Triceps surae muscle-tendon properties in older endurance- and sprint-trained athletes

Structure and function of Achilles and patellar tendons following moderate slow resistance training in young and old men

The aim of this study was to investigate the effect of aging and resistance training with a moderate load on the size and mechanical properties of the patellar (PT) and Achilles tendon (AT) and their associated aponeuroses; medial gastrocnemius (MG) and vastus lateralis (VL). Young (Y55; 24.8 ± 3.8 yrs, n = 11) and old men (O55; 70.0 ± 4.6 yrs, n = 13) were assigned to undergo a training program (12 weeks; 3 times/week) of moderate slow resistance training [55% of one repetition maximum (RM)] of the triceps surae and quadriceps muscles. Tendon dimensions were assessed using 1.5 T magnetic resonance imaging before and after 12 weeks. AT and PT cross sectional area (CSA) were determined every 10% of tendon length. Mechanical properties of the free AT, MG aponeurosis, PT, and VL aponeurosis were assessed using ultrasonography (deformation) and tendon force measurements. CSA of the AT but not PT was greater in O55 compared with Y55. At baseline, mechanical properties were generally lower in O55 than Y55 for AT, MG aponeurosis and VL aponeurosis (Young's modulus) but not for PT. CSA of the AT and PT increased equally in both groups following training. Further, for a given force, stiffness and Young's modulus also increased equally for VL aponeurosis and AT, for boths groups. The present study highlights that except for the PT, older men have lower tendon (AT, MG aponeurosis, and VL aponeurosis) mechanical properties than young men and 12-weeks of moderate slow resistance training appears sufficient to improve tendon size and mechanical adaptations in both young and older men. New and Noteworthy: These novel findings suggest that short-term moderate slow resistance training induces equal improvements in tendon size and mechanics regardless of age.

Sedentary behaviour (especially accumulation pattern) has an independent negative impact on skeletal muscle size and architecture in community-dwelling older adults

Prolonged sedentary behaviour (SB) i.e. longer bouts, is suggested to have a range of negative health effects, independent of habitual light and medium-to-vigorous physical activity (LIPA or MVPA). Any effect on musculoskeletal size, architecture or morphology has seldom been reported in older adults. Moreover, no study has yet determined if any association would persist following adjustment for covariates. Therefore, the aim of the present study was to investigate the associations between SB, and properties of the Gastrocnemius Medialis (GM) muscle, in a cross-sectional sample of older adults using compositional data analysis. 105 healthy older adults (73±6y) wore a thigh mounted tri-axial accelerometer for seven consecutive days, and underwent ultrasound [e.g. muscle length (Lm), anatomical cross-sectional area (ACSA), muscle volume (VM), fascicle length (LF), & physiological cross-sectional area (PCSA)], body composition (e.g. DEXA) and health (e.g. medical history) assessments. In-unadjusted models, SB time was negatively associated with ACSA at 75% of Lm (R2adj = 0.085), VM (R2adj = 0.020), and PCSA (R2adj = 0.039). Standing was positively associated with pennation angle (R2adj = 0.110), which persisted following co-variate adjustment (R2adj = 0.296). In fully adjusted models, both SB & LIPA time were associated with ACSA at 75% of Lm (Both R2adj = 0.393). Standing and light activity time were also associated with LF, VM, & PCSA (R2adj 0.116-0.573). In fully adjusted models, SB pattern parameters (i.e. the manner in which sedentary behaviour is accumulated daily throughout waking hours such as the timing, duration and frequency of sedentary bouts), were associated with GM muscle properties (R2adj 0.156-0.564) including LM, LF, and VM. The pattern, rather than accumulated daily SB time, was associated with the size and architecture of the GM. Our results suggest that regardless of co-existing habitual physical activities, SB bouts should be kept short and frequently interrupted to offset some of the deleterious ageing-related muscle architecture characteristics changes.

Spatiotemporal and kinematic adjustments in master runners may be associated with the relative physiological effort during running

Master runners maintain a similar running economy to young runners, despite displaying biomechanical characteristics that are associated with a worse running economy. This apparent paradox may be explained by a greater physiological effort-i.e., percentage of maximal oxygen uptake (VO2-max)-that master runners perform at a given speed. Moreover, age-related responses to non-exhaustive sustained running are yet underexplored. The aims of this study were, therefore, to examine if biomechanical adjustments in master runners are physiological-effort dependent, and to explore the age-related biomechanical changes during a non-exhaustive sustained run. Young (23.9 ± 6; n = 12) and master (47.3 ± 6.9; n = 12) runners performed a sustained 30-minute treadmill run matched for relative physiological effort (70% VO2-max), while spatiotemporal and lower-limb kinematic characteristics were collected during the 1st and 30th minute. Group differences were observed in step/stride length, knee touch-down angle, and knee stiffness. However, both groups of runners had a similar step frequency, vertical center of mass oscillation, and knee range of motion. Age-related adjustment in these latter characteristics may thus not be an inevitable result of the aging process but rather a strategy to maintain running economy. The relative physiological effort of runners should, therefore, be considered when examining age-related adjustments in running biomechanics.

In Vivo Strain Patterns in the Achilles Tendon During Dynamic Activities: A Comprehensive Survey of the Literature

Achilles' tendon (AT) injuries such as ruptures and tendinopathies have experienced a dramatic rise in the mid- to older-aged population. Given that the AT plays a key role at all stages of locomotion, unsuccessful rehabilitation after injury often leads to long-term, deleterious health consequences. Understanding healthy in vivo strains as well as the complex muscle-tendon unit interactions will improve access to the underlying aetiology of injuries and how their functionality can be effectively restored post-injury. The goals of this survey of the literature with a systematic search were to provide a benchmark of healthy AT strains measured in vivo during functional activities and identify the sources of variability observed in the results. Two databases were searched, and all articles that provided measured in vivo peak strains or the change in strain with respect to time were included. In total, 107 articles that reported subjects over the age of 18 years with no prior AT injury and measured while performing functional activities such as voluntary contractions, walking, running, jumping, or jump landing were included in this review. In general, unclear anatomical definitions of the sub-tendon and aponeurosis structures have led to considerable confusion in the literature. MRI, ultrasound, and motion capture were the predominant approaches, sometimes coupled with modelling. The measured peak strains increased from 4% to over 10% from contractions, to walking, running, and jumping, in that order. Importantly, measured AT strains were heavily dependent on measurement location, measurement method, measurement protocol, individual AT geometry, and mechanical properties, as well as instantaneous kinematics and kinetics of the studied activity. Through a comprehensive review of approaches and results, this survey of the literature therefore converges to a united terminology of the structures and their common underlying characteristics and presents the state-of-knowledge on their functional strain patterns.

Supersonic shear wave elastography of human tendons is associated with in vivo tendon stiffness over small strains

Supersonic shear wave (SW) elastography has emerged as a useful imaging modality offering researchers and clinicians a fast, non-invasive, quantitative assessment of tendon biomechanics. However, the exact relationship between SW speed and in vivo tendon stiffness is not intuitively obvious and needs to be verified. This study aimed to explore the validity of supersonic SW elastography against a gold standard method to measure the Achilles tendon's in vivo tensile stiffness by combining conventional ultrasound imaging with dynamometry. Twelve healthy participants performed maximal voluntary isometric plantarflexion contractions (MVC) on a dynamometer with simultaneous ultrasonographic recording of the medial gastrocnemius musculotendinous junction for dynamometry-based measurement of stiffness. The tendon's force-elongation relationship and stress-strain behaviour were assessed. Tendon stiffness at different levels of tension was calculated as the slope of the stress-strain graph. SW speed was measured at the midportion of the free tendon and tendon Young's modulus was estimated. A correlation analysis between the two techniques revealed a statistically significant correlation for small strains (r(10) = 0.604, p =.038). SW-based assessments of in vivo tendon stiffness were not correlated to the gold standard method for strains in the tendon>10 % of the maximum strain during MVC. The absolute values of SW-based Young's modulus estimations were approximately-three orders of magnitude lower than dynamometry-based measurements. Supersonic SW elastography should be only used to assess SW speed for the detection and study of differences between tissue regions, differences between people or groups of people or changes over time in tendon initial stiffness (i.e., stiffness for small strains).

Towards modern understanding of the Achilles tendon properties in human movement research

The Achilles tendon (AT) is the strongest tendon in humans, yet it often suffers from injury. The mechanical properties of the AT afford efficient movement, power amplification and power attenuation during locomotor tasks. The properties and the unique structure of the AT as a common tendon for three muscles have been studied frequently in humans using in vivo methods since 1990's. As a part of the celebration of 50 years history of the International Society of Biomechanics, this paper reviews the history of the AT research focusing on its mechanical properties in humans. The questions addressed are: What are the most important mechanical properties of the Achilles tendon, how are they studied, what is their significance to human movement, and how do they adapt? We foresee that the ongoing developments in experimental methods and modeling can provide ways to advance knowledge of the complex three-dimensional structure and properties of the Achilles tendon in vivo, and to enable monitoring of the loading and recovery for optimizing individual adaptations.

Linking muscle architecture and function in vivo: conceptual or methodological limitations?

Background

Despite the clear theoretical link between sarcomere arrangement and force production, the relationship between muscle architecture and function remain ambiguous in vivo.

Methods

We used two frequently used ultrasound-based approaches to assess the relationships between vastus lateralis architecture parameters obtained in three common conditions of muscle lengths and contractile states, and the mechanical output of the muscle in twenty-one healthy subjects. The relationship between outcomes obtained in different conditions were also examined. Muscle architecture was analysed in panoramic ultrasound scans at rest with the knee fully extended and in regular scans at an angle close to maximum force (60°), at rest and under maximum contraction. Isokinetic and isometric strength tests were used to estimate muscle force production at various fascicle velocities.

Results

Measurements of fascicle length, pennation angle and thickness obtained under different experimental conditions correlated moderately with each other (r = 0.40-.74). Fascicle length measured at 60° at rest correlated with force during high-velocity knee extension (r = 0.46 at 400° s^-1) and joint work during isokinetic knee extension (r = 0.44 at 200° s^-1 and r = 0.57 at 100° s^-1). Muscle thickness was related to maximum force for all measurement methods (r = 0.44-0.73). However, we found no significant correlations between fascicle length or pennation angle and any measures of muscle force or work. Most correlations between architecture and force were stronger when architecture was measured at rest close to optimal length.

Conclusion

These findings reflect methodological limitations of current approaches to measure fascicle length and pennation angle in vivo. They also highlight the limited value of static architecture measurements when reported in isolation or without direct experimental context.

Relationship Between Age and Running Kinematics in Female Recreational Runners

Sex-based analyses are important when studying running kinematics. Females experience a unique aging process and demonstrate differences in running biomechanics from males. The purpose was to determine the relationship between age and running kinematics in female runners. Forty-six female runners (18-65 y) ran at self-selected jogging and maximal speed on a treadmill. Lower-extremity joint kinematics were calculated, and 2 principal component analyses (jogging speed and maximal speed) were performed from kinematic variables. Regression was used to examine the relationship between age and identified components, and between age and the variables with the highest loadings within these components. For jogging speed, there was a positive relationship between age and ankle varus at initial contact and a negative relationship between age and peak eversion, hip adduction, knee flexion, dorsiflexion, and hip adduction at initial contact (Ps < .05). For maximal speed, initial contact ankle frontal plane angle became more positive with age, and there was a negative relationship with age and peak eversion, dorsiflexion and knee flexion, and knee flexion and hip adduction at initial contact (Ps < .05). Primarily distal joint angles decreased with increasing age in female recreational runners at self-selected running speeds.

Relationship Between Isokinetic Lower-Limb Joint Strength, Isometric Time Force Characteristics, and Leg-Spring Stiffness in Recreational Runners

Neuromuscular characteristics, such as lower-limb joint strength and the ability to rapidly generate force, may play an important role in leg-spring stiffness regulation. This study aimed to investigate the relationship between isokinetic knee and ankle joint peak torque (PT), the force-time characteristics of isometric mid-thigh pull (IMTP), and leg stiffness (K_leg)/vertical stiffness (K_vert) in recreationally trained runners. Thirty-one male runners were recruited and underwent three separate tests. In the first session, the body composition, K_leg, and K_vert at running speeds of 12 and 14 km⋅h^–1 were measured. In the second session, isokinetic knee and ankle joint PT at 60°⋅s^–1 were tested. The force-time characteristics of the IMTP were evaluated in the final session. Pearson’s product-moment correlations, with the Benjamini–Hochberg correction procedure, showed that the knee flexor concentric and eccentric and extensor concentric PT (r = 0.473–0.654, p < 0.05) were moderate to largely correlated with K_leg and K_vert at 12 and 14 km⋅h^–1. The knee extensor eccentric PT (r = 0.440, p = 0.050) was moderately correlated with the 14 km⋅h^–1K_vert. The ankle plantar flexor concentric and dorsiflexor eccentric PT (r = 0.506–0.571, p < 0.05) were largely correlated with K_leg at 12 km⋅h^–1. The ankle plantar flexor concentric and eccentric and dorsiflexor eccentric PT (r = 0.436–0.561, p < 0.05) were moderate to largely correlated with K_vert at 12 and 14 km⋅h^–1. For IMTP testing, high correlation was only found between the IMPT peak force (PF) and K_vert at 14 km⋅h^–1 (r = 0.510, p = 0.014). Thus, superior leg-spring stiffness in recreational runners may be related to increased knee and ankle joint strength, eccentric muscular capacity, and maximal force production.

Reduced Achilles Tendon Stiffness Disrupts Calf Muscle Neuromechanics in Elderly Gait

Older adults walk slower and with a higher metabolic energy expenditure than younger adults. In this review, we explore the hypothesis that age-related declines in Achilles tendon stiffness increase the metabolic cost of walking due to less economical calf muscle contractions and increased proximal joint work. This viewpoint may motivate interventions to restore ankle muscle-tendon stiffness, improve walking mechanics, and reduce metabolic cost in older adults.

Morphological and mechanical properties of lower limbs in competitive racewalkers: Associations with performance

Racewalking is an unconventional form of competitive gait that elicits a unique loading profile on lower limb muscles and tendons. This study mapped the structural and mechanical properties of lower limbs in competitive racewalkers and made associations with World Athletics competition performance points. Fourteen international racewalkers (seven men, seven women) were recruited for this study. Static ultrasonography was used to quantify muscle and tendon morphological characteristics. An isokinetic dynamometer was used to measure passive musculotendinous stiffness of the triceps surae, isometric (seven knee/ankle angle combinations) and isokinetic (four angular velocities) strength parameters in the plantarflexors and dorsiflexors, and isokinetic knee flexion and extension strength at five angular velocities. Correlations were found between performance and fascicle length of gastrocnemius medialis (r = -0.569, p = 0.034), dorsiflexor strength at 120°/s (r = 0.649, p = 0.016) and knee flexor strength at 30°/s (r = 0.632, p = 0.020). No associations were found for isometric plantarflexion or passive stiffness properties. Overall, the study showed various morphological and mechanical properties are associated with performance in competitive racewalkers. These associations seem to be related to the specific and unique biomechanical characteristics of racewalking.

Habitual side-specific loading leads to structural, mechanical and compositional changes in the patellar tendon of young and senior life-long male athletes

Effects of life-long physical activity on tendon function have been investigated in cross-sectional studies, but these are at risk of "survivorship" bias. Here, we investigate if life-long side-specific loading is associated with greater cross-sectional area (CSA), mechanical properties, cell density (DNA content) and collagen cross-link composition of the male human patellar tendon (PT), in vivo. Nine seniors and six young male life-long elite badminton players and fencers were included. CSA of the PT obtained by 3-tesla MRI, and ultrasonography-based bilateral PT mechanics were assessed. Collagen fibril characteristics, enzymatic cross-links, non-enzymatic glycation (autofluorescence), collagen and DNA content were measured biochemically in PT biopsies. The elite athletes had a ≥15% side-to-side difference in maximal knee extensor strength, reflecting chronic unilateral sport-specific loading patterns. The PT CSA was greater on the lead extremity compared with the non-lead extremity (17 %, p=0.0001). Furthermore, greater tendon stiffness (18 %, p=0.0404) together with lower tendon stress (22 %, p=0.0005) and tendon strain (18 %, p=0.0433) were observed on the lead extremity. No effects were demonstrated from side-to-side for glycation, enzymatic cross-link, collagen, and DNA content (50%, p=0.1160). Moreover, tendon fibril density was 87±28 fibrils/μm² on the lead extremity and 68±26 fibrils/μm² on the non-lead extremity (28%, p=0.0544). Tendon fibril diameter was 86±14 nm on the lead extremity and 94±14 nm on the non-lead extremity (-9%, p=0.1076). These novel data suggest that life-long side-specific loading in males yields greater patellar tendon size and stiffness possibly with concomitant greater fibril density but without changes of collagen cross-link composition.

Effects of old age and contraction mode on knee extensor muscle ATP flux and metabolic economy in vivo

KEY POINTS

We used 31-phosphorus magnetic resonance spectroscopy to quantify in vivo skeletal muscle metabolic economy (ME; mass-normalized torque or power produced per ATP consumed) during three 24 s maximal-effort contraction protocols: (1) sustained isometric (MVIC), (2) intermittent isokinetic (MVDC_IsoK ), and (3) intermittent isotonic (MVDC_IsoT ) in the knee extensor muscles of young and older adults. ME was not different between groups during the MVIC but was lower in older than young adults during both dynamic contraction protocols. These results are consistent with an increased energy cost of locomotion, but not postural support, with age. The effects of old age on ME were not due to age-related changes in muscle oxidative capacity or ATP flux. Specific power was lower in older than young adults, despite similar total ATP synthesis between groups. Together, this suggests a dissociation between cross-bridge activity and ATP utilization with age.

ABSTRACT

Muscle metabolic economy (ME; mass-normalized torque or power produced per ATP consumed) is similar in young and older adults during some isometric contractions, but less is known about potential age-related differences in ME during dynamic contractions. We hypothesized that age-related differences in ME would exist only during dynamic contractions, due to the increased energetic demand of dynamic versus isometric contractions. Ten young (Y; 27.5 ± 3.9 years, 6 men) and 10 older (O; 71 ± 5 years, 5 men) healthy adults performed three 24 s bouts of maximal contractions: (1) sustained isometric (MVIC), (2) isokinetic (120°·s^-1 , MVDC_IsoK ; 0.5 Hz), and (3) isotonic (load = 20% MVIC, MVDC_IsoT ; 0.5 Hz). Phosphorus magnetic resonance spectroscopy of the vastus lateralis muscle was used to calculate ATP flux (mM ATP·s^-1 ) through the creatine kinase reaction, glycolysis and oxidative phosphorylation. Quadriceps contractile volume (cm³ ) was measured by MRI. ME was calculated using the torque-time integral (MVIC) or power-time integral (MVDC_IsoK and MVDC_IsoT ), total ATP synthesis and contractile volume. As hypothesized, ME was not different between Y and O during the MVIC (0.12 ± 0.03 vs. 0.12 ± 0.02 Nm^. s^. cm^{-3 .} mM ATP^-1 , mean ± SD, respectively; P = 0.847). However, during both MVDC_IsoK and MVDC_IsoT , ME was lower in O than Y adults (MVDC_IsoK : 0.011 ± 0.003 vs. 0.007 ± 0.002 J^. cm^{-3 .} mM ATP^-1 ; P < 0.001; MVDC_IsoT : 0.011 ± 0.002 vs. 0.008 ± 0.002; P = 0.037, respectively), despite similar muscle oxidative capacity, oxidative and total ATP flux in both groups. The lower specific power in older than young adults, despite similar total ATP synthesis between groups, suggests there is a dissociation between cross-bridge activity and ATP utilization with age.

Effect of Achilles Tendon Mechanics on the Running Economy of Elite Endurance Athletes

The Achilles tendon stores and releases strain energy, influencing running economy. The present study aims to verify the influence of the Achilles tendon tangent modulus, as a material property, on running economy by comparing two groups of elite endurance-performance athletes undergoing different running training volumes. Twelve athletes, six long-distance runners and six pentathletes, were studied. Long-distance runners had a higher weekly running training volume (116.7±13.7 vs. 58.3±20.4 km, p<0.05) and a better running economy (204.3±12.0 vs. 222.0±8.7 O₂ mL ∙ kg^-1 ∙ km^-1, p<0.05) evaluated in a treadmill at 16 km·h^-1, 1% inclination. Both groups presented similar VO_2max (68.5±3.8 vs. 65.7±5.0 mL ∙ min^-1 ∙ kg^-1, p>0.05). Achilles tendon tangent modulus was estimated from ultrasound-measured deformations, with the ankle passively mobilized by a dynamometer. True stress was calculated from the measured torque. The long-distance runners had a higher maximum tangent modulus (380.6±92.2 vs. 236.2±82.6 MPa, p<0.05) and maximum true stress than pentathletes (24.2±5.1 vs. 16.0±3.5 MPa, p<0.05). The correlation coefficient between tangent modulus at larger deformations was R=-0.7447 (p<0.05). Quantifying tendon tissue adaptations associated with different running training volumes will support subject and modality-specific workouts prescription of elite endurance athletes.

Evidence that ageing does not influence the uniformity of the muscle-tendon unit adaptation in master sprinters

Differences in the adaptation processes between muscle and tendon in response to mechanical loading can lead to non-uniform mechanical properties within the muscle-tendon unit (MTU), potentially increasing injury risk. The current study analysed the mechanical properties of the triceps surae (TS) MTU in 10 young (YS; 22 ± 3 yrs) and 10 older (OS; age 65 ± 8 yrs; i.e. master) (inter)national level sprinters and 11 young recreationally active adults (YC; 23 ± 3 yrs) to detect possible non-uniformities in muscle and tendon adaptation due to habitual mechanical loading and ageing. Triceps surae muscle strength, tendon stiffness and maximal tendon strain were assessed in both legs during maximal voluntary isometric plantarflexion contractions via dynamometry and ultrasonography. Irrespective of the leg, OS and YC in comparison to YS demonstrated significantly (P < 0.05) lower TS muscle strength and tendon stiffness, with no differences between OS and YC. Furthermore, no group differences were detected in the maximal tendon strain (average of both legs: OS 3.7 ± 0.8%, YC 4.4 ± 0.8% and YS 4.3 ± 0.9%) as well as in the inter-limb symmetry indexes in muscle strength, tendon stiffness and maximal tendon strain (range across groups: -5.8 to 4.9%; negative value reflects higher value for the non-preferred leg). Thus, the findings provide no clear evidence for a disruption in the TS MTU uniformity in master sprinters, demonstrating that ageing tendons can maintain their integrity to meet the increased functional demand due to elite sports.

Morphological Characteristics of Passive and Active Structures of the Foot Across Populations With Different Levels of Physical Activity

BACKGROUND

Imaging diagnosis plays a fundamental role in the evaluation and management of injuries suffered in sports activities.

OBJECTIVE

To analyze the differences in the thickness of the Achilles tendon, patellar tendon, plantar fascia, and posterior tibial tendon in the following levels of physical activity: persons who run regularly, persons otherwise physically active, and persons with a sedentary lifestyle.

DESIGN

Cross-sectional and observational.

PARTICIPANTS

The 91 volunteers recruited from students at the university and the Triathlon Club from December 2016 to June 2019. The data were obtained (age, body mass index, and visual analog scale for quality of life together with the ultrasound measurements).

RESULTS

Tendon and ligament thickness was greater in the runners group than in the sedentary and active groups with the exception of the posterior tibial tendon. The thickness of the Achilles tendon was greater in the runners than in the other groups for both limbs (P = .007 and P = .005). This was also the case for the cross-sectional area (P < .01) and the plantar fascia at the heel insertion in both limbs (P = .034 and P = .026) and for patellar tendon thickness for the longitudinal measurement (P < .01). At the transversal level, however, the differences were only significant in the right limb (P = .040).

CONCLUSION

The thickness of the Achilles tendon, plantar fascia, and patellar tendon is greater in runners than in persons who are otherwise active or who are sedentary.

Age-related myofiber atrophy in old mice is reversed by ten weeks voluntary high-resistance wheel running

OBJECTIVE

Age-related loss of muscle mass and function can be attenuated in rodents with life-long voluntary wheel running with moderate resistance. The present study assessed if sarcopenia could be counteracted with ten weeks high intensity training.

METHOD

Old (22-23 months) and middle-aged (11 months) mice were divided into three physical activity groups: Ten weeks of voluntary running in wheels with high (HR) or low resistance (LR), or no running wheel (SED). The wheel resistance was 0.5-1.5 g in the LR group and progressed from 5 g to 10 g in the HR group. Six, 8 and 5 old and 8, 9 and 9 middle-aged mice of the SED, LR and HR groups, respectively, were included in the analysis. Wheel activity was monitored throughout the intervention. Muscle mass of the tibialis anterior, gastrocnemius, soleus and plantaris muscles were measured post-mortem. Fiber type distribution and myofiber cross sectional areal (CSA) were quantified in the gastrocnemius and soleus muscles as well as total number of fibers in the soleus muscle.

RESULTS

In the SED, the mass of all individual muscles was reduced in the old vs middle-aged (P < 0.001). In the training groups, the old mice ran significantly less, slower and for shorter bouts than the middle-aged throughout the intervention (P < 0.05). HR running increased the gastrocnemius and soleus muscle mass by 6% and 18% respectively in the old compared to SED. Fiber CSA was significantly reduced in the old SED mice, whereas fiber CSA in the old HR gastrocnemius and soleus muscles was comparable to the SED middle-aged. Fiber type shifted from 2b towards 2a in the gastrocnemius muscle of the trained old mice. HR running was more efficient than LR in maintaining muscle mass and myofiber size, and in shifting fiber types. In the middle-aged mice, similar effects were found, but less pronounced. Interestingly, fiber CSA was unaffected by running in the middle-aged.

CONCLUSION

Ten weeks of HR running had a positive effect on muscle mass and morphology in both middle-aged and old mice. The old HR fiber CSA was greater than in old SED and comparable to the middle-aged, and the fibers shifted to a more oxidative composition (2b → 2a). Albeit less pronounced, similar training effects were observed in the middle-aged mice despite running faster and longer than the old.

Age and training volume influence joint kinetics during running

Recently, we proposed the hypothesis that weekly running volume and preferred running pace may play a role in preserving ankle joint kinetics in middle-age runners as ankle joint kinetics were generally similar in young and middle-aged runners with similar running volume and preferred pace. To further address this hypothesis, we compared lower extremity joint kinetics between high and low training volume runners in both young and middle-aged groups. Joint kinetics calculated from 3D kinematic and ground reaction force data during over-ground running at 2.7 m·s^-1 from young and middle-aged runners who ran low or high weekly volume were analyzed. A two-factor analysis of variance was used to compare joint kinetics between age and running volume groups. Positive hip work was greater in middle-aged compared to young runners (P = .005). Plantarflexor torque (P = .009) and positive ankle work (P = .042) were greater in young compared to middle-aged runners. Positive ankle work was also greater in the high compared to the low volume group (P = .021). Finally, age by volume interactions were found for knee extensor torque (P = .024), negative knee work (P = .018), and positive knee work (P = .019) but not for ankle and hip joint kinetics. These findings suggest less distal-to-proximal difference in positive joint work with high running volume in both young and middle-aged runners as a result of greater power generation at the ankle. Given the age main effects, our findings are also the first to suggest the age-related distal-to-proximal shift in joint kinetics appears in middle-aged runners.

Lower leg muscle-tendon unit characteristics are related to marathon running performance

The human ankle joint and plantar flexor muscle–tendon unit play an important role in endurance running. It has been assumed that muscle and tendon interactions and their biomechanical behaviours depend on their morphological and architectural characteristics. We aimed to study how plantar flexor muscle characteristics influence marathon running performance and to determine whether there is any difference in the role of the soleus and gastrocnemii. The right lower leg of ten male distance runners was scanned with magnetic resonance imagining. The cross-sectional areas of the Achilles tendon, soleus, and lateral and medial gastrocnemius were measured, and the muscle volumes were calculated. Additional ultrasound scanning was used to estimate the fascicle length of each muscle to calculate the physiological cross-sectional area. Correlations were found between marathon running performance and soleus volume (r = 0.55, p = 0.048), soleus cross-sectional area (r = 0.57, p = 0.04), soleus physiological cross-sectional area (PCSA-IAAF r = 0.77, p < 0.01, CI± 0.28 to 0.94), Achilles tendon thickness (r = 0.65, p < 0.01), and soleus muscle-to-tendon ratio (r = 0.68, p = 0.03). None of the gastrocnemius characteristics were associated with marathon performance. We concluded that a larger soleus muscle with a thicker Achilles tendon is associated with better marathon performance. Based on these results, it can be concluded the morphological characteristics of the lower leg muscle–tendon unit correlate with running performance.

The Free Achilles Tendon Is Shorter, Stiffer, Has Larger Cross-Sectional Area and Longer T2* Relaxation Time in Trained Middle-Distance Runners Compared to Healthy Controls

Tendon geometry and tissue properties are important determinants of tendon function and injury risk and are altered in response to ageing, disease, and physical activity levels. The purpose of this study was to compare free Achilles tendon geometry and mechanical properties between trained elite/sub-elite middle-distance runners and a healthy control group. Magnetic resonance imaging (MRI) was used to measure free Achilles tendon volume, length, average cross-sectional area (CSA), regional CSA, moment arm, and T2^* relaxation time at rest, while freehand three-dimensional ultrasound (3DUS) was used to quantify free Achilles tendon mechanical stiffness, Young’s modulus, and length normalised mechanical stiffness. The free Achilles tendon in trained runners was significantly shorter and the average and regional CSA (distal end) were significantly larger compared to the control group. Mechanical stiffness of the free Achilles tendon was also significantly higher in trained runners compared to controls, which was explained by the group differences in tendon CSA and length. T2^* relaxation time was significantly longer in trained middle-distance runners when compared to healthy controls. There was no relationship between T2^* relaxation time and Young’s modulus. The longer T2^* relaxation time in trained runners may be indicative of accumulated damage, disorganised collagen, and increased water content in the free Achilles tendon. A short free Achilles tendon with large CSA and higher mechanical stiffness may enable trained runners to rapidly transfer high muscle forces and possibly reduce the risk of tendon damage from mechanical fatigue.

Ankle kinetics and plantarflexor morphology in older runners with different lifetime running exposures

Running promotes better cardiovascular health and has positive effects on the musculoskeletal system in older adults. However, older adults have lower ankle plantarflexor torques and positive powers during running, and exhibit changes in plantarflexor morphology than young adults. Since older runners who run as much as younger runners exhibit youthful ankle mechanical outputs, running exposure may preserve the locomotor factors that mediate running speed. The purpose of this study was to compare ankle mechanical output during running and plantarflexor morphological characteristics between older runners who have low or high lifetime running exposure. Ten older runners with low lifetime running exposure and nine older runners with high lifetime running exposure performed over-ground running trials at 3.0 m/s (±5%) while kinematic and ground reaction force (GRF) data were collected and used to compute joint angular kinetics. Right medial gastrocnemius morphological characteristics were assessed using ultrasonography at rest and during isometric contractions. Ankle torques, powers, and plantarflexor morphology were compared between groups. Older runners with different lifetime running exposures ran with similar ankle mechanical output (i.e. no effect of running exposure) (p > .05) and exhibited similar medial gastrocnemius morphology during isometric testing. The findings from this study demonstrate that lifetime running exposure does not appear to influence ankle mechanical output or plantarflexor morphology in middle-aged runners.

Tracking of Time-Dependent Changes in Muscle Hardness After a Full Marathon

Inami, T, Nakagawa, K, Yonezu, T, Fukano, M, Higashihara, A, Iizuka, S, Abe, T, and Narita, T. Tracking of time-dependent changes in muscle hardness after a full marathon. J Strength Cond Res 33(12): 3431-3437, 2019-We sought to identify changes in individual muscle hardness after a full marathon and to track time-dependent changes using ultrasound strain elastography (SE). Twenty-one collegiate marathon runners were recruited. Muscle hardness (i.e., strain ratio, SR) was measured using SE for the rectus femoris (RF), vastus lateralis (VL), biceps femoris (BF) long head, tibialis anterior (TA), gastrocnemius medial (GM) head, and soleus (SOL) muscles at the following time points: pre (PRE), immediately post (POST), day-1 (D1), day-3 (D3), and day-8 (D8), after a full marathon. We found that the SR decreased after the full marathon (i.e., the muscle became harder), and that the lowest SR across all measured muscles was observed on D1. Although there was no difference in the magnitude of change in SR between the muscles of the thigh, that of the MG and SOL were significantly larger than that of the TA. Muscle hardness in the vastus lateralis, biceps femoris, and SOL recovered at D8 (i.e., nonsignificant difference from PRE), whereas recovery of rectus femoris and gastrocnemius medial hardness at D8 was not observed. Thus, the degree of change in muscle hardness does not occur uniformly within the lower extremity muscles. In particular, changes in muscle hardness of the TA after a full marathon are small compared with other muscles and time-dependent changes in each muscle vary during recovery. The features of muscle hardness identified in this study will be useful for coaches when mentoring runners on proper forms and for training advisers and therapists who seek to address deficiencies in running.

Magnetic Resonance Imaging and Freehand 3-D Ultrasound Provide Similar Estimates of Free Achilles Tendon Shape and 3-D Geometry

The purpose of this study was to assess the similarity of free Achilles tendon shape and 3-D geometry between magnetic resonance imaging (MRI) and freehand 3-D ultrasound (3-DUS) imaging methods. Fourteen elite/sub-elite middle-distance runners participated in the study. MRI and 3-DUS scans of the Achilles tendon were acquired on two separate imaging sessions, and all 3-D reconstructions were performed using identical methods. Shape similarity of free Achilles tendon reconstructed from MRI and 3-DUS data was assessed using Jaccard index, Hausdorff distance and root mean square error (RMSE). The Jaccard index, Hausdorff distance and RMSE values were 0.76 ± 0.05, 2.70 ± 0.70 and 0.61 ± 0.10 mm, respectively. The level of agreement between MRI and 3-DUS for free Achilles tendon volume, length and average cross-sectional area (CSA) was assessed using Bland-Altman analysis. Compared to MRI, freehand 3-DUS overestimated volume, length and average CSA by 30.6 ± 15.8 mm³ (1.1% ± 0.6%), 0.3 ± 0.7 mm (0.6% ± 1.9%) and 0.3 ± 1.42 mm² (0.4% ± 2.0%), respectively. The upper and lower limits of agreement between MRI and 3-DUS for volume, length and average CSA were -0.4 to 61.7 mm³ (-0.2% to 2.3%), -1.0 to 1.5 mm (-3.2% to 4.5%) and -2.5 to 3.1 mm² (-3.5% to 4.3%), respectively. There were no significant differences between imaging methods in CSA along the length of the tendon. In conclusion, MRI and freehand 3-DUS may be considered equivalent methods for estimating shape and 3-D geometry of the free Achilles tendon. These findings, together with the practical benefits of being able to assess 3-D Achilles tendon shape and geometry in a laboratory environment and under isometric loading, make 3-DUS an attractive alternative to MRI for assessing 3-D free Achilles tendon macro-structure in future studies.

Comparison of Muscle Function, Bone Mineral Density and Body Composition of Early Starting and Later Starting Older Masters Athletes

Masters endurance runners can epitomize healthy aging; being reflective of the physiological processes of aging without the compounded effects of inactivity. The primary aim of the present study was to determine, using cross-sectional data, whether individuals taking up training after the age of 50 years can achieve the same level of athletic performance and musculoskeletal characteristics in their older age as those who trained all of their adult lives. A total of 150 master endurance runners [age 68 (5) years; 111 male, 39 female] were divided into early starters (training all of their adulthood) and late starters (started training after age 50 years). A comparative non-athletic group of 59 healthy older adults [age 73 (4) years; 30 female, 29 male] were additionally included for analysis. Training intensity, age-graded performance (AGP) and musculoskeletal assessments were performed. Results showed that there was no difference between athlete groups for training intensity or age-graded performance, despite the 30-year difference in training history. Body fat percentage and leg lean mass did not differ between athlete groups, but were 17% lower and 12% greater, respectively, in athlete groups compared with controls. Power normalized to body mass did not differ between any groups. Spine BMD was lower in late starters than controls, while early starters did not differ from late starters or controls. Hip BMD did not differ between any of the groups. These findings show that the Masters athletes we studied that started intense endurance running after the age of 50 years had lower body fat and higher leg lean mass compared to non-athletes. Body composition and athletic performance of the late starters was very similar to those who trained all of their adult lives.

Effects of Long-Term Physical Activity and Diet on Skin Glycation and Achilles Tendon Structure

Advanced glycation end-products (AGEs) accumulate with aging and have been associated with tissue modifications and metabolic disease. Regular exercise has several health benefits, and the purpose of this study was to investigate the effect of regular long-term exercise and diet on skin autofluorescence (SAF) as a measure of glycation and on Achilles tendon structure. In connection with the 2017 European Masters Athletics Championships Stadia, high-level male athletes (n = 194) that had regularly trained for more than 10 years were recruited, in addition to untrained controls (n = 34). SAF was non-invasively determined using an AGE Reader. Achilles tendon thickness and vascular Doppler activity were measured by ultrasonography, and diet was assessed by a questionnaire. There was no significant difference in SAF between the athletes and controls. However, greater duration of exercise was independently associated with lower SAF. Diet also had an effect, with a more "Western" diet in youth being associated with increased SAF. Furthermore, our data demonstrated that greater Achilles tendon thickness was associated with aging and training. Together, our data indicate that long-term exercise may yield a modest reduction in glycation and substantially increase Achilles tendon size, which may protect against injury.

The Physiology and Biomechanics of the Master Runner

The Master runner (age 35 y and above) represents a unique athletic patient. Lifelong participation in endurance running slows the inevitable age-related decline in aerobic function and muscular strength. Still, the Master runner does not escape the inevitable effects of aging. Master runners experience a steady decline in running performance, that is, typical and maximal running speeds, after the age of 50 years of age. Age-related declines in running performance are driven by a host of factors, including declining cardiovascular function, reduced muscular capacity, altered biomechanics, and greater susceptibility to running-related injury. This review discusses age-related changes in physiology, biomechanics, and running injury susceptibility and practical strategies to maximize running participation in the Master runner.

A review of methods to measure tendon dimensions

Tendons are soft tissues of the musculoskeletal system that are designed to facilitate joint movement. Tendons exhibit a wide range of mechanical properties matched to their functions and, as a result, have been of interest to researchers for many decades. Dimensions are an important aspect of tendon properties.

Change in the dimensions of tissues is often seen as a sign of injury and degeneration, as it may suggest inflammation or general disorder of the tissue. Dimensions are also important for determining the mechanical properties and behaviours of materials, particularly the stress, strain, and elastic modulus. This makes the dimensions significant in the context of a mechanical study of degenerated tendons. Additionally, tendon dimensions are useful in planning harvesting for tendon transfer and joint reconstruction purposes.

Historically, many methods have been used in an attempt to accurately measure the dimensions of soft tissue, since improper measurement can lead to large errors in the calculated properties. These methods can be categorised as destructive (by approximation), contact, and non-contact and can be considered in terms of in vivo and ex vivo.

Fascial tissue research in sports medicine: from molecules to tissue adaptation, injury and diagnostics: consensus statement

The fascial system builds a three-dimensional continuum of soft, collagen-containing, loose and dense fibrous connective tissue that permeates the body and enables all body systems to operate in an integrated manner. Injuries to the fascial system cause a significant loss of performance in recreational exercise as well as high-performance sports, and could have a potential role in the development and perpetuation of musculoskeletal disorders, including lower back pain. Fascial tissues deserve more detailed attention in the field of sports medicine. A better understanding of their adaptation dynamics to mechanical loading as well as to biochemical conditions promises valuable improvements in terms of injury prevention, athletic performance and sports-related rehabilitation. This consensus statement reflects the state of knowledge regarding the role of fascial tissues in the discipline of sports medicine. It aims to (1) provide an overview of the contemporary state of knowledge regarding the fascial system from the microlevel (molecular and cellular responses) to the macrolevel (mechanical properties), (2) summarise the responses of the fascial system to altered loading (physical exercise), to injury and other physiological challenges including ageing, (3) outline the methods available to study the fascial system, and (4) highlight the contemporary view of interventions that target fascial tissue in sport and exercise medicine. Advancing this field will require a coordinated effort of researchers and clinicians combining mechanobiology, exercise physiology and improved assessment technologies.

Age-Related Changes in Achilles Tendon Stiffness and Impact on Functional Activities: A Systematic Review and Meta-Analysis

Achilles tendon stiffness determines calf muscle functioning during functional activities. However, contrasting evidence was found in studies comparing Achilles tendon stiffness in older and younger adults. Therefore, this systematic review compares Achilles tendon stiffness and elastic modulus in older and younger adults and reviews functional implications. Studies revealed by systematic bibliographic searches were included if healthy older adults were investigated, and if Achilles tendon stiffness was measured using ultrasound and dynamometry. Meta-analyses were performed to compare Achilles tendon stiffness and elastic modulus in older and younger adults. Achilles tendon stiffness (weighted standardized mean difference = 1.40, 95% confidence intervals [0.42-2.38]) and elastic modulus (weighted standardized mean difference = 1.74, 95% confidence intervals [0.99-2.49]) were decreased in older compared with younger adults. Decreased Achilles tendon stiffness was related to walking performance and balance. Possibly, decreased Achilles tendon stiffness is caused by altered elastic modulus in older adults. Training interventions increasing Achilles tendon stiffness could improve functional capacity.

Non-uniformity in the healthy patellar tendon is greater in males and similar in different age groups

There is increasing evidence that tendons are heterogeneous and take advantage of structural mechanisms to enhance performance and reduce injury. Fascicle-sliding, for example, is used by energy-storing tendons to enable them to undergo large extensions while protecting the fascicles from damage. Reductions in fascicle-sliding capacity may thus predispose certain populations to tendinopathy. Evidence from the Achilles tendon of significant superficial-to-deep non-uniformity that is reduced with age supports this theory. Similar patellar tendon non-uniformity has been observed, but the effects of age and sex have yet to be assessed. Healthy adults (n = 50, 25M/25F) from a broad range of ages (23-80) were recruited and non-uniformity was quantified using ultrasound speckle-tracking during passive knee extension. Significant superficial-to-deep non-uniformity and proximal/distal variations were observed. No effect of age was found, but males exhibited significantly greater non-uniformity than females (p < 0.05). The results contrast with previous findings in the Achilles tendon; in this study, tendons and tendon regions at high risk for tendinopathy (i.e. males and proximal regions, respectively) exhibited greater non-uniformity, whereas high-risk Achilles tendons (i.e. older adults) previously showed reduced non-uniformity. This suggests that non-uniformity may be dominated by factors other than fascicle-sliding. Anatomically, the varied proximal attachment of the patellar tendon may influence non-uniformity, with quadriceps passive resistance limiting superficial tendon movement, thus linking flexibility, non-uniformity and injury risk. This study also provides evidence of a differential effect of aging on the patellar tendon compared with evidence from prior studies on other tendons necessitating further study to elucidate links between non-uniformity and injury.

Patellar tendon properties distinguish elite from non-elite soccer players and are related to peak horizontal but not vertical power

PURPOSE

To investigate potential differences in patellar tendon properties between elite and non-elite soccer players, and to establish whether tendon properties were related to power assessed during unilateral jumps performed in different directions.

METHODS

Elite (n = 16; age 18.1 ± 1.0 years) and non-elite (n = 13; age 22.3 ± 2.7 years) soccer players performed vertical, horizontal-forward and medial unilateral countermovement jumps (CMJs) on a force plate. Patellar tendon (PT) cross-sectional area, elongation, strain, stiffness, and Young's modulus (measured at the highest common force interval) were assessed with ultrasonography and isokinetic dynamometry.

RESULTS

Elite demonstrated greater PT elongation (6.83 ± 1.87 vs. 4.92 ± 1.88 mm, P = 0.011) and strain (11.73 ± 3.25 vs. 8.38 ± 3.06%, P = 0.009) than non-elite soccer players. Projectile range and peak horizontal power during horizontal-forward CMJ correlated positively with tendon elongation (r = 0.657 and 0.693, P < 0.001) but inversely with Young's modulus (r = - 0.376 and - 0.402; P = 0.044 and 0.031). Peak medial power during medial CMJ correlated positively with tendon elongation (r = 0.658, P < 0.001) but inversely with tendon stiffness (r = - 0.368, P = 0.050).

CONCLUSIONS

Not only does a more compliant patellar tendon appear to be an indicator of elite soccer playing status but it may also facilitate unilateral horizontal-forward and medial, but not vertical CMJ performance. These findings should be considered when prescribing talent selection and development protocols related to direction-specific power in elite soccer players.

Muscle morphology and performance in master athletes: A systematic review and meta-analyses

INTRODUCTION

The extent to which chronic exercise training preserves age-related decrements in physical function, muscle strength, mass and morphology is unclear. Our aim was to conduct a systematic review of the literature to determine to what extent chronically trained master athletes (strength/power and endurance) preserve levels of physical function, muscle strength, muscle mass and morphology in older age, compared with older and younger controls and young trained individuals.

METHODS

The systematic data search included Medline, EMBASE, SPORTDiscus, CINAHL and Web of Science databases.

INCLUSION CRITERIA

i) master athletes mean exercise training duration ≥20 years ii) master athletes mean age of cohort >59 years) iii) at least one measurement of muscle mass/volume/fibre-type morphology and/or strength/physical function.

RESULTS

Fifty-five eligible studies were identified. Meta-analyses were carried out on maximal aerobic capacity, maximal voluntary contraction and body composition. Master endurance athletes (42.0 ± 6.6 ml kg^-1 min^-1) exhibited VO_2max values comparable with young healthy controls (43.1 ± 6.8 ml kg^-1 min^-1, P = .84), greater than older controls (27.1 ± 4.3 ml kg^-1 min^-1, P < 0.01) and master strength/power athletes (26.5 ± 2.3 mlkg^-1 min^-1, P < 0.01), and lower than young endurance trained individuals (60.0 ± 5.4 ml kg^-1 min^-1, P < 0.01). Master strength/power athletes (0.60 (0.28-0.93) P < 0.01) and young controls (0.71 (0.06-1.36) P < 0.05) were significantly stronger compared with the other groups. Body fat% was greater in master endurance athletes than young endurance trained (-4.44% (-8.44 to -0.43) P < 0.05) but lower compared with older controls (7.11% (5.70-8.52) P < 0.01).

CONCLUSION

Despite advancing age, this review suggests that chronic exercise training preserves physical function, muscular strength and body fat levels similar to that of young, healthy individuals in an exercise mode-specific manner.

Patellar tendon buckling is altered with age

Recent evidence has revealed that the patellar tendon exhibits buckling during passive knee extension, wherein the tendon folds back onto itself. The clinical relevance of such buckling is unclear, but it has been suggested that it serves to protect the patellar tendon from rupture when subjected to a sudden extreme contraction. Although prior evidence suggests buckling occurs universally, it is poorly understood, and may be influenced by age and sex. Healthy adults (n = 41, aged 21-80 years) were recruited to assess age- and sex-based differences in patellar tendon buckling during passive knee extension. 93% of subjects exhibited buckling in extension, with buckling more prominent in the distal tendon. No age- or sex-based differences in buckling magnitude were observed, but a significant age-based difference in buckling angle was found, with the tendon unbuckling later in flexion in younger adults compared with middle-aged (p = 0.025) and older (p = 0.014) adults. Intrinsic factors were also linked with buckling; for example, smaller maximum knee extension (i.e. less flexibility) correlated with smaller buckling magnitude (p = 0.037, R² = 0.116), suggesting a link between patellar tendon buckling and joint-level mechanics. These results suggest that buckling is an inherent component of normal knee function that older adults may be failing to take advantage of, predisposing them to injury. Further study will be critical to elucidate the clinical implications of patellar tendon buckling.

Influence of forearm orientation on biceps brachii tendon mechanics and elbow flexor force steadiness

Achilles tendon mechanics influence plantar flexion force steadiness (FS) and balance. In the upper limb, elbow flexor FS is greater in supinated and neutral forearm orientations compared to pronated, with contributions of tendon mechanics remaining unknown in position-dependent FS. This study investigated whether distal biceps brachii (BB) tendon mechanics across supinated, neutral and pronated forearm orientations influence position-dependent FS of the elbow flexors. Eleven males (23 ± 3 years) performed submaximal isometric elbow flexion tasks at low (5, 10% maximal voluntary contraction (MVC)) and high (25, 50, 75% MVC) force levels in supinated, neutral and pronated forearm orientations. Distal BB tendon elongation and CSA were recorded on ultrasound to calculate mechanics of tendon stress, strain and stiffness. Relationships between FS, calculated as coefficient of variation (CV) of force, and tendon mechanics were evaluated with multiple regressions. Supinated and neutral were ∼50% stronger and ∼60% steadier than pronated (p < 0.05). Tendon stress was ∼52% greater in supinated and neutral compared to pronated, tendon strain was ∼36% greater in neutral than pronated (p < 0.05), while tendon stiffness (267.4 ± 78.9 N/mm) did not differ across orientations (p > 0.05). At low forces, CV of force was predicted by MVC (r²: 0.52) in supinated, and MVC and stress in neutral and pronated (r²: 0.65-0.81). At high force levels, CV of force was predicted by MVC and stress in supinated (r²: 0.49), and MVC in neutral (r²: 0.53). Absolute strength and tendon mechanics influence the ability of the BB tendon to distribute forces, and thus are key factors in position-dependent FS.

Lower Leg Morphology and Stretch-Shortening Cycle Performance of Dancers

Greater levels of bone ultimate fracture load, bone stress–strain index, muscle cross-sectional area, and maximal voluntary isometric plantarflexion (MVIP) strength of the lower leg may be adaptations from chronic exposure to stretch-shortening cycle (SSC) actions. Dancers, a population that habitually performs SSC movements primarily about the ankle joint, may serve as a novel population to gain broader understanding of SSC function. A total of 10 female collegiate dancers and 10 untrained controls underwent peripheral quantitative computed tomography scans of both lower legs and performed MVIPs, countermovement hops, and drop hops at 20, 30, and 40 cm on a custom-made inclined sled. Dancers had greater right and left ultimate fracture load values and significantly (P ≤ .05) greater left leg stress–strain index than controls. Dancers had significantly larger right and left muscle cross-sectional area and MVIP values and hopped significantly higher during all hopping conditions in comparison with controls. Average force–time and power–time curves revealed significantly greater relative force and power measurements during the concentric phase for all hopping conditions in dancers when compared with controls. This investigation provides evidence that dance may be a stimulus for positive muscle and bone adaptations, strength levels, and enhanced SSC capabilities.

Three-dimensional architecture of the whole human soleus muscle in vivo

Background

Most data on the architecture of the human soleus muscle have been obtained from cadaveric dissection or two-dimensional ultrasound imaging. We present the first comprehensive, quantitative study on the three-dimensional anatomy of the human soleus muscle in vivo using diffusion tensor imaging (DTI) techniques.

Methods

We report three-dimensional fascicle lengths, pennation angles, fascicle curvatures, physiological cross-sectional areas and volumes in four compartments of the soleus at ankle joint angles of 69 ± 12° (plantarflexion, short muscle length; average ± SD across subjects) and 108 ± 7° (dorsiflexion, long muscle length) of six healthy young adults. Microdissection and three-dimensional digitisation on two cadaveric muscles corroborated the compartmentalised structure of the soleus, and confirmed the validity of DTI-based muscle fascicle reconstructions.

Results

The posterior compartments of the soleus comprised 80 ± 5% of the total muscle volume (356 ± 58 cm³). At the short muscle length, the average fascicle length, pennation angle and curvature was 37 ± 8 mm, 31 ± 3° and 17 ± 4 /m, respectively. We did not find differences in fascicle lengths between compartments. However, pennation angles were on average 12° larger (p < 0.01) in the posterior compartments than in the anterior compartments. For every centimetre that the muscle-tendon unit lengthened, fascicle lengths increased by 3.7 ± 0.8 mm, pennation angles decreased by −3.2 ± 0.9° and curvatures decreased by −2.7 ± 0.8 /m. Fascicles in the posterior compartments rotated almost twice as much as in the anterior compartments during passive lengthening.

Discussion

The homogeneity in fascicle lengths and inhomogeneity in pennation angles of the soleus may indicate a functionally different role for the anterior and posterior compartments. The data and techniques presented here demonstrate how DTI can be used to obtain detailed, quantitative measurements of the anatomy of complex skeletal muscles in living humans.

Influence of biceps brachii tendon mechanical properties on elbow flexor force steadiness in young and old males

Elbow flexor force steadiness (FS) depends on strength and decreases with age. Achilles tendon mechanics effect standing balance and isometric plantarflexion FS. This study investigated the influence of distal biceps brachii (BB) tendon mechanics and elbow flexor strength on age-related decline in FS. Nine young (23 ± 2 years) and nine old (77 ± 5 years) males performed submaximal isometric elbow flexion tasks at low (2.5%, 5%, 10% maximal voluntary contraction (MVC)) and high (20%, 40%, 60%, 80%MVC) forces in a neutral forearm position. Distal BB tendon elongation and cross-sectional area (CSA) were recorded on ultrasound to calculate mechanics of strain, stress, and stiffness. Coefficient of variation (CV) of force was used to assess relationship of FS to tendon mechanics and strength. Young were 22% stronger and 41% steadier than old (P < .05). Tendon stiffness (170.1 ± 132.9 N/mm; 113.0 ± 55.1 N/mm) did not differ with age (P > .05). Young had 40% less strain compared to old at 5% MVC, but 42% greater strain at 60% and 80% MVC (P ≤ .05). Stress was ~18% greater in young at 10%, 20%, and 80% MVC (P ≤ .05). At low forces, CV of force was predicted by stress (r²  = 0.56) in young, and stress and MVC (r²  = 0.641) in old. At high forces for both age groups, CV of force was predicted by MVC and stress (r²  = 0.39-0.43). Stress and strain is greater in young compared with old males. Because strength influences tendon mechanics and is also associated with FS, absolute strength is a large and modifiable contributor to age-related decline in FS.

Quantification of Internal Stress-Strain Fields in Human Tendon: Unraveling the Mechanisms that Underlie Regional Tendon Adaptations and Mal-Adaptations to Mechanical Loading and the Effectiveness of Therapeutic Eccentric Exercise

By virtue of their anatomical location between muscles and bones, tendons make it possible to transform contractile force to joint rotation and locomotion. However, tendons do not behave as rigid links, but exhibit viscoelastic tensile properties, thereby affecting the length and contractile force in the in-series muscle, but also storing and releasing elastic stain energy as some tendons are stretched and recoiled in a cyclic manner during locomotion. In the late 90s, advancements were made in the application of ultrasound scanning that allowed quantifying the tensile deformability and mechanical properties of human tendons in vivo. Since then, the main principles of the ultrasound-based method have been applied by numerous research groups throughout the world and showed that tendons increase their tensile stiffness in response to exercise training and chronic mechanical loading, in general, by increasing their size and improving their intrinsic material. It is often assumed that these changes occur homogenously, in the entire body of the tendon, but recent findings indicate that the adaptations may in fact take place in some but not all tendon regions. The present review focuses on these regional adaptability features and highlights two paradigms where they are particularly evident: (a) Chronic mechanical loading in healthy tendons, and (b) tendinopathy. In the former loading paradigm, local tendon adaptations indicate that certain regions may “see,” and therefore adapt to, increased levels of stress. In the latter paradigm, local pathological features indicate that certain tendon regions may be “stress-shielded” and degenerate over time. Eccentric exercise protocols have successfully been used in the management of tendinopathy, without much sound understanding of the mechanisms underpinning their effectiveness. For insertional tendinopathy, in particular, it is possible that the effectiveness of a loading/rehabilitation protocol depends on the topography of the stress created by the exercise and is not only reliant upon the type of muscle contraction performed. To better understand the micromechanical behavior and regional adaptability/mal-adaptability of tendon tissue it is important to estimate its internal stress-strain fields. Recent relevant advancements in numerical techniques related to tendon loading are discussed.