The Utility of Myotonometry in Musculoskeletal Rehabilitation and Human Performance Programming

Abstract

Myotonometry is a relatively novel method used to quantify the biomechanical and viscoelastic properties (stiffness, compliance, tone, elasticity, creep, and mechanical relaxation) of palpable musculotendinous structures with portable mechanical devices called myotonometers. Myotonometers obtain these measures by recording the magnitude of radial tissue deformation that occurs in response to the amount of force that is perpendicularly applied to the tissue through a device’s probe. Myotonometric parameters such as stiffness and compliance have repeatedly demonstrated strong correlations with force production and muscle activation. Paradoxically, individual muscle stiffness measures have been associated with both superior athletic performance and a higher incidence of injury. This indicates optimal stiffness levels may promote athletic performance, whereas too much or too little may lead to an increased risk of injury. Authors of numerous studies suggested that myotonometry may assist practitioners in the development of performance and rehabilitation programs that improve athletic performance, mitigate injury risk, guide therapeutic interventions, and optimize return-to-activity decision-making. Thus, the purpose of our narrative review was to summarize the potential utility of myotonometry as a clinical tool that assists musculoskeletal clinicians with the diagnosis, rehabilitation, and prevention of athletic injuries.

Acute effects of muscle mechanical properties after 2000-m rowing in young male rowers

“… Valderrabano et al (2007) and Bravo-Sánchez et al (2019) pointed out that habitually loaded activities induce changes in the structural and mechanical properties of athletes’ tendons and muscles, especially between the dominant and non-dominant side limbs. Most sports-induced injuries are overuse injuries, mainly manifested as contractures or muscle shortening, characterized by increased muscle tension and stiffness in addition to changes in muscle elasticity ( Iwata et al, 2019 ; McGowen et al, 2023 ). For example, a prospective study of lower limb stiffness and injury incidence among elite netball players found that during the season, the mean quasi-static stiffness of the soleus muscles and Achilles tendon of injured elite players was significantly higher than that of the uninjured elite players ( Pickering Rodriguez et al, 2017 ).…”

Effects of maturation on myotonometric parameters and their predictors of athletic performance in elite youth soccer players

“…Recently, the MyotonPRO has been developed as a simple, non-invasive, lower-cost, reliable, and user-friendly tool, making it accessible to individuals with less technical expertise 11 . It is an effective method for assessing muscle mechanical properties when compared to other methods, such as TMG 12 , 13 .…”

Myotonometry and extended field-of-view ultrasound imaging allow reliable quantification of patellar tendon stiffness and length at rest and during maximal load, whereas several restrictions exist for the Achilles tendon

“…Previous studies have evaluated different practicable approaches for determining tendon stiffness and length. Myotonometry-based approaches have been established concerning stiffness ( 8 ). Myotonometry is an indirect and non-invasive method that is based on the analysis of the deformation and oscillations of soft biological tissues induced by a short mechanical impulse applied perpendicular to the tissue surface ( 8 ).…”

“…Myotonometry-based approaches have been established concerning stiffness ( 8 ). Myotonometry is an indirect and non-invasive method that is based on the analysis of the deformation and oscillations of soft biological tissues induced by a short mechanical impulse applied perpendicular to the tissue surface ( 8 ). A frequently used instrument for objective measurements is the MyotonPRO digital palpation device ( 9 , 10 ), which has the highest estimated intraclass correlation coefficient (ICC), ranging from .94 to .98, compared to other handheld devices for measuring the stiffness of different layers in a phantom tissue model ( 11 ).…”