Incidence of Achilles and Patellar Tendinopathy in Adolescent Elite Athletes

Cassel, Michael; Risch, Lucie; Intziegianni, Konstantina; Mueller, Juergen; Stoll, Josefine; Brecht, Pia; Mayer, Frank

doi:10.1055/a-0633-9098

Cited by 27 publications

(29 citation statements)

References 33 publications

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“…In particular, the Achilles tendon (AT) is predisposed for tendon injuries due to a considerably lower safety factor (ratio between ultimate failure stress and functional stress) in comparison to other tendons (Ker et al, 1988; Magnusson et al, 2001) and the prevalence of AT tendinopathies seems to increase after maturity in adult athletes (Cassel et al, 2018; Janssen et al, 2018). A recent study demonstrated higher m. triceps surae (TS) muscle strength and AT stiffness for the take-off leg in comparison to the swing leg in male collegiate track and field jumpers with somewhat higher inter-limb dissimilarities in AT stiffness in relation to muscle strength (Bayliss et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Evidence of a Uniform Muscle-Tendon Unit Adaptation in Healthy Elite Track and Field Jumpers: A Cross Sectional Investigation

et al. 2019

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Different adaptive responses to mechanical loading between muscle and tendon can lead to non-uniform biomechanical properties within the muscle-tendon unit. The current study aimed to analyze the mechanical properties of the triceps surae muscle-tendon unit in healthy male and female elite track and field jumpers in order to detect possible inter-limb differences and intra-limb non-uniformities in muscle and tendon adaptation. The triceps surae muscle strength and tendon stiffness were analyzed in both limbs during maximal voluntary isometric plantar flexion contractions using synchronous dynamometry and ultrasonography in sixty-seven healthy young male ( n = 35) and female ( n = 32) elite international level track and field jumpers (high jump, long jump, triple jump, pole vault). Triceps surae muscle-tendon unit intra-limb uniformity was assessed using between limb symmetry indexes in the muscle strength and tendon stiffness. Independent from sex and jumping discipline the take-off leg showed a significantly higher ( p < 0.05) triceps surae muscle strength and tendon stiffness, suggesting different habitual mechanical loading between legs. However, despite these inter-limb discrepancies no differences were detected in the symmetry indexes of muscle strength (5.9 ± 9.4%) and tendon stiffness (8.1 ± 11.5%). This was accompanied by a significant correlation between the symmetry indexes of muscle strength and tendon stiffness ( r = 0.44; p < 0.01; n = 67). Thus, the current findings give evidence for a uniform muscle-tendon unit adaptation in healthy elite track and field jumpers, which can be reflected as a protective mechanism to maintain its integrity to meet the functional demand.

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Section: Introductionmentioning

confidence: 99%

Evidence of a Uniform Muscle-Tendon Unit Adaptation in Healthy Elite Track and Field Jumpers: A Cross Sectional Investigation

et al. 2019

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“…It has recently been shown that prevalence and incidence of back pain as well as of lower extremity tendinopathies are underreported in young adolescent elite athletes (Cassel et al, 2015, 2018; Simpson et al, 2016; Müller et al, 2017). Due to the long-standing and the potentially chronifying character of the diseases early diagnostics and clear treatment strategies are mandatory, especially in adolescent elite athletes (Cook et al, 2016; Simpson et al, 2016; Hartvigsen et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

“…Bones are less mineralized and have reduced fracture toughness in young individuals resulting in a higher proportion of fractures concerning all sustained injuries during adolescence (Kontulainen et al, 2007; Darrow et al, 2009). Furthermore, it has been frequently reported that young adolescent athletes have an increased risk of sustaining severe and overuse skeletal injuries compared to non-athletes (Villemure and Stokes, 2009; Stracciolini et al, 2013; Cassel et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Orthopedic Injury Profiles in Adolescent Elite Athletes: A Retrospective Analysis From a Sports Medicine Department

et al. 2019

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Aim: The aim of the study was to identify common orthopedic sports injury profiles in adolescent elite athletes with respect to age, sex, and anthropometrics. Methods: A retrospective data analysis of 718 orthopedic presentations among 381 adolescent elite athletes from 16 different sports to a sports medical department was performed. Recorded data of history and clinical examination included area, cause and structure of acute and overuse injuries. Injury-events were analyzed in the whole cohort and stratified by age (11–14/15–17 years) and sex. Group differences were tested by chi-squared-tests. Logistic regression analysis was applied examining the influence of factors age, sex, and body mass index (BMI) on the outcome variables area and structure (α = 0.05). Results: Higher proportions of injury-events were reported for females (60%) and athletes of the older age group (66%) than males and younger athletes. The most frequently injured area was the lower extremity (47%) followed by the spine (30.5%) and the upper extremity (12.5%). Acute injuries were mainly located at the lower extremity (74.5%), while overuse injuries were predominantly observed at the lower extremity (41%) as well as the spine (36.5%). Joints (34%), muscles (22%), and tendons (21.5%) were found to be the most often affected structures. The injured structures were different between the age groups ( p = 0.022), with the older age group presenting three times more frequent with ligament pathology events (5.5%/2%) and less frequent with bony problems (11%/20.5%) than athletes of the younger age group. The injured area differed between the sexes ( p = 0.005), with males having fewer spine injury-events (25.5%/34%) but more upper extremity injuries (18%/9%) than females. Regression analysis showed statistically significant influence for BMI ( p = 0.002) and age ( p = 0.015) on structure, whereas the area was significantly influenced by sex ( p = 0.005). Conclusion: Events of soft-tissue overuse injuries are the most common reasons resulting in orthopedic presentations of adolescent elite athletes. Mostly, the lower extremity and the spine are affected, while sex and age characteristics on affected area and structure must be considered. Therefore, prevention strategies addressing the injury-event profiles should already be implemented in early adolescence taking age, sex as well as injury entity into account.

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“…Moreover, a higher prevalence of structural intratendinous changes have been observed in adolescent athletes with patellar tendinopathy symptoms than those without [336]. In addition, intratendinous alterations that were associated with tendinopathies have been reported in adolescent youth athletes compared to recreationally active controls [337]. However, such issues may not only be impacted by training activity but also impacted by growth and maturation processes due to increases in aspects such as moment arm lengths and muscle activation, which leads to a disproportionate increase of muscle strength [338].…”

Section: Other Programming Considerationsmentioning

confidence: 99%

Eccentric Resistance Training in Youth: Perspectives for Long-Term Athletic Development

Drury

Ratel

Clark

et al. 2019

JFMK

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The purpose of this narrative review is to discuss the role of eccentric resistance training in youth and how this training modality can be utilized within long-term physical development. Current literature on responses to eccentric exercise in youth has demonstrated that potential concerns, such as fatigue and muscle damage, compared to adults are not supported. Considering the importance of resistance training for youth athletes and the benefits of eccentric training in enhancing strength, power, speed, and resistance to injury, its inclusion throughout youth may be warranted. In this review we provide a brief overview of the physiological responses to exercise in youth with specific reference to the different responses to eccentric resistance training between children, adolescents, and adults. Thereafter, we discuss the importance of ensuring that force absorption qualities are trained throughout youth and how these may be influenced by growth and maturation. In particular, we propose practical methods on how eccentric resistance training methods can be implemented in youth via the inclusion of efficient landing mechanics, eccentric hamstrings strengthening and flywheel inertia training. This article proposes that the use of eccentric resistance training in youth should be considered a necessity to help develop both physical qualities that underpin sporting performance, as well as reducing injury risk. However, as with any other training modality implemented within youth, careful consideration should be given in accordance with an individual’s maturity status, training history and technical competency as well as being underpinned by current long-term physical development guidelines.

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Incidence of Achilles and Patellar Tendinopathy in Adolescent Elite Athletes

Cited by 27 publications

References 33 publications

Evidence of a Uniform Muscle-Tendon Unit Adaptation in Healthy Elite Track and Field Jumpers: A Cross Sectional Investigation

Evidence of a Uniform Muscle-Tendon Unit Adaptation in Healthy Elite Track and Field Jumpers: A Cross Sectional Investigation

Orthopedic Injury Profiles in Adolescent Elite Athletes: A Retrospective Analysis From a Sports Medicine Department

Eccentric Resistance Training in Youth: Perspectives for Long-Term Athletic Development

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