Related Experiment Video
Updated: Dec 28, 2025
Ultrasound Tissue Characterization of Human Achilles Tendon by Stability Quantification of Echo Patterns
Published on: September 5, 2025
Ultrasound speckle tracking of Achilles tendon in individuals with unilateral tendinopathy: a pilot study
Christian Couppé1,2,3, René B Svensson4,5, Christian Orhammer Josefsen4,6
1Department of Orthopaedic Surgery M, Faculty of Health and Medical Sciences, Institute of Sports Medicine Copenhagen, Bispebjerg Hospital and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark. christian.couppe@regionh.dk.
Purpose:
Differential displacement between tendon layers has been shown to occur within the healthy Achilles tendon, and changes of this mechanism have been proposed to result in shear forces, which potentially could lead to tendinopathy. The magnitude of displacement between the tendon layers in tendinopathy is unknown. The purpose of this study was to investigate Achilles tendon layer displacement in individuals suffering from unilateral tendinopathy compared with the asymptomatic contralateral side.
Methods:
Ten participants (9 men and 1 woman 45 ± 10 years, BMI: 28 ± 5) with unilateral Achilles tendinopathy were included. Intra-tendinous motion was assessed using ultrasonography during dynamic unilateral heel rises in standing and seated position. Speckle displacement was determined using a cross-correlation algorithm, in four independent rows, representing superficial and deep tendon layers.
Results:
The most superficial layer displaced less than the deepest in all condition, except standing for the tendinopathic leg. There was a strong tendency (p = 0.054) for the displacement difference being reduced in the tendinopathic tendon (Tendinopathic side: 0.52 ± 0.16 mm vs. asymptomatic contralateral side: 1.02 ± 0.18 mm).
Conclusion:
These novel data suggest that the presence of tendinopathy diminishes intra-tendinous sliding in the Achilles tendon.
