Using Ultrasound Measurement of the Achilles Tendon in Asymptomatic Runners to Assist in Predicting Tendinopathy.

OBJECTIVES

The Achilles tendon is the strongest tendon in the human body, and Achilles tendinopathy is common in athletes due to the stress imparted by repetitive forces. The prevalence of Achilles tendon abnormalities in asymptomatic elite runners is unknown. Since there is a substantial risk of developing symptomatic tendinopathy in those with abnormal tendons, identifying those asymptomatic athletes with abnormal tendons and characterizing baseline characteristics of elite runners using ultrasound (US) are valuable injury prevention tools.

METHODS

This study used US to evaluate the Achilles tendons of 27 asymptomatic National Collegiate Athletic Association Division I cross-country athletes and performed correlations between dominant and nondominant side tendon size (cross-sectional area [CSA] and thickness) and athlete characteristics. Tendons were also assessed for signs of abnormalities that were suggestive of Achilles tendinopathy.

RESULTS

The prevalence of tendon abnormalities in asymptomatic collegiate runners was 11%. Among the participants included in this study, dominant and nondominant Achilles tendons did not vary significantly in thickness or CSA (P > .05). The CSA was found to correlate with height, weight, sex, body mass index, and miles run per week (P < .05). Thickness was found to correlate best with miles run per week (P < .05).

CONCLUSIONS

A US evaluation of the Achilles tendon has potential to identify changes in tendon size in addition to abnormalities consistent with tendinopathy. As more normative values are identified among various populations, tendon size may have prognostic value for collegiate athletes in the evaluation of Achilles tendinopathy.