Ultrasound as a predictor of time-loss injury for the patellar tendon, Achilles tendon and plantar fascia in division I collegiate athletes

Key Points

1. Sonographic abnormalities of the Achilles and patellar tendon and plantar fascia are independently associated with increased risk of time loss due to injury.

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BACKGROUND AND OBJECTIVE

Patellar tendinopathy, achilles tendinopathy and plantar fasciopathy are common conditions that can negatively impact performance and even limit participation. These three lower extremity injury patterns are thought to occur through a combination of repeated overuse, increased tissue loading, and impaired recovery process (1). Previous investigations into risk factors confirm prior injury as the most obvious and common predictive risk factor for future injury (2).

Real time ultrasound (US) is emerging as a cost-effective and accessible diagnostic tool that is validated against MRIs and has feasibility in large group athlete settings (3). US is increasingly being used to diagnose tendinopathies and fasciopathies with encouraging results (4,5). The authors of this paper sought to determine if a preseason sonographic evaluation of the patellar and achilles tendon and plantar fascia can identify association with future time-loss injuries.

Patellar tendinopathy, achilles tendinopathy and plantar fasciopathy are common conditions that can negatively impact performance and even limit participation.

The negative predictive value of diagnostic ultrasound was shown to be extremely high, however the positive predictive value was relatively low, indicating that most athletes who had abnormalities did not go on to develop an injury.

METHODS

• 677 Division 1 (39% male) athletes were recruited during their preparticipation physical examination over a 3-year period starting in 2021.

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