Journal article
Impingement in Insertional Achilles Tendinopathy Occurs Across a Larger Range of Ankle Angles and Is Associated With Increased Tendon Thickness
Foot & ankle international, Vol.43(5), pp.683-693
05/2022
DOI: 10.1177/10711007211069570
PMCID: PMC9240994
PMID: 35081809
Abstract
Insertional Achilles tendinopathy (IAT) is characterized by tendon degeneration and thickening near the tendon-bone insertion.
Calcaneal impingement is believed to contribute to the pathogenesis of IAT.
However, it is unclear how increased tendon thickness in individuals with IAT influences impingement. This study aimed to compare Achilles tendon impingement in individuals with and without IAT.
Eight healthy adults and 12 adults with clinically diagnosed symptomatic IAT performed a passive flexion exercise during which ankle flexion angle, anterior-posterior (A-P) thickness, and an ultrasonographic image sequence of the Achilles tendon insertion were acquired. The angle of ankle plantarflexion at which the calcaneus first impinges the Achilles tendon, defined as the impingement onset angle, was identified by (1) a anonymized observer (visual inspection method) and (2) a computational image deformation-based approach (curvature method).
Although the 2 methods provided different impingement onset angles, the measurements were strongly correlated (
= 0.751,
< .05). The impingement onset angle and the thickness of the Achilles tendon insertion were greater in subjects with clinically diagnosed IAT (
= .0048,
= .0047). Furthermore, impingement onset angle proved to have a moderate correlation with anterior-posterior thickness (
= 0.454,
< .05).
Our findings demonstrated that increased tendon thickness in IAT patients is associated with larger impingement onset angles, raising the range of ankle angles over which the tendon is exposed to impingement.
Increased susceptibility to impingement may exacerbate or perpetuate the pathology, highlighting the need for clinical strategies to reduce impingement in IAT patients.
Details
- Title: Subtitle
- Impingement in Insertional Achilles Tendinopathy Occurs Across a Larger Range of Ankle Angles and Is Associated With Increased Tendon Thickness
- Creators
- Anthony N Aggouras - Rochester Institute of TechnologyRuth L Chimenti - University of IowaA Samuel Flemister - University of RochesterJohn Ketz - University of RochesterLaura C Slane - University of RochesterMark R Buckley - University of RochesterMichael S Richards - Rochester Institute of Technology
- Resource Type
- Journal article
- Publication Details
- Foot & ankle international, Vol.43(5), pp.683-693
- DOI
- 10.1177/10711007211069570
- PMID
- 35081809
- PMCID
- PMC9240994
- NLM abbreviation
- Foot Ankle Int
- ISSN
- 1071-1007
- eISSN
- 1944-7876
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health, award: R01 AR070765
- Language
- English
- Date published
- 05/2022
- Academic Unit
- Physical Therapy and Rehabilitation Science
- Record Identifier
- 9984281748902771
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