Hagan Kenton L, Hullfish Todd, Casey Ellen, Baxter Josh R
Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
J Appl Physiol (1985). 2018 Dec 1;125(6):1743-1748. doi: 10.1152/japplphysiol.00723.2018. Epub 2018 Sep 27.
Achilles tendinopathy is 10 times more common among running athletes compared with age-matched peers. Load-induced tendon remodeling and its progression in an at-risk population of developing symptomatic tendinopathy are not well understood. The purpose of this study was to prospectively characterize Achilles and patellar tendon structure in competitive collegiate distance runners over different competitive seasons using quantitative ultrasound imaging. Twenty-two collegiate cross-country runners and eleven controls were examined for this study. Ultrasound images of bilateral Achilles and patellar tendons were obtained near the start and end of the collegiate cross-country season and the conclusion outdoor track season. Collagen organization, mean echogenicity, tendon thickness, and neovascularity were determined using well-established image processing techniques. Achilles tendon collagen was less aligned in runners compared with controls (28% greater) but improved slightly (7% decrease) after the completion of the track season. Conversely, patellar tendons in runners were similar to control tendons throughout the cross-country season but underwent collagen alignment (17% decrease) and tendon hypertrophy (21% increase). Our findings indicate that Achilles tendon structure in trained runners differs structurally from control tendons but is stable throughout training while patellar tendon structure changes in response to the transition in training volume between cross-country and track seasons. These findings expand upon prior reports that some degree of tendon remodeling may act as a protective adaptation for sport specific loading. In this study we prospectively examined the Achilles and patellar tendon structure of distance runners to determine if continued training through multiple seasons elicits tendon remodeling or pathology. We found that Achilles and patellar tendons respond uniquely to the changing loads required during each season. Achilles tendon collagen alignment is mostly stable throughout the competitive cycle, but the patellar tendon structurally remodels following the transition from cross-country to track season.
与年龄匹配的同龄人相比，跟腱病在跑步运动员中更为常见，发病率是他们的10倍。在有症状性肌腱病风险的人群中，负荷诱导的肌腱重塑及其进展尚未得到充分了解。本研究的目的是通过定量超声成像，对不同竞技赛季的大学竞技长跑运动员的跟腱和髌腱结构进行前瞻性特征描述。本研究对22名大学越野跑运动员和11名对照组人员进行了检查。在大学越野赛季开始和结束时以及室外田径赛季结束时，获取双侧跟腱和髌腱的超声图像。使用成熟的图像处理技术确定胶原蛋白的排列、平均回声性、肌腱厚度和新生血管情况。与对照组相比，跑步运动员的跟腱胶原蛋白排列较差（高出28%），但在田径赛季结束后略有改善（降低7%）。相反，在整个越野赛季中，跑步运动员的髌腱与对照肌腱相似，但胶原蛋白排列出现变化（降低17%），肌腱肥大（增加21%）。我们的研究结果表明，经过训练的跑步运动员的跟腱结构在结构上与对照肌腱不同，但在整个训练过程中保持稳定，而髌腱结构则会随着越野和田径赛季之间训练量的变化而改变。这些发现扩展了先前的报道，即一定程度的肌腱重塑可能是对特定运动负荷的一种保护性适应。在本研究中，我们前瞻性地检查了长跑运动员的跟腱和髌腱结构，以确定多个赛季的持续训练是否会引发肌腱重塑或病变。我们发现，跟腱和髌腱对每个赛季所需的变化负荷有独特的反应。在整个竞技周期中，跟腱胶原蛋白排列大多保持稳定，但从越野赛季过渡到田径赛季后，髌腱会在结构上发生重塑。
