Intratendinous pressure changes in the Achilles tendon during stretching and eccentric loading: implications for Achilles tendinopathy

Review written by Dr Seth O’Neill info

Key Points

  1. Intra-tendon compression occurs in all regions of the Achilles tendon.
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BACKGROUND & OBJECTIVE

Mechanical load, particularly tensile load has been a long-standing consideration in Achilles tendinopathy. In recent years there has been a consideration of compressive loads, but this has largely been from external sites like bones. However, when tendons are elongated, the tissue will be pulled taught and much like an elastic band – it will compress (thinning). This internal compression has not been previously measured.

The aim of this study was to measure the internal (intratendinous) pressure within the Achilles tendon during stretching and an “eccentric” contraction at 3 anatomical locations (proximal, mid-portion- insertion) and two different tendon depths (ventral and dorsal regions) at the insertional zone.

Mechanical load has been a long-standing consideration in Achilles tendinopathy.
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Eccentric heel-drops into dorsiflexed positions are often an effective and functional exercise to use during rehabilitation if the patient can tolerate walking.

METHODS

  • The study utilized 12 cadavers (6 male and 6 female), with both limbs removed (disarticulated), frozen, then CT scanned and thawed before being placed into a bespoke rig. The Rig allowed dorsiflexion and plantarflexion and alongside eccentric testing during dorsiflexion.
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