Abstract
The purpose of this study was to determine and explore factors (age, sex, anthropometry, running and injury/pain history, tendon gross morphology, neovascularization, ankle range of motion, and ankle plantarflexor muscle endurance) related to intra-tendinous morphological alterations of the Achilles tendon in runners. An intra-tendinous morphological change was defined as collagen fiber disorganization detected by a low peak spatial frequency radius (PSFR) obtained from spatial frequency analysis (SFA) techniques in sonography. Ninety-one runners (53 males and 38 females; 37.9 ± 11.6 years) with 8.8 ± 7.3 years of running experience participated. Height, weight, and waist and hip circumferences were recorded. Participants completed a survey about running and injury/pain history and the Victorian Institute of Sport Assessment-Achilles (VISA-A) survey. Heel raise endurance and knee-to-wall composite dorsiflexion were assessed. Brightness-mode (B-mode) sonographic images were captured longitudinally and transversely on the Achilles tendon bilaterally. Sonographic images were analyzed for gross morphology (i.e., cross-sectional area [CSA]), neovascularization, and intra-tendinous morphology (i.e., PSFR) for each participant. The factors associated with altered intra-tendinous morphology of the Achilles tendon were analyzed using a generalized linear mixed model. Multivariate analyses revealed that male sex was significantly associated with a decreased PSFR. Additionally, male sex and the presence of current Achilles tendon pain were found to be significantly related to decreased PSFR using a univariate analysis. Our findings suggested that male sex and presence of current Achilles tendon pain were related to intra-tendinous morphological alterations in the Achilles tendon of runners.
Citation: Ho K-Y, Baquet A, Chang Y-J, Chien L-C, Harty M, Bashford G, et al. (2019) Factors related to intra-tendinous morphology of Achilles tendon in runners. PLoS ONE 14(8):
e0221183.
https://doi.org/10.1371/journal.pone.0221183
Editor: James H-C Wang, University of Pittsburgh, UNITED STATES
Received: May 13, 2019; Accepted: July 31, 2019; Published: August 14, 2019
Copyright: © 2019 Ho et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: Data have been deposited to Figshare: http://dx.doi.org/10.6084/m9.figshare.8313386.
Funding: The authors did not receive funding or financial support for conducting this research study. The publication fee for this article was supported by the University of Nevada, Las Vegas University Libraries Open Article Fund.
Competing interests: The authors have declared that no competing interests exist.