Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania.
Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania.
J Appl Physiol (1985). 2018 Aug 1;125(2):453-458. doi: 10.1152/japplphysiol.00012.2018. Epub 2018 May 17.
Achilles tendinopathy affects many running athletes and often leads to chronic pain and functional deficits. Although changes in tendon structure have been linked with tendinopathy, the effects of distance running on tendon structure are not well understood. Therefore, the purpose of this study was to characterize structural differences in the Achilles tendons in healthy young adults and competitive distance runners using quantitative ultrasound analyses. We hypothesized that competitive distance runners with no clinical signs or symptoms of tendinopathy would have quantitative signs of tendon damage, characterized by decreased collagen alignment and echogenicity, in addition to previous reports of thicker tendons. Longitudinal ultrasound images of the right Achilles tendon midsubstance were acquired in competitive distance runners and recreationally active adults. Collagen organization, mean echogenicity, and tendon thickness were quantified using image processing techniques. Clinical assessments confirmed that runners had no signs or symptoms of tendinopathy, and controls were only included if they had no history of Achilles tendon pain or injuries. Runner tendons were 40% less organized, 48% thicker, and 41% less echogenic compared with the control tendons ( P < 0.001). Young adults engaged in competitive distance running have structurally different tendons than recreationally active young adults. NEW & NOTEWORTHY In this study, we quantified the Achilles tendon substructure in distance runners, and a control group of young adults, to determine whether distance running elicits structural adaptations of the tendon. We found that competitive distance runners have structurally compromised Achilles tendons despite not showing any clinical signs or symptoms of tendon injury. These findings suggest that distance running may stimulate structural changes as a protective mechanism against tendon pain and dysfunction.
跟腱病影响许多跑步运动员，常导致慢性疼痛和功能障碍。尽管肌腱结构的变化与跟腱病有关，但长距离跑步对肌腱结构的影响还不太清楚。因此，本研究的目的是使用定量超声分析来描述健康年轻成年人和竞技长跑运动员跟腱的结构差异。我们假设，没有跟腱病临床症状或体征的竞技长跑运动员除了之前报道的肌腱增厚外，还会出现定量的肌腱损伤迹象，表现为胶原排列和回声降低。对竞技长跑运动员和有规律运动的成年人的右跟腱中份进行了纵向超声检查。使用图像处理技术对胶原组织、平均回声和肌腱厚度进行了量化。临床评估证实，跑步者没有跟腱病的迹象或症状，并且只有在没有跟腱疼痛或受伤史的情况下才将对照组纳入研究。跑步者的肌腱组织比对照组的更不规整（减少 40%）、更厚（增加 48%）、回声更低（减少 41%）（P＜0.001）。与有规律运动的年轻人相比，从事竞技长跑的年轻人的跟腱结构不同。在这项研究中，我们对长跑运动员和对照组年轻人的跟腱亚结构进行了定量分析，以确定长跑是否会引起跟腱的结构适应。我们发现，尽管竞技长跑运动员没有任何跟腱损伤的临床症状或体征，但他们的跟腱结构受损。这些发现表明，长跑可能会刺激结构变化，作为一种预防跟腱疼痛和功能障碍的保护机制。
