Lower Body Stiffness Research Articles

Effects of maturation on myotonometric parameters and their predictors of athletic performance in elite youth soccer players

The aim of the present study was to investigate the variations in individual muscle stiffness across different maturation stages (i.e., peak height velocity [PHV]) in elite youth soccer players and to explore the associations between lower limb muscle stiffness and performance in sprinting (10, 20, and 40 m sprint), maneuverability (9–3-6–3-9 m sprint test), and jumping (countermovement jump [CMJ]). A total of 131 elite youth soccer players aged 12–18 years, volunteered to participate in the study and were divided into pre-PHV (n = 21), mid-PHV (n = 33), and post-PHV (n = 80). Muscle stiffness of the rectus femoris (RF) and biceps femoris (BF) muscles was assessed using a MyotonPRO. Results showed that players in the pre-PHV stage had lower stiffness in the BF and RF muscles compared to mid-PHV (p < 0.001; effect size [ES] = moderate to large) and post-PHV players (p < 0.001; ES = moderate to large). It was also observed that the mid-PHV group had lower stiffness levels in their RF muscle compared to the post-PHV group (p < 0.001; ES = small). Significant correlations were found between BF and RF stiffness and sprint (p < 0.001) and maneuverability (p < 0.001) performance. RF stiffness showed a significant positive correlation with CMJ (p < 0.05), suggesting that greater lower body stiffness is beneficial for athletic performance in youth soccer players. The findings highlighting the importance of considering training methods that increase muscular stiffness, particularly in relation to the RF muscle, to optimize athletic performance.

Characterization of orthopedic manifestations in patients with mucopolysaccharidosis II using data from 15 years of the Hunter Outcome Survey.

Mucopolysaccharidosis II (MPS II) is a rare, life-limiting lysosomal storage disease caused by reduced iduronate-2-sulfatase activity. Patients experience broad ranging signs and symptoms, including bone and joint manifestations. This study reported on orthopedic involvement and management in patients with MPS II using 15 years of data from the Hunter Outcome Survey (HOS). Of the 245 patients in the study population, 90.2% had skeletal deformity (median onset, 2.8 years), 76.7% had upper body stiffness (onset, 4.2 years), and 61.2% had lower body stiffness (onset, 5.3 years); 63.7% of patients had at least three joint manifestations. Orthopedic manifestations were common in adults and children with MPS II, and in patients with and without cognitive impairment. Joint range of motion (JROM) was restricted in all joints assessed (shoulder, elbow, hip, wrist, knee, and ankle). Little correlation was observed between JROM measurements, subjective reports of joint stiffness and limited function, and 6-minute walk test results. Patients with joint stiffness and limited function were generally more likely to have central and peripheral nervous system, pulmonary, and cardiovascular manifestations than those without these symptoms. Carpal tunnel decompression was the most common orthopedic surgery (recorded in 49/245 patients [20.0%]), but orthopedic surgeries were uncommon overall. Our findings highlight the need for routine monitoring of orthopedic manifestations using multiple assessment types in patients with MPS II to help inform clinical decision-making and improve patient quality of life. They also underline the contribution of factors other than orthopedic manifestations to the walking ability of patients with MPS II.

Anxiety state impact on recovery of runners with lower extremity injuries.

This prospective cohort study examined the impact of high anxiety levels on psychological state and gait performance during recovery in runners with lower body injuries. Recreational runners diagnosed with lower body injuries who had reduced running volume (N = 41) were stratified into groups using State Trait Anxiety Inventory (STAI) scores: high anxiety (H-Anx; STAI ≥40 points) and low anxiety (L-Anx; STAI <40 points). Runners were followed through rehabilitation to return-to-run using monthly surveys. Main outcome measures included kinesiophobia (Tampa Scale of Kinesiophobia, TSK-11), Positive and Negative Affect Schedule (PANAS; Positive and negative scores), Lower Extremity Function Scale (LEFS), running recovery (University of Wisconsin Running Injury and Recovery Index [UWRI]) and CDC Healthy Days modules for general health, days of anxiety/tension, disrupted sleep and work/usual activities. Running biomechanics were assessed at baseline and the final visit using 3D motion capture and a force-plated treadmill. The time to return-to-running for was 5.0±3.1 and 7.9±4.1 months for L-Anx and H-Anx, respectively and participants who withdrew (n = 15) did so at 7.7±6.2 months. L-Anx maintained low anxiety and H-Anx reduced anxiety from baseline to final visit (STAI = 31.5 to 28.4 points, 50.4 to 37.8 points, respectively), whereas the withdrawn runners remained clinically anxious at their final survey (41.5 to 40.3 points; p < .05). Group by time interactions were found for PANAS positive, LEFS UWRI, general health scores, and days feeling worry, tension and anxiety (all p < .05). Final running performance in L-Anx compared to H-Anx was most improved with cadence (8.6% vs 3.5%; p = .044), impact loading rate [-1.9% vs +8.9%] and lower body stiffness [+14.1% vs +3.2%; all p < .05). High anxiety may identify runners who will experience a longer recovery process, health-related functional disruptions, and less optimization of gait biomechanics during rehabilitation after a lower extremity injury.

Influence of footwear, foot-strike pattern and step frequency on spatiotemporal parameters and lower-body stiffness in running

ABSTRACT This study aimed to determine the influence of footwear condition, foot-strike pattern and step frequency on running spatiotemporal parameters and lower-body stiffness during treadmill running. Thirty-one amateur endurance runners performed a two-session protocol (shod and barefoot). Each session consisted of two trials at 12 km · h−1 over 5 minutes altering step frequency every minute (150, 160, 170, 180 and 190 spm). First, participants were instructed to land with the heel first; after completion, the same protocol was repeated landing with the forefoot first. Repeated measures ANOVAs showed significant differences for footwear condition, foot-strike pattern and step frequency for each variable: percent contact time, percent flight time, vertical stiffness and leg stiffness (all p < 0.001). The results demonstrate greater estimated vertical and leg stiffness when running barefoot for both foot-strike patterns showing the largest values for barefoot+forefoot condition. Likewise, both vertical and leg stiffness became greater as step frequency increased. The proper manipulation of these variables facilitates our understanding of running performance and assist in training programmes design and injury management.

Hydrolyzed Collagen Supplementation on Lower Body Stiffness in Recreational Triathletes

Background: Myotendinous stiffness is related to the collagen content of the muscle and tendon, and can be estimated during running by changes in vertical stiffness (kvert) and the resulting modifications of the spatiotemporal parameters (on-off ground asymmetry and landing-takeoff asymmetry). Supplementation with amino acids found in collagen, such as proline, glycine, and hydroxyl proline, combined with ascorbic acid, improve collagen synthesis and potentially result in improved mechanical strength and stiffness. Objectives: To determine if hydrolyzed collagen (HC) supplementation increases kvert and improves the spatiotemporal parameters during running in recreational triathletes. Methods: Nine active males (weight; 68.4 ± 5.7 kg, height; 171.8 ± 5.4 cm, age; 32.5 ± 4.1 years; Vo2max; 53.15 ± 2.19 mL/kg/min) were randomly distributed into a collagen group (CollG, n = 5) and a control group (CG, n = 4). Participants were supplemented for 4 weeks with 15g HC (CollG) or 15g placebo (CG; maltodextrin), 3 times per week. One hour after supplementation, the participants of both groups were asked to perform four repetitions of short sprints to further stimulate collagen synthesis. The ground reaction forces were recorded during running at 4.44 m s-1, 5.55 m.s-1, and 6.66 m.s-1 for assessment of kvert and the spatiotemporal step parameters. Results: Both groups increased kvert with speed (4.44 - 6.66 m s-1) from 24.8 ± 2.7 to 53.7 ± 16.5 N/m and from 25.1 to 49.8 N/m in the CollG and CG, respectively (P &lt; 0.0001); however, there were no differences between groups before and after the supplementation period. As a consequence, the spatiotemporal parameters of running were also similar between groups. Conclusions: Four weeks of HC supplementation does not improve the bouncing mechanism of running in recreational triathletes.

Modulators of Change-of-Direction Economy After Repeated Sprints in Elite Soccer Players.

To investigate the acute effect of repeated-sprint activity (RSA) on change-of-direction economy (assessed using shuttle running economy [SRE]) in soccer players and explore neuromuscular and cardiorespiratory characteristics that may modulate this effect. Eleven young elite male soccer players (18.5 [1.4]y old) were tested on 2 different days during a 2-week period in their preseason. On day 1, lower-body stiffness, power and force were assessed via countermovement jumps, followed by an incremental treadmill test to exhaustion to measure maximal aerobic capacity. On day 2, 2 SRE tests were performed before and after a repeated-sprint protocol with heart rate, minute ventilation, and blood lactate measured. Pooled group analysis indicated no significant changes for SRE following RSA due to variability in individual responses, with a potentiation or impairment effect of up to 4.5% evident across soccer players. The SRE responses to RSA were significantly and largely correlated to players' lower-body stiffness (r = .670; P = .024), and moderately (but not significantly) correlated to players' force production (r = -.455; P = .237) and blood lactate after RSA (r = .327; P = .326). In summary, SRE response to RSA in elite male soccer players appears to be highly individual. Higher lower-body stiffness appears as a relevant physical contributor to preserve or improve SRE following RSA.

Stiffness in Running: A Narrative Integrative Review

ABSTRACT Researching running spatiotemporal parameters has deepened knowledge of the spring-mass model and its capacity to estimate and predict kinetic and kinematic variables. However, although the impact of lower-limb stiffness on athletic performance seems considerable, recognition of lower-limb stiffness among coaches and practitioners remains sparse. This review highlights factors influencing lower-limb stiffness during running and their relationship to injury prevention and performance. Current knowledge of lower-body stiffness during running is integrated and new scientific scope offered. Because the different variables are correlational, it is strongly recommended not to measure their effects on lower-limb stiffness individually. The spring-mass model behavior when altering variables such as footwear or foot-strike pattern needs cautious examination. Although both stretch-shortening cycle and lower-limb stiffness are key parameters in elastic strain energy storage and release during sport activities, hormonal fluctuations (particularly associated with the menstrual cycle) should draw special attention because they affect musculotendinous stiffness properties and therefore may influence athletic performance and injury prevalence. Introducing lower-limb strength training would improve the characteristics of stiffness in running, contributing to maximized performance and reduced injury risk.

Impact of Body Mass Index on Biomechanics of Recreational Runners.

Some recreational runners with obesity successfully train or compete without musculoskeletal injury. Insight into the key kinetic strategies of injury-free heavier runners is necessary to appropriately guide development of safe training programs for this population. To determine key biomechanical strategies of running in individuals with body mass index (BMI) values above and equal to and higher than 30 kg/m2 . This was a case-control study. Runners with obesity (n =18; 42.7 years, 38.9% women) who were matched by sex, age, footstrike type, footwear characteristics, and running speed with healthy runners (n = 36; 41.7 years, 32.5% women). Research laboratory affiliated with an academic medical center. A seven-camera optical motion analysis system was used to capture running kinematics and an instrumented treadmill captured kinetic data. Main outcomes were temporal spatial parameters, joint excursions, peak ground reaction forces (GRFs), joint moments, vertical average loading rate (VALR), impulses, and vertical stiffness (Kvert ). Runners with obesity demonstrated 15% less vertical excursion of the center of mass, 18% wider strides, and 3% longer stance times than nonobese runners (P < .05). Normalized peak GRFs and VALRs were higher in the nonobese group. GRF impulse was higher in the group with obesity compared to the nonobese group (means ± SD; 339.6 ± 55.2 Ns vs. 255.0 ± 45.8 Ns; P = .0001). Kvert was higher in the obese group compared to the nonobese group (238.6 ± 50.3 N/cm vs. 183.1 ± 29.4 N/cm; P = .0001). Peak hip moments were higher in runners with obesity in the sagittal and frontal planes (P < .05). Runners with obesity dampened impact forces and controlled loading rate more than nonobese runners by increasing lower body stiffness and constraining vertical displacement.

Test–retest reliability of the OptoGait system for the analysis of spatiotemporal running gait parameters and lower body stiffness in healthy adults

Despite the widespread use of the OptoGait photoelectric cell system for the analysis of running spatiotemporal parameters, its reliability has not been proved. Consequently, this study intends to determine the test–retest reliability of the system when applied to treadmill running spatiotemporal parameters and lower body stiffness at a constant velocity. Amateur endurance runners (n = 31; age: 34.42 ± 9.26 years; height: 171.54 ± 9.15 cm; body mass: 66.63 ± 11.3 kg) voluntarily consented to participate in this study. Data for each participant were recorded twice per session across two testing sessions. The intra-session and inter-session reliabilities of spatiotemporal parameters and lower body stiffness were determined through test–retest analysis. Although mean comparisons revealed significant differences between measurements in spatiotemporal running gait characteristics and lower body stiffness for intra-session (p &lt; 0.05 in all parameters), the effect size was always small (&lt;0.4). Moreover, the relationship between measurements was very large for spatiotemporal parameters and lower body stiffness (r &gt; 0.7). The intraclass correlation coefficients revealed an almost perfect correlation between measurements (intraclass correlation coefficients &gt;0.81), except Kleg with substantial reliability (intraclass correlation coefficient = 0.788). The inter-session reliability revealed some significant differences in contact time (p = 0.009) and Kleg (p = 0.013), although Cohen’s d indicated small effect size (&lt;0.31). The relationship between sessions was very large for spatiotemporal parameters and lower body stiffness (r &gt; 0.8), and the intraclass correlation coefficients revealed an almost perfect inter-session association (intraclass correlation coefficients &gt;0.881). The results found here show that the OptoGait system can be used confidently for running spatiotemporal parameters analysis and lower body stiffness at a constant velocity for healthy adults.

The Within-Subjects Effects of Practice on Performance of Drop Landing in Healthy, Young Adults.

Most studies of high-speed lower body movements include practice repetitions for facilitating consistency between the trials. We investigated whether 20 repetitions of drop landing (from a 30.5-cm platform onto a force plate) could improve consistency in maximum ground reaction force, linear lower body stiffness, depth of landing, and jump height in 20 healthy, young adults. Coefficient of variation was the construct for variability used to compare the first to the last five repetitions for each variable. We found that the practice had the greatest effect on maximum ground reaction force (p = .017), and had smaller and similar effects on lower body stiffness and depth of landing (p values = .074 and .044, respectively), and no measurable effect on jump height. These findings suggest that the effect of practice on drop landing differs depending upon the variable measure and that 20 repetitions significantly improve consistency in ground reaction force.

How Do Spatiotemporal Parameters and Lower-Body Stiffness Change with Increased Running Velocity? A Comparison Between Novice and Elite Level Runners.

This study aimed to examine the effect of running velocity on spatiotemporal parameters and lower-body stiffness of endurance runners, and the influence of the performance level on those adaptations. Twenty-two male runners (novice [NR], n = 12, and elite runners [ER], n = 10) performed an incremental running test with a total of 5 different running velocities (10, 12, 14, 16, 18 km/h). Each condition lasted 1 min (30 s acclimatization period, and 30 s recording period). Spatiotemporal parameters were measured using the OptoGait system. Vertical (Kvert) and leg (Kleg) stiffness were calculated according to the sine-wave method. A repeated measures ANOVA (2 x 5, group x velocities) revealed significant adaptations (p < 0.05) to increased velocity in all spatiotemporal parameters and Kvert in both NR and ER. ER showed a greater flight time (FT) and step angle (at 18 km/h) (p < 0.05), longer step length (SL) and lower step frequency (SF) (p < 0.05), whereas no between-group differences were found in contact time (CT) nor in the sub-phases during CT at any speed (p ≥ 0.05). ER also showed lower Kvert values at every running velocity (p < 0.05), and no differences in Kleg (p ≥ 0.05). In conclusion, lower SF and Kvert and, thereby, longer FT and SL, seem to be the main spatiotemporal characteristics of high-level runners compared to their low-level counterparts.

Variations in lower body stiffness during sports-specific tasks in well-trained female athletes

ABSTRACT The present study aimed to assess the differences in leg stiffness and the associated performance variables between athletes from various training backgrounds during tasks relevant to athletic training. Forty-seven female participants (20 nationally identified netballers, 13 high-level endurance athletes and 14 age-matched controls) completed a sprint, anticipated sidestep change of direction and unilateral repetitive hopping task to assess leg stiffness and the relationship of stiffness between the different tasks. Leg stiffness and performance variables were evaluated with a 10-camera motion analysis system and force plate, and leg stiffness was derived through the McMahon and Cheng methodology (1990). Significant differences were evident in leg stiffness, and the contributing performance variables between groups across all assessed tasks (p < 0.001–0.017). Furthermore, results indicated the control group displayed no leg stiffness relationship between the evaluated tasks, while the stiffness relationship between tasks within athletic populations reflected training-specific demands of athletes. The results of this study indicated that the athletic training background of individuals may contribute to inherent leg stiffness differences between groups. Furthermore, the stiffness relationship observed between tasks suggests practitioners should take care in the selection of task used to monitor leg stiffness from a performance or injury risk perspective.

Using stiffness to assess injury risk: comparison of methods for quantifying stiffness and their reliability in triathletes.

BackgroundA review of the literature has indicated that lower body stiffness, defined as the extent to which the lower extremity joints resists deformation upon contact with the ground, may be a useful measure for assessing Achilles injury risk in triathletes. The nature of overuse injuries suggests that a variety of different movement patterns could conceivably contribute to the final injury outcome, any number and combination of which might be observed in a single individual. Measurements which incorporate both kinetics and kinematics (such as stiffness) of a movement may be better able to shed light on individuals at risk of injury, with further analysis then providing the exact mechanism of injury for the individual. Stiffness can be measured as vertical, leg or joint stiffness to model how the individual interacts with the environment upon landing. However, several issues with stiffness assessments limit the effectiveness of these measures to monitor athletes’ performance and/or injury risk. This may reflect the variety of common biomechanical stiffness calculations (dynamic, time, true leg and joint) that have been used to examine these three stiffness levels (vertical, leg and joint) across a variety of human movements (i.e. running or hopping) as well as potential issues with the reliability of these measures, especially joint stiffness. Therefore, the aims of this study were to provide a comparison of the various methods for measuring stiffness during two forms of human bouncing locomotion (running and hopping) along with the measurement reliability to determine the best methods to assess links with injury risk in triathletes.MethodsVertical, leg and joint stiffness were estimated in 12 healthy male competitive triathletes on two occasions, 7 days apart, using both running at 5.0 ms−1 and hopping (2.2 Hz) tasks.ResultsInter-day reliability was good for vertical (ICC = 0.85) and leg (ICC = 0.98) stiffness using the time method. Joint stiffness reliability was poor when assessed individually. Reliability was improved when taken as the sum of the hip, knee and ankle (ICC = 0.86). The knee and ankle combination provided the best correlation with leg stiffness during running (Pearson’s Correlation = 0.82).DiscussionThe dynamic and time methods of calculating leg stiffness had better reliability than the “true” method. The time and dynamic methods had the best correlation with the different combinations of joint stiffness, which suggests that they should be considered for biomechanical screening of triathletes. The knee and ankle combination had the best correlation with leg stiffness and is therefore proposed to provide the most information regarding lower limb mechanics during gait in triathletes.

Examination of the neuromechanical factors contributing to golf swing performance

ABSTRACTThis study investigated the relationship between a range of neuromechanical variables in the lower- and upper-body, and golf performance. Participants were assessed for individual muscle stiffness, vertical stiffness (Kvert), flexibility, power and maximal isometric strength. Furthermore, golf performance was determined by handicap and club head speed. Pearson’s correlations quantified the relationships between neuromechanical variables and performance measures. Participants were also separated into relatively high club head speed (HC) and low club head speed (LC) groups and compared for physical characteristics. Club head speed showed positive relationships with Kvert and power and a negative relationship with hip mobility. The HC group exhibited superior Kvert and power, while strength and flexibility measures were not related to performance. Higher levels of lower-body stiffness, rate of force development and power output appear to be beneficial for generating superior club head speed. A stiffer system may reduce the time needed to remove the “slack” from the series elastic component therefore, reducing electromechanical delay and enhancing rate of force development. The large positive association with rate of force development suggests that increasing this component, along with power production may be superior focal components for training in golfers due to the short duration of the downswing.

Correlation Analysis of Landing Error Score and Lower Body Stiffness for Evaluating Anterior Cruciate Ligament Risk Factors in Female Soccer Players.

Correlation Analysis of Landing Error Score and Lower Body Stiffness for Evaluating Anterior Cruciate Ligament Risk Factors in Female Soccer Players.

The relationship between mechanical stiffness and athletic performance markers in sub-elite footballers

ABSTRACTThis study investigated the relationship between several measures of lower-body stiffness and physical performance variables in 22 sub-elite male football players (mean ± SD; 21.9 ± 1.5 yr; 1.79 ± 0.06 m; 72.2 ± 7.2 kg). The participants were assessed for individual muscle stiffness of the Rectus Femoris (RF), Biceps Femoris (BF) and Medial Gastrocnemius (MG) muscles and vertical stiffness (Kvert) was also assessed assessed running acceleration, maximal sprint speed, agility, vertical jumping and muscular strength. Pearson’s correlations quantified the relationships and participants were also separated into relatively stiff (SG) and compliant groups (CG) for each variable. When ranked by Kvert the SG exhibited superior performance during sprinting, agility, jumping and strength (p ≤ 0.05) and when ranked by RF stiffness, SG exhibited superior sprint, agility and drop jump performance (p ≤ 0.05), while MG and BF stiffness were not related to performance. Higher stiffness appears to be beneficial to athletic performance for football players and therefore it may be beneficial for practitioners working with athletes that are required to perform dynamic activities to consider the contribution of stiffness to athletic performance.

The relationship between lower body stiffness and injury incidence in female netballers

The aim of this study was to provide contemporary information on injury rates in an elite and sub-elite netball population and to explore the relationship between lower body stiffness and lower body injuries. One elite and two sub-elite teams of female netballers (n = 29) performed the vertical hop test to assess active lower body stiffness (Kvert) and myometry to assess quasi-static stiffness. Lower body injuries were monitored via self-reporting and liaison with physiotherapists. Twelve lower body non-contact injuries were sustained by 10 players, equating to 11.29 lower body injuries per 1,000 exposure hours. The most commonly injured sites were the calf (33%) and ankle (25%). No significant differences between Kvert of injured and non-injured players were reported, however, injured elite players recorded significantly higher season mean quasi-static stiffness in the soleus (p = 0.037) and Achilles (p = 0.004) than non-injured elite players. Elite and sub-elite netball players recorded a higher injury incidence than previous reports of injuries in recreational netballers. Within the constraints of the study, relatively high stiffness of the soleus and Achilles appears to be related to lower body non-contact injury incidence in female netballers, particularly at the elite level. These results provide a basis for development of injury prevention strategies.

Lower Body Stiffness Modulation Strategies in Well Trained Female Athletes.

Millett, EL, Moresi, MP, Watsford, ML, Taylor, PG, and Greene, DA. Lower body stiffness modulation strategies in well trained female athletes. J Strength Cond Res 30(10): 2845-2856, 2016-Lower extremity stiffness quantifies the relationship between the amount of leg compression and the external load to which the limb are subjected. This study aimed to assess differences in leg and joint stiffness and the subsequent kinematic and kinetic control mechanisms between athletes from various training backgrounds. Forty-seven female participants (20 nationally identified netballers, 13 high level endurance athletes and 14 age and gender matched controls) completed a maximal unilateral countermovement jump, drop jump and horizontal jump to assess stiffness. Leg stiffness, joint stiffness and associated mechanical parameters were assessed with a 10 camera motion analysis system and force plate. No significant differences were evident for leg stiffness measures between athletic groups for any of the tasks (p = 0.321-0.849). However, differences in joint stiffness and its contribution to leg stiffness, jump performance outcome measures and stiffness control mechanisms were evident between all groups. Practitioners should consider the appropriateness of the task utilised in leg stiffness screening. Inclusion of mechanistic and/or more sports specific tasks may be more appropriate for athletic groups.

Stiffness as a Risk Factor for Achilles Tendon Injury in Running Athletes.

Overuse injuries are multifactorial resulting from cumulative loading. Therefore, clear differences between normal and at-risk individuals may not be present for individual risk factors. Using a holistic measure that incorporates many of the identified risk factors, focusing on multiple joint movement patterns may give better insight into overuse injuries. Lower body stiffness may provide such a measure. To identify how risk factors for Achilles tendon injuries influence measures of lower body stiffness. SPORTDiscus, Web of Science, CINAHL and PubMed were searched for Achilles tendon injury risk factors related to vertical, leg and joint stiffness in running athletes. Increased braking force and low surface stiffness, which were clearly associated with increased risk of Achilles tendon injuries, were also found to be associated with increased lower body stiffness. High arches and increased vertical and propulsive forces were protective for Achilles tendon injuries and were also associated with increased lower body stiffness. Risk factors for Achilles tendon injuries that had unclear associations were also investigated with the evidence trending towards an increase in leg stiffness and a decrease in ankle stiffness being detrimental to Achilles tendon health. Few studies have investigated the link between lower body stiffness and Achilles injury. High stiffness is potentially associated with risk factors for Achilles tendon injuries although some of the evidence is controversial. Prospective injury studies are needed to confirm this relationship. Large amounts of high-intensity or high-speed work or running on soft surfaces such as sand may increase Achilles injury risk. Coaches and clinicians working with athletes with new or reoccurring injuries should consider training practices of the athlete and recommend reducing speed or sand running if loading is deemed to be excessive.

Differences in Lower-Body Stiffness Between Levels of Netball Competition

There are many notable differences in physical and skill attributes between competition levels, especially in team sports. Stiffness is an important mechanical factor to measure when considering athletic performance and injury incidence. Active vertical stiffness (K(vert)) during hopping and passive stiffness during lying and standing were measured during the preseason period for 46 female netballers (24.0 ± 3.7 years, 72.2 ± 7.6 kg, 175.2 ± 6.7 cm). Participants were classified as elite, sub-elite, representative or recreational based on their current level of competition. A 1-way analysis of variance revealed that elite players possessed significantly higher K(vert) than recreational players (p = 0.018). Large effect sizes (ES) suggested that elite players also possessed higher K(vert) than sub-elite (d = 1.11) and representative (d = 1.11) players. A number of large and moderate ES were also present when comparing the passive stiffness of elite players to their lower-ranked counterparts. The results of this study suggest that elite players possess higher levels of active stiffness when compared with their lower-ranked counterparts. The differences in stiffness levels may contribute to a player's ability to physically perform at an elite level and also provide one explanation into elevated rates of injury at higher levels of competition.