Department of Physical Therapy and Athletic Training, Saint Louis University, St. Louis, Missouri, USA.
Department of Physical Therapy, University of Delaware, Newark, Delaware, USA.
Scand J Med Sci Sports. 2022 Aug;32(8):1201-1212. doi: 10.1111/sms.14178. Epub 2022 May 22.
We aimed to (1) compare pain, tendon structure, lower limb function, and Achilles tendon loads while running between limbs in runners with Achilles tendinopathy, and (2) explore the relations of pain, tendon structure, and lower limb function to Achilles tendon loads while running. Twenty runners with Achilles tendinopathy participated in this pilot study. Pain was assessed with questionnaires, quantitative sensory testing, and functional testing. Tendon morphology and mechanical properties were evaluated with ultrasound imaging, continuous shear wave elastography, and ultrasound imaging combined with dynamometry. Lower limb function was assessed with an established test battery. Achilles tendon loads were estimated from biomechanical data acquired during running. Compared to the least symptomatic limb, the most symptomatic limb had lower scores on the Victorian Institute of Sports Assessment - Achilles questionnaire and worse pain during drop countermovement jumping, hopping, and running. Tendon thickness and cross-sectional area were greater, and Young's modulus, drop countermovement jump height, and plyometric quotient during hopping were lower on the most symptomatic limb. Side-to-side differences in drop countermovement jump height were significantly associated with side-to-side differences in Achilles tendon peak forces and average loading rates during running. Various measures of pain, structure, and function differ between limbs in runners with Achilles tendinopathy during return-to-sport. Tendon forces, however, do not differ between limbs during comfortable running. In addition to measures that differ between limbs, measures of performance during drop countermovement jumping may aid in clinical decision-making during return-to-sport because they are associated with tendon forces while running.
（1）比较患有跟腱病的跑步者在双腿跑步时的疼痛、跟腱结构、下肢功能和跟腱负荷；（2）探索疼痛、跟腱结构和下肢功能与跑步时跟腱负荷的关系。20 名患有跟腱病的跑步者参与了这项初步研究。疼痛通过问卷调查、定量感觉测试和功能测试进行评估。使用超声成像、连续剪切波弹性成像和超声成像与测力联合评估肌腱形态和机械特性。使用既定的测试组合评估下肢功能。根据跑步时获得的生物力学数据来估计跟腱负荷。与症状最轻的肢体相比，症状最严重的肢体在维多利亚州运动评估-跟腱问卷上的得分更低，在反向纵跳、单足跳和跑步时的疼痛更严重。最严重的肢体的跟腱厚度和横截面积更大，反向纵跳高度和单足跳的弹性能量比更低，而杨氏模量更高。反向纵跳高度的侧间差异与跑步时跟腱峰值力和平均加载率的侧间差异显著相关。在重返运动期间，患有跟腱病的跑步者的双腿之间在疼痛、结构和功能的各种测量指标上存在差异。然而，在舒适跑步时，双腿之间的跟腱力并无差异。除了在双腿之间存在差异的测量指标外，反向纵跳高度的测量指标可能有助于重返运动期间的临床决策，因为它们与跑步时的跟腱力相关。
