scholarly journals Achilles tendon structure in distance runners does not change following a competitive season

2018 ◽  
Author(s):  
Todd J. Hullfish ◽  
Kenton L. Hagan ◽  
Ellen Casey ◽  
Josh R. Baxter
Keyword(s):  
Achilles Tendon ◽  
Protective Mechanism ◽  
Healthy Controls ◽  
Distance Runners ◽  
Competitive Season ◽  
Tendon Thickness ◽  
Cross Country ◽  
The Right ◽  
Structural Indicators ◽  
Tendon Remodeling

AbstractAchilles tendon structure differs between trained distance runners and healthy controls, but the progression of tendon remodeling over the course of a competitive season is poorly understood. Therefore, the purpose of this study was to quantify Achilles tendon structure at the beginning and completion of a cross country season. We hypothesized that athletes who did not develop tendinopathy would not present with changes in tendon structure. Ultrasound assessments of the right Achilles tendon mid-substance were performed to quantify tendon organization, thickness, and echogenicity. Subjective structural measures and reported outcomes were also collected to determine if tendinopathy was present in any of the subjects. None of the subjects developed symptomatic tendinopathy over the course of the competitive season, but one runner did show signs of mild neovascularization. Tendon organization and echogenicity did not change over the course of the season. Tendon thickness increased by 7% (P < 0.001) but the effect size was small (d = 0.36). Runners who do not develop symptomatic tendinopathy have habituated tendon structure that may serve as a protective mechanism against the rigors of distance running. Monitoring tendon structure may serve as a means of detecting signs of structural indicators of tendinopathy prior to the presentation of symptoms.

scholarly journals Tendon structure quantified using ultrasound imaging differs based on location and training type

2018 ◽  
Vol 125 (6) ◽  
pp. 1743-1748 ◽  
Author(s):  
Kenton L. Hagan ◽  
Todd Hullfish ◽  
Ellen Casey ◽  
Josh R. Baxter
Keyword(s):  
Achilles Tendon ◽  
Patellar Tendon ◽  
Ultrasound Imaging ◽  
Ultrasound Images ◽  
Distance Runners ◽  
Specific Loading ◽  
Cross Country ◽  
Collagen Alignment ◽  
Tendon Remodeling ◽  
Tendon Collagen

Achilles tendinopathy is 10 times more common among running athletes compared with age-matched peers. Load-induced tendon remodeling and its progression in an at-risk population of developing symptomatic tendinopathy are not well understood. The purpose of this study was to prospectively characterize Achilles and patellar tendon structure in competitive collegiate distance runners over different competitive seasons using quantitative ultrasound imaging. Twenty-two collegiate cross-country runners and eleven controls were examined for this study. Ultrasound images of bilateral Achilles and patellar tendons were obtained near the start and end of the collegiate cross-country season and the conclusion outdoor track season. Collagen organization, mean echogenicity, tendon thickness, and neovascularity were determined using well-established image processing techniques. Achilles tendon collagen was less aligned in runners compared with controls (28% greater) but improved slightly (7% decrease) after the completion of the track season. Conversely, patellar tendons in runners were similar to control tendons throughout the cross-country season but underwent collagen alignment (17% decrease) and tendon hypertrophy (21% increase). Our findings indicate that Achilles tendon structure in trained runners differs structurally from control tendons but is stable throughout training while patellar tendon structure changes in response to the transition in training volume between cross-country and track seasons. These findings expand upon prior reports that some degree of tendon remodeling may act as a protective adaptation for sport specific loading. NEW & NOTEWORTHY In this study we prospectively examined the Achilles and patellar tendon structure of distance runners to determine if continued training through multiple seasons elicits tendon remodeling or pathology. We found that Achilles and patellar tendons respond uniquely to the changing loads required during each season. Achilles tendon collagen alignment is mostly stable throughout the competitive cycle, but the patellar tendon structurally remodels following the transition from cross-country to track season.

scholarly journals Tendon Structure Quantified using Ultrasound Imaging Differs Based on Location and Training Type

2018 ◽  
Author(s):  
Kenton L. Hagan ◽  
Todd Hullfish ◽  
Ellen Casey ◽  
Josh R. Baxter
Keyword(s):  
Achilles Tendon ◽  
Patellar Tendon ◽  
Ultrasound Imaging ◽  
Structural Changes ◽  
Ultrasound Images ◽  
Distance Runners ◽  
Cross Sectional ◽  
Specific Loading ◽  
Cross Country ◽  
Tendon Remodeling

AbstractAchilles tendinopathy is ten-times more common amongst running athletes compared to age-matched peers. Load induced tendon remodeling and its progression in an at-risk population of developing symptomatic tendinopathy is not well understood. The purpose of this study was to prospectively characterize Achilles and patellar tendon structure in competitive collegiate distance runners over different competitive seasons using quantitative ultrasound imaging. Twenty-two collegiate cross country runners and eleven controls were examined for this study. Longitudinal and cross-sectional ultrasound images of bilateral Achilles and patellar tendons were obtained at the one week prior to start of formal collegiate cross country practices, one week after the conclusion of cross country season, and one week prior to outdoor track and field championships. Collagen organization, mean echogenicity, tendon thickness, and neovascularity were determined using well established image processing techniques. We found that Achilles and patellar tendons respond differently to high-volume running and transitions from one sport season to another, suggesting that tendon structure is sensitive to differences in tendon loading biomechanics. Our findings indicate that Achilles tendon structure in trained runners differ structurally to control tendons but is stable throughout training while patellar tendon structure changes in response to the transition in training volume between cross country and track seasons. These findings expand upon prior reports that some degree of tendon remodeling may act as a protective adaptation for sport specific loading.News and NoteworthyIn this study we prospectively examined the Achilles and patellar tendon structure of distance runners to determine if continued training through multiple seasons elicits tendon remodeling or pathology. We found that Achilles and patellar tendons respond uniquely to the changing loads required during each season. Achilles tendon collagen alignment is mostly stable throughout the competitive cycle, but the patellar tendon undergoes structural changes following the transition from cross-country to track season.

scholarly journals Symptomatic Achilles Tendons are Thicker than Asymptomatic Tendons on Ultrasound Examination in Recreational Long-Distance Runners

Sports ◽  
2019 ◽  
Vol 7 (12) ◽  
pp. 245 ◽  
Author(s):  
Bo Tillander ◽  
Håkan Gauffin ◽  
Johan Lyth ◽  
Anders Knutsson ◽  
Toomas Timpka
Keyword(s):  
Achilles Tendon ◽  
Ultrasound Examination ◽  
Morphological Changes ◽  
Clinical Decision ◽  
Multiple Model ◽  
Distance Runners ◽  
Long Distance ◽  
Clinical Indicators ◽  
Morphological Findings ◽  
Tendon Thickness

There is a need for clinical indicators that can be used to guide the treatment of Achilles tendon complaints in recreational runners. Diagnostic ultrasound has recently been introduced for clinical decision support in tendon pain management. The aim of this study was to determine whether tendon thickness and morphological changes in the Achilles tendon detected in ultrasound examinations are associated with local symptoms in middle-age recreational long-distance runners. Forty-two Achilles tendons (21 middle-aged runners) were investigated by ultrasound examination measuring tendon thickness and a morphology score indicating tendinosis. The Generalized Estimating Equations method was applied in multiple models of factors associated with reporting a symptomatic tendon. Eleven symptomatic and 31 asymptomatic Achilles tendons were recorded. In the multiple model that used tendon thickness measured 30 mm proximal to the distal insertion, an association was found between thickness and reporting a symptomatic tendon (p < 0.001; OR 12.9; 95% CI 3.1 to 53.2). A qualitative morphology score was not found to be significantly associated with reporting a symptomatic tendon (p = 0.10). We conclude that symptomatic Achilles tendons were thicker than asymptomatic tendons on ultrasound examination among recreational long-distance runners and that the importance of parallel morphological findings need to be further investigated in prospective studies.

Changes in Achilles’ Tendon Cross-sectional Area in Collegiate Cross-country Runners Across a Competitive Season

2014 ◽  
Vol 46 ◽  
pp. 951
Author(s):  
Katy Neves ◽  
A Wayne Johnson ◽  
Joseph William Myrer ◽  
Coulter Neves ◽  
Jarom Bridges ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Competitive Season ◽  
Cross Country ◽  
Cross Country Runners

scholarly journals Achilles Tendon Structure Differs Between Runners And Non-Runners Despite No Clinical Signs Or Symptoms Of Mid-Substance Tendinopathy

2018 ◽  
Author(s):  
Todd J. Hullfish ◽  
Kenton L. Hagan ◽  
Ellen Casey ◽  
Josh R. Baxter
Keyword(s):  
Young Adults ◽  
Achilles Tendon ◽  
Clinical Symptoms ◽  
Clinical Signs ◽  
Achilles Tendinopathy ◽  
Ultrasound Images ◽  
Distance Running ◽  
Distance Runners ◽  
Structural Differences ◽  
The Right

AbstractAchilles tendinopathy affects many running athletes and often leads to chronic pain and functional deficits. While changes in tendon structure have been linked with tendinopathy, the effects of distance running on tendon structure is not well understood. Therefore, the purpose of this study was to characterize structural differences in the Achilles tendons in healthy young adults and competitive distance runners using quantitative ultrasound analyses. We hypothesized that competitive distance runners with no clinical signs or symptoms of tendinopathy would have quantitative signs of tendon damage, characterized by decreased collagen alignment and echogenicity, in addition to previous reports of thicker tendons. Longitudinal ultrasound images of the right Achilles tendon mid-substance were acquired in competitive distance runners and recreationally-active adults. Collagen organization, mean echogenicity, and tendon thickness were quantified using image processing techniques. Clinical assessments confirmed that runners had no signs or symptoms of tendinopathy and controls were only included if they had no history of Achilles tendon pain or injuries. Runner tendons were 40% less organized, 48% thicker, and 41% less echogenic compared to the control tendons (p < 0.001). Young adults engaged in competitive distance-running have structurally different tendons than recreationally-active young adults. While these structural differences have been associated with tendon damage, the lack of clinical symptoms of tendinopathy may suggest that these detected differences may either be precursors of tendinopathy development or protective adaptations to cyclic tendon loading experienced during running.

scholarly journals Achilles tendon structure differs between competitive distance runners and nonrunners despite no clinical signs or symptoms of midsubstance tendinopathy

2018 ◽  
Vol 125 (2) ◽  
pp. 453-458 ◽  
Author(s):  
Todd J. Hullfish ◽  
Kenton L. Hagan ◽  
Ellen Casey ◽  
Josh R. Baxter
Keyword(s):  
Young Adults ◽  
Achilles Tendon ◽  
Structural Changes ◽  
Clinical Signs ◽  
Tendon Injury ◽  
Control Group ◽  
Protective Mechanism ◽  
Ultrasound Images ◽  
Distance Running ◽  
Distance Runners

Achilles tendinopathy affects many running athletes and often leads to chronic pain and functional deficits. Although changes in tendon structure have been linked with tendinopathy, the effects of distance running on tendon structure are not well understood. Therefore, the purpose of this study was to characterize structural differences in the Achilles tendons in healthy young adults and competitive distance runners using quantitative ultrasound analyses. We hypothesized that competitive distance runners with no clinical signs or symptoms of tendinopathy would have quantitative signs of tendon damage, characterized by decreased collagen alignment and echogenicity, in addition to previous reports of thicker tendons. Longitudinal ultrasound images of the right Achilles tendon midsubstance were acquired in competitive distance runners and recreationally active adults. Collagen organization, mean echogenicity, and tendon thickness were quantified using image processing techniques. Clinical assessments confirmed that runners had no signs or symptoms of tendinopathy, and controls were only included if they had no history of Achilles tendon pain or injuries. Runner tendons were 40% less organized, 48% thicker, and 41% less echogenic compared with the control tendons ( P < 0.001). Young adults engaged in competitive distance running have structurally different tendons than recreationally active young adults. NEW & NOTEWORTHY In this study, we quantified the Achilles tendon substructure in distance runners, and a control group of young adults, to determine whether distance running elicits structural adaptations of the tendon. We found that competitive distance runners have structurally compromised Achilles tendons despite not showing any clinical signs or symptoms of tendon injury. These findings suggest that distance running may stimulate structural changes as a protective mechanism against tendon pain and dysfunction.

Achilles tendon adaptation in cross-country runners across a competitive season

2017 ◽  
Vol 28 (1) ◽  
pp. 303-310 ◽  
Author(s):  
L. E. Stanley ◽  
A. Lucero ◽  
T. C. Mauntel ◽  
M. Kennedy ◽  
N. Walker ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Competitive Season ◽  
Tendon Adaptation ◽  
Cross Country ◽  
Cross Country Runners

CMR markers for early right ventricular dysfunction in precapillary pulmonary hypertension

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J Vos ◽  
T Leiner ◽  
A.P.J Van Dijk ◽  
F.J Meijboom ◽  
G.T Sieswerda ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Right Ventricle ◽  
Right Ventricular ◽  
Circumferential Strain ◽  
Peak Strain ◽  
Healthy Controls ◽  
Free Wall ◽  
Global Circumferential Strain ◽  
The Right ◽  
Rv Function

Abstract Introduction Precapillary pulmonary hypertension (pPH) causes right ventricular (RV) pressure overload inducing RV remodeling, often resulting in dysfunction and dilatation, heart failure, and ultimately death. The ability of the right ventricle to adequately adapt to increased pressure loading is key for patients' prognosis. RV ejection fraction (RVEF) by cardiac magnetic resonance (CMR) is related to outcome in pPH patients, but this global measurement is not ideal for detecting early changes in RV function. Strain analysis on CMR using feature tracking (FT) software provides a more detailed assessment, and might therefore detect early changes in RV function. Aim 1) To compare RV strain parameters in pPH patients and healthy controls, and 2) to compare strain parameters in a subgroup of pPH patients with preserved RVEF (pRVEF) and healthy controls. Methods In this prospective study, a CMR was performed in pPH patients and healthy controls. Using FT-software on standard cine images, the following RV strain parameters were analyzed: global, septal, and free wall longitudinal strain (GLS, sept-LS, free wall-LS), time to peak strain (TTP, as a % of the whole cardiac cycle), the fractional area change (FAC), global circumferential strain (GCS), global longitudinal and global circumferential strain rate (GLSR and GCSR, respectively). A pRVEF is defined as a RVEF &gt;50%. To compare RV strain parameters in pPH patients to healthy controls, the Mann-Whitney U test was used. Results 33 pPH-patients (55 [45–63] yrs; 10 (30%) male) and 22 healthy controls (40 [36–48] yrs; 15 (68%) male) were included. All RV strain parameters were significantly reduced in pPH patients compared to healthy controls (see table), except for GCS and GCSR. Most importantly, in pPH patients with pRVEF (n=8) GLS (−26.6% [−22.6 to −27.3] vs. −28.1% [−26.2 to −30.6], p=0.04), sept-LS (−21.2% [−19.8 to −23.2] vs. −26.0% [−24.0 to −27.9], p=0.005), and FAC (39% [35–44] vs. 44% [42–47], p=0.02) were still significantly impaired compared to healthy controls. The RV TTP was significantly increased in pPH patients compared to healthy controls (47% [44–57] vs. 40% [33–43], p≤0.001). Conclusions Several CMR-FT strain parameters of the right ventricle are impaired in pPH patients when compared to healthy controls. Moreover, even in pPH patients with a preserved RVEF multiple RV strain parameters (GLS, sept-LS, and FAC) remained significantly impaired, and TTP significantly prolonged, in comparison to healthy controls. This suggests that RV strain parameters may be used as an early marker of RV dysfunction in pPH patients. Funding Acknowledgement Type of funding source: None

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