A Longitudinal Study of the Physical Characteristics, Muscle-Tendon Structure Properties, and Skeletal Age in Preadolescent Boys.

OBJECTIVES: The purpose of this study was to examine longitudinal growth changes in physical characteristics, muscle-tendon structure properties, and skeletal age in preadolescent boys and to compare the relationship between the changes in physical characteristics and muscle-tendon properties and the changes in chronological and skeletal ages. METHODS: Fourteen prepubescent boys (10.9 ± 1.1 years old at the onset of the study) participated in this study over two years (yearly). Maximal muscle strength and maximal strain of tendon structure during ramp isometric contraction and muscle and tendon thickness for knee extensors and plantar flexors were measured. In addition, skeletal age was assessed using Tanner-Whitehouse three method. RESULTS: Changes in height, thigh length, and lower leg length were highly correlated with changes in skeletal age but not chronological age. However, changes in the morphological and mechanical properties of muscle and tendon structure were not significantly associated with changes in chronological and skeletal ages. CONCLUSION: The present preliminary results suggest that longitudinal growth changes in the long-axis of the body are highly correlated with skeletal age change, whereas those in the muscle-tendon structure properties were not.

Active muscle and tendon stiffness of plantar flexors in sprinters.

The aim of the present study was to investigate and compare muscle and tendon stiffness under active conditions in sprinters and untrained participants. In total, 14 sprinters and 24 untrained men participated in this study. Active muscle stiffness in the medial gastrocnemius muscle was calculated based on changes in estimated muscle force and fascicle length during fast stretching after submaximal isometric contractions. Tendon stiffness was determined during isometric plantar flexion using ultrasonography. No significant differences were observed in active muscle stiffness between sprinters and untrained men at any torque levels. Furthermore, no significant difference was noted in tendon stiffness between the two groups. These results suggest that muscle and tendon mechanical properties in the plantar flexors under active conditions are similar in sprinters and untrained participants.

Relationship between elastic properties of tendon structures and performance in long distance runners.

INTRODUCTION: The purpose of this study was to investigate the relationship between running performance (best official record in a 5000 m race) and elastic properties of tendon structures in knee extensors and plantar flexors among a large population of long distance runners. METHODS: Sixty-four highly trained male long distance runners participated in this study. Elongation of tendon structures in the knee extensors and plantar flexors was measured using ultrasonography while subjects performed ramp isometric contractions up to the voluntary maximum. The relationship between the estimated muscle force and tendon elongation was fit to a linear regression, the slope of which was defined as the stiffness of the tendon structures. Muscle and tendon thicknesses were also measured in the knee extensors and plantar flexors using ultrasonography. RESULTS: The best official record in a 5000 m race was negatively correlated to the stiffness of the tendon structures in the knee extensors (r = -0.341, p < 0.01), whereas it was positively correlated to the stiffness of the tendon structures in the plantar flexors (r = 0.414, p < 0.001). In both the knee extensors and plantar flexors, the other measured variables of muscle and tendon structures did not correlate with the best official record in a 5000 m race. CONCLUSION: These results suggested that better long distance runners had stiffer tendon structures in the knee extensors and more compliant ones in the plantar flexors. These results implied that tendon structures in knee extensors and plantar flexors adapted to endurance running training and contributed to running performance of long distance runners separately.

Relationship between Achilles tendon properties and foot strike patterns in long-distance runners.

The purpose of this study was to investigate the relationship between Achilles tendon properties and foot strike patterns in long-distance runners. Forty-one highly trained male long-distance runners participated in this study. Elongation of the Achilles tendon and aponeurosis of the medial gastrocnemius muscle were measured using ultrasonography, while the participants performed ramp isometric plantar flexion up to the voluntary maximum. The relationship between the estimated muscle force and tendon elongation during the ascending phase was fit to a linear regression, the slope of which was defined as stiffness. In addition, the cross-sectional area of the Achilles tendon was measured using ultrasonography. Foot strike patterns (forefoot, midfoot and rearfoot) during running were determined at submaximal velocity (18 km · h(-1)) on a treadmill. The number of each foot strike runner was 12 for the forefoot (29.3%), 12 for the midfoot (29.3%) and 17 for the rearfoot (41.5%). No significant differences were observed in the variables measured for the Achilles tendon among the three groups. These results suggested that the foot strike pattern during running did not affect the morphological or mechanical properties of the Achilles tendon in long-distance runners.

Growth changes in morphological and mechanical properties of human patellar tendon in vivo.

The purpose of this study was to compare the morphological and mechanical properties of the human patellar tendon among elementary school children (prepubertal), junior high school students (pubertal), and adults. Twenty-one elementary school children, 18 junior high school students, and 22 adults participated in this study. The maximal strain, stiffness, Young's modulus, hysteresis, and cross-sectional area of the patellar tendon were measured using ultrasonography. No significant difference was observed in the relative length (to thigh length) or cross-sectional area (to body mass(2/3)) of the patellar tendon among the three groups. Stiffness and Young's modulus were significantly lower in elementary school children than in the other groups, while no significant differences were observed between junior high school students and adults. No significant differences were observed in maximal strain or hysteresis among the three groups. These results suggest that the material property (Young's modulus) of the patellar tendons of elementary school children was lower than that of the other groups, whereas that of junior high school students was already similar to that of adults. In addition, no significant differences were observed in the extensibility (maximal strain) or viscosity (hysteresis) of the patellar tendon among the three groups.

Muscles used for chest compression under static and transportation conditions.

BACKGROUND: Unstable conditions during ambulance transportation are not conducive to the performance of high-quality cardiopulmonary resuscitation by emergency medical technicians. OBJECTIVE: The present study was conducted to clarify differences in the quality of chest compression and associated muscle activity between static and ambulance transportation conditions. METHODS: Nine paramedic students performed chest compression for 5 minutes on the floor and during ambulance transportation. Compression rate and depth and success and error rates of chest compression were determined using the Resusci Anne manikin with a PC SkillReporting System (Laerdal Medical). Integrated electromyography (i-EMG) values of eight different muscles were also recorded bilaterally during the first and last 30 seconds of compression. RESULTS: There was no significant difference in compression rate per minute (p = 0.232) and depth of chest compression (p = 0.174) between the two conditions. The success rate was significantly lower under the ambulance transportation condition than under the static condition (p = 0.0161). Compared with those under the static condition, the total i-EMG values were significantly lower for the multifidus (p = 0.0072) and biceps femoris (p < 0.0001) muscles and significantly higher for the deltoid (p = 0.0032), pectoralis major (p = 0.0037), triceps brachii (p = 0.0014), vastus lateralis (p < 0.0001), and gastrocnemius (p = 0.0004) muscles under the ambulance transportation condition. CONCLUSIONS: Chest compression is performed mainly through flexion and extension of the hip joint while kneeling on the floor and through the elbow and shoulder joints while standing in a moving ambulance. Therefore, the low quality of chest compression during ambulance transportation may be attributable to an altered technique of performing the procedure.

Time course of changes in the human Achilles tendon properties and metabolism during training and detraining in vivo.

The purpose of this study was to investigate the time course of changes in human tendon properties and metabolism during resistance training and detraining. Nine men (21-27 years) completed 3 months of isometric plantar flexion training and another 3 months of detraining. At the beginning and on every 1 month of training and detraining periods, the stiffness, blood circulation (blood volume and oxygen saturation), serum procollagen type 1 C-peptide (P1P; reflects synthesis of type 1 collagen), echointensity (reflects collagen content), and MRI signal intensity (reflects collagen structure) of the Achilles tendon were measured. Tendon stiffness did not change until 2 months of training, and the increase (50.3%) reached statistical significance at the end of the training period. After 1 month of detraining, tendon stiffness had already decreased to pre-training level. Blood circulation in the tendon did not change during the experimental period. P1P increased significantly after 2 months of training. Echointensity increased significantly by 9.1% after 2 months of training, and remained high throughout the experiment. MRI signal intensity increased by 24.2% after 2 months and by 21.4% after 3 months of training, but decreased to the pre-training level during the detraining period. These results suggested that the collagen synthesis, content, and structure of human tendons changed at the 2-month point of training period. During detraining, the sudden decrease in tendon stiffness might be related to changes in the structure of collagen fibers within the tendon.

Effects of mechanical properties of muscle and tendon on performance in long distance runners.

The purpose of this study was to investigate the mechanical properties of muscle and tendon in long distance runners and their relations to running performance. Fifteen long distance runners (LDR) and 21 untrained subjects (CON) participated in this study. Muscle strength and activation level of knee extensors and plantar flexors were measured. Tendon elongation was determined using ultrasonography, while subjects performed ramp isometric knee extension and plantar flexion up to the voluntary maximum. Relative MVC (to body mass) of LDR was significantly lower than that of CON for knee extensors, but not for plantar flexors. No significant difference in the neural activation levels was found between LDR and CON for both sites. Maximal tendon elongation of LDR was significantly lower than that of CON for knee extensors, but not for plantar flexors. Furthermore, faster running time in a 5,000 m race (best official record of LDR) was associated with lower tendon stiffness for both sites. In conclusion, the tendon of long distance runners is less extensible than those of untrained subjects for knee extensors, but not for plantar flexors. For both sites, however, the lower tendon stiffness may be in favor of the running performance in long distance runners.

Time course of changes in muscle and tendon properties during strength training and detraining.

The purpose of this study was to investigate the time course of changes in mechanical and morphological properties of muscle and tendon during isometric training and detraining. Eight subjects completed 3 months of isometric knee extension training and detraining for another 3 months. At beginning and on every 1 month of training and detraining periods, muscle strength, neural activation level, muscle and tendon cross-sectional areas (CSA), and tendon stiffness were measured. Training increased muscle strength and neural activation level by 29.6 and 7.3% after 2 months and by 40.5 and 8.9% after 3 months (all p's < 0.05). Muscle CSA and tendon stiffness did not change until 2 months of training period, and afterward, the increases in muscle CSA and tendon stiffness reached statistical significance at the end of training period (both p's < 0.05). During detraining period, muscle strength and neural activation level did not change, although muscle CSA and tendon stiffness decreased to pre-training level at 1 and 2 months of detraining, respectively. These results suggest that the adaptations of tendon properties and muscle morphology to resistance training are slower than those of muscle function and inversely that the adaptations of former to detraining are faster than those of latter.

A longitudinal assessment of running economy and tendon properties in long-distance runners.

The aim of this study was to investigate longitudinal changes in tendon properties and running economy of long-distance runners (LDRs) in the preparatory periods of track season (TS) and road season (RS). Eleven well-trained LDRs and 6 untrained subjects participated in the present study. In each period, muscle strength, neural activation level, and tendon elongation for both knee extensors and plantar flexors, jump performances, and oxygen consumption during submaximal running velocities were measured. No significant differences observed in any measured variables between the 2 seasons for untrained subjects. For LDRs, the total running distance during 1 month preceding RS (832 +/- 95 km) was significantly longer than that during 1 month preceding TS (718 +/- 80 km). No significant differences in the muscle strength, neural activation level, and jump performances were found between TS and RS. The stiffness of tendon structures in RS was significantly lower than those in TS for both knee extensors (-14.4%, p = 0.023) and plantar flexors (-16.6%, p = 0.040). At 3 running velocities, the oxygen consumptions in RS were significantly lower than those in TS. These results suggested that the lower oxygen consumption during submaximal running velocities observed in the preparatory period of RS may be attributable to the more compliant tendon structures but not in the neuromuscular characteristics.

Mechanical properties of muscle and tendon at high strain rate in sprinters.

The aim of the present study was to compare the mechanical properties of muscles and tendons at high strain rates between sprinters and untrained men. Fifteen sprinters and 18 untrained men participated in this study. Active muscle stiffness of the medial gastrocnemius muscle was calculated according to changes in the estimated muscle force and fascicle length during fast stretching at five different angular velocities (100, 200, 300, 500, and 600 deg·s-1 ) after submaximal isometric contractions. Stiffness and hysteresis of tendon structures were measured during ramp and ballistic contractions. Active muscle stiffness at 500 deg·s-1 (p = .070) and 600 deg·s-1 (p = .041) was greater in sprinters than untrained men, whereas no differences in those at 100, 200, and 300 deg·s-1 were found between the two groups. There were no differences in stiffness or hysteresis of tendon structures measured during ramp and ballistic contractions between the two groups. These results suggest that, for sprinters, greater active muscle stiffness at a high angular velocity is caused by exercising with a high angular velocity that is typical of their training.

Effects of static and dynamic training on the stiffness and blood volume of tendon in vivo.

The purpose of this study was to investigate the effects of static and dynamic training on the stiffness and blood volume of the human tendon in vivo. Ten subjects completed 12 wk (4 days/wk) of a unilateral training program for knee extensors. They performed static training on one side [ST; 70% of maximum voluntary contraction (MVC)] and dynamic training on the other side (DT; 80% of one repetition maximum). Before and after training, MVC, neural activation level (by interpolated twitch), muscle volume (by magnetic resonance imaging), stiffness of tendon-aponeurosis complex and patella tendon (by ultrasonography), and blood volume of patella tendon (by red laser lights) were measured. Both protocols significantly increased MVC (49% for ST, 32% for DT; both P < 0.001), neural activation level (9.5% for ST, 7.6% for DT; both P < 0.01), and muscle volume (4.5% for ST, 5.6% for DT; both P < 0.01). The stiffness of tendon-aponeurosis complex increased significantly after ST (55%; P = 0.003) and DT (30%; P = 0.033), while the stiffness of patella tendon increased significantly after ST (83%; P < 0.001), but not for DT (P = 0.110). The blood volume of patella tendon increased significantly after DT (47%; P = 0.016), but not for ST (P = 0.205). These results implied that the changes in the blood volume of tendon would be related to differences in the effects of resistance training on the tendon properties.

Muscle force per cross-sectional area is inversely related with pennation angle in strength trained athletes.

The present study aimed to examine the effect of pennation angle on the force per cross-sectional area for elbow extensor muscles in strength-trained athletes. A total of 52 male bodybuilders (n = 32) and Olympic weightlifters (n = 20) did maximal isometric elbow extension on an isokinetic dynamometer. Muscle cross-sectional area (CSA) and muscle-fiber pennation angle (PA) of the triceps brachii muscles were measured by ultrasonography. Bodybuilders had significantly greater isometric elbow extension force (F), CSA and PA than weightlifters. The ratio of force to CSA (F/CSA) of bodybuilders was significantly lower than that of weightlifters. A significant positive correlation was observed between CSA and PA in both groups (r = 0.832, P < 0.001, and r = 0.682, P < 0.001, for bodybuilders and weightlifters, respectively). The F/CSA was negatively correlated to PA both for bodybuilders (r = -0.408, P < 0.05) and weightlifters (r = -0.465, P < 0.05). Thus present study indicates that the larger pennation angle is associated with the lower force relative to muscle CSA in strength-trained athletes.

Is the stiffness of human muscle and tendon structures related to muscle fiber composition in vivo?

BACKGROUND: The aim of the present study was to investigate the relationship between estimated muscle fiber composition (time-to-peak twitch torque; TPT) and muscle stiffness under passive and active conditions as well as stiffness of tendon structures in human plantar flexors. METHODS: TPT was assessed using supramaximal electrical stimulation. Active muscle stiffness in the medial gastrocnemius muscle was calculated based on changes in estimated muscle force and fascicle length during fast stretching after 50% maximal isometric contractions. Passive muscle stiffness was also calculated from estimated passive muscle force and fascicle length during slow passive stretching. Stiffness of tendon structures was determined during isometric plantar flexion using ultrasonography. RESULTS: TPT did not correlate with passive muscle stiffness (r=0.039, P=0.790), active muscle stiffness (r=0.185, P=0.203), or stiffness of tendon structures (r=-0.178, P=0.477). CONCLUSIONS: These results suggested that the muscle fiber composition of the human medial gastrocnemius muscle was not related to the mechanical properties of muscles or tendon structures.

Age-related differences in the force generation capabilities and tendon extensibilities of knee extensors and plantar flexors in men.

BACKGROUND: Recently, the number of elderly individuals who participate in sports has increased, thus injuries from overuse are now becoming recognized in the elderly population. Therefore, it is important to determine which muscle groups and tendons are most affected with aging to plan appropriate exercise interventions for elderly individuals. In particular, muscles and tendons in knee extensors and plantar flexors play an important role during locomotion. The purpose of this study was to compare the knee extensor and plantar flexor muscles and tendons. METHODS: Young (n = 19) and elderly (n = 17) men performed isometric voluntary knee extension and plantar flexion contractions. Muscle thickness and elongation of tendon structures in knee extensors and plantar flexors were measured by ultrasonography. RESULTS: Relative muscle thickness (to limb length) in the elderly group was significantly lower than that in the young group in knee extensors (p <.001), although no significant difference was found between the two groups in plantar flexors (p =.063). Relative muscle strength (to body mass) in the elderly group was significantly lower than that in the young group in both sites (all p <.001). Ratio of muscle strength to muscle thickness in the elderly group was significantly lower than that in the young group in plantar flexors, but not in knee extensors. The elderly group had significantly lower maximal elongation and strain of tendon structures in both sites than the young group had. CONCLUSION: These results suggest that the age-related weakness in knee extensors may be attributed to muscle atrophy, whereas that in plantar flexors is not, and that elderly persons have less extensible tendon structures in both sites.

Age-related differences in the properties of the plantar flexor muscles and tendons.

PURPOSE: The purpose of this study was to determine age-related differences in the human plantar flexor muscles and tendon. METHODS: Four age groups--a 20-yr group (20-27 yr, N = 19), 30-yr group (31-38 yr, N = 15), 50-yr group (46-57 yr, N = 10) and 70-yr group (62-77 yr, N = 15)--volunteered to take part in the present study. Muscle thickness, strength, and activation level (using twitch-interpolation technique) of plantar flexor muscles were measured. Elongation of the Achilles tendon was determined using ultrasonography while subjects performed ramp isometric plantar flexion up to the voluntary maximum. RESULTS: No significant difference in relative muscle thickness (to limb length) was observed among the four age groups. Muscle strength and activation level of the 20-yr group were significantly higher than those of the 50- and 70-yr groups (activation levels were not measured in the 70-yr group), and maximal strain (elongation/initial tendon length) of the Achilles tendon decreased with aging. Although there were no differences in muscle strength and activation levels between the 20- and 30-yr groups, maximal strain of the Achilles tendon of the 30-yr group was already lower than that of the 20-yr group (P = 0.062). CONCLUSION: These results suggest that the processes of age-related changes in the muscle and tendon are different. Furthermore, the differences in age-related changes of muscle and tendon might play a role in the frequency of Achilles tendon ruptures among men in their 30s.

Effects of plyometric and weight training on muscle-tendon complex and jump performance.

PURPOSE: The purpose of this study was to investigate the effects of plyometric and weight training protocols on the mechanical properties of muscle-tendon complex and muscle activities and performances during jumping. METHODS: Ten subjects completed 12 wk (4 d.wk(-1)) of a unilateral training program for plantar flexors. They performed plyometric training on one side (PT; hopping and drop jump using 40% of 1RM) and weight training on the other side (WT; 80% of 1RM). Tendon stiffness was measured using ultrasonography during isometric plantar flexion. Three kinds of unilateral jump heights using only ankle joint (squat jump: SJ; countermovement jump: CMJ; drop jump: DJ) on sledge apparatus were measured. During jumping, electromyographic activities were recorded from plantar flexors and tibial anterior muscle. Joint stiffness was calculated as the change in joint torque divided by the change in ankle angle during eccentric phase of DJ. RESULTS: Tendon stiffness increased significantly for WT, but not for PT. Conversely, joint stiffness increased significantly for PT, but not for WT. Whereas PT increased significantly jump heights of SJ, CMJ, and DJ, WT increased SJ only. The relative increases in jump heights were significantly greater for PT than for WT. However, there were no significant differences between PT and WT in the changes in the electromyographic activities of measured muscles during jumping. CONCLUSION: These results indicate that the jump performance gains after plyometric training are attributed to changes in the mechanical properties of muscle-tendon complex, rather than to the muscle activation strategies.

Are the knee and ankle angles at contact related to the tendon properties of lower limbs in long distance runners?

The purpose of this study was to investigate whether the knee and ankle angles at contact during running were related to the elastic properties of tendon structures in knee extensors and plantar flexors and performance in trained long distance runners. Thirty-two highly trained male long distance runners participated in this study. Elongation of tendon structures in knee extensors and plantar flexors were measured using ultrasonography while subjects performed ramp isometric contractions up to the voluntary maximum. The relationship between estimated muscle force and tendon elongation was fit to a linear regression, the slope of which was defined as the stiffness of tendon structures. Knee and ankle angles at contact during running were determined at a speed of 18 km/h on a treadmill. Knee and ankle angles at contact were not correlated to the stiffness of tendon structures in knee extensors and plantar flexors. In addition, the best official record in a 5000-m race was not significantly correlated to knee and ankle joint angles at contact. In conclusion, knee and ankle angles at contact were not related to the elastic properties of tendon structures in knee extensors and plantar flexor and the performance of long distance running.

Weight-bearing-line analysis in supramalleolar osteotomy for varus-type osteoarthritis of the ankle.

BACKGROUND: We determined the preoperative and postoperative passing points of the mechanical axis of the lower limb at the level of the tibial plafond using a new method involving a full-length standing posteroanterior radiograph that includes the calcaneus (a hip-to-calcaneus radiograph) and correlated them to the clinical results after supramalleolar osteotomy for ankle osteoarthritis. METHODS: We reviewed the hip-to-calcaneus radiographs of fifty lower limbs of forty-one patients treated for lower limb malalignment at our institution. The mechanical axis point of the ankle was the point at which the mechanical axis divides the coronal length of the plafond, expressed as a percentage. Four independent observers performed all measurements twice. Supramalleolar tibial osteotomy was performed in twenty-seven ankles (twenty-four patients) to treat moderate varus-type osteoarthritis of the ankle. The mean follow-up period was 2.8 years (range, two to 5.3 years). Clinical assessment was based on the American Orthopaedic Foot & Ankle Society (AOFAS) scale. RESULTS: Interobserver and intraobserver reliability in identifying the mechanical ankle joint axis point were very high. The mean postoperative mechanical axis point was 50% (range, 13% to 70%) in ankles for which the preoperative point was ≤0%, whereas the mean postoperative point was 81% (range, 48% to 113%) in ankles for which the preoperative point was >0%. The mean change in AOFAS score was significantly less for patients with a preoperative point of ≤0% than for those with a preoperative point of >0% (p=0.004). Improvement was significantly greater in ankles with a postoperative mechanical ankle joint axis point of ≥80% than in ankles with a postoperative mechanical ankle joint axis point of <60% (p=0.030). CONCLUSIONS: Traditional tibial correction resulted in great variation in the locations of the postoperative mechanical ankle joint axis point. In ankles with the preoperative point more medial than the tibial plafond, the point was insufficiently moved to the lateral side, and the clinical outcomes were less satisfactory.

Passive and active muscle stiffness in plantar flexors of long distance runners.

The aim of the present study was to compare passive and active muscle stiffness and tendon stiffness between long distance runners and untrained men. Twenty long distance runners and 24 untrained men participated in this study. Active muscle stiffness in the medial gastrocnemius muscle was calculated according to changes in estimated muscle force and fascicle length during fast stretching after submaximal isometric contractions. Passive muscle stiffness was also calculated from estimated passive muscle force and fascicle length during slow passive stretching. Tendon stiffness was determined during isometric plantar flexion by ultrasonography. Passive muscle stiffness of long distance runners was significantly higher than that of untrained men (p<0.001). Active muscle stiffness at all torque levels of long distance runners was also significantly higher than that of untrained men (p<0.001). No significant difference was observed in tendon stiffness between long distance runners and untrained men (p=0.869). These results suggested that passive and active muscle stiffness were higher in long distance runners than in untrained men, whereas no significant difference was observed in tendon stiffness between the two groups.