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

Stanley, Laura E.; Lucero, Angela; Mauntel, Timothy C.; Kennedy, Madison; Walker, Nina; Marshall, Stephen W.; Padua, Darin A.; Berkoff, David J.

doi:10.1111/sms.12903

Cited by 17 publications

(19 citation statements)

References 46 publications

(82 reference statements)

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“…Without sufficient recovery, running at faster speeds could lead to increased degeneration of the tendon. However, habitual loading has demonstrated positive adaptations of the Achilles tendon 6,10 and high‐performing runners exhibit different running patterns to recreational runners 11 . Therefore, understanding factors such as running speed and the consequential potential changes in loading in high‐performing runners can support the development of appropriate training and competition programs to minimize the risk of developing Achilles tendinopathy.…”

Section: Introductionmentioning

confidence: 99%

The effect of speed on Achilles tendon forces and patellofemoral joint stresses in high‐performing endurance runners

Starbuck

Bramah

Herrington

et al. 2021

Scandinavian Med Sci Sports

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Achilles tendinopathy and patellofemoral pain are common running injuries associated with increased Achilles tendon (AT) forces and patellofemoral joint (PFJ) stresses. This study examined AT forces and PFJ stresses at different running speeds in high‐performing endurance runners. Twenty runners ran overground at four running speeds (3.3, 3.9, 4.8, and 5.6 m/s). AT forces and PFJ stresses were estimated from kinematic and kinetic data. Repeated measures ANOVA with partial eta squared effect sizes was conducted to assess differences between running speeds. Increased peak AT forces (19.5%; p < 0.001) and loading rates (57.3%; p < 0.001) from 3.3 m/s to 5.6 m/s were observed. Cumulative AT loading was greater in the faster speeds compared to the slower speeds. Faster running speeds resulted in increased peak plantar flexor moments, increased peak plantar flexion angles, and a more flexed knee and an anterior center of pressure position at touchdown. Peak PFJ stress was lower in the slowest speed (3.3 m/s) compared to the faster running speeds (3.9–5.6 m/s; p = 0.005). PFJ stress loading rate significantly increased (43.6%; p < 0.001). Greater AT loading observed could be associated with strategies such as increased plantar flexor moments and altered lower body position at touchdown which are commonly employed to generate greater ground contact forces. Greater AT and PFJ loading rates were likely due to shorter ground contact times and therefore less time available to reach the peak. Running at faster speeds could increase the risk of developing Achilles tendinopathy and patellofemoral pain or limit recovery from these injuries without sufficient recovery.

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Section: Introductionmentioning

confidence: 99%

The effect of speed on Achilles tendon forces and patellofemoral joint stresses in high‐performing endurance runners

Starbuck

Bramah

Herrington

et al. 2021

Scandinavian Med Sci Sports

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“…16,31,38 Soldiers that were not injured during the course had a significantly higher prevalence of pre-course echo-type I fibers compared to soldiers that were injured during the course. A high prevalence of echo-type I fibers was previously reported among athletes 18,19,30 and it was suggested that this was related to exposure to high levels of physical activity on a daily basis, and to positive adaptation of the tendons to adequate and correct loads. 21,24 Rosengarten et al 24 found 92% of echo-type I fibers among elite football players.…”

Section: Discussionmentioning

confidence: 86%

“…18,[25][26][27][28] UTC was found to be suitable for quantifying changes in tendon structure as it has the ability to detect subtle changes in tendon structure in response to increasing loads and exercises. [29][30][31][32] The first aim of this study was to determine whether Achilles tendon (AT) and patellar tendon (PT) structure are risk factors for musculoskeletal injuries in combat soldiers. As musculoskeletal injuries are a major contributor to morbidity and reduced military readiness, 33,34 there is a lack of research regarding the relationship between the initial (precourse) tendon structure and the risk for injuries (during the course) in military troops.…”

mentioning

confidence: 99%

Can Achilles and patellar tendon structures predict musculoskeletal injuries in combat soldiers?

Steinberg

Pantanowitz

Funk

et al. 2020

Scandinavian Med Sci Sports

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Aiming to investigate whether Achilles tendon (AT) structure and patellar tendon (PT) structure are risk factors for musculoskeletal injuries in combat soldiers, 168 participants were recruited from an infantry commander's course. The AT and PT were examined pre‐course using UTC to capture the structure of four echo‐type fibers (I–IV). All injuries were assessed by military physicians pre‐course and throughout the 14‐week course. Soldiers who were injured during the course had a significantly higher pre‐course prevalence of AT and PT echo‐type III and echo‐type IV compared to soldiers that were not injured during the course. Variables that were found to be associated with injured/non‐injured participants were echo‐type III + IV of the PT (OR = 1.44, 95% CI = 1.24‐1.68) and echo‐type III of the AT (OR = 1.69, 95% CI = 1.35‐2.12). ROC analyses showed that the best model, exhibiting both high sensitivity and low specificity, was that participants with PT echo‐type III + IV > 10% or AT echo‐type III >8.5% had the highest risk of being injured during the course. In conclusions, the tendon structure at the beginning of high‐intensity activity or physical training program might be a risk factor for subsequent injury during the course. Soldiers and high‐level athletes should be aware of the cutoff points for fiber types in tendon structure that might put them at high risk for future injury. At‐risk soldiers/athletes should be provided with an intervention program before they start their training program, with the aim of improving the tendon structure and preventing subsequent injury.

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“…13 In fact, previous studies have shown that running training could propitiate a protective adaptation for running specific loading, with large cross-sectional area and tendon architecture changes. 7,16,17 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 Even, Stanley et al 17 AT response to cumulative load over a season is unknown.…”

Section: Discussionmentioning

confidence: 99%

“…7,16,17 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 Even, Stanley et al 17 AT response to cumulative load over a season is unknown. The purpose of this study was to evaluate AT response across a four-month competitive season in collegiate cross-country (XC found a positive adaptation in Achilles tendon structural integrity over a cross country training season.…”

Section: Discussionmentioning

confidence: 99%

Thickness and Cross-Sectional Area of the Achilles Tendon in Marathon Runners: A Cross-Sectional Study

Salinero

Lara

Gutiérrez-Hellín

et al. 2020

Rev Bras Med Esporte

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Introduction: This study aimed to measure thickness and cross-sectional area of the Achilles tendon (AT), and the range of motion of the ankle joint in dorsiflexion of amateur marathon runners compared to non-active people. Objectives: To analyze the relationship between cross-sectional area and thickness of the Achilles tendon in marathon runners and age, anthropometric characteristics (height and body mass), training habits, running experience, marathon performance, and range of motion in the ankle joint. Methods: Achilles tendon thickness and cross-sectional area were measured using ultrasound images of the left leg in 97 male amateur marathon runners (age 42.0 ± 9.6 years; height 175 ± 6 cm; and body mass 73.7 ± 8.6 kg), and 47 controls (39.9 ± 11.6 years; 176 ± 7 cm; 79.6 ± 16.1 kg). Results: Achilles tendon thickness (4.81 ± 0.77 vs. 4.60 ± 0.66 mm; p = 0.01) and cross-sectional area (60.41 ± 14.36 vs. 53.62 ± 9.90 mm2; p < 0.01) were greater in the marathon runners than in non-active people. Achilles tendon thickness has been correlated, in a weak but significant manner, with years of running experience. Moreover, marathon runners showed increased ankle range of motion (81.81 ± 6.93 vs. 77.86 ± 7.27 grades; p<0.01). Conclusion: Male amateur marathon runners have hypertrophy of the Achilles tendon compared to non-active people, and this enlargement is mediated by running experience. In addition, range of motion in ankle dorsiflexion is favored by marathon training. Level of evidence III; Retrospective study.

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

Cited by 17 publications

References 46 publications

The effect of speed on Achilles tendon forces and patellofemoral joint stresses in high‐performing endurance runners

The effect of speed on Achilles tendon forces and patellofemoral joint stresses in high‐performing endurance runners

Can Achilles and patellar tendon structures predict musculoskeletal injuries in combat soldiers?

Thickness and Cross-Sectional Area of the Achilles Tendon in Marathon Runners: A Cross-Sectional Study

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