TY  - JOUR
A1  - Cassel, Michael
A1  - Risch, Lucie
A1  - Mayer, Frank
A1  - Kaplick, Hannes
A1  - Engel, Aaron
A1  - Kulig, Kornelia
A1  - Bashford, Greg
T1  - Achilles tendon morphology assessed using image based spatial frequency analysis is altered among healthy elite adolescent athletes compared to recreationally active controls
JF  - Journal of science and medicine in sport : official journal of Sports Medicine Australia
N2  - Objectives: Although expected, tendon adaptations in adolescent elite athletes have been underreported. Morphologically, adaptations may occur by an increase in collagen fiber density and/or organization. These characteristics can be captured using spatial frequency parameters extracted from ultrasound images. This study aims to compare Achilles tendon (AT) morphology among sports-specific cohorts of elite adolescent athletes and to compare these findings to recreationally active controls by use of spatial frequency analysis. Design: Cross-sectional observational study. Method: In total, 334 healthy adolescent athletes from four sport categories (ball, combat, endurance, explosive strength) and 35 healthy controls were included. Longitudinal ultrasound scans were performed at the AT insertion and midportion. Intra-tendinous-morphology was quantified by performing spatial frequency analysis assessing eight parameters at standardized ROls. Increased values in five parameters suggest a higher structural organization, and in two parameters higher fiber density. One parameter represents a quotient combining both organization and fiber density. Results: Among athletes, only ball sport athletes exhibited an increase in one summative parameter at pre-insertion site compared to athletes from other sport categories. When compared to athletes, controls had significantly higher values of four parameters at pre-insertion and three parameters at midportion site reflecting differences in both, fiber organization and density. Conclusions: Intra-tendinous-morphology was similar in all groups of adolescent athletes. Higher values found in non-athletes might suggest higher AT fiber density and organization. It is yet unclear whether the lesser structural organization in young athletes represents initial AT pathology, or a physiological adaptive response at the fiber cross-linking level. (C) 2019 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
KW  - Tendon structure
KW  - Adaptation
KW  - Ultrasound
KW  - Athletic loading
KW  - Tendinopathy
Y1  - 2019
U6  - https://doi.org/10.1016/j.jsams.2019.03.011
SN  - 1440-2440
SN  - 1878-1861
VL  - 22
IS  - 8
SP  - 882
EP  - 886
PB  - Elsevier
CY  - Oxford
ER  - 
TY  - JOUR
A1  - Cassel, Michael
A1  - Stoll, Josefine
A1  - Mayer, Frank
T1  - Tendinopathies of the Lower Extremities in Sport - Diagnostics and Therapy
JF  - Sportverletzung, Sportschaden : Grundlagen, Prävention, Rehabilitation
N2  - Tendinopathies are frequently the cause of chronic, load-dependent complaints of the lower extremity. Commonly, the large tendons of the ankle and knee joints are affected, especially the Achilles and patellar tendons. Repeated overuse in sports and/or daily activities is assumed as the aetiology. Besides the clinical examination including a comprehensive anamnesis of pain and training/loading, sonographic imaging has a high training/loading relevance for the diagnosis of tendon pathologies of the lower extremity. Training concepts are considered in first line as the treatment of choice. A combination with physical therapy interventions can be useful. In cases of a more severe pathology and long-standing complaints multimodal therapeutic options should be employed. The use of surgical treatment procedures should only be taken into account in case of failed response to conservative treatment.
KW  - Tendinopathy
KW  - sonography
KW  - principles of therapy
Y1  - 2015
U6  - https://doi.org/10.1055/s-0034-1399668
SN  - 0932-0555
SN  - 1439-1236
VL  - 29
IS  - 2
SP  - 87
EP  - 98
PB  - Thieme
CY  - Stuttgart
ER  -