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- Issue 67
- Can we really say getting stronger…
Can we really say getting stronger makes your tendon feel better? No current evidence of a relationship between change in Achilles tendinopathy pain or disability and changes in Triceps Surae structure or function when completing rehabilitation: a systematic review
Key Points
- It is unclear whether current Achilles tendinopathy exercise protocols improve muscular strength or function.
BACKGROUND & OBJECTIVE
The Achilles Tendon is the largest and strongest tendon in the body. It is routinely subjected to loads up to 6 to 12 times bodyweight. The triceps surae muscle group and tendon play a large role in athletic movements, propulsion, and rapid force production by storing and releasing high amounts of energy. The presence of Achilles Tendinopathy (AT) has been thought to be associated with significant deficits in strength and power production (1).
Despite loading protocols becoming the standard care for AT, the mechanisms of improvement in clinical symptoms for AT are not well understood. It is thought that improvements in Triceps Surae structure and function may act as a stress shield to the Achilles tendon contributing to improvements in symptoms of mid-portion AT (2).
The authors of this paper sought to answer two questions:
Are changes in muscle structure/function related to changes in Achilles tendon pain/disability during exercise rehabilitation?
How effective are rehabilitation protocols for improving triceps surae structure and function?
Although the method of improvement is not well understood, loading protocols remain an appropriate entry point for mid portion AT rehabilitation.
METHODS
The authors narrowed down their systematic review to 17 total studies, representing 25 total cohorts with 432 participants (age range 20 to 55). All studies provided some measure of muscle structure and function and focused on mid portion AT. Individual