Tendon morphological changes after a prolonged ski race can be detected by ultrasound echo intensity

• Published in: Journal of foot and ankle research Vol. 13; no. 1; pp. 34 - n/a
• Main Authors: Schneebeli, Alessandro, Visconti, Lorenzo, Cescon, Corrado, Clijsen, Ron, Giardini, Guido, Arizzio, Maria Elisabetta, Barbero, Marco
• Format: Journal Article
• Language: English
• Published: London BioMed Central 10-06-2020; BioMed Central Ltd; Wiley
• Subjects: Achilles tendon; Achilles Tendon - diagnostic imaging; Adult; Athletes; Competition; Connective tissue; Gray scale analysis; Humans; Image Interpretation, Computer-Assisted - methods; Mechanical properties; Morphology; Mountain climbing; Patellar Ligament - diagnostic imaging; Patellar tendon; Skeletal muscle; Skiing; Skiing - physiology; Statistical analysis; Strength training; Tendinopathy - diagnostic imaging; Tendons; Ultrasonic imaging; Ultrasonography - methods; Ultrasound; United States > US; Italy; Patellar tendon; Gray scale analysis; Achilles tendon
• ISSN: 1757-1146; 1757-1146
• DOI: 10.1186/s13047-020-00398-9

Background
Ultrasound imaging techniques have been used to assess the characteristics of skeletal muscles and tendons. Such techniques (gray scale analysis) allow qualitative evaluation and have been used recently to assess the internal structure of muscles and tendons by computer‐aided gray scale analysis. We hypothesized that changes in the internal structure of the Achilles and patellar tendons after a ski mountaineering race competition could be detected with ultrasound.
Methods
Twenty athletes were recruited during the 19th Millet Tour du Rutor extreme, a three‐day ski mountaineering competition. Ultrasound measurements of the Achilles and patellar tendons were carried out before the first race and immediately after each of the three competition days. Tendon thickness, cross‐sectional area (CSA), and ultrasound gray scale analysis were calculated.
Results
Significant differences (p < 0.05) were observed between the pre‐ and post‐race measurements for the Achilles tendon thickness and CSA, while no significant differences were noted for the patellar tendon thickness and CSA. However, gray scale analysis of both the Achilles and patellar tendons showed significantly higher post‐race values, than the pre‐race values (p < 0.05).
Conclusions
Achilles and patellar tendons of healthy athletes are highly responsive to an acute increase in mechanical load. Those changes can be detected from classical (thickness and CSA) and innovative (gray scale) ultrasound‐based parameters.
Trial registration
This study was approved by the Azienda USL Valle d'Aosta Ethics Committee (protocol no. 23/03/2018.0026243.I).