Tendon develops force proportional to the distance it is stretched beyond its slack length. Tendon slack length is an important parameter for musculoskeletal models because it can greatly affect estimations of muscle force. Unfortunately, tendon slack length is a difficult parameter to measure, and therefore values for it are not often reported in the literature. In this paper we present a numerical method for estimating tendon slack length from architectural parameters of the muscle. Specifically, tendon slack length is computed iteratively from musculotendon lengths determined when a corresponding joint is held at two angles, and from knowledge of the muscle's optimal fiber length. Idealized data generated using SIMM were used to test the tendon slack length algorithm. The method converged to within 1% of the “true” tendon slack length specified in the SIMM model. The advantage of the method outlined in this paper is that it yields subject-specific estimates of tendon slack length, given subject-specific input parameters.
Kurt Manal and Thomas S. Buchanan
Niell Elvin, Alex Elvin, Cornie Scheffer, Steven Arnoczky, Edwin Dillon and P. J. Erasmus
The etiology of patellar tendinopathy (jumper’s knee) has been attributed to a significant increase in patellar tendon torques associated with jumping. While some investigators have suggested that patellar tendon torques are greater during takeoff, little is known about the relative magnitudes of patellar tendon torques during takeoff and landing. We hypothesized that peak patellar tendon torques are greater in jump takeoff than in landing, and that there is a linear correlation between jump height and peak patellar tendon torque. Seven asymptomatic, recreational male athletes each performed a series of 21 jumps ranging from low to maximal height. A calibrated fiber-optic sensor, implanted transversely within the patellar tendon was used to measure the knee torque during takeoff and landing. There was no significant difference in the peak patellar tendon torque experienced during takeoff and landing within individuals. There was a moderate correlation (r = .64) between maximum takeoff patellar tendon torques and jump height. There was a weak correlation (r = .52) between maximum landing patellar tendon torques and jump height. There was a moderate correlation (r = .67) between maximum 60°/s isokinetic extension torque and maximum jump height. The lack of a strong correlation between jump height and patellar tendon forces during takeoff or landing suggests that these forces may be technique dependent. Therefore, modifying takeoff and/or landing techniques could reduce patellar tendon force and potentially lessen the incidence of patellar tendinopathy.
Atsuki Fukutani and Toshiyuki Kurihara
Recent studies have reported that resistance training increases the cross-sectional areas (CSAs) of tendons; however, this finding has not been consistently observed across different studies. If tendon CSA increases through resistance training, resistance-trained individuals should have larger tendon CSAs as compared with untrained individuals. Therefore, in the current study, we aimed to investigate whether resistance training increases tendon CSAs by comparing resistance-trained and untrained individuals. Sixteen males, who were either body builders or rugby players, were recruited as the training group, and 11 males, who did not participate in regular resistance training, were recruited into the control group. Tendon CSAs and muscle volumes of the triceps brachii, quadriceps femoris, and triceps surae were calculated from images obtained by using magnetic resonance imaging. The volumes of the 3 muscles were significantly higher in the training group than in the control group (P < .001 for all muscles). However, a significant difference in tendon CSAs was found only for the distal portion of the triceps surae tendon (P = .041). These findings indicate that tendon CSA is not associated with muscle volume, suggesting that resistance training does not increase tendon CSA.
Taija Finni and Paavo V. Komi
During dynamic activities it is difficult to assess in vivo length changes in human tendon and aponeurosis. The present study compared the outcome of two methods during unilateral squat jump and drop jump performances of four volunteers. Tendinous tissue elongation of vastus lateralis muscle was estimated using either (a) direct measurement of in vivo fascicle length change and muscletendon length estimation (kinematic method), or (b) prediction using a quadratic force function in combination with direct tendon force measurement (force method). In the kinematic method the most critical measures contributing to the 10% uncertainty were the fascicle angle and fraction of the estimated fascicle length. The force method was most sensitive to resting length, with 1% error margin. Both methods predicted the same pattern of tendinous elongation because of the monotonic force/length relationship. The magnitude of length change, however, differed considerably between both methods. Based on the force method, the changes were only 20% (absolute values) or 30% (strain values) of those obtained with the kinematic method. On average, the maximum strains were 5% with the force method and 15% with the kinematic method. This difference can be explained by the fact that the kinematic method characterizes not only the changes in tendon length but also includes aponeurosis strain along the muscle belly. In addition, the kinematic method may be affected by non-uniform distribution of fascicle length change along the length of the muscle. When applying either method for estimating the patterns of tendon and tendinous tissue length changes during human locomotion, the given methodological considerations should be acknowledged.
Christina Davlin and Jody Jenike
To present the case of a Division I female college basketball player with a complete Achilles tendon rupture.
A 19-year-old, female college basketball player ruptured her right Achilles tendon during preseason conditioning. She had no previous history of heel cord symptoms.
The athlete underwent open surgical repair of Achilles tendon. The athlete successfully progressed through a functional rehabilitation program focused on early mobilization and weight bearing. The rehabilitation program was continually modified to address deficiencies and to keep the athlete actively engaged. She was cleared for full, unrestricted activity 15 weeks and 3 days after surgery and returned to game participation in 16 weeks.
This case provides evidence that early mobilization and weight bearing can be used while still protecting the repaired tendon.
Senshi Fukashiro, Dean C. Hay and Akinori Nagano
This paper reviews the research findings regarding the force and length changes of the muscle-tendon complex during dynamic human movements, especially those using ultrasonography and computer simulation. The use of ultrasonography demonstrated that the tendinous structures of the muscle-tendon complex are compliant enough to influence the biomechanical behavior (length change, shortening velocity, and so on) of fascicles substantially. It was discussed that the fascicles are a force generator rather than a work generator; the tendinous structures function not only as an energy re-distributor but also as a power amplifier, and the interaction between fascicles and tendinous structures is essential for generating higher joint power outputs during the late pushoff phase in human vertical jumping. This phenomenon could be explained based on the force-length/velocity relationships of each element (contractile and series elastic elements) in the muscle-tendon complex during movements. Through computer simulation using a Hill-type muscle-tendon complex model, the benefit of making a countermovement was examined in relation to the compliance of the muscle-tendon complex and the length ratio between the contractile and series elastic elements. Also, the integral roles of the series elastic element were simulated in a cyclic human heel-raise exercise. It was suggested that the storage and reutilization of elastic energy by the tendinous structures play an important role in enhancing work output and movement efficiency in many sorts of human movements.
Jinah Kim, Sung Cheol Lee, Youngmin Chun, Hyung-Pil Jun, Jeffrey G. Seegmiller, Kyung Min Kim and Sae Yong Lee
Posterior tibial tendon dysfunction (PTTD) is a common cause of adult-acquired flatfoot deformity. This dysfunction is typically represented by the “too many toes” sign, which is a combination of rearfoot valgus, forefoot abduction, and flattened medial longitudinal arch (MLA). Johnson and Strom 1
Alan Barr and David Hawkins
An anatomical database was constructed containing three-dimensional geometric representations of the structures comprising the lower extremity. The database was constructed by digitizing 100 high-resolution digital photographic images supplied from the National Library of Medicine’s Visual Human Male (VHM) project. These images were taken of sequential transverse cross-sectional slices of the leg. Slices were located 1 cm apart between a location approximately 3 mm below the superior aspect of the ilium and approximately 2 mm below the distal end of the fibula. Image Tool Software (v. 2.0) was used to manually digitize the perimeters of muscles, tendons, and bones of the pelvis, thigh, and shank from the right leg of the VHM. Additionally, the perimeter of the leg and the inner aspect of the superficial fat layer were digitized. The pelvis was digitized as a hemi-pelvis. Tissue perimeters were characterized using between 10 and 151 nodes within each slice; the number of nodes varied depending on the tissue’s size. Transverse cross-sectional slice number, structure identification, node number, and the two-dimensional coordinates of each node were stored in a data file. The information contained in this file is unique and provides a database that researchers can use to investigate questions related to tissue anatomy and movement mechanics that cannot be considered using existing musculoskeletal data sets.
Akinori Nagano, Senshi Fukashiro and Taku Komura
Contribution of series elasticity of the human mm. triceps surae in cyclic heel-raise exercise (similar to hopping but the feet do not leave the floor) was examined via computer modeling and simulation. A two-dimensional skeletal model of the human body was constructed. Upright posture was maintained throughout the simulation to prevent the model from falling. A mathematical representation of the mm. triceps surae was implemented in the skeletal model. The muscle was activated by the neural activation input signal with a time resolution of 0.050 sec. Cyclic heel-raise exercises of cycle duration ranging from 0.300 sec to 0.900 sec, corresponding to the motion frequency of 200 to 66.7 cycles/min, were generated using an optimization approach. The goal of the numerical optimization was to generate cyclic motions with as much range of motion as possible. As a result, realistic heel-raise motions were generated with the range of motion between 0.0023 m (cycle duration = 0.300 sec) and 0.0414 m (cycle duration = 0.900 sec). It was found that contribution of the series elasticity in positive mechanical work output of the muscle-tendon complex during the pushoff phase (from the lowest position to the termination of a cycle) increased as motion frequency increased (3% at 66.7 cycles/min to 47% at 200 cycles/min). Relatively higher muscle activation was found during the downward moving phase when the motion frequency was higher. These tendencies are consistent with the findings reported in preceding studies involving experimental animals as well as human participants. It is suggested that series elasticity plays an integral role in the generation of cyclic human motions.
Kosuke Fujita, Masatoshi Nakamura, Hiroki Umegaki, Takuya Kobayashi, Satoru Nishishita, Hiroki Tanaka, Satoko Ibuki and Noriaki Ichihashi
studies, 1 – 3 , 9 however, used joint ROM as an index of muscle flexibility, which is known to be affected by psychological factors, such as pain and stretch tolerance. 11 Recently, measurement of muscle tendon unit stiffness during passive movement has been shown to be a preferred index of muscle