Quantification of the in vivo stiffness and natural length of the human plantar aponeurosis during quiet standing using ultrasound elastography.

This study aimed to identify the stiffness and natural length of the human plantar aponeurosis (PA) during quiet standing using ultrasound shear wave elastography. The shear wave velocity (SWV) of the PA in young healthy males and females (10 participants each) was measured by placing a probe in a hole in the floor plate. The change in the SWV with the passive dorsiflexion of the metatarsophalangeal (MP) joint was measured. The Young's modulus of the PA was estimated to be 64.7 ± 9.4 kPa, which exponentially increased with MP joint dorsiflexion. The PA was estimated to have the natural length when the MP joint was plantarflexed by 13.8°, indicating that the PA is stretched by arch compression during standing. However, the present study demonstrated that the estimated stiffness for the natural length in quiet standing was significantly larger than that in the unloaded condition, revealing that the PA during standing is stiffened by elongation and through the possible activation of intrinsic muscles. Such quantitative information possibly contributes to the detailed biomechanical modeling of the human foot, facilitating an improved understanding of the mechanical functions and pathogenetic mechanisms of the PA during movements.

Dynamics of Quadriceps Muscles during Isometric Contractions: Velocity-Encoded Phase Contrast MRI Study.

OBJECTIVE: To quantify the spatial heterogeneity of displacement during voluntary isometric contraction within and between the different compartments of the quadriceps. METHODS: The thigh muscles of seven subjects were imaged on an MRI scanner while performing isometric knee extensions at 40% maximal voluntary contraction. A gated velocity-encoded phase contrast MRI sequence in axial orientations yielded tissue velocity-encoded dynamic images of the four different compartments of the thigh muscles (vastus lateralis (VL), vastus medialis (VM), vastus intermedius (VI), and rectus femoris (RF)) at three longitudinal locations of the proximal-distal length: 17.5% (proximal), 50% (middle), and 77.5% (distal). The displacement, which is the time integration of the measured velocity, was calculated along the three orthogonal axes using a tracking algorithm. RESULTS: The displacement of the muscle tissues was clearly nonuniform within each axial section as well as between the three axial locations. The ensemble average of the magnitude of the total displacement as a synthetic vector of the X, Y, and Z displacements was significantly larger in the VM at the middle location (p < 0.01), and in the VI at the distal location than in the other three muscles. The ensemble average of Z-axis displacement, which was almost aligned with the line of action, was significantly larger in VI than in the other three muscles in all three locations. Displacements of more than 20 mm were observed around the central aponeuroses, such as those between VI and the other surrounding muscles. CONCLUSIONS: These results imply that the quadriceps muscles act as one functional unit in normal force generation through the central aponeuroses despite complex behavior in each of the muscles, each of which possesses different physiological characteristics and architectures.

Biomechanical Gain in Joint Excursion from the Curvature of the Achilles Tendon: Role of the Geometrical Arrangement of Inflection Point, Center of Rotation, and Calcaneus.

The dorsal movement of the Achilles tendon during ankle rotation is restricted by anatomical obstructions. Previously, we demonstrated that the anatomical obstruction provides a gain (gainAT) in the proximal displacement of the calcaneus compared to the change in the Achilles tendon length. Here, we empirically validate and extend our previous modeling study by investigating the effects of a broad range of obstruction locations on gainAT. The largest gainAT could be achieved when the obstruction was located on the most ventral and distal sides within the physiological range of the Achilles tendon, irrespective of the ankle position.

Effects of Four-Week Kayak Training on Three-Dimensional Paddling Kinetics, Body Kinematics, and Electromyography Activity in a Novice Paddler: A Case Study.

From a biomechanical viewpoint, no longitudinal quantitative studies have been conducted on inexperienced paddlers. The present study aimed to investigate changes in three-dimensional paddling kinetics and kinematics, whole-body kinematics, and muscle activity with four-week on-water kayak training in a novice paddler. The participant practiced kayak paddling on river for four weeks. Before and after training, paddling kinetics and kinematics, body kinematics, and electromyography (EMG) activity were measured using a kayak ergometer. After the four-week training, the time required for on-water paddling for 270 m was reduced by 7.3% from pre to post training, while the average impulse in the x-direction significantly (P < 0.001, partial eta squared [η2] = 0.82) increased from 71.9 ± 1.9 to 91.1 ± 5.4 N kg-1 s-1. Furthermore, with training, the stroke rate and stroke length in the x-direction significantly (P < 0.001, partial η2 = 0.80 and 0.79, respectively) increased from 62.8 ± 1.2 to 81.0 ± 2.9 spm and from 1.53 ± 0.04 to 1.71 ± 0.02 m, respectively. After training, the transition time significantly (P < 0.001, partial η2 = 0.32) decreased (from 0.04 ± 0.01 to 0.01 ± 0.01 s), and there was an increase in paddle catch position (from -0.88 ± 0.01 to -1.04 ± 0.03 m). The pull time was not significantly changed (P = 0.077, partial η2 = 0.08) because of the increasing stroke length after training, meaning that substantial pull time, which defined as pull time relative to the stroke displacement, was shorter in post-training than in pre-training. The relative change in average impulse in the x-direction with training was significantly (r = 0.857, P = 0.014) correlated with that of vastus lateralis EMG. These results indicated that after four-week kayak training of the novice paddler, the key mechanism underlying time reduction to perform on-water paddling for 270 m was associated with (1) increased average impulse along the propulsive direction caused by an increase in vastus lateralis EMG and (2) a higher stroke rate, which was attributed to a reduction in the pull and transition times.

Role of the Extracellular Matrix in Loss of Muscle Force With Age and Unloading Using Magnetic Resonance Imaging, Biochemical Analysis, and Computational Models.

The focus of this review is the application of advanced MRI to study the effect of aging and disuse related remodeling of the extracellular matrix (ECM) on force transmission in the human musculoskeletal system. Structural MRI includes (i) ultra-low echo times (UTE) maps to visualize and quantify the connective tissue, (ii) diffusion tensor imaging (DTI) modeling to estimate changes in muscle and ECM microstructure, and (iii) magnetization transfer contrast imaging to quantify the macromolecular fraction in muscle. Functional MRI includes dynamic acquisitions during contraction cycles enabling computation of the strain tensor to monitor muscle deformation. Further, shear strain extracted from the strain tensor may be a potential surrogate marker of lateral transmission of force. Biochemical and histological analysis of muscle biopsy samples can provide "gold-standard" validation of some of the MR findings. The review summarizes biochemical studies of ECM adaptations with age and with disuse. A brief summary of animal models is included as they provide experimental confirmation of longitudinal and lateral force transmission pathways. Computational muscle models enable exploration of force generation and force pathways and elucidate the link between structural adaptations and functional consequences. MR image findings integrated in a computational model can explain and predict subject specific functional changes to structural adaptations. Future work includes development and validation of MRI biomarkers using biochemical analysis of muscle tissue as a reference standard and potential translation of the imaging markers to the clinic to noninvasively monitor musculoskeletal disease conditions and changes consequent to rehabilitative interventions.

Forefoot running requires shorter gastrocnemius fascicle length than rearfoot running.

This study aimed to investigate the influence of foot strike patterns on the behaviour of the triceps surae muscle-tendon unit, including the Achilles tendon whose length nearly corresponds to force of the triceps surae, and the medial gastrocnemius muscle (MG) during running. Seven male volunteers ran with forefoot and rearfoot strikes at 10, 14 and 18 km h-1 on a treadmill. The MG fascicle length was measured using ultrasonography. The in vivo length of the curved Achilles tendon was quantified by combining ultrasonography with optical motion capture of reflective markers on the right lower limb and an ultrasound probe. The forefoot strike resulted in a significantly shorter MG fascicle length at the initial contact, at Achilles tendon peak elongation, and at toe-off, than the rearfoot strike. The Achilles tendon length at initial contact was greater during the forefoot strike than during the rearfoot strike at 18 km h-1, while its peak elongation was not significantly different during forefoot and rearfoot running. These results indicate that the MG, with a shorter length during forefoot running, manages to address demands for a similar peak force of the triceps surae than during rearfoot running.

A Multi-modality Approach Towards Elucidation of the Mechanism for Human Achilles Tendon Bending During Passive Ankle Rotation.

The in vitro unconstrained Achilles tendon is nearly straight, while in vivo experiments reveal that the proximal region of the Achilles tendon, adjacent to Kager's fat pad, bends ventrally during plantarflexion but remains nearly straight during dorsiflexion. Tendon bending is an important factor in determining the displacement of the foot compared to the shortening of the muscle fibers. The objective of this study was to elucidate the various mechanisms that could cause tendon bending, which currently remain unknown. Examination of Thiel-embalmed cadavers, with preservation of native articular joint mobility, revealed that the Achilles tendon still bent ventrally even when its surrounding tissues, including the skin surface, Kager's fat pad, and distal portions of the soleus muscle were removed. Shear modulus and collagen fiber orientation were distributed homogeneously with respect to the longitudinal line of the tendon, minimizing their causative contributions to the bending. Given that tendon bending is not caused by either the nature of the deformations of the tissues surrounding the Achilles tendon or its physical properties, we conclude that it results from the geometric architecture of the Achilles tendon and its configuration with respect to the surrounding tissues.

Activation of plantar flexor muscles is constrained by multiple muscle synergies rather than joint torques.

Behavioral evidence has suggested that a small number of muscle synergies may be responsible for activating a variety of muscles. Nevertheless, such dimensionality reduction may also be explained using the perspective of alternative hypotheses, such as predictions based on linear combinations of joint torques multiplied by corresponding coefficients. To compare the explanatory capacity of these hypotheses for describing muscle activation, we enrolled 12 male volunteers who performed isometric plantar flexor contractions at 10-100% of maximum effort. During each plantar flexor contraction, the knee extensor muscles were isometrically contracted at 0%, 50%, or 100% of maximum effort. Electromyographic activity was recorded from the vastus lateralis, medial gastrocnemius (MG), lateral gastrocnemius (LG), and soleus muscles and quantified using the average rectified value (ARV). At lower plantar flexion torque, regression analysis identified a clear linear relationship between the MG and soleus ARVs and between the MG and LG ARVs, suggesting the presence of muscle synergy (r2 > 0.65). The contraction of the knee extensor muscles induced a significant change in the slope of this relationship for both pairs of muscles (MG × soleus, P = 0.002; MG × LG, P = 0.006). Similarly, the slope of the linear relationship between the plantar flexion torque and the ARV of the MG or soleus changed significantly with knee extensor contraction (P = 0.031 and P = 0.041, respectively). These results suggest that muscle synergies characterized by non-mechanical constraints are selectively recruited according to whether contraction of the knee extensor muscles is performed simultaneously, which is relatively consistent with the muscle synergy hypothesis.

Simultaneous Knee Extensor Muscle Action Induces an Increase in Voluntary Force Generation of Plantar Flexor Muscles.

Suzuki, T, Shioda, K, Kinugasa, R, and Fukashiro, S. Simultaneous knee extensor muscle action induces an increase in voluntary force generation of plantar flexor muscles. J Strength Cond Res 31(2): 365-371, 2017-Maximum activation of the plantar flexor muscles is required for various sporting activities that involve simultaneous plantar flexion and knee extension. During a multi-joint movement, activation of the plantar flexor muscles is affected by the activity of the knee extensor muscles. We hypothesized that coactivation of the plantar flexor muscles and knee extensor muscles would result in a higher plantar flexion torque. To test this hypothesis, 8 male volunteers performed maximum voluntary isometric action of the plantar flexor muscles with and without isometric action of the knee extensor muscles. Surface electromyographic data were collected from 8 muscles of the right lower limb. Voluntary activation of the triceps surae muscles, evaluated using the interpolated twitch technique, significantly increased by 6.4 percentage points with intentional knee extensor action (p = 0.0491). This finding is in line with a significant increase in the average rectified value of the electromyographic activity of the vastus lateralis, fibularis longus, and soleus muscles (p = 0.013, 0.010, and 0.045, respectively). The resultant plantar flexion torque also significantly increased by 11.5% of the predetermined maximum (p = 0.031). These results suggest that higher plantar flexor activation coupled with knee extensor activation facilitates force generation during a multi-joint task.

Influence of intramuscular fiber orientation on the Achilles tendon curvature using three-dimensional finite element modeling of contracting skeletal muscle.

Tendon curvature plays a key role in mechanical gain (amplifying the joint excursion relative to fiber length change) during joint motion, but the mechanism remains unresolved. A three-dimensional finite element (FE) model was used to investigate the influence of intramuscular fiber orientation upon the curvature pattern of the Achilles tendon during active muscular contraction. Two simulation models, with fiber pennation angles of θ = 25° and 47° were tested for the gastrocnemius and soleus muscles. A smaller pennation angle (25°) of the soleus muscle fibers was accompanied by a large change in curvature whereas a larger pennation angle (47°) of the soleus muscle was accompanied by small effects. These results suggest that the fiber pennation angle determines the curvature of the tendon, and the magnitude of the curvature varies along the length of the aponeurosis. Such FE modeling has the potential of determining changes in force output consequent to changes in intramuscular fiber orientation arising from resistance training or unloading, and provides mechanism for predicting the risk of Achilles tendon ruptures.

How Fast Can a Human Run? - Bipedal vs. Quadrupedal Running.

Usain Bolt holds the current world record in the 100-m run, with a running time of 9.58 s, and has been described as the best human sprinter in history. However, this raises questions concerning the maximum human running speed, such as "Can the world's fastest men become faster still?" The correct answer is likely "Yes." We plotted the historical world records for bipedal and quadrupedal 100-m sprint times according to competition year. These historical records were plotted using several curve-fitting procedures. We found that the projected speeds intersected in 2048, when for the first time, the winning quadrupedal 100-m sprint time could be lower, at 9.276 s, than the winning bipedal time of 9.383 s. Video analysis revealed that in quadrupedal running, humans employed a transverse gallop with a small angular excursion. These results suggest that in the future, the fastest human on the planet might be a quadrupedal runner at the 2048 Olympics. This may be achieved by shifting up to the rotary gallop and taking longer strides with wide sagittal trunk motion.

Age-related differences in strain rate tensor of the medial gastrocnemius muscle during passive plantarflexion and active isometric contraction using velocity encoded MR imaging: potential index of lateral force transmission.

PURPOSE: The strain rate (SR) tensor measures the principal directions and magnitude of the instantaneous deformation; this study aims to track age-related changes in the 2D SR tensor in the medial gastrocnemius during passive joint rotation and active isometric contraction. METHODS: SR tensors were derived from velocity encoded magnetic resonance phase-contrast images in nine young (28 years) and eight senior (78 years) women. Strain rates along and in the cross-section of the fiber were calculated from the SR tensor and used to derive the out-plane SR. Age-related and regional differences in the SR eigenvalues, orientation, and the angle between the SR and muscle fiber (SR-fiber angle) were statistically analyzed. RESULTS: SR along the fiber was significantly different between the cohorts during isometric contraction with higher values in the young (P < 0.05). The SR-fiber angle was larger in the young for both motion types but this difference was not statistically significant. Significant regional differences in the SR indices was seen in passive joint rotation (P < 0.05) for both cohorts. CONCLUSION: SR mapping reflects age-related and regional differences during active and passive motion respectively; this may arise from differences in contractility (active motion) and elastic properties (active and passive motion).

Interaponeurosis shear strain modulates behavior of myotendinous junction of the human triceps surae.

Muscle fascicles insert into a sheet-like aponeurosis. Adjacent aponeuroses are structurally in contact with each other, and ultimately merge into a common tendon. Consequently, fascicle shortening in planes of tissue layers in adjacent compartments must cause sliding between aponeuroses parallel to the acting forces. In this study, we used velocity-encoded, phase-contrast, and water-saturated spin-lattice relaxation time-weighted imaging to identify and track fascicle and aponeurosis behaviors of human medial gastrocnemius (MG) and soleus (Sol) during 15° dorsiflexion to 30° plantarflexion contractions of the ankle. Interaponeurosis shear strain, which was defined as the relative displacement of the aponeurosis at the fascicle end points (insertion) of the MG and Sol, was an average of 1.35 ± 0.27% (range 1.12 ∼ 1.87%), indicating that the strain is greater in the aponeurosis of MG fascicle insertion than the Sol. The myotendinous junction (MTJ) displacement increased significantly with decreasing interaponeurosis shear strain (P < 0.05). The magnitude of interaponeurosis shear strain had significant correlation with the temporal difference between the time at which the peak aponeurosis displacement of the MG and Sol occurred (P < 0.05). Our model also indicated that theoretical MTJ displacement varies in relation to temporal difference: no temporal difference caused the largest MTJ displacement and presence of temporal differences indicated a reduction in MTJ displacement. Therefore, we concluded that interaponeurosis shear strain is a mechanism enabling individual muscle contraction and thus specific loading of the tendon and joint.

Computer-controlled, MR-compatible foot-pedal device to study dynamics of the muscle tendon complex under isometric, concentric, and eccentric contractions.

PURPOSE: To design a computer-controlled, magnetic resonance (MR)-compatible foot pedal device that allows in vivo mapping of changes in morphology and in strain of different musculoskeletal components of the lower leg under passive, isometric, concentric, and eccentric contractions. MATERIALS AND METHODS: A programmable servomotor in the control room pumped hydraulic fluid to rotate a foot-pedal inside the magnet. To validate the performance of the device, six subjects were imaged with gated velocity-encoded phase-contrast (VE-PC) imaging to investigate the dynamics of muscle and aponeurotic structures. RESULTS: Artifact-free VE-PC imaging clearly delineated different muscle compartments by differences in distribution of mechanical strains. High repeatability of contraction cycles allowed establishing that fascicles lengthened 6.1% more during passive compared with eccentric contractions. Aponeurosis separation during passive (range between three locations: -2.6≈1.3 mm) and active (range: -2.4≈1.6 mm) contractions were similar but significantly different from concentric (range: -0.9≈3.3 mm), with proximal and distal regions showing mostly negative values for the first two modes, but positive for the last. CONCLUSION: The device was sufficiently robust and artifact-free to accurately assess, using VE-PC imaging, physiologically important structure and dynamics of the musculotendon complex.

Relationship between muscle volume and muscle torque of the hamstrings after anterior cruciate ligament lesion.

PURPOSE: This study was conducted to identify factors other than morphological muscle strength factors that affect injured and uninjured sides of knee flexors with anterior cruciate ligament (ACL) lesions. METHODS: The study population consisted of 22 patients with ACL lesions. Their hamstring muscle volume was measured on MRI, and muscle torque per muscle volume was calculated as the peak torque of knee flexion divided by hamstring muscle volume. RESULTS: The mean muscle torque per unit volume of hamstrings in patients with ACL rupture was 0.09 ± 0.02 Nm/cm(3) at 60°/s and 0.08 ± 0.01 Nm/cm(3) at 180°/s on the injured side, and 0.11 ± 0.02 Nm/cm(3) at 60°/s and 0.08 ± 0.01 Nm/cm(3) at 180°/s on the uninjured side. The mean muscle torque per unit volume of hamstrings in control subjects was 0.11 ± 0.02 Nm/cm(3) at 60°/s and 0.08 ± 0.03 Nm/cm(3) at 180°/s. One-factor ANOVA analysis found no significant differences between the three groups at either flexion velocity. CONCLUSIONS: Neurological dysfunction does not appear to exist in knee flexor muscles after ACL injury, unlike the quadriceps. Since the mechanism of muscle weakness will differ depending on the muscle, it is important for clinicians to take this discrepancy into consideration. LEVEL OF EVIDENCE: II.

Asymmetric deformation of contracting human gastrocnemius muscle.

Muscle fiber deformation is related to its cellular structure, as well as its architectural arrangement within the musculoskeletal system. While playing an important role in aponeurosis displacement, and efficiency of force transmission to the tendon, such deformation also provides important clues about the underlying mechanical structure of the muscle. We hypothesized that muscle fiber cross section would deform asymmetrically to satisfy the observed constant volume of muscle during a contraction. Velocity-encoded, phase-contrast, and morphological magnetic resonance imaging techniques were used to measure changes in fascicle length, pinnation angle, and aponeurosis separation of the human gastrocnemius muscle during passive and active eccentric ankle joint movements. These parameters were then used to subsequently calculate the in-plane muscle area subtended by the two aponeuroses and fascicles and to calculate the in-plane (dividing area by fascicle length), and through-plane (dividing muscle volume by area) thicknesses. Constant-volume considerations of the whole-muscle geometry require that, as fascicle length increases, the muscle fiber cross-sectional area must decrease in proportion to the length change. Our empirical findings confirm the definition of a constant-volume rule that dictates that changes in the dimension perpendicular to the plane, i.e., through-plane thickness, (-6.0% for passive, -3.3% for eccentric) equate to the reciprocal of the changes in area (6.8% for passive, 3.7% for eccentric) for both exercise paradigms. The asymmetry in fascicle cross-section deformation for both passive and active muscle fibers is established in this study with a ∼22% in-plane and ∼6% through-plane fascicle thickness change. These fiber deformations have functional relevance, not only because they affect the force production of the muscle itself, but also because they affect the characteristics of adjacent muscles by deflecting their line of pull.

Unique spatial distribution of in vivo human muscle activation.

The present study examined spatial changes in the muscle activation pattern with different contraction intensity using magnetic resonance imaging (MRI). Transverse relaxation time (T2)-weighted MRI was used to acquire 22 axial slices, which covered the entire medial gastrocnemius muscle, before and immediately after seven sets of 10 plantarflexions with loads that were approximately 20 and 60% of their one-repetition maximum, respectively. Reconstructions of the activated regions from MR images revealed the following: (1) the muscle activation determined by MRI correlated significantly (P < 0.05) with the results of electromyography; (2) the activated area distribution increased with increasing force levels; and (3) differential activation between 20 and 60% load was distributed in a spatially non-uniform manner within the muscle, and some regions indicated reduced activity. These results indicate that at submaximal contraction intensity, activation does not necessarily increase in the whole muscle with increase in contraction intensity.

Relationship between quadriceps femoris muscle volume and muscle torque after anterior cruciate ligament rupture.

PURPOSE: The purpose of this study was to obtain evidence to support the hypothesis that motor unit recruitment is reduced in the quadriceps femoris (QF) of patients with ACL rupture. METHODS: We compared muscle torque per unit volume in the QF from injured and uninjured sides to normal subjects. If high-threshold motor unit recruitment is reduced in patients with ACL rupture, this reduction will theoretically lead to a reduction in muscle torque per unit volume compared to the control group. The subjects included 22 patients with ACL rupture and 22 subjects with no history of knee injury. To identify the muscle torque per unit volume, the isokinetic peak torque was divided by QF volume which was obtained by MRI. RESULTS: Tests revealed that the mean muscle torque per unit volume of the uninjured and injured sides was significantly lower than those of the control group. CONCLUSION: This study demonstrated that the values of the muscle torque per unit volume of both injured and uninjured sides of patients with ACL rupture were significantly lower than those of the control group, thereby providing indirect evidence of the hindrance of motor unit recruitment in these patients. The results of the present study also indicate that there may be bilateral QF weakness in patients with ACL rupture. Since persistent QF weakness is a significant barrier to effective rehabilitation in patients with ACL injuries, a better understanding of the underlying mechanisms will allow clinicians and scientists to develop more effective therapeutic strategies for patient rehabilitation.

Reduction in tendon elasticity from unloading is unrelated to its hypertrophy.

Tendinous tissues respond to chronic unloading with adaptive changes in mechanical, elastic, and morphological properties. However, little is known about the changes in the detailed structures of the entire tendinous tissue and whether the change in tendon stiffness is related to morphology. We investigated changes in dimensional (volume, cross-sectional area, segmented lengths) and elastic (Young's modulus) properties of the Achilles tendon and distal aponeurosis in response to chronic unilateral lower limb suspension (ULLS) using velocity encoded phase contrast (VE-PC) and three-dimensional morphometric magnetic resonance imaging (MRI). Five healthy subjects underwent ULLS for 4 wk. Axial morphometric MRI was acquired along the entire length from the calcaneous to the medial gastrocnemius insertion. An oblique sagittal VE-PC MRI was also acquired. The Young's modulus could be calculated from this cine dynamic sequence of velocity encoded images from the slope of the stress-strain curve during the submaximal isometric plantar flexion. After 4 wk of ULLS, we found significant (46.7%) decrease in maximum plantar flexion torque. The total volumes of entire tendinous tissue (determined as the sum of the Achilles tendon and distal aponeurosis) increased significantly by 6.4% (11.9 vs. 12.7 ml) after ULLS. In contrast, Young's modulus decreased significantly by 10.4% (211.7 vs. 189.6 MPa) for the Achilles tendon and 29.0% for the distal aponeurosis (158.8 vs. 113.0 MPa) following ULLS. There was no significant correlation between relative change in volume and Young's modulus with 4 wk of ULLS. It is suggested that, although tendon hypertrophy can be expected to adversely affect tendon stiffness, the absence of any significant correlation between the magnitude of tendon hypertrophy and reduced Young's modulus indicates that dimensional factors were not critical to the elastic properties.

Phase-contrast MRI reveals mechanical behavior of superficial and deep aponeuroses in human medial gastrocnemius during isometric contraction.

The behavior of the entire medial gastrocnemius (MG) superficial and deep aponeurosis structure was investigated with velocity-encoded phase-contrast, spin-tag, and three-dimensional morphometric magnetic resonance imaging. The displacements and strain of both these aponeuroses, muscle length, and the cross-sectional segment length of the deep aponeurosis were measured during isometric plantarflexion at 20% and 40% of maximal voluntary contraction (MVC). The length of the entire MG shortened during 20% and 40% MVC. All regions of interest in both aponeuroses moved proximally. Positive strain (lengthening) occurred in both ends of the deep aponeurosis and in the proximal region of the superficial aponeurosis. In contrast, negative strain (shortening) was observed in the middle region of the deep aponeurosis and in the distal region of the superficial aponeurosis. Consistent with this shortening of the deep aponeurosis length along the proximal-distal axis was expansion of the aponeuroses in the medial-lateral and anterior-posterior directions in the cross-sectional plane. It is concluded that at low to moderate force levels of isometric contraction, regional differences in strain occur along the proximal-distal axis of both aponeuroses, and some regions of both aponeuroses shorten.