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Updated: Jun 21, 2026

Ultrasound Tissue Characterization of Human Achilles Tendon by Stability Quantification of Echo Patterns
Published on: September 5, 2025
Ultrasonographically detected changes in Achilles tendons and self reported symptoms in elite gymnasts compared with
Claire Emerson1, Dylan Morrissey, Mark Perry
1Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Mile End Hospital, London E1 4DG, UK.
Abstract:
There are no published data on the prevalence of Achilles tendinopathy in gymnasts. 40 elite gymnasts and 41 controls of mean (SD) age 16.3 (2.1) years had bilateral AT thickness (at 3 points along the tendon in longitudinal and transverse views) and abnormality measured using ultrasound (US). Data on a history of AT symptoms were gathered using a questionnaire. Among female gymnasts there were 17.5% of Achilles tendons (ATs) with current symptoms, compared with none of the controls (chi(2)=6.2, p<0.05). Similarly, among male gymnasts 12.5% of ATs were currently symptomatic, compared with none of the controls (chi(2)=6.62, p<0.01). US scanning showed gymnasts had significantly (p<0.001 to p<0.05) thicker ATs for 5 out of 6 measures, and had more irregular longitudinal AT thickness (p<0.05). 32.5% of female gymnast ATs had US abnormalities, compared with 6.2% of female control ATs (chi(2)=7.43, p<0.01). Similarly, 35% of male gymnast ATs had US abnormalities, compared with 4% of male control ATs (chi(2)=7.43, p=0<01). There was no relationship between AT symptoms and US-detected abnormalities in the gymnasts. Achilles tendinopathy is a common problem in gymnasts. The poor correlation between signs and symptoms suggests pathology is not always symptomatic.
