Altered tendon characteristics and mechanical properties associated with insertional achilles tendinopathy

Ruth L Chimenti; Adolph S Flemister; Joshua Tome; James M McMahon; Marie A Flannery; Ying Xue; Jeff R Houck

doi:10.2519/jospt.2014.5369

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Altered tendon characteristics and mechanical properties associated with insertional achilles tendinopathy

Journal article

Open access

Peer reviewed

Altered tendon characteristics and mechanical properties associated with insertional achilles tendinopathy

Ruth L Chimenti, Adolph S Flemister, Joshua Tome, James M McMahon, Marie A Flannery, Ying Xue and Jeff R Houck

The journal of orthopaedic and sports physical therapy, Vol.44(9), pp.680-689

09/2014

DOI: 10.2519/jospt.2014.5369

PMID: 25103130

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Abstract

Case-control laboratory study. To compare tendon characteristics (shape, composition) and mechanical properties (strain, stiffness) on the involved side of participants with insertional Achilles tendinopathy (IAT) to the uninvolved side and to controls, and to examine if severity of tendon pathology is associated with severity of symptoms during function. Despite the severity and chronicity of IAT, the quality of theoretical evidence available to guide the development of exercise interventions is low. While tendon pathology of midportion Achilles tendinopathy has been described, there are few studies specific to IAT. Twenty individuals with unilateral IAT and 20 age- and sex-matched controls volunteered to participate. Ultrasound imaging was used to quantify changes in tendon shape (diameter) and composition (echogenicity). A combination of ultrasound and dynamometry was used to measure tendon mechanical properties (strain and stiffness) during passive ankle rotation toward dorsiflexion. Generalized estimating equations were used to examine the association between IAT, alterations in tendon properties, and participant demographics. Pearson correlation was used to examine the association between severity of tendon pathology and severity of symptoms (Victorian Institute of Sport Assessment-Achilles). The side with IAT had a larger tendon diameter (P<.001), lower echogenicity (P<.001), higher strain (P = .011), and lower stiffness (P = .007) compared to the side without IAT and the controls. On the involved side of participants with IAT, a lower echogenicity correlated with higher severity of symptoms (r = 0.603, P = .010). Ultrasound imaging combined with dynamometry can discriminate alterations in tendon shape, composition, and mechanics in participants with IAT. Future clinical trials for IAT may consider strategies to alter tendon characteristics and restore tendon mechanics.

Tendinopathy - pathology

Achilles Tendon - pathology

Humans

Middle Aged

Tendinopathy - diagnostic imaging

Male

Case-Control Studies

Achilles Tendon - diagnostic imaging

Biomechanical Phenomena

Muscle, Skeletal - diagnostic imaging

Muscle, Skeletal - physiopathology

Ultrasonography

Female

Achilles Tendon - physiopathology

Muscle, Skeletal - pathology

Tendinopathy - physiopathology

Details

Title: Subtitle: Altered tendon characteristics and mechanical properties associated with insertional achilles tendinopathy
Creators: Ruth L Chimenti - Department of Biomedical Engineering, University of Rochester Medical Center, Rochester, NY
Adolph S Flemister
Joshua Tome
James M McMahon
Marie A Flannery
Ying Xue
Jeff R Houck
Resource Type: Journal article
Publication Details: The journal of orthopaedic and sports physical therapy, Vol.44(9), pp.680-689
DOI: 10.2519/jospt.2014.5369
PMID: 25103130
NLM abbreviation: J Orthop Sports Phys Ther
ISSN: 0190-6011
eISSN: 1938-1344
Language: English
Date published: 09/2014
Academic Unit: Physical Therapy and Rehabilitation Science
Record Identifier: 9984083870402771

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