Level 3, 12 Gilles Street, Adelaide

Clinic Number




Sonoelastography of the Achilles Tendon: Prevalence and Prognostic Value Among Asymptomatic Elite Australian Rules Football Players

Journal Article

Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine 26(4) · October 2015


Chin Chin Ooi, Michal E. Schneider, Peter Malliaris, Donna Jones, Steven W. Saunders, Andrew McMahon, David Connell


Objective: To investigate the prevalence of sonographic abnormalities at the mid-Achilles tendon among a cohort of asymptomatic professional football players and to determine whether these sonographic abnormalities predict midportion Achilles tendon symptoms.

Design: Longitudinal study.

Setting: A single competitive season in the Australian Rules Football League.

Participants: Forty-two elite Australian Rules football players.

Main outcome measures: Using ultrasound and sonoelastography, 42 players were examined at baseline and again 9 months later (postseason) for the existence of intratendinous hypoechogenicity, delamination, softening, and neovascularization. The anterio-posterior (AP) thickness and cross-sectional area (CSA) were measured. Players reporting Achilles tendon pain or with Victorian Institute of Sports Assessment-Achilles scores below 80 at the end of the season were classified as symptomatic.

Results: At preseason, ultrasound and/or sonoelastographic abnormalities were found in 22 (22/42, 52.4%) asymptomatic players. Baseline AP thickness and CSA were significantly greater in symptomatic players at the end season than those in asymptomatic players (0.57 ± 0.05 cm vs 0.50 ± 0.03 cm; P < 0.001 and 0.67 ± 0.07 cm vs 0.57 ± 0.06 cm; P < 0.001, respectively). The presence of intratendinous softening and delaminations at baseline was associated with pain onset during the season (P = 0.046; P = 0.048, respectively). Conclusions: Ultrasound and sonoelastography-detected abnormalities were relatively common among the asymptomatic footballers. Greater AP thickness and CSA and also the presence of intratendinous softening and delaminations were associated with the increased risk of developing symptoms. Clinical relevance: Conventional ultrasound supplement with sonoelastography may be able to identify elite athletes at risk of Achilles tendon injury, which may, in turn, impact therapeutic decisions.

Featured Articles

Latest from Twitter

Are you a new or existing patient?

Book With Saunders Physiotherapy Online

New patients and current patients can now book their appointments through HotDoc by pressing the appropriate button. Please call the clinic on (08) 8410 5666 if you wish to book a KangaTech assessment and our staff will find an appointment that best suits you.