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Effects of tendon viscoelasticity in Achilles tendinosis on explosive performance and clinical severity in athletes


Corresponding author: Hsing-Kuo Wang, PhD, Sports Physiotherapy Laboratory, School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Floor 3, No.17, Xuzhou Rd., Zhongzheng District, Taipei City 100, Taiwan. Tel: +886 2 33668134, Fax: +886 2 33668160, E-mail:


The aim was to compare viscoelastic properties of Achilles tendons between legs in elite athletes with unilateral tendinosis, and to investigate relationships between the properties and explosive performance and clinical severity. Seventeen male athletes (mean ± standard deviation age, 27.3 ± 2.0 years) who had unilateral, chronic middle-portion tendinopathy of the Achilles tendon were assessed by the Victorian Institute of Sport Assessment questionnaire, measurements of tendon viscoelastic properties, voluntary electromechanical delay (EMD), normalized rate of force development (RFD), and one-leg hopping distance. Compared with the non-injured leg, the tendinopathic leg showed reduced tendon stiffness (−19.2%. P < 0.001), greater mechanical hysteresis (+21.2%, P = 0.004), lower elastic energy storage and release (−14.2%, P = 0.002 and −19.1%, P < 0.001), lower normalized RFD at one-fourth (−16.3%, P = 0.02), 2/4 (−17.3%, P = 0.006), and three-fourths maximal voluntary contraction (−13.7%, P = 0.02), longer soleus and medial gastrocnemius voluntary EMD (+26.9%, P = 0.009 and +24.0%, P = 0.004), and shorter hopping distances (−34.1%, P < 0.001). Tendon stiffness was correlated with normalized RFD, voluntary EMD in the medial gastrocnemius, and hopping distances (r ranged from −0.35 to 0.64, P < 0.05). Hysteresis was correlated to the soleus voluntary EMD and hopping distances (r = 0.42 and −0.39, P < 0.05). We concluded that altered tendon viscoelastic properties in Achilles tendinosis affect explosive performance in athletes.