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1 Bispebjerg Hospital, Institute of Sports Medicine, Copenhagen, 2400, Denmark
* To whom correspondence should be addressed. E-mail: mk11{at}bbh.hosp.dk.
The prevalence of Achilles tendon (AT) injury is high in various sports, and AT rupture patients have been reported to have a 200-fold risk of sustaining a contralateral rupture. Tendon adaptation to different exercise modes is not fully understood. The present study investigated the structural properties of the AT in male elite athletes that subject their AT to different exercise modes as well as in Achilles rupture patients. Magnetic resonance imaging of the foot and leg, anthropometric measurements and maximal isometric plantar flexion force were obtained in 6 male AT rupture patients and 25 male elite athletes (kayak/control group n=9, volleyball n=8 & endurance running n=8). AT CSA was normalised to body mass. Runners had a larger normalised AT CSA along the entire length of the tendon compared to the control group (P<0.05). The volleyball subjects had a larger normalised CSA compared to the control group (P<0.05) in the area of thinnest tendon CSA. No structural differences of the AT were found in the rupture subjects in comparison to the control group. Rupture subjects did not subject their AT to greater force or stress during a maximal voluntary isometric plantar flexion than the other groups. The CSA of the triceps surae musculature was the strongest predictor of AT CSA (rs= 0.569, P<0.001). This study is the first to show larger CSA in tendons that are subjected to intermittent high loads. AT rupture patients did not display differences in structural or loading properties of the tendons.
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