Aponeurosis behaviour during muscular contraction: A narrative review.

There is an abundance of evidence that suggests elastic tendons can enhance both animal and human muscle performance. However, in many terrestrial animals, including humans, a large proportion of the elastic tissue within the muscle-tendon unit is located within the muscle. This continuous elastic sheet, which provides muscle fibre attachment, is known as the aponeurosis. The aponeurosis has a much more complicated shape than the free tendon and it undergoes a more complicated loading regime during contraction, due to its relationship with the bulging muscle fibres, which remain isovolumetric during force production. Muscle contraction may dynamically modulate the stiffness of the aponeurosis at the same active versus passive force, by increasing the intramuscular pressure and transverse forces within the muscle, which may stretch the aponeurosis in width and subsequently reduce its longitudinal strain. Some evidence also suggests that the aponeurosis mechanical properties may be affected by muscle length, which appears to reduce the fascicle strains for a given muscle force at longer muscle lengths. This narrative review outlines the animal and human studies that have investigated aponeurosis behaviour during contraction and discusses how an elastic sheet with a variable stiffness under activation might be beneficial for muscle performance. While it is clear that our understanding of the role of aponeurosis is lacking, it is hoped that further work will attempt to determine how this tissue contributes to power amplification and elastic energy savings during locomotion and potentially uncover how aponeurosis behaviour contributes to injury risk.