Journal of Applied Physiology AJP: Endocrinology and Metabolism
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J Appl Physiol (June 12, 2008). doi:10.1152/japplphysiol.90361.2008
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Submitted on March 4, 2008
Revised on June 6, 2008
Accepted on June 11, 2008

Habitual loading results in tendon hypertrophy and increased stiffness of the human patellar tendon

Christian Couppe1, Mads Kongsgaard2, Per Aagaard3, Phillip Hansen2, Jens Bojsen-Moller2, Michael Kjaer2, and S Peter Magnusson4*

1 Institute of Sportsmedicine-Copenhagen
2 Institute of Sports Medicine Copenhagen
3 University of Southern Denmark
4 University of Copenhagen

* To whom correspondence should be addressed. E-mail: p.magnusson{at}mfi.ku.dk.

Purpose: To examine patellar tendon (PT) size and mechanical properties in subjects with a side to side strength difference of ≥ 15 % due to sport induced loading. Material and Methods: Seven elite fencers & badminton players were included. Cross-sectional area (CSA) of the PT were obtained from sagital MRI, and ultrasonography based measurement of tibial and patellar movement together with PT force during isometric contractions were used to estimate mechanical properties of the PT bilaterally. Results: Distal and proximal tendon, but not mid-tendon CSA were greater on the lead extremity compared to the non-lead extremity (distal: 139±11 mm2 vs. 116±7 mm2; mid-tendon: 85±5 mm2 vs. 77±3 mm2; proximal 106±7 mm2 vs. 83±4 mm2; P<0.05). Distal tendon CSA was greater than proximal and mid-tendon CSA on both the lead and non-lead extremity (P<0.05). For a given common force, stress was lower on the lead extremity (52.9±4.8 MPa) compared to the non-lead extremity (66.0±8.0 MPa)(P<0.05). PT stiffness was also higher in the lead extremity (4766±716 N mm-1) compared to the non-lead extremity (3494±446 N mm-1) (P<0.05) while the modulus did not differ (lead 2.27±0.27 GPa vs. non-lead 2.16±0.28 GPa) at a common force. Conclusion: These data show that a habitual loading is associated with a significant increase in patellar tendon size and mechanical properties.




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