Adolescent Marathon Training

Lempke, Alexandra F. DeJong; Willwerth, Sarah; Hunt, Danielle; Meehan, William P.; Whitney, Kristin E.

doi:10.1002/jum.16105

Cited by 6 publications

(13 citation statements)

References 38 publications

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“…19,[21][22][23] Patients were first placed in a supine position on a treatment table to obtain bilateral short-and long-axis images of the patellar tendon, tibialis anterior, abductor hallicus, and flexor digitorum brevis at the midbelly of each structure (Figure 1). 23,24,28,29 Patients then were positioned prone on the treatment table with their ankle in a neutral position to obtain bilateral shortand long-axis images of the medial gastrocnemius and Achilles tendon structures (Figure 1, Figure S1). 23,24,28,29…”

Section: Methodsmentioning

confidence: 99%

“…23,24,28,29 Patients then were positioned prone on the treatment table with their ankle in a neutral position to obtain bilateral shortand long-axis images of the medial gastrocnemius and Achilles tendon structures (Figure 1, Figure S1). 23,24,28,29…”

Section: Methodsmentioning

confidence: 99%

“…Patients were excluded if they had a medical diagnosis of compartment syndrome or grade 2 or higher stress fractures, primary symptom of pain over the Achilles tendon or popliteal fossa due to potential neurovascular involvement, or were currently unable to run because of functional limitations or antalgia secondary to leg pain 7,8 . Uninjured adolescent participants were recruited from a community afterschool running program and were included if they were not currently experiencing any pain during running and did not report any lower extremity injuries within 3 months of the study 24,26 . Participants in both groups were excluded if they had any other lower extremity injuries and/or a history of lower extremity surgery.…”

Section: Methodsmentioning

confidence: 99%

“…Musculotendinous thickness measures were obtained from long-axis ultrasound images by measuring a vertical line spanning between the superior and inferior borders of each structure. Thickness measures were normalized to participant mass (kg) 24,30,31 to ensure an equivocal comparison across groups. Echogenicity measures were obtained by a computerized histogram analysis (0-255 scale) for the cross-sectional area of each structure.…”

Section: Data Processingmentioning

confidence: 99%

“…This clinical measurement approach has been primarily used to examine adults with lower extremity pathologies 18,19 . More recently, ultrasound imaging has been used to explore musculotendinous characteristics among uninjured adolescent runners, supporting the use of this assessment technique in younger athletic populations 24 . Therefore, the purpose of this study was to compare ultrasound‐derived lower extremity musculotendinous thickness and echogenicity and extrinsic ankle muscle pennation angles between adolescent runners with and without ERLLP.…”

Section: Introductionmentioning

confidence: 99%

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Adolescent exercise‐related lower leg pain musculotendinous characteristics

Lempke

Jackson

Stracciolini

et al. 2023

PM&R

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BackgroundExercise‐related lower leg pain (ERLLP) is one of the most common injuries among adolescent runners; however, there is limited information available on lower extremity musculotendinous characteristics in relationship to injury. Ultrasound imaging has previously been used to evaluate musculotendinous structures among adults with chronic lower limb injuries. Similar measurement approaches may be adopted to assess young runners with ERLLP.ObjectiveTo compare ultrasound‐derived lower extremity musculotendinous thickness, echogenicity, and muscle fiber pennation angles between adolescent runners with and without ERLLP.DesignCross‐sectional design.SettingHospital‐affiliated sports injury prevention center.ParticipantsTwenty‐eight adolescent runners with (N = 14) and without ERLLP (N = 14).InterventionsRunners' patellar and Achilles tendons, and tibialis anterior, medial gastrocnemius, abductor hallicus, and flexor digitorum brevis muscles were assessed with ultrasound imaging using standardized procedures.Main Outcome MeasuresSeparate repeated measures multivariate analyses of covariance (covariate: gender) were used to compare groups and limbs for mass‐normalized musculotendinous thickness, musculotendinous echogenicity, and extrinsic ankle muscle fiber pennation angles.ResultsThe adolescent ERLLP group had reduced average muscle size for all structures except the tibialis anterior compared to the uninjured group (mean difference [MD] range: −0.12–0.49 mm/kg; p range: .002–.05), and reduced average medial gastrocnemius pennation angles on their case limb compared to their contralateral limb and the uninjured group (MD range: −3.7–6.4°; p < .001). The ERLLP group additionally had reduced average patellar and Achilles tendon size (MD range: −0.14–−0.15 mm/kg; p range: .02–.03), and lower Achilles tendon echogenicity compared to uninjured counterparts (MD: −18; p = .02).ConclusionsAdolescent runners with ERLLP exhibited morphological musculotendinous changes that may occur either as a result of or as a contributing factor to pain and persistent dysfunction. The findings highlight key targets for rehabilitation for young, injured runners, particularly intrinsic foot muscle strengthening.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Data Processingmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Adolescent exercise‐related lower leg pain musculotendinous characteristics

Lempke

Jackson

Stracciolini

et al. 2023

PM&R

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Youth Athletes With Sever's Disease Exhibit Altered Achilles Tendon Ultrasound Characteristics

Hanlon,

Whitney,

DeJong Lempke

2024

J of Ultrasound Medicine

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ObjectivesCalcaneal apophysitis (Sever's disease) is an overuse condition caused by repetitive traction stress to the calcaneal apophysis. Whether Achilles tendon morphology is altered in this young patient population remains unknown. Therefore, we aimed to identify differences in Achilles tendon morphology between youth athletes diagnosed with calcaneal apophysitis and healthy controls.MethodsThis retrospective chart review included 46 patients (n = 23 Sever's disease, 15F/8M, 12.4 ± 2.3 years old) and (n = 23 healthy controls, 13F/10M, 15.9 ± 1.5 years old) who sought care in a Children's Hospital Sports Medicine/Orthopedics Department between 2012 and 2022. We measured ultrasound‐derived degree of tendon thickening, Achilles tendon thickness (cm), and cross‐sectional area (CSA [cm2]). Separate multivariate analyses of covariance (MANCOVAs) were used to compare degree of thickening, mass‐normalized Achilles tendon thickness, and CSA between participant groups, covarying for age. Cohen's d effect sizes were used to assess the magnitude of mean differences and standard error (MDSE) between groups.ResultsYoung athletes with Sever's disease had a significantly greater degree of tendon thickening with a large effect compared with healthy controls (MDSE: 0.07 [0.01] mm P < .001, d = 1.39). Achilles tendon thickness and CSA did not statistically differ between groups; however, the magnitude of between‐group differences for these measures (MDSE: 0.18 [0.05] cm, MDSE: 0.27 [0.07] cm2, respectively) were moderate.ConclusionsOur findings demonstrate previously unrecognized differences in Achilles tendon morphology between young athletes with clinically diagnosed Sever's disease and healthy controls. Our study supports incorporating diagnostic ultrasound as part of a comprehensive examination to ensure appropriate diagnosis and clinical management for adolescents with heel pain.

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