combininG biOmechanical and neuRophysiological knowledGE tO better UnderStand and better treat ACHILLES tendinopathy; GORGEOUS_ACHILLES.

This proposal aims to provide a better understanding of the pathogenesis of Achilles tendinopathy in order to define optimal rehabilitation programs. Achilles tendinopathy is a musculoskeletal disorder affecting the Achilles tendon, which is resistant to treatment in 24 to 46% of cases and has a high recurrence rate. The fact that current rehabilitation approaches are far from optimal is likely because the pathogenesis of Achilles tendinopathy remains poorly understood. We know that in the disease progression, Achilles tendon load magnitude plays a crucial role, but the impact of load distribution on Achilles tendon is unknown. Specifically, Achilles tendon is divided into three subtendons that each arises from a muscle belonging to the triceps surae. It is possible that differences in the forces generated by each of the three triceps surae muscles, and transmitted to each subtendon, are responsible for unbalanced loading of Achilles tendon, potentially inducing pathogenic strain. To that extent, people with Achilles tendinopathy have a lower gastrocnemius lateralis contribution to overall triceps surae force compared to controls. This proposal consists of a longitudinal study that will compare people with and without Achilles tendinopathy to (1) map Achilles tendon mechanical loading during rehabilitation-type movements; (2) explore triceps surae neural control; and (3) implement different exercise-based rehabilitation programs that aim to redistribute Achilles tendon load.

Keywords:Triceps surae, force distribution, rehabilitation

Disciplines:Biomechanics, Motor control, Physiotherapy