Prof. Dr. K. Albracht 7 th European Pole Vault and High Jump Conference Cologne November 11 th, 2016

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fascicle length force Achilles tendon forces during running 7 th EuropeanPole Vault and High Jump Conference Cologne November 11-13, 2016 TENDON ELASTICITY: LATEST

de University of Applied Science Aachen, Faculty of Medical Engineering and Technomathematics, albracht@fh-aachen.de 5 12 body weigth adapted from Komi et al.

et al., 2012, J Biomech) http://www.iaaf.org/about-iaaf/documents/research Source of energy Material properties are important to allow energy storage in the tendon.

, 2012, J Biomech COM energy conservation Muscle power amplification modified from Roberts & Azizi, 2011, J Exp Biol Energy conservation Energy conservation high

1 fascicle length force Achilles tendon forces during running 7 th EuropeanPole Vault and High Jump Conference Cologne November 11-13, 2016 TENDON ELASTICITY: LATEST FINDINGS AND STATE OF THE ART PROF. DR.KIRSTEN ALBRACHT German Sport University Cologne, Institute of Biomechanics and Orthopaedics, albracht@dshs-koeln.de University of Applied Science Aachen, Faculty of Medical Engineering and Technomathematics, albracht@fh-aachen.de 5 12 body weigth adapted from Komi et al. 1992, J Sports Sci Sprint performance - Tendon compliance/stiffness - Jumps with a run up No series-elastic compliance in all MTUs 26% maximum sprinting velocity (Miller et al., 2012, J Biomech) Source of energy Material properties are important to allow energy storage in the tendon. + adapted from Miller et al., 2012, J Biomech COM energy conservation Muscle power amplification modified from Roberts & Azizi, 2011, J Exp Biol Energy conservation Energy conservation high efficiency high efficiency stance adapted and modified from Roberts & Azizi, J Exp Biol, 2011 adapted and modified from Roberts & Azizi, J Exp Biol, iates/cfs/movies/cfs_wallaby.avi Touch down Toe off iates/cfs/movies/cfs_wallaby.avi time adapted and modified from Biewener et al., J Exp Biol,

proximal distal Energy conservation Human muscle tendon behavior in vivo high efficiency adapted and

edu/affil iates/cfs/movies/cfs_wallaby.avi adapted from Biewener et al.

heel Muscle tendon function during human running high efficiency (?) 0.

00-0.25 energy storage energy release -0.

2 proximal distal Energy conservation Human muscle tendon behavior in vivo high efficiency adapted and modified from Roberts & Azizi, J Exp Biol, iates/cfs/movies/cfs_wallaby.avi adapted from Biewener et al., J Exp Biol, 1998 & Roberts & Azizi, J Exp Biol, 2011 Muscle tendon behaviour during human running knee heel Muscle tendon function during human running high efficiency (?) 0.50 Phase 1: COM Deceleraton Phase 2: COM Acceleration fascicle MTU change in length [ l 0,fl ] energy storage energy release Stance [%] Tendons enables an independent behavior of the fascicle e.g. Aggelousis et al., 2009, Albracht & Arampatzis, 2013 Albracht & Arampatzis, 2013 Muscle tendon function during human running Muscle tendon function during hopping high efficiency (?) stance energy storage energy release Hopping Albracht & Arampatzis., 2013 Sano K, Ishikawa M, Nobue A, Danno Y, Akiyama M, Oda T, Ito A, Hoffrén M, Nicol C, Locatelli E, Komi PV. Eur J Appl Physiol, in press 2

Muscle tendon function during drop jumps Regulation of muscle stiffness Optimum Drop Heigth 120 % Optimum

of muscle stiffness Power = Work / Time Muscle activation before ground contact (Pre-activation) regulates

Gollhofer, 1997; Ishikawa & Komi, 2004) Catapult effect Power Amplifikation - Squat Jumpadapted and

- Squat Jump- http://video.nationalgeographic.com/video/news/frogmuscle-study H. C. Astley & T. J. Robert, 2012 Roberts, T.

3 Muscle tendon function during drop jumps Regulation of muscle stiffness Optimum Drop Heigth 120 % Optimum Drop Heigth Drop jumps modified from Ishikawa & Komi, Exercise and Sport Science Reviews, 2008 Regulation of muscle stiffness Power = Work / Time Muscle activation before ground contact (Pre-activation) regulates muscle stiffness and therefore energy storage in the tendon (Gollhofer & Kyröläinen, 1991; Komi & Gollhofer, 1997; Ishikawa & Komi, 2004) Catapult effect Power Amplifikation - Squat Jumpadapted and modified from Roberts & Azizi, 2011, J Exp Biol The catapult mechanism of frog jumping Power Amplifikation - Squat Jump- H. C. Astley & T. J. Robert, 2012 Roberts, T. J., Abbott, E. M. and Azizi, E adapted and modified from Kurokawa et al., 2001, J Appl Physiol 3

Force Tendon force [N] Force Force Power Amplifikation - Squat Jump- Tendon function Force

unit enable the muscle to work at a higher force potential due to the force length and force

the muscle from strain injuries adapted and modified from Kurokawa et al.

deformation in response to an applied force Tendon stiffness (k): The extent to which the

Legerlotz et al., 2007, k= Legerlotz et al.

4 Force Tendon force [N] Force Force Power Amplifikation - Squat Jump- Tendon function Force transmission Energy Storage & Release Decoupling of the muscle from the entire muscle-tendon unit enable the muscle to work at a higher force potential due to the force length and force velocity relationship high power output due to a quick release of the stored energy prevent the muscle from strain injuries adapted and modified from Kurokawa et al., 2001, J Appl Physiol Tendon stiffness (k): The extent to which the tendon resists deformation in response to an applied force Tendon stiffness (k): The extent to which the tendon resists deformation in response to an applied force Stiff tendon Less stiff tendon Legerlotz et al., 2007, k= Legerlotz et al., 2007, J Appl Physioll J Appl Physioll k= Deformation Deformation - Energy - in vivo - Achilles tendon - Energy Legerlotz et al., 2007, J Appl Physioll Def Deformation [mm] 4

mechanical work muscle architecture CONTRACTION REST

Tibia Patella ultrasound probe KONTRAKTION Def CSA

, 2002 Tendon material properties - Modulus of

AJSM 2010 sport performance sport performance great

Physiol, 2013 Albracht & Arampatzis, Biol. Cybern.

Isometric contraction long tendon pennated muscle short

5 mechanical work muscle architecture CONTRACTION REST Force in vivo - Patellar tendon - RUHE Patellasehne Tibia Patella ultrasound probe KONTRAKTION Def CSA Length Materialproperties Raspanti et al., 2002 Tendon material properties - Modulus of Elasticity or Young s Modulus (YM)- Crosslinks Raspanti et al., 2002, Arch. Histol. Cytol. Fibril morphologie Kongsgaard et al. AJSM 2010 sport performance sport performance great fascicle shortening amplitude Sano K et al, Eur J Appl Physiol, 2013 Albracht & Arampatzis, Biol. Cybern., 2006 short tendon paralell fascicles short fascicles Isometric contraction long tendon pennated muscle short fascicles optimal muscle & tendon properties spring-like muscle-tendon function adapted and modified from Biewener, J Exp. Biol.,

Force Effects of resistance training - M. triceps surae - Stenroth et al.

, 2007 J Biomech Mechanical & morphological properties of the Tendon - Effects of resistance training -

, 2002 Tendons adapt to resistance training by an increase in tendon stiffness mainly due to a change

, Med Sci Sports Exerc, 20015 Habitual loading results in tendon hypertrophy and increased stiffness of

isometric knee extensor strength of at least 15%.

extremity 2 0 Stiffness [kn/mm] Proximal YM [GPa] Mid YM [GPa] Distal YM [GPa] adapted and modified

6 Force Effects of resistance training - M. triceps surae - Stenroth et al., J Appl Physiol, 2013 Similar results are published by A. Arampatzis et al., 2007 J Biomech Mechanical & morphological properties of the Tendon - Effects of resistance training - Def CSA Length Materialproperties Raspanti et al., 2002 Tendons adapt to resistance training by an increase in tendon stiffness mainly due to a change in material properties Wiesinger et al., Med Sci Sports Exerc, Habitual loading results in tendon hypertrophy and increased stiffness of the human patellar tendon 7 elite fencers and badminton players with a side-to-side difference in isometric knee extensor strength of at least 15%. Plasticity of human Achilles tendon - Effects of strain magnitude- 6 4 * Lead extremity Non-lead extremity 2 0 Stiffness [kn/mm] Proximal YM [GPa] Mid YM [GPa] Distal YM [GPa] adapted and modified from Couppé C, J Appl Physiol P R E T E S T Plantarflexion restistance training 90% MVC M V C t01 t02 t03 t04 week 01 Plantarflexion restistance training 90% MVC M V C t05 t06 t07 t08 week 02,, P Plantarflexion O restistance training 90% MVC S M T V T C t53 t54 t55 t56 E S week 14 T Arampatzis, Karamanidis, Albracht., 2007, J. Exp. Biol 6

Plasticity of human Achilles tendon - Effects

Isometric resistance training 14 weeks Low: 55%

38% 180 160 140 120 100 80 60 40 20 0 Moment

50 0 low high low high Arampatzis, Karamanidis,

Biol Arampatzis, Bierbaum, Peper, Albracht.

Biomech of loading duration - Human Achilles

duration - 3s loading, 3s rest 1s loading, 1s

Biol Human Achilles duration - Effect of

muscle-tendon properties JUMPS Long duration

sets of six eccentric contractions at 120% MVC

7 Plasticity of human Achilles tendon - Effects of strain magnitude- Plasticity of human Achilles tendon - Effects of loading duration - Isometric resistance training 14 weeks Low: 55% MWC/ 2.85±0.99% High: 90% MVC / 4.55±1.38% Moment [Nm] Stiffness [N/mm] 300 * * * low high low high Arampatzis, Karamanidis, Albracht., 2007, J. Exp. Biol Arampatzis, Bierbaum, Peper, Albracht., 2010, J. Biomech Plasticity of human Achilles tendon - Effects of loading duration - Human Achilles tendon plasticity - Effects of strain rate and duration - 3s loading, 3s rest 1s loading, 1s rest 3 x 4 Repetitions 72 Jumps (one leg) 1 Repetition Arampatzis, Bierbaum, Peper, Albracht., 2010, J. Biomech Bohm et al., 2014, J. Exp. Biol Human Achilles tendon plasticity - Effects of strain rate and duration - Effect of eccentric training on the plantar flexor muscle-tendon properties JUMPS Long duration Training protocol 18 sessions over 7 weeks Six sets of six eccentric contractions at 120% MVC 3-s eccentric actions ROM: ~ /s Bohm et al., 2014, J. Exp. Biol Duclay et al, Muscle Nerve, 7

Modified muscle & tendon properties: impact on function?

weeks high intensive resistance training: sign.

greater normalized tendon stiffness (~15%, p < 0.0001) sign.

002 Albracht & Arampatzis, Eur J Appl Physiol, 2013 Tendon s response to training is

, Journal of Strength and Conditioning Research, 24 (2), 2010 Conclusion Tendons

Optimal tendon stiffness is task specific and depends on the mechanical and

properties) Training a tendon high strain, moderate duration Tendons response to

8 Modified muscle & tendon properties: impact on function? Mechanical & morphological properties of tendons - Effects of resistance training - 14 weeks high intensive resistance training: sign. greater maximum isometric plantarflexion moment (~7%, p = 0.005) sign. greater normalized tendon stiffness (~15%, p < ) sign. better running economy: ~4.0 %, p < Albracht & Arampatzis, Eur J Appl Physiol, 2013 Tendon s response to training is later than that of muscle Kubo et al., Journal of Strength and Conditioning Research, 24 (2), 2010 Conclusion Tendons material properties play an important role in athletic performance! Optimal tendon stiffness is task specific and depends on the mechanical and morphological properties of the MTU Tendons have the potential to adapt (CSA, material properties) Training a tendon high strain, moderate duration Tendons response to training is later than that of muscle acknowledgements G-P Brüggemann J Rittweger J Mester W Ritzdorf A Knicker O Seynnes J Goldmann B Braunstein M Sanno S Willwacher K Heinrich J Boijsen-Moller S Schneider A Niehoff A Gollhofer D Belavy M Gruber H Maek E Zack B Stäudle J Meskemper A Fasse M Küsel T Förster J Geiermann S Mohr 8

Applied tendon stiffness analysis

Applied tendon stiffness analysis Gaspar Epro Institute of Movement and Sport Gerontology & Institute of Biomechanics and Orthopaedics, German Sport University Cologne Muscle-Tendon complex M. triceps