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Achilles Subtendon Structure and Behavior as Evidenced From Tendon Imaging and Computational Modeling
Geoffrey G Handsfield1, Joachim Greiner2,3, Josef Madl2,3
1Auckland Bioengineering Institute, University of Auckland, Auckland, New Zealand.
Frontiers in Sports and Active Living
|December 21, 2020
Summary
Understanding Achilles tendon subtendon sliding is key for treating injuries. New models show specific exercises can improve sliding and reduce strain during Achilles tendinopathy rehabilitation.
Area of Science:
- Biomechanics
- Biomaterials Science
- Medical Imaging
Background:
- The Achilles tendon's subtendons, arising from the triceps surae, are crucial for elastic energy storage and locomotion.
- Subtendon sliding is vital for healthy Achilles tendon function, but this property is altered in aging and disease.
- Current understanding relies on advanced imaging and computational modeling techniques.
Purpose of the Study:
- To investigate the structure-function relationship of Achilles subtendons using imaging and computational modeling.
- To develop a 3D geometrical model of Achilles subtendons from UTE MRI data.
- To analyze the role of subtendon twisting and sliding in tendon mechanics and injury, particularly in Achilles tendinopathy.
Main Methods:
- Dual-echo UTE MRI to create a 3D geometrical model of Achilles subtendons.
- Second harmonic generation imaging to visualize collagenous subtendons and inter-subtendon regions in rabbits.
- Computational modeling of subtendon twisting and sliding, coupled with human exercise trials for Achilles tendinopathy rehabilitation.
Main Results:
- A 3D model of Achilles subtendons was constructed, revealing an inter-subtendon region of approximately 30 μm in rabbits.
- Computational models suggest optimal subtendon twist reduces rupture loads and stress concentrations.
- Wheat germ agglutinin entry indicates a glycoprotein matrix facilitating low-friction sliding in healthy mammals.
- Human trials demonstrated that specific rehabilitation exercises can maximize subtendon sliding and interface strains without excessive subtendon strain.
Conclusions:
- Imaging and computational modeling are valuable tools for understanding Achilles tendon structure-function relationships.
- The inter-subtendon matrix likely plays a role in facilitating low-friction sliding.
- Targeted exercise strategies can optimize subtendon sliding during Achilles tendinopathy rehabilitation, potentially improving treatment outcomes.

