Are the mechanical properties of Achilles tendon altered in CrossFit athletes? Reliability and accuracy of myotonometry

Szajkowski, Sebastian; Pasek, Jarosław; Dwornik, Michał; Zajączkowski, Mateusz; Cieślar, Grzegorz

doi:10.37190/abb-02283-2023-01

Abstract

Purpose: Tendons adapt to loads affecting them by changing tendons’ mechanical and morphological properties. The aim of the study was to investigate the influence of involvement in sport activities in the form of CrossFit training by individuals of different age upon the mechanical properties of Achilles tendon.

Methods: 231 people participated in the study. One group consisted of subjects who trained CrossFit as amateurs, the other group comprised subjects who were not physically active. Achilles tendon was studied for various positions of the ankle joint: 0° DF/PF, 10° DF, 20° DF, 20° PF and 40° PF. The following mechanical and viscoelastic tendon properties were measured using MyotonPRO: frequency [Hz], stiffness [N/m], decrement [log], relaxation time [ms] and creep [De]. The results have been compared in reference to physical activity, BMI, age and length of training history.

Results: Both the tension and stiffness increased with degree of Achilles tendon stretching and decreased as it contracted. Higher values have been noted in the group of people in training and with higher BMI values. The elasticity of Achilles tendon decreased with plantar flexion increase. Lower elasticity has been recorded in the group in training and with higher BMI. No significant influence of age and length of training history upon the parameters achieved has been noted.

Conclusions: The specificity of CrossFit training and accompanying mechanical load result in development of adaptation changes in Achilles tendon, in the form of its higher tone/tension and stiffness, as well as lower elasticity.

References

Alawna M.A., Unver B.H., Yuksel E.O., The Reliability of a Smartphone Goniometer Application Compared With a Traditional Goniometer for Measuring Ankle Joint Range of Motion, J. Am. Podiatr. Med. Assoc., 2019, 109 (1), 22–29, DOI: 10.7547/16-128.
Search in Google Scholar Back to article
Barreto S., Pierantoni M., Hammerman M., Törnquist E., Le Cann S., Diaz A., Engqvist J. et al., Nanoscale characterization of collagen structural responses to in situ loading in rat Achilles tendons, Matrix Biol., 2023, 115, 32–47, DOI: 10.1016/j.matbio.2022.11.006.
Search in Google Scholar Back to article
Bizzini M., Mannion A.F., Reliability of a new, hand-held device for assessing skeletal muscle stiffness, Clin. Biomech., 2003, 18, 5, 459–461, DOI: 10.1016/s0268-0033(03)00042-1.
Search in Google Scholar Back to article
Camy C., Brioche T., Senni K., Bertaud A., Genovesio C., Lamy E., Fovet T. et al., Effects of hindlimb unloading and subsequent reloading on the structure and mechanical properties of Achilles tendon-to-bone attachment, Faseb J., 2022, 36, 10, e22548, DOI: 10.1096/fj.202200713R.
Search in Google Scholar Back to article
Cardona-Ramirez S., Stoker A.M., Cook J.L., Richard M., Fibroblasts From Common Anterior Cruciate Ligament Tendon Grafts Exhibit Different Biologic Responses to Mechanical Strain, Am. J. Sports Med., 2021, 49, 1, 215–225, DOI: 10.1177/0363546520971852.
Search in Google Scholar Back to article
Chen L., Cheng Y., Zhou L., Zhang L., Deng X., Quantitative shear wave elastography compared to standard ultrasound (qualitative B-mode grayscalesonography and quantitative power Doppler) for evaluation of achillotendinopathy in treatment-naïve individuals: A cross-sectional study, Adv. Clin. Exp. Med., 2022, 31, 8, 847–854, DOI: 10.17219/acem/147878. PMID: 35593220.
Search in Google Scholar Back to article
Crawford S.K., Thelen D., Yakey J.M., Heiderscheit B.C., Wilson J.J., Lee K.S., Regional shear wave elastography of Achilles tendinopathy in symptomatic versus contralateral Achilles tendons, Eur. Radiol., 2023, 33, 1, 720–729, DOI: 10.1007/s00330-022-08957-3.
Search in Google Scholar Back to article
Cronin N.J., Lichtwark G., The use of ultrasound to study muscle-tendon function in human posture and locomotion, Gait Posture, 2013, 37, 305–312, DOI: 10.1016/j.gaitpost.2012.07.024.
Search in Google Scholar Back to article
De Marchi A., Pozza S., Cenna E., Cavallo F., Gays G., Simbula L., De Petro P., Massè A., Massazza G., In Achilles tendinopathy, the neovascularization, detected by contrast-enhanced ultrasound (CEUS), is abundant but not related to symptoms, Knee Surg. Sports Traumatol. Arthrosc., 2018, 26, 2051–2058, doi.org/10.1007/s00167-017-4710-8
Search in Google Scholar Back to article
Feng Y.N., Li Y.P., Liu C.L., Assessing the elastic properties of skeletal muscle and tendon using shearwave ultrasound elastography and MyotonPRO, Sci. Rep., 2018, 8, 17064.
Search in Google Scholar Back to article
Finnamore E., Waugh C., Solomons L., Transverse tendon stiffness is reduced in people with Achilles tendinopathy: a cross-sectional study, PLoS One, 2019, 14, e0211863.
Search in Google Scholar Back to article
Fisker F.Y., Kildegaard S., Thygesen M., Grosen K., Pfeiffer-Jensen M., Acute tendon changes in intense CrossFit workout: an observational cohort study, Scand. J. Med. Sci. Sports, 2017, 27, 11, 1258–1262, DOI: 10.1111/sms.12781.
Search in Google Scholar Back to article
Hui W., Ruyue Y.U., Meng W., Shikun W., Xingyu O., Zhiwen Y., Shuai C.H. et al., Insulin-like growth factor binding protein 4 loaded electrospun membrane ameliorating tendon injury by promoting retention of IGF-1, J. Control Release, 2023, 356, 162–174, DOI: 10.1016/j.jconrel.2023.02.039.
Search in Google Scholar Back to article
Ianieri G., Saggini R., Marvulli R., Tondi G., Aprile A., Ranieri M., Benedetto G. et al., New approach in the assessment of the tone, elasticity and the muscular resistance: nominal scales vs MYOTON, Int. J. Immunopathol. Pharmacol., 2009, 22, 3, 21–24, DOI: 10.1177/03946320090220S304.
Search in Google Scholar Back to article
Iwata M., Yamamoto A., Matsuo S., Hatano G., Miyazaki M., Fukaya T., Fujiwara M., Asai Y., Suzuki S., Dynamic Stretching Has Sustained Effects on Range of Motion and Passive Stiffness of the Hamstring Muscles, J. Sports Sci. Med., 2019, 11, 18 (1), 13–20.
Search in Google Scholar Back to article
Konow N., Azizi E., Roberts T.J., Muscle power attenuation by tendon during energy dissipation, Proc. R. Soc., 2012, 279, 1108–1113, DOI: 10.1098/rspb. 2011.1435.
Search in Google Scholar Back to article
Konow N., Roberts T., The series elastic shock absorber: tendon elasticity modulates energy dissipation by muscle during burst deceleration, Proc. Biol. Sci., 2015, 7, 282, DOI: 10.1098/rspb.2014.2800.
Search in Google Scholar Back to article
Kubo K., Miyazaki D., Yamada K., Yata H., Shimoju S., Tsunoda N., Passive and active muscle stiffness in plantar flexors of long distance runners, J. Biomech., 2015, 48, 10, 1937–1943, DOI: 10.1016/j.jbiomech.2015.04.012.
Search in Google Scholar Back to article
Lazarczuk S.L., Maniar N., Opar D.A., Duhig S.J., Shield A., Barrett R.S., Bourne M.N., Mechanical, Material and Morphological Adaptations of Healthy Lower Limb Tendons to Mechanical Loading: A Systematic Review and Meta-Analysis, Sports Med., 2022, 52, 10, 2405–2429, DOI: 10.1007/s40279-022-01695-y.
Search in Google Scholar Back to article
Lee Y., Kim M., Lee H., The Measurement of Stiffness for Major Muscles with Shear Wave Elastography and Myoton: A Quantitative Analysis Study, Diagnostics (Basel), 2021, 11, 3, 524, DOI: 10.3390/diagnostics11030524.
Search in Google Scholar Back to article
Li H., Korcari A., Ciufo D., Mendias C.L., Rodeo S.A., Buckley M.R., Loiselle A.E. et al., Increased Ca 2+ signaling through Ca V 1.2 induces tendon hypertrophy with increased collagen fibrillogenesis and biomechanical properties, BioRxiv, 2023, 24, 119–127, DOI: 10.1101/2023.01.24.525119. Preprint.
Search in Google Scholar Back to article
Li Y.P., Liu C.L., Zhang Z.J., Feasibility of Using a Portable MyotonPRO Device to Quantify the Elastic Properties of Skeletal Muscle, Med. Sci. Monit., 2022, 28, e934121, DOI: 10.12659/MSM.934121.
Search in Google Scholar Back to article
Liu C.L., Li Y.P., Wang X.Q., Quantifying the stiffness of Achilles tendon: intra- and Inter-Operator reliability and the effect of ankle joint motion, Med. Sci. Monit., 2018, 24, 4876–4881, DOI: 10.12659/MSM.909531.
Search in Google Scholar Back to article
Maeda E., Kawamura R., Suzuki T., Matsumoto T., Rapid fabrication of tendon-like collagen gel via simultaneous fibre alignment and intermolecular cross-linking under mechanical loading, Biomed. Mater., 2022, 17, 4, DOI: 10.1088/1748-605X/ac7305.
Search in Google Scholar Back to article
Magnusson S.P., Kjaer M., The impact of loading, unloading, ageing and injury on the human tendon, J. Physiol., 2019, 597, 1283–1298, DOI: 10.1113/JP275450.
Search in Google Scholar Back to article
Mahan J., Damodar D., Trapana E., Barnhill S., Ugarte Nuno A., Smyth N.A., Aiyer A. et al., Achilles tendon complex: The anatomy of its insertional footprint on the calcaneus and clinical implications, J. Orthop., 2019, 17, 221–227, DOI: 10.1016/j.jor.2019.06.008.
Search in Google Scholar Back to article
Miyamoto N., Hirata K., Inoue K., Hashimoto T., Muscle Stiffness of the VastusLateralis in Sprinters and Long-Distance Runners, Med. Sci. Sports Exerc., 2019, 51, 10, 2080–2087, DOI: 10.1249/MSS.0000000000002024.
Search in Google Scholar Back to article
Morgan G.E., Martin R., Williams L., Objective assessment of stiffness in Achilles tendinopathy: a novel approach using the MyotonPRO, BMJ Open Sport Exerc. Med., 2018, 4, e000446.
Search in Google Scholar Back to article
Mrozik K., Błach B., Kusiak M., Janusiak M., Pożarowszczyk B., Kisilewicz A., Kawczyński A. et al., Defects of plyometric training on the rectus femoris muscle stiffness among volleyball players measured by myotometry, Polish J. Sport Med., 2017, 4 (4), 273–279, DOI: 10.5604/01.3001.0010.7966.
Search in Google Scholar Back to article
Nguyen A.P., Detrembleur C., Fisette P., Selves C., Mahaudens P., MyotonPro Is a Valid Device for Assessing Wrist Biomechanical Stiffness in Healthy Young Adults, Front Sports Act. Living, 2022, 4, 797975.
Search in Google Scholar Back to article
Nuñez F.J., Ritzmann R., Hernandez-Abad F., Martinez J.C., Suarez-Arrones L., Muscle Architecture, Morphology, and Mechanical and Functional Properties of Biceps Femoris Long Head in Professional Soccer Players with a Prior Healed Injured Hamstring, J. Clin. Med., 2022, 11, 23, 7222, DOI: 10.3390/jcm11237222.
Search in Google Scholar Back to article
Orner S., Kratzer W., Schmidberger J., Quantitative tissue parameters of Achilles tendon and plantar fascia in healthy subjects using a handheld myotonometer, J. Bodyw. Mov. Ther., 2018, 22, 105–111, DOI: 10.1016/j.jbmt.2017.06.015.
Search in Google Scholar Back to article
Pożarowszczyk B., Pawlaczyk W., Smoter M., Zarzycki A., Mroczek D., Kumorek M., Witkowski K. et al., Effects of Karate Fights on Achilles Tendon Stiffness Measured by Myotonometry, J. Hum. Kinet., 2017, 56, 93–97, DOI: 10.1515/hukin-2017-0026.
Search in Google Scholar Back to article
Ramírez-Delacruz M., Bravo-Sánchez A., Esteban-García P., Jiménez F., Abián-Vicén J., Effects of Plyometric Training on Lower Body Muscle Architecture, Tendon Structure, Stiffness and Physical Performance: A Systematic Review and Meta-analysis, Sports Med. Open., 2022, 8, 1, 40, DOI: 10.1186/s40798-022-00431-0.
Search in Google Scholar Back to article
Rogers S.A., Whatman C.S., Pearson S.N., Kilding A.E., Assessments of Mechanical Stiffness and Relationships to Performance Determinants in Middle-Distance Runners, Int. J. Sports Physiol. Perform., 2017, 12, 10, 1329–1334, DOI: 10.1123/ijspp.2016-0594.
Search in Google Scholar Back to article
Sawadkar P., Player D., Bozec L., Mudera V., The mechanobiology of tendon fibroblasts under static and uniaxial cyclic load in a 3D tissue engineered model mimicking native extracellular matrix, J. Tissue Eng. Regen. Med., 2020, 14, 1, 135–146, DOI: 10.1002/term.2975.
Search in Google Scholar Back to article
Schneebeli A., Falla D., Clijsen R., Barbero M., Myotonometry for the evaluation of Achilles tendon mechanical properties: a reliability and construct validity study, BMJ Open Sport Exerc. Med., 2020, 6, 1, e000726, DOI: 10.1136/bmjsem-2019-000726.
Search in Google Scholar Back to article
Tas S., Salkin Y., An investigation of the sex-related differences in the stiffness of the Achilles tendon and gastrocnemius muscle: Inter-observer reliability and inter-day repeatability and the effect of ankle joint motion, Foot, 2019, 41, 44–50, DOI: 10.1016/j.foot.2019.09.003
Search in Google Scholar Back to article
Tsuchiya Y., Takakura H., Osawa S., Izawa T., Impact of high-intensity interval training on tendon related gene expression in rat Achilles tendon, Biochem. Biophys. Res. Commun., 2023, 658, 116–121, DOI: 10.1016/j.bbrc.2023.03.076.
Search in Google Scholar Back to article
Vatovec R., Marušič J., Marković G., Šarabon N., Effects of Nordic hamstring exercise combined with glider exercise on hip flexion flexibility and hamstring passive stiffness. J. Sports Sci., 2021, 39, 20, 2370–2377, DOI: 10.1080/02640414.2021.1933350.
Search in Google Scholar Back to article
Wang H.K., Lin K.H., Su S.C., Effects of tendon viscoelasticity in Achilles tendinosis on explosive performance and clinical severity in athletes, Scand. J. Med. Sci. Sports, 2012, 22, e147–e155, DOI: 10.1111/j.1600-0838.2012.01511.x.
Search in Google Scholar Back to article
Winnicki K., Ochała-Kłos A., Rutowicz B., Pękala P.A., Tomaszewski K.A., Functional anatomy, histology and biomechanics of the human Achilles tendon – A comprehensive review, Ann. Anat., 2020, 229, 151461, DOI: 10.1016/j.aanat.2020.151461.
Search in Google Scholar Back to article
Yu C., Deng L., Li L., Zhang X., Fu W., Exercise Effects on the Biomechanical Properties of the Achilles Tendon-A Narrative Review, Biology, 2022, 11, 2, 172, DOI: 10.3390/biology11020172.
Search in Google Scholar Back to article
Yu J.F., Chang T.T., Zhang Z.J., The Reliability of MyotonPRO in Assessing Masseter Muscle Stiffness and the Effect of Muscle Contraction, Med. Sci. Monit., 2020, 26, e926578, DOI: 10.12659/MSM.926578.
Search in Google Scholar Back to article
Zhang Z.J., Ng G.Y., Fu S.N., Effects of habitual loading on patellar tendon mechanical and morphological properties in basketball and volleyball players, Eur. J. Appl. Physiol., 2015, 115, 11, 2263–2269, DOI: 10.1007/s00421-015-3209-6.
Search in Google Scholar Back to article

Are the mechanical properties of Achilles tendon altered in CrossFit athletes? Reliability and accuracy of myotonometry

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