in all 3 groups. Individualized treatment of acute ATR using an ultrasonographic selection algorithm did not reduce calf muscle atrophy or tendon elongation when compared with surgical and nonsurgical treatment. Surgical treatment did not reduce calf muscle atrophy or tendon elongation compared with nonsurgical treatment.

Early Tendon Morphology as a Biomarker of Long-term Patient Outcomes After Surgical Repair of Achilles Tendon Rupture: A Prospective Cohort Study

Background: Patient outcome after acute Achilles tendon rupture (ATR) varies and is difficult to predict. Whether early variations in healing, visualized with ultrasonography, can predict long-term patient outcome is unclear. Purpose: To (1) examine the associations of Achilles tendon cross-sectional area (CSA) and elongation (TE) during healing of ATR repair with patient outcomes at 12 months postoperatively and (2) investigate the predictive or diagnostic capacity of the morphological biomarkers. Study Design: Cohort study; Level of evidence, 2. Methods: This study was based on previously collected data from 86 patients who underwent acute standardized ATR repair between 2013 and 2018 and who were included in a prior randomized trial investigating early functional mobilization (EFM). In the EFM group, loading was allowed immediately after surgery, while in the comparison group, loading was allowed first at 2 weeks postoperatively. Achilles tendon CSA and length were measured with ultrasound at 6 weeks, 6 months, and 12 months postoperatively. CSA ratio and absolute difference in the length of the healthy and injured tendons were calculated. Patient-reported outcome was registered with the validated Achilles tendon Total Rupture Score and functional outcome with the heel-rise endurance test at 12 months postoperatively. The limb symmetry index (LSI) was calculated for maximum heel-rise height (HRHmax) and total concentric work. Multiple linear regression adjusted for age was used, and the area under the receiver operating characteristic curve (AUC) was calculated to evaluate predictive capacity. Results: A larger CSA ratio at 6 weeks was associated with higher LSI HRHmax at 12 months ( R2, 0.35; P < .001) and exhibited good predictive capacity (AUC, 0.82). More TE at 12 months was associated with lower LSI total concentric work at 12 months ( R2, 0.21; P = .001) and exhibited acceptable predictive capacity (AUC, 0.71). Conclusion: Greater Achilles tendon CSA seen on ultrasound 6 weeks after surgical repair had good clinical prediction for long-term functional outcome. TE at 12 months was predictive of inferior functional outcome. Registration: NCT02318472 (ClinicalTrials.gov identifier).

Measurement of Healthy and Injured Triceps Surae Morphology.

Achilles tendon injuries occur throughout the lifespan and can negatively affect quality of life and overall health. Achilles tendinopathy is generally classified as an overuse injury associated with fusiform tendon thickening, neovascularization, and interstitial tendon degeneration. Current literature suggests these structural changes are associated withsymptoms and lower physical activity levels, as well assymptoms and lower extremity function in the long term. Surgically and non-surgically managed Achilles tendon ruptures result in increased tendon cross-sectional area (CSA) and a lengthened Achilles tendon. Both structural outcomes have clinical implications, as larger CSA positively predicts function, whereas increased tendon lengthening predicts reduced function after Achilles tendon rupture. Given the relationship between structural changes associated with Achilles tendon injuries for both injury severity and injury recovery, it is critical to be able to quantify Achilles tendon structure reliably and accurately. Silbernagel's group has established a valid and reliable method for efficiently evaluating triceps surae muscle and tendon structure. In this protocol, B-mode musculoskeletal ultrasound imaging is used to measure triceps surae structure, including Achilles tendon thickness and CSA, soleus thickness, and the presence of additional findings (calcifications and bursitis). B-mode extended field-of-view is used to measure Achilles tendon length and gastrocnemius anatomical CSA. Finally, power Doppler is used to identify intratendinous neovascularization. Quantification of triceps surae structure allows for comparison between limbs as well as longitudinal changes in response to exercise and treatment for healthy individuals and those with Achilles tendon injuries. This protocol has been used in many research studies to date and proves valuable in understanding the relationship between tendon structure and injury development, severity, and recovery. As ultrasound devices are becoming more affordable and portable, this protocol proves promising as a clinical tool, given its quick and efficient methods.

How susceptible are our Achilles Tendons? Sonoanatomical assessment. A cross-sectional study

Objectivethe aim of this study is to observe whether there are ultrasound changes between men and women in the Achilles tendon at rest, at maximum passive force is applied and during walking. Material and methodsit was a cross-sectional study involving 27 healthy young participants recruited as volunteers between April to July 2022. A variety of data was recorded: (age, Body Mass Index, sex, smoking, current injury status, allergies, medications, previous surgeries, type of sport, and number of weekly workouts) and ultrasound measurements at rest and at passive force (Cross Sectional Area Achilles Tendon length, tendon thickness, Cross Sectional Area and pennation angle of the soleus muscle to the Achilles Tendon). Resultswomen demonstrated a statistically significant lower proximal and median thickness both at rest (4.5 vs 5.1 mm with p < 0.001 for proximal thickness; 4.4 vs 5.3 mm with p < 0.001 for median thickness) as well as during maximum eccentric contraction (4.3 vs 4.8 mm with p=<0.001 for proximal thickness; 4.1 vs 4.8 mm with p < 0.001 for median thickness). Conclusionthere are significant sonoanatomical differences in vivo Achilles tendon between men and women.

Evaluation of the morphometric features of Achilles tendon with tendinopathy: an MRI study

Objectives: The Achilles tendon, the biggest tendon in the body, transmits the mechanical force received from the body to the ankle through the calcaneus. The aim of this study was to evaluate the effects of morphometric characteristics of the soleus and gastrocnemius muscles that make up the Achilles tendon on tendinopathy by MRI. Methods: Foot magnetic resonance images of 128 patients (121 males and 107 females) were retrospectively analyzed. The cases were divided into two groups, the tendinopathy group and the control group. The length and the thickness of the Achilles tendon and the distance of the maximum thickness from the calcaneal insertion were measured in both groups and evaluated for differences between the groups and between genders.Results: In the comparison between genders, the thickness of the Achilles tendon and the distance of the maximum thickness to the calcaneal insertion were higher in males than in females. The length and the thickness of the Achilles tendon was significantly increased in the tendinopathy group compared to the control group. Conclusion: In this study, we investigated the relationship between Achilles tendinopathy and the morphometric properties of the muscles forming the Achilles tendon. The results of our study showed that Achilles tendon length and tendon thickness increased in patients with tendinopathy compared to the control group.

More than energy cost: multiple benefits of the long Achilles tendon in human walking and running.

Elastic strain energy that is stored and released from long, distal tendons such as the Achilles during locomotion allows for muscle power amplification as well as for reduction of the locomotor energy cost: as distal tendons perform mechanical work during recoil, plantar flexor muscle fibres can work over smaller length ranges, at slower shortening speeds, and at lower activation levels. Scant evidence exists that long distal tendons evolved in humans (or were retained from our more distant Hominoidea ancestors) primarily to allow high muscle-tendon power outputs, and indeed we remain relatively powerless compared to many other species. Instead, the majority of evidence suggests that such tendons evolved to reduce total locomotor energy cost. However, numerous additional, often unrecognised, advantages of long tendons may speculatively be of greater evolutionary advantage, including the reduced limb inertia afforded by shorter and lighter muscles (reducing proximal muscle force requirement), reduced energy dissipation during the foot-ground collisions, capacity to store and reuse the muscle work done to dampen the vibrations triggered by foot-ground collisions, reduced muscle heat production (and thus core temperature), and attenuation of work-induced muscle damage. Cumulatively, these effects should reduce both neuromotor fatigue and sense of locomotor effort, allowing humans to choose to move at faster speeds for longer. As these benefits are greater at faster locomotor speeds, they are consistent with the hypothesis that running gaits used by our ancestors may have exerted substantial evolutionary pressure on Achilles tendon length. The long Achilles tendon may therefore be a singular adaptation that provided numerous physiological, biomechanical, and psychological benefits and thus influenced behaviour across multiple tasks, both including and additional to locomotion. While energy cost may be a variable of interest in locomotor studies, future research should consider the broader range of factors influencing our movement capacity, including our decision to move over given distances at specific speeds, in order to understand more fully the effects of Achilles tendon function as well as changes in this function in response to physical activity, inactivity, disuse and disease, on movement performance.

Muscle fascicle and sarcomere adaptation in response to Achilles tendon elongation in an animal model.

Permanent loss of muscle function seen after an Achilles tendon rupture may partly be explained by tendon elongation and accompanying shortening of the muscle. Muscle fascicle length shortens, serial sarcomere number is reduced, and the sarcomere length is unchanged after Achilles tendon transection (ATT) and these changes are mitigated with suturing. Controlled laboratory study. Two groups of rats underwent ATT on one side with a contralateral control (CTRL): A) ATT with 3 mm removal of the Achilles tendon and no suturing (substantial tendon elongation), and B) ATT with suture repair (minimal tendon elongation). The operated limb was immobilized for 2 weeks to reduce load. Four weeks after surgery the rats were euthanized, and hindlimbs were analyzed for tendon length, gastrocnemius medialis (GM) muscle mass, length, fascicle length, sarcomere number and length. No differences were observed between the groups, and in both groups the Achilles tendon length was longer (15.2%, P<0.001), GM muscle mass was smaller (17.5%, P<0.001), and muscle length was shorter (8.2%, P<0.001) on the ATT compared to CTRL side. GM fascicle length was shorter (11.2%, P<0.001), and sarcomere number was lower (13.8%, P<0.001) on the ATT side in all regions. Sarcomere length was greater in the proximal (5.8%, P<0.001) and mid (4.2%, P=0.003), but not distal region on the ATT side. In this animal model, regardless of suturing, ATT resulted in tendon elongation, loss of muscle mass and length and reduced serial sarcomere number, which resulted in an "overshoot" lengthening of the sarcomeres.

Is the muscle–tendon architecture of non-athletic Kenyans different from that of Japanese and French males?

BackgroundIn endurance running, elite Kenyan runners are characterized by longer thigh, shank, and Achilles tendon (AT) lengths combined with shorter fascicles and larger medial gastrocnemius (MG) pennation angles than elite Japanese runners. These muscle-tendon characteristics may contribute to the running performance of Kenyans. Furthermore, these specific lower-leg musculoskeletal architectures have been confirmed not only in elite Kenyan runners but also in non-athletic Kenyans since early childhood. However, it remains questionable whether the differences in muscle-tendon architecture between Kenyans and Japanese differ from those of European Caucasians. Therefore, this study aimed to compare anthropometry and muscle–tendon architecture of young non-athletic Kenyan males with their Japanese and French counterparts.MethodsA total of 235 young non-athletic males, aged 17–22 years, volunteered. The anthropometric measures, thigh, and shank lengths, as well as AT and MG muscle architecture, were measured using ultrasonography and a tape measure. Inter-group differences in anthropometry and muscle-tendon architecture were tested using one-way ANOVA and ANCOVA analyses controlling for shank length and muscle thickness.ResultsThe anthropometric and muscle-tendon characteristics of the non-athletic French were closer to those of the Kenyans than to those of the Japanese. However, the ultrasonography analysis confirmed that the non-athletic Kenyans had the longest AT as well as the shortest MG fascicles and the largest pennation angle compared to the French and Japanese, even after controlling for shank length and muscle thickness with ANCOVA, respectively.ConclusionsThese results confirmed the specificity of the muscle-tendon architecture of the triceps surae in Kenyans in comparison to their Japanese and French counterparts in non-athletic adults. This study provides additional support to the fact that Kenyans may have musculotendinous advantages in endurance running.

Measurements of tendon length changes during stretch–shortening cycles in rat soleus

The muscle force attained during concentric contractions is augmented by a preceding eccentric contraction (the stretch–shortening cycle (SSC) effect). At present, tendon elongation is considered the primary mechanism. However, we recently found that the magnitude of the SSC effect was not different, even after removing the Achilles tendon. To resolve these discrepant results, direct measurement of changes in Achille tendon length is required. Therefore, this study aimed to elucidate the influence of tendon elongation on the SSC effect by directly measuring the changes in Achilles tendon length. The rat soleus was subjected to pure concentric contractions (pure shortening trials) and concentric contractions with a preceding eccentric contraction (SSC trials). During these contractions, the Achilles tendon length was visualized using a video camera. The muscle force attained during the concentric contraction phase in the SSC trial was significantly larger than that in the pure shortening trial (p = 0.022), indicating the existence of the SSC effect. However, the changes in Achilles tendon length were not different between trials (i.e., the magnitude of tendon shortening attained during the shortening phase was 0.20 ± 0.14 mm for the SSC trial vs. 0.17 ± 0.09 mm for the pure shortening trial), indicating that the observed SSC effect is difficult to be explained by the elastic energy stored in tendons or muscle–tendon interaction. In conclusion, the effect of tendon elongation on the SSC effect should be reconsidered, and other factors may contribute to the SSC effect.

CAPACITAÇÃO DE PRATICANTES DE BOXE CHINÊS SOB TREINAMENTO PRECOCE

ABSTRACT Introduction: Early special training has been widely used to improve athletic performance in young Chinese boxing athletes. For athletes to make better use of training time and accumulate maximum special competitive skills, intensive training is required from their youth. Objective: Study the competitive ability of Chinese boxing athletes under strengthening through early physical training. Methods: Through literature method, experimental methods, and mathematical statistical analysis, the athletes’ body composition and their performance in specific and functional physical activities were analyzed. results: Young athletes significantly differed in BMI, height, and limb length (P&lt;0.05). There was no significant difference in height, the distance between fingers, Achilles tendon length (P&gt;0.05). No significant difference was found in flexibility and sensitivity among volunteers (P&gt;0.05). Conclusion: The athletes participating in early training are uniformly matched, the level of tactical ability of the athletes under training has a differential that can directly impact future sports performance, and this practice is recommended to improve the athletes’ sports performance. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Achilles tendon resting angle is able to detect deficits after an Achilles tendon rupture, but it is not a surrogate for direct measurements of tendon elongation, function or symptoms

PurposeThe aim of this study was to investigate how the Achilles tendon resting angle (ATRA), an indirect measurement of tendon elongation, correlates with ultrasonography (US) measurements of the Achilles tendon length 6 and 12 months after an acute ATR and relates to other clinical outcome measurements such as heel-rise height, jumping ability and patient-reported outcome measurements (PROMs).MethodsPatients were included following acute Achilles tendon rupture (ATR). Achilles tendon length, ATRA, heel-rise height (HRH), drop countermovement jump (Drop CMJ) and PROMs (Achilles tendon total rupture score (ATRS) and physical activity scale (PAS)) were evaluated 6 and 12 months after injury. Achilles tendon length was evaluated using US, while the ATRA was measured with a goniometer.ResultsSixty patients (13 women, 47 men), mean (SD) age 43 (9) years, with an acute ATR undergoing either surgical (35%) or non-surgical (65%) treatment were evaluated. A negative correlation (r = − 0.356, p = 0.010) between relative ATRA and tendon elongation was seen at 12 months after ATR. There were also significant positive correlations at 6 and 12 months between relative ATRA and HRH (r = 0.330, p = 0.011 and r = 0.379, p = 0.004). There were no correlations between ATRA and ATRS or ATRA and Drop CMJ, at either 6 or 12 months after the injury.ConclusionIn combination with other clinical evaluations such as HRH and US, ATRA could be a clinical tool for indirect measurements of tendon elongation. However, ATRA cannot be recommended as a direct surrogate for US for determining Achilles tendon length.Level of evidenceIII.

The Distal Free Achilles Tendon Is Longer in People with Tendinopathy than in Controls: A Retrospective Case-Control Study.

The free Achilles tendon is defined as the region of tendon distal to the soleus which is "unbuttressed," i.e., unsupported by muscular tissue. We reasoned that a relative lack of distal buttressing could place the tendon at a greater risk for developing Achilles tendinopathy. Therefore, our primary goal was to compare the free Achilles tendon length between those with midportion or insertional Achilles tendinopathy and healthy controls. This is a retrospective case-control study. Setting. Hospital in Vancouver, Canada. Participants. 66 cases with Achilles tendinopathy (25 insertional, 41 midportion) consecutively drawn from a hospital database within a 5-year period and matched to 66 controls (without tendinopathy) based on sex, age, and weight. Main outcome measures. Odds ratio of the risk of developing Achilles tendinopathy given the length of free tendon, defined anatomically on MRI, after adjustment for confounders. MRI-defined free Achilles tendon length is a statistically significant predictor of having midportion Achilles tendinopathy (odds ratio = 0.53, 95% confidence interval 1.13 to 2.07). Midportion Achilles tendinopathy cases had significantly longer free tendons (Mdn = 51.2 mm, IQR = 26.9 mm) compared to controls (Mdn = 40.8 mm, IQR = 20.0 mm), p = 0.007. However, there was no significant difference between the free Achilles tendon lengths in insertional AT cases (Mdn = 47.9 mm, IQR = 15.1 mm) and controls (Mdn = 39.2 mm, IQR = 17.9 mm), p = 0.158. Free Achilles tendon length was also correlated with the tendon thickness among those with Achilles tendinopathy, rτ = 0.25, and p = 0.003. The MRI-defined length of the free Achilles tendon is positively associated with the risk of midportion Achilles tendinopathy. A relative lack of distal muscular buttressing of the Achilles tendon may therefore influence the development of tendinopathy.

Does the Achilles Tendon Influence Foot Strike Patterns During an Exhaustive Run?

The study purpose was to investigate whether there is a relationship between the Achilles tendon (AT) length, moment arm length, and the foot strike pattern (FP) change during an exhaustive run (EXR) in nonrearfoot FP runners. Twenty-eight runners were recruited and divided into 2 groups (highly trained/moderately trained) according to their weekly training volume. Participants underwent the graded exercise test, the EXR with biomechanical analysis at the beginning, and at the end, and the magnetic resonance imaging scan of the AT. Correlations were used to assess associations between FP change (value of the difference between end and beginning) and the selected performance and AT variables. AT length significantly correlated with the FP change according to foot strike angle (r = -.265, P = .049). The AT moment arm length significantly correlated with the FP change according to strike index during EXR (r = -.536, P = .003). Multiple regression showed that AT length was a significant predictor for the FP change according to foot strike angle if the second predictor was the graded exercise test duration and the third predictor was training group association. These results suggest that a runner's training volume, along with a longer AT and AT moment arm appear to be associated with the ability to maintain a consistent FP during EXR by nonrearfoot FP runners.

Validity and reliability of a novel 3D ultrasound approach to assess static lengths and the lengthening behavior of the gastrocnemius medialis muscle and the Achilles tendon in vivo

PurposeHuman muscle–tendon units (MTUs) are highly plastic and undergo changes in response to specific diseases and disorders. To investigate the pathological changes and the effects of therapeutic treatments, the use of valid and reliable examination methods is of crucial importance. Therefore, in this study, a simple 3D ultrasound approach was developed and evaluated with regard to: (1) its validity in comparison to magnetic resonance imaging (MRI) for the assessment of the gastrocnemius medialis (GM) MTU, muscle belly, and Achilles tendon lengths; and (2) its reliability for static and dynamic length measurements.MethodsSixteen participants were included in the study. To evaluate the validity and reliability of the novel 3D ultrasound approach, two ultrasound measurement sessions and one MRI assessment were performed. By combining 2D ultrasound and 3D motion capture, the tissue lengths were assessed at a fixed ankle joint position and compared to the MRI measurements using Bland–Altman plots. The intra-rater and inter-rater reliability for the static and dynamic length assessments was determined using the coefficient of variation, standard error of measurement (SEM), minimal detectable change (MDC95), and intraclass correlation coefficient (ICC).ResultsThe 3D ultrasound approach slightly underestimated the length when compared with MRI by 0.7%, 1.5%, and 1.1% for the GM muscle belly, Achilles tendon, and MTU, respectively. The approach showed excellent intra-rater as well as inter-rater reliability, with high ICC (≥ 0.94), small SEM (≤ 1.3 mm), and good MDC95 (≤ 3.6 mm) values, with even better reliability found for the static length measurements.ConclusionThe proposed 3D ultrasound approach was found to be valid and reliable for the assessment of the GM MTU, muscle belly, and Achilles tendon lengths, as well as the tissue lengthening behavior, confirming its potential as a useful tool for investigating the effects of training interventions or therapeutic treatments (e.g., surgery or conservative treatments such as stretching and orthotics).Level of evidenceLevel II.

Neuromuscular and structural tendon adaptations after 6 weeks of either concentric or eccentric exercise in individuals with non-insertional Achilles tendinopathy: protocol for a randomised controlled trial

IntroductionThere is limited evidence on the neural strategies employed by the central nervous system to control muscle force in the presence of non-insertional Achilles tendinopathy (NIAT). Additionally, the neuromuscular mechanisms...

Muscle-tendon architecture in Kenyans and Japanese: Potential role of genetic endowment in the success of elite Kenyan endurance runners.

The specificity of muscle-tendon and foot architecture of elite Kenyan middle- and long-distance runners has been found to contribute to their superior running performance. To investigate the respective influence of genetic endowment and training on these characteristics, we compared leg and foot segmental lengths as well as muscle-tendon architecture of Kenyans and Japanese males (i) from infancy to adulthood and (ii) non-athletes versus elite runners. The 676 participants were divided according to their nationality (Kenyans and Japanese), age (nine different age groups for non-athletes) and performance level in middle- and long-distance races (non-athlete, non-elite and elite adult runners). Shank and Achilles tendon (AT) lengths, medial gastrocnemius (MG) fascicle length, pennation angle and muscle thickness, AT moment arm (MAAT ), and foot lever ratio were measured. Above 8years old, Kenyans had a longer shank and AT, shorter fascicle, greater pennation angle, thinner MG muscle as well as longer MAAT , with lower foot lever ratio than age-matched Japanese. Among adults of different performance levels and independently of the performance level, Kenyans had longer shank, AT and MAAT , thinner MG muscle thickness, and lower foot lever ratio than Japanese. The decrease in MG fascicle length and increase pennation angle observed for the adult Japanese with the increase in performance level resulted in a lack of difference between elite Kenyans and Japanese. The specificity of muscle-tendon and foot architecture of elite Kenyan runners could result from genetic endowment and contribute to the dominance of Kenyans in middle- and long-distance races.

Gender difference in Achilles tendon length by resting angle measurement in correlation to body parameters between Egyptian physical therapy students

Gender difference in Achilles tendon length by resting angle measurement in correlation to body parameters between Egyptian physical therapy students

A new early hominin calcaneus from Kromdraai (South Africa).

The Kromdraai site in South Africa has yielded numerous early hominin fossils since 1938. As a part of recent excavations within Unit P, a largely complete early hominin calcaneus (KW 6302) was discovered. Due to its role in locomotion, the calcaneus has the potential to reveal important form/function relationships. Here, we describe KW 6302 and analyze its preserved morphology relative to human and nonhuman ape calcanei, as well as calcanei attributed to Australopithecus afarensis, Australopithecus africanus, Australopithecus sediba, Homo naledi, and the Omo calcaneus (either Paranthropus or early Homo). KW 6302 calcaneal morphology is assessed using numerous quantitative metrics including linear measures, calcaneal robusticity index, relative lateral plantar process position, Achilles tendon length reconstruction, and a three-dimensional geometric morphometric sliding semilandmark analysis. KW 6302 exhibits an overall calcaneal morphology that is intermediate between humans and nonhuman apes, although closer to modern humans. KW 6302 possesses many traits that indicate it was likely well-adapted for terrestrial bipedal locomotion, including a relatively flat posterior talar facet and a large lateral plantar process that is similarly positioned to modern humans. It also retains traits that indicate that climbing may have remained a part of its locomotor repertoire, such as a relatively gracile tuber and a large peroneal trochlea. Specimens from Kromdraai have been attributed to either Paranthropus robustus or early Homo; however, there are no definitively attributed calcanei for either genus, making it difficult to taxonomically assign this specimen. KW 6302 and the Omo calcaneus, however, fall outside the range of expected variation for an extant genus, indicating that if the Omo calcaneus was Paranthropus, then KW 6302 would likely be attributed to early Homo (or vice versa).