Entheseal Changes

This chapter focuses on locations called entheses where muscles attach to bones and whether muscle use can create changes at these locations. Entheseal changes, which have also been called musculoskeletal stress markers, have been utilized to reconstruct activity patterns in a wide range of studies. Some entheseal change researchers suggest that the muscle use causes microtrauma at the entheses; others suggest that bone remodeling (rather than repair) sufficiently explains the localized changes found at entheses. Yet entheseal changes also correlate with non-activity variables; age is the best predictor of entheseal changes. It seems that fibrocartilaginous entheses, which attach muscle to bone via a fibrous tendon, are less prone to non-activity confounds than the more often examined fibrous entheses, which involve large muscles that attach directly onto bone.