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Relationship between the architecture and function of ankle plantar flexors with Achilles tendon morphology in ballet dancers
Institution:1. Department of Physiotherapy, Federal University of São Carlos, São Carlos, Brazil;2. Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Brazil;1. School of Health Sciences, University of East Anglia, UK;2. Institute of Sports, Exercise and Health, University College London, London, UK;3. Emergency Medicine, Whittington Hospital, Whittington Hospital NHS Trust, London, UK;4. Hypermobility Unit, Hospital of St John and St Elizabeth, London, UK;5. Ballet Healthcare, The Royal Ballet, London, UK;6. Norwich Medical School, University of East Anglia, UK;1. School of Physical Education from State University of Minas Gerais (UEMG), 700, Passos, MG, 37902-092, Brazil;2. Motricity Science Institute, Rehabilitation Science Program, Physiotherapy Department from Federal University of Alfenas (UNIFAL), Av. Jovino Fernandes Sales, 2600 - Santa Clara, 37133-840, Alfenas, MG, Brazil;3. Department of Physical Education and Human Motricity from Federal University of São Carlos (UFSCar), Rodovia Washington Luiz, Km. 235, São Carlos, SP, 13565-905, Brazil;4. Department of Occupational Therapy, Federal University of São Carlos (UFSCar), Rodovia Washington Luiz, Km. 235, São Carlos, SP, 13565-905, Brazil;5. Optics Group from São Carlos Institute of Physics (IFSC), University of São Paulo (USP), Av. Trabalhador Sãocarlense, 400 – Centro, 13560-970, São Carlos, SP, Brazil;1. Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy;2. Gait and Posture Analysis Laboratory, University of Catania, Catania, Italy;3. Physical Medicine and Rehabilitation Residency Program, University of Catania, Catania, Italy
Abstract:Achilles tendinopathy is the most frequent foot overuse injury in ballet dancers and knowledge of clinically modifiable factors related to tendon structure in a population at risk, such as ballet dancers, would be important for the development of preventive programs. Therefore, the present study aimed to assess relationships of gastrocnemius muscle architecture and ankle plantar flexors function with Achilles tendon morphology in ballet dancers. Fifty-four measures from 27 ballet dancers were collected. Tendon morphology (thickness, echogenicity, hypoechoic areas and neovascularisation) and muscle architecture (thickness, pennation angle and fascicle length) were evaluated using ultrasonography; ankle plantar flexors torque was evaluated using hand-held dynamometry, flexibility was evaluated in maximal weight-bearing ankle dorsiflexion position using inclinometer, and endurance was evaluated using the heel rise test. Ankle plantar flexors torque and medial gastrocnemius muscle architecture (thickness, pennation angle and fascicle length) are associated with Achilles tendon thickness in ballet dancers (r2 = 0.24, p = 0.008). Ankle plantar flexors torque and medial gastrocnemius muscle fascicle length are also associated with the echogenicity of the Achilles tendon (r2 = 0.13, p = 0.03). These findings call attention to the potential importance of ankle plantar flexors muscle force in healthy ballet dancers for the prevention of alterations in Achilles tendon structure.
Keywords:Tendinopathy  Strength  Flexibility  Endurance  Triceps surae
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