Dynamics of the suprapatellar bursa during knee joint extension.

PURPOSE: The suprapatellar bursa is located in the proximal deep layer of the patella and is thought to reduce tissue friction by changing from a single-membrane structure to a double-membrane structure during knee joint motion. However, the dynamics of the suprapatellar bursa have only been inferred from positional relationships, and the actual dynamics have not been confirmed. METHODS: Dynamics of the suprapatellar bursa during knee joint motion were observed in eight knees of four Thiel-fixed cadavers and the angle at which the bursa begins to show a double membrane was revealed. The flexion angles of knee joints were measured when the double-membrane structure of the suprapatellar bursa began to appear during knee joint extension. RESULTS: The suprapatellar bursa changes from a single membrane to a double-membrane structure at 91 ± 4° of flexion, when the knee joint is moved from a flexed position to an extended position. CONCLUSION: The suprapatellar bursa may be involved in limitations to knee joint range of motion and pain at an angle of approximately 90°. Further studies are needed to verify whether the same dynamics are observed in living subjects.

Relationship between joint structure of the first tarsometatarsal joint and its degeneration.

This study aimed to elucidate the relationship between joint structures of the first tarsometatarsal and articular facet degeneration. A total of 100 feet from 50 cadavers were examined. The articular facets of the first metatarsal and medial cuneiform were categorized into four types based on the superior and inferior facets' separation, and the formation of the inferior lateral facet on the lateral plantar prominence: Type I, a single facet with no separation or inferior lateral facet; Type II-a, two facets with separation but no inferior lateral facet; Type II-b, two facets, no separation, but with an inferior lateral facet; Type III, three facets with separation and an inferior lateral facet. When both bone types matched, they were defined as Type I, Type II-a, Type II-b, and Type III joints, respectively; unmatched types were classified as Unpair joints. The severity of articular cartilage degeneration on both bones was assessed using a 5-point scale. The degeneration grade was compared among joint types. Type III joints exhibited significantly milder articular cartilage degeneration in medial cuneiform compared to Type II-a, II-b, Unpair joints. The formation of inferior lateral facet and separation of the superior and inferior facets might be crucial for the joint's stability.

Relationship between first tarsometatarsal ligament morphology and its continuity with the fibularis longus and first tarsometatarsal joint degeneration.

This study explored the relationship between the morphological characteristics of the first tarsometatarsal ligaments and fibularis longus (FL) and the severity of articular cartilage degeneration in the first tarsometatarsal joint. Sixty legs from 30 cadavers were examined. The plantar, dorsal, and medial first tarsometatarsal ligaments were classified by fiber bundle number, and their morphological characteristics (fiber bundle length, width, thickness) were measured. The FL was categorized by its continuity with the plantar first tarsometatarsal ligament (PTML): Type A, connection with the PTML only on the first metatarsal; Type B, connection along the entire PTML; and Type C, no connection with the PTML. The severity of articular cartilage degeneration was assessed in four stages. No significant differences in cartilage degeneration among ligament types were found. Negative correlations were observed between the fiber bundle width and thickness of the PTML and the severity of cartilage degeneration. FL was classified as Type A in 68%, Type B in 27%, and Type C in 5% of feet. The fiber bundle thickness of the PTML in Type B was greater than in other types. Our findings suggest that smaller fiber bundle width and thickness in the PTML may be associated with severe cartilage degeneration. The FL had continuity with the PTML in 95% of feet and could enhance the mechanical strength of the PTML in Type B feet.

Changes in the mechanical properties of the thigh and lower leg muscle-tendon units during the early follicular and early luteal phases.

Background: This study aimed to determine changes in the muscle and tendon stiffness of the thigh and lower leg muscle-tendon units during the early follicular and early luteal phases, and check for possible relations between muscle and tendon stiffness in each phase. Methods: The sample consisted of 15 female university students with regular menstrual cycles. The basal body temperature method, ovulation kit, and salivary estradiol concentration measurement were used to estimate the early follicular and early luteal phases. A portable digital palpation device measured muscle-tendon stiffness in the early follicular and early luteal phases. The measurement sites were the rectus femoris (RF), vastus medialis (VM), patellar tendon (PT), medial head of gastrocnemius muscle, soleus muscle, and Achilles tendon. Results: No statistically significant differences in the thigh and lower leg muscle-tendon unit stiffness were seen between the early follicular and early luteal phases. Significant positive correlations were found between the stiffness of the RF and PT (r = 0.608, p = 0.016) and between the VM and PT (r = 0.737, p = 0.002) during the early luteal phase. Conclusion: The present results suggest that the stiffness of leg muscle-tendon units of the anterior thigh and posterior lower leg do not change between the early follicular and early luteal phases and that tendons may be stiffer in those women who have stiffer anterior thigh muscles during the early luteal phase.

Validation of anterior ankle soft tissue dynamics and shear modulus for anterior ankle impingement syndrome after ankle fracture surgery.

Anterior ankle impingement syndrome (AAIS) has been reported to account for a high percentage of complications following ankle fracture surgery. The soft tissue etiology of AAIS is thought to be thickening and inflammation of the anterior ankle soft tissues intervening anteriorly at the tibiotalar joint, causing pain and functional limitation during dorsiflexion. However, the effects of anterior ankle soft tissue dynamics and stiffness on AAIS have yet to be clarified. This study aimed to determine the relationship between AAIS and the anterior ankle soft tissue thickness change ratio and shear modulus using ultrasonography (US). The participants were 20 patients with ankle joint fractures (AO classification A, B) who had undergone open reduction and internal fixation and 20 healthy adults. The evaluation periods were 3 months and 6 months postoperatively. US was used to delineate the tibialis anterior tendon, extensor hallucis longus tendon, and the extensor digitorum longus tendon over the talus and tibia on a long-axis image. Anterior ankle soft tissue thickness was measured as the shortest distance from the most convex part of the talus to the tendon directly above it. The Anterior ankle soft tissue thickness change ratio was determined by dividing the value at 0° dorsiflexion by the value at 10° plantarflexion. The same images as for the anterior soft tissue thickness measurement were drawn for the shear modulus measurement, and the average shear modulus (kPa) was calculated using shear-wave elastography. There was no significant difference in the thickness change ratio between the postoperative and healthy groups. Compared with the healthy group, the shear modulus was significantly higher at 3 and 6 months in the postoperative group (p < 0.01). The shear elastic modulus at 6-month postoperative group was significantly lower than at 3-month postoperative group (p < 0.01). Anterior ankle joint soft tissue stiffness may increase after surgery for an ankle fracture.

Effects of transcutaneous auricular vagus nerve stimulation at left cymba concha on experimental pain as assessed with the nociceptive withdrawal reflex, and correlation with parasympathetic activity.

The aim of this study was to clarify the effects of transcutaneous auricular vagus nerve stimulation (taVNS) to the left cymba concha on the pain perception using nociceptive withdrawal reflex (NWR), which is known to be associated with chronic pain, and to investigate whether there is a relationship between taVNS-induced suppression of the NWR and parasympathetic activation. We applied either 3.0 mA, 100 Hz taVNS for 120 s on the left cymba concha (taVNS condition) or the left earlobe (Sham condition) for 20 healthy adults. NWR threshold was measured before (Baseline), immediately after (Post 0), 10 min (Post 10) and 30 min after (Post 30) stimulation. The NWR threshold was obtained from biceps femoris muscle by applying electrical stimulation to the sural nerve. During taVNS, electrocardiogram was recorded, and changes in autonomic nervous activity measured by heart rate variability (HRV) were analyzed. We found that the NWR thresholds at Post 10 and Post 30 increased compared with baseline in the taVNS group (10 min after: p = .008, 30 min after: p = .008). In addition, increased parasympathetic activity by taVNS correlated with a greater increase in NWR threshold at Post 10 and Post 30 (Post 10: p = .003; Post 30: p = .001). The present results of this single-blinded study demonstrate the pain-suppressing effect of taVNS on NWR threshold and suggest that the degree of parasympathetic activation during taVNS may predict the pain-suppressing effect of taVNS after its application.

Elbow valgus stress during towel drills in college baseball players.

BACKGROUND: In baseball players with elbow injuries, towel drills are clinically used before initiating active throwing exercises to gradually increase stress across the elbow. However, elbow valgus torque during towel drills remains unknown. Moreover, towel drills and active ball throws might have different relationships between biomechanical metrics, such as elbow stress, arm slot, and arm speed. Therefore, the aims of this study were 1) to demonstrate the difference in elbow valgus stress between towel drills and active ball throws and 2) to evaluate the correlation between elbow valgus torque and other biomechanical metrics including arm slot and arm speed in towel drills and active ball throws. METHODS: Seventeen healthy college baseball players performed three towel drills using a face towel, short foam tube, and long foam tube, followed by full-effort throwing on flat ground. Each participant completed five consecutive trials of each task, and the elbow valgus torque, arm slot, and arm speed were measured using wearable sensors. One-way repeated analysis of variance and post-hoc tests were used to determine the differences in biomechanical metrics among the tasks. Furthermore, the correlation between the elbow valgus torque and other metrics was evaluated using Pearson correlation coefficients. RESULTS: Elbow valgus torque was lower in towel drills compared to that of active ball throws; however, the stress during towel drills using a face towel reached almost 80% of the maximum effort of active ball throws. There was no relationship between elbow valgus stress and arm slot in either the towel or active ball throw tasks. However, a higher arm speed was associated with greater elbow valgus torque in towel drills, whereas no relationship between elbow stress and arm speed was found in active ball throws. CONCLUSION: Precaution must be taken in athletes following a progressive throwing program because elbow valgus stress reaches almost 80% of the full-effort throw, even when using a face towel in a towel drill. Hence, the subjective intensity must be controlled even in towel drills to gradually increase the medial elbow stress. Moreover, the mechanisms underlying changes in elbow stress may differ between towel drills and active ball throws. Future investigations on the difference between towel drills and active ball throws may help understand the underlying mechanism of alterations in elbow valgus torque during the throwing movement.

Anatomical study of type classification and surface area of attachment sites for tibialis anterior tendon.

BACKGROUND: The purpose of this study was to clarify the attachment types of the tibialis anterior tendon (TAT) in Japanese fixed cadavers and to determine the attachment site area in three dimensions. METHODS: We examined 100 feet from 50 Japanese cadavers. The TAT was classified according to differences in the number of fiber bundles as: Type I, with one fiber bundle; Type II, with two fiber bundles; and Type III, with three fiber bundles. The attachment site area of the TAT was measured using a three-dimensional scanner. RESULTS: Cases were Type II in 95% and Type III in 5%, with no cases of Type I identified. In Type II, mean attachment site areas were 85.2 ± 18.2 mm2 for the medial cuneiform bone (MCB) and 72.4 ± 19.0 mm2 for the first metatarsal bone (1 MB), showing a significantly larger area for MCB than for 1 MB. CONCLUSIONS: These findings suggest the possibility of ethnic differences in TAT attachment types and suggest that TAT attachments in Japanese individuals are highly likely to be Type II, with rare cases of Type III. Accurate measurement of attachment site areas is possible with appropriate three-dimensional measurements.

Relationship Between Posterior Shoulder Tightness and Lower-Limb Flexibility in College Baseball Players.

CONTEXT: Posterior shoulder tightness evaluated as limited glenohumeral internal rotation and horizontal adduction is a risk factor for throwing-related shoulder and elbow injuries. Given that the throwing motion uses the entire body kinematics, limited lower-limb flexibility might be associated with posterior shoulder tightness. Therefore, we aimed to investigate the relationships between posterior shoulder tightness and lower-limb flexibility in college baseball players. DESIGN: Cross-sectional study. SETTING: University laboratory. PARTICIPANTS: Twenty-two college baseball players (20 right-handed and 2 left-handed). METHODS: To investigate the relationships between glenohumeral range of motion and lower-limb flexibility using simple linear regression analysis, we measured passive range of motion of glenohumeral internal rotation and horizontal adduction, hip internal/external rotation in the prone/sitting position, ankle dorsiflexion, and quadriceps and hamstrings flexibility from both shoulders and legs. RESULTS: Our analysis indicated that decreases in the lead leg hip external rotation in the prone position were moderately associated with limitations in glenohumeral internal rotation (R2 = .250, ß [95% confidence interval, CI] = 0.500 [0.149 to 1.392], P = .018) and horizontal adduction (R2 = .200, ß [95% CI] = 0.447 [0.051 to 1.499], P = .019) on the throwing shoulder. Furthermore, there were significant moderate relationships between decreases in glenohumeral internal rotation and limited lead leg quadriceps flexibility (R2 = .189, ß [95% CI] = 0.435 [0.019 to 1.137], P = .022), and between decreases in glenohumeral horizontal adduction and limited stance leg ankle dorsiflexion (R2 = .243, ß [95% CI] = 0.493 [0.139 to 1.438], P = .010). CONCLUSION: College baseball players with limited lower-limb flexibilities including the lead leg hip external rotation in the prone position, the lead leg quadriceps flexibility, and the stance leg ankle dorsiflexion showed excessive posterior shoulder tightness. The current results support the hypothesis that lower-limb flexibility is associated with posterior shoulder tightness in college baseball players.

Relationship between Joint and Ligament Structures of the Subtalar Joint and Degeneration of the Subtalar Articular Facet.

This study aimed to clarify the relationship between the joint and ligament structures of the subtalar joint and degeneration of the subtalar articular facet. We examined 50 feet from 25 Japanese cadavers. The number of articular facets, joint congruence, and intersecting angles were measured for the joint structure of the subtalar joint, and the footprint areas of the ligament attachments of the cervical ligament, interosseous talocalcaneal ligament (ITCL), and anterior capsular ligament were measured for the ligament structure. Additionally, subtalar joint facets were classified into Degeneration (+) and (-) groups according to degeneration of the talus and calcaneus. No significant relationship was identified between the joint structure of the subtalar joint and degeneration of the subtalar articular facet. In contrast, footprint area of the ITCL was significantly higher in the Degeneration (+) group than in the Degeneration (-) group for the subtalar joint facet. These results suggest that the joint structure of the subtalar joint may not affect degeneration of the subtalar articular facet. Degeneration of the subtalar articular facet may be related to the size of the ITCL.

Supraspinatus tendon thickness and subacromial impingement characteristics in younger and older adults.

BACKGROUND: Subacromial impingement (SAI) may be a cause of age-related rotator cuff abnormalities; therefore, the purpose of this study was to compare SAI characteristics between younger and older adults. In addition to the fact that thickened supraspinatus tendon (SST) indicates tendon abnormalities, SAI characteristics have been recognized as follows: greater SST thickness, reduced acromiohumeral distance (AHD), greater reduction of AHD (∆AHD) with arm elevation, and a higher percentage of SST within AHD (i.e., occupation ratio: OcAHD). Furthermore, we investigated the relationships between SST thickness and AHD, as well as SST thickness and ∆AHD to clarify the effect of SAI on rotator cuff abnormalities. METHODS: Healthy younger (n = 18, 21-24-year-old) and older (n = 27, 45-80-year-old) adults without any shoulder symptoms participated in this study. We measured their SST thickness and AHD at rest and at arm elevation (30° and 60°) in the scapular plane using ultrasound, and calculated ∆AHD as the relative change expressed as a percentage of the baseline. OcAHD was expressed as the ratio of SST thickness at rest to AHD at rest and in elevated positions. RESULTS: The older subjects had approximately one mm thicker SST (P = 0.003, 95% Confidence interval [CI] = 0.410 to 1.895) and approximately 1.0 to 1.3 mm greater AHD than the younger subjects (P = 0.011, 95%CI = 0.284 to 2.068 at rest; P = 0.037, 95%CI = 0.082 to 2.609 for 30° of arm elevation; P = 0.032, 95%CI = 0.120 to 2.458 for 60° of arm elevation). However, there were no differences in ΔAHD and OcAHD between the groups. CONCLUSION: This study demonstrated that, compared with the younger subjects, the older subjects showed thicker supraspinatus tendon but no other SAI characteristics including decreases in AHD and increases in OcAHD. Thus, this study suggests that older subjects showed age-related SST abnormalities without SAI, although the magnitude of the differences in SST thickness is notably small and the clinical significance of this difference is unclear.

Supraspinatus Tendon Changes and Glenohumeral Range of Motion in College Baseball Players.

Baseball players commonly show altered glenohumeral range of motion during internal rotation, external rotation, total rotation, and horizontal adduction. These altered ranges of motion appear to be associated with throwing shoulder injuries, which frequently involve the supraspinatus tendons; thus, we aimed to examine the relationship between altered glenohumeral range of motion and supraspinatus tendon changes in collegiate baseball players. To investigate this association using the Pearson correlation coefficient, we measured glenohumeral internal rotation, external rotation, total rotation, and horizontal adduction ranges of motion and supraspinatus tendon thickness in 22 college baseball players. Consequently, there was a significant relationship between increase in supraspinatus tendon thickness and greater deficit of internal rotation (r=-0.520, P=0.013). Increased supraspinatus tendon thickness tended to be associated with greater external rotation gain (r=0.394, P=0.073). No other range of motion had any relationship with supraspinatus tendon changes. These results might indicate that restricted glenohumeral internal rotation and excessive gain in external rotation increase the risk of supraspinatus tendon abnormalities in baseball players.

Relationship between Changes in Foot Arch and Sex Differences during the Menstrual Cycle.

This study investigated the relationship between changes in foot characteristics and sex differences during the menstrual cycle in healthy male and female university students. We examined 10 female subjects and 14 male subjects. The menstrual cycle was divided into the three phases: the early follicular phase, ovulatory phase, and luteal phase via basal body temperature, an ovulation kit, and salivary estradiol and progesterone concentration measurements. Foot characteristics required for the calculation of the arch height index (AHI) were measured using a three-dimensional foot scanner under conditions of 10% and 50% weight-bearing loads. Arch height at 50% of foot length and truncated foot length were measured, and AHI was calculated by dividing arch height by truncated foot length. Arch height flexibility (AHF) was defined as the change in arch height from 10% weight-bearing load to 50% weight-bearing load. AHI was significantly lower in females than in males in the early follicular and ovulatory phases but did not differ significantly between males and females in each phase. AHF did not differ significantly between males and females in each phase. AHI and AHF showed no periodic fluctuation, suggesting that sex differences in AHF may be absent.

Effects of the strain rate on mechanical properties of tendon structures in knee extensors and plantar flexors in vivo.

The purpose of present study was to investigate site differences in the effects of strain rate on tendon properties between knee extensors and plantar flexors. Elongation of tendon structures (L) in vastus lateralis and medial gastrocnemius muscles was measured by ultrasonography while participants performed ramp and ballistic contractions to their voluntary maximum, followed by ramp and sudden relaxation. The relationship between muscle force (Fm) and L was fit to linear regression, the slope of which was defined as stiffness of tendon structures. Hysteresis of tendon structures was calculated as ratio of area within Fm-L loop to area beneath loading portion of curve. In knee extensors and plantar flexors, L values at all force levels were significantly lower during ballistic than ramp contractions. However, no significant differences were observed in stiffness of tendon structures between two contractions at both measured sites. Hysteresis of tendon structures was significantly higher during ballistic than ramp contractions for knee extensors and plantar flexors. In conclusion, elongation of tendon structures was lower and hysteresis was greater during ballistic than ramp contractions. Furthermore, site differences in the effects of strain rate on tendon properties were not found between knee extensors and plantar flexors.

Mechanical properties and collagen fiber orientation of tendon in young and elderly.

BACKGROUND: The purpose of this study was to investigate differences in the mechanical properties and collagen fiber orientation of tendon structures between young and elderly groups. METHODS: The mechanical properties of tendon structures in medial gastrocnemius muscle were measured using ultrasonography during ramp and ballistic contractions. Tendon collagen fiber orientation was estimated from coefficient of variation (CV) of echogenicity on transverse ultrasonic images of Achilles tendon. FINDINGS: Differences in elongation between ramp and ballistic contractions of elderly were significantly smaller than those of young group at 20-80% of MVC. During ramp contraction, hysteresis of elderly was significantly higher than that of young, whereas no difference in hysteresis during ballistic contraction was found between the two groups. Difference in hysteresis between ramp and ballistic contractions of elderly tended to be lower than that of young group. Mean echogenicity of elderly was significantly higher than that of young group, whereas no difference in CV of echogenicity was found between the two groups. INTERPRETATION: These results suggest that smaller differences in elongation and hysteresis between ramp and ballistic contractions of elderly may be related to decreased water content within tendons. Furthermore, no difference in collagen fiber orientation of tendons was noted between the two groups.

Effects of eccentric training with different training frequencies on blood circulation, collagen fiber orientation, and mechanical properties of human Achilles tendons in vivo.

PURPOSE: The purpose of the present study was to compare the effects of eccentric training with different training frequencies on the blood circulation, collagen orientation, and mechanical properties of the human Achilles tendon in vivo. METHODS: Ten healthy males completed 12 weeks of a unilateral eccentric training program {(15 repetitions with knee straight and 15 repetitions with knee slightly bent) × 6 sets in a single session} for the plantar flexor muscles. They performed training three times per week on one side (3TW) and six times per week on the other side (6TW). Before and after training, changes in blood volume, coefficient of variation (CV) of echogenicity (reflects collagen fiber orientation), and stiffness of the Achilles tendon were compared by two-way analysis of variance. RESULTS: The tendon blood volume tended to increase after 3TW and 6TW (p = 0.064). Tendon stiffness did not change after 3TW and 6TW, whereas the elongation of tendon structures at three force levels (50, 100, and 150 N) significantly decreased with 3TW, but not 6TW. The CV of echogenicity significantly decreased after 3TW and 6TW. However, no significant differences were observed in the relative changes in these measured variables between 3TW and 6TW. CONCLUSION: The present results demonstrated an increase in blood volume, the alignment of collagen fibers, and unchanged stiffness of the Achilles tendon after 12 weeks of eccentric training. Furthermore, the training frequency did not influence these training-induced changes in the tendon properties.

Measurement of active muscle stiffness with and without the stretch reflex.

The purpose of the present study was to evaluate active muscle stiffness with the stretch reflex according to changes (in 110-ms period after stretching) in torque and fascicle length during slower angular velocity (peak angular velocity of 100 deg·s-1) in comparison with active muscle stiffness without the stretch reflex (in 60-ms period after stretching) during slower and faster (peak angular velocity of 250 deg·s-1) angular velocities. Active muscle stiffness in the medial gastrocnemius muscle was calculated according to changes in estimated muscle force and fascicle length with slower and faster stretching during submaximal isometric contractions (10-90% maximal voluntary contractions). Active muscle stiffness significantly increased for both angular velocities and analyzed periods as torque levels exerted became higher. The effects of angular velocities and the interaction between angular velocities and torque levels were not significantly different between 250 deg·s-1 (in 60-ms period after stretching) and 100 deg·s-1 (in 110-ms period after stretching) conditions. The effects of the analyzed periods and the interaction between analyzed periods and torque levels were not significantly different between the analyzed periods (60-ms and 110-ms periods after stretching) for the 100 deg·s-1 condition. Furthermore, active muscle stiffness measured during the same angular velocity had significant correlations between those calculated in the different analyzed periods, whereas those under 250 deg·s-1 (60-ms period after stretching) did not correlate with those under 100 deg·s-1 (110-ms period after stretching). These results suggest that active muscle stiffness is not influenced by the stretch reflex.

Effects of plyometric and isometric training on muscle and tendon stiffness in vivo.

The purpose of this study was to compare the effects of plyometric and isometric training on tendon properties during ramp and ballistic contractions and muscle stiffness under passive and active conditions. Eleven subjects completed 12 weeks (3 days/week) of a unilateral training program for the plantar flexors. They performed plyometric training on one side (PLY) and isometric training on the other side (ISO). Active muscle stiffness in the medial gastrocnemius muscle was calculated according to changes in estimated muscle force and fascicle length during fast stretching after submaximal isometric contractions. Passive muscle stiffness was also calculated from estimated passive muscle force and fascicle length during slow passive stretching. Stiffness and hysteresis of tendon structures were measured using ultrasonography during ramp and ballistic contractions. Passive muscle stiffness and tendon hysteresis did not change for PLY or ISO Active muscle stiffness significantly increased for PLY, but not for ISO Tendon stiffness during ramp and ballistic contractions increased significantly for ISO, but not for PLY In addition, tendon elongation values at force production levels beyond 100 N during ballistic contractions increased for PLY These results suggest that plyometric training (but not isometric training) enhances the extensibility of tendon structures during ballistic contractions and active muscle stiffness during fast stretching, and these changes may be related to improved performances during stretch-shortening cycle exercises.

Quantification of collagen fiber orientation in human tendons with the coefficient of variation of echogenicity.

The grayscale distribution on the ultrasonic images of tendons may be reduced with alignment of collagen fibers, because ultrasound signal intensity changes with alterations in tendon collagen fiber orientation due to acoustic anisotropy in the tendons. The purpose of this study was to investigate changes in the coefficient of variation (CV) of echogenicity in the Achilles tendon during passive dorsiflexion (the angle task) and isometric plantar flexion (the contraction task). Achilles tendon transverse ultrasonic images were collected from 14 healthy individuals every 10° from 20° to -20° (positive values for plantar flexion) in the angle task and every 10% maximum voluntary contraction (MVC) from 0% to 70% MVC in the contraction task. The CV of echogenicity was measured in each image. In addition, relative changes in the measured variables between the former half (20-0° in the angle task, 0% to 30% MVC in the contraction task) and the latter half (0° to -20° in the angle task, 40% to 70% MVC in the contraction task) of each task were compared. The CV of echogenicity decreased with increases in the dorsiflexion angle and intensity of isometric contractions. Furthermore, relative changes in the CV of echogenicity were greater at more dorsiflexed positions in the angle task and at lower torque levels in the contraction task. These results suggested that decreases in the CV of echogenicity were partially related to the alignment of the tendon collagen fibers with tendon stretching.

Does restriction of glenohumeral horizontal adduction reflect posterior capsule thickening of the throwing shoulder?

[Purpose] Glenohumeral posterior capsule tightness possibly relates to posterior capsule thickness (PCT). The purpose of the current study was to analyze the relationships between PCT and glenohumeral range of motion (ROM) in horizontal adduction (HAdd) and internal rotation (IR). [Subjects and Methods] This study recruited 39 healthy collegiate baseball players. We measured PCT by using ultrasonography and ROM of the glenohumeral joint of the throwing shoulder by using a digital inclinometer. Pearson's correlation coefficients were calculated between PCT and HAdd or IR ROM. [Results] There was no correlation between PCT and HAdd ROM, but PCT was significantly correlated with IR ROM. [Conclusion] This result indicates that posterior shoulder capsule tightness only relates to IR ROM, and that restricted HAdd ROM might reflect tightness of other tissue, such as the posterior deltoid.