The Utility of Myotonometry in Musculoskeletal Rehabilitation and Human Performance Programming

Effects of maturation on myotonometric parameters and their predictors of athletic performance in elite youth soccer players

The aim of the present study was to investigate the variations in individual muscle stiffness across different maturation stages (i.e., peak height velocity [PHV]) in elite youth soccer players and to explore the associations between lower limb muscle stiffness and performance in sprinting (10, 20, and 40 m sprint), maneuverability (9-3-6-3-9 m sprint test), and jumping (countermovement jump [CMJ]). A total of 131 elite youth soccer players aged 12-18 years, volunteered to participate in the study and were divided into pre-PHV (n = 21), mid-PHV (n = 33), and post-PHV (n = 80). Muscle stiffness of the rectus femoris (RF) and biceps femoris (BF) muscles was assessed using a MyotonPRO. Results showed that players in the pre-PHV stage had lower stiffness in the BF and RF muscles compared to mid-PHV (p < 0.001; effect size [ES] = moderate to large) and post-PHV players (p < 0.001; ES = moderate to large). It was also observed that the mid-PHV group had lower stiffness levels in their RF muscle compared to the post-PHV group (p < 0.001; ES = small). Significant correlations were found between BF and RF stiffness and sprint (p < 0.001) and maneuverability (p < 0.001) performance. RF stiffness showed a significant positive correlation with CMJ (p < 0.05), suggesting that greater lower body stiffness is beneficial for athletic performance in youth soccer players. The findings highlighting the importance of considering training methods that increase muscular stiffness, particularly in relation to the RF muscle, to optimize athletic performance.

Myotonometry and extended field-of-view ultrasound imaging allow reliable quantification of patellar tendon stiffness and length at rest and during maximal load, whereas several restrictions exist for the Achilles tendon

Introduction

Stiffness and length are well-established tendon parameters in sports and medicine. Myotonometry and ultrasound imaging are the commonly used methods to quantify these parameters. However, further studies are needed to clarify the reliability of these methods, especially when assessing maximally loaded tendons and when conducted by different experienced investigators. This study aimed to determine the intra- and interrater reliabilities of measuring the stiffness and length of the patellar tendon (PT) and Achilles tendon (AT) using the myotonometry method and the extended field-of-view ultrasound (EFOV-US) technique at rest and maximal load performed by different experienced investigators.

Methods

Twenty-seven participants were examined on three different days by one experienced investigator and one novice investigator. Primary outcomes were the intraclass correlation coefficient (ICC) and associated 95% confidence interval (95% CI), coefficient of variation (CV), standard error of measurement (SEM), and minimal detectable change (MDC) across the measurement days and investigators.

Results

For PT measurements at rest and maximal load, the estimated ICCs for stiffness and length were ≥.867 and ≥.970, respectively, with 95% CIs ranging from poor (.306) to excellent (.973) and good (.897) to excellent (.999). The CV, SEM, and MDC for PT stiffness and length were ≤5.2% and ≤2.0%, ≤39.3 N/m and ≤0.9 mm, and ≤108.9 N/m and ≤2.6 mm, respectively. For AT measurements, some restrictions were evident for stiffness at rest and both parameters at maximal load. However, regarding AT length at rest, the estimated ICC was ≥.996, with an excellent 95% CI (.987-.999). The CV, SEM, and MDC for AT length at rest were 2.8%, ≤1.1 mm, and ≤2.9 mm, respectively.

Conclusion

The estimated ICCs show good to excellent reliability for the myotonometry method and the EFOV-US technique for measuring PT stiffness and length at rest and maximal load for experienced and novice investigators. However, some restrictions are evident for the AT, especially for measurements at maximal load.

Acute effects of muscle mechanical properties after 2000-m rowing in young male rowers

Background

The mechanical properties of muscles, such as changes in muscle tone and stiffness, are related to sports performance and injuries. Rowers are at increased risk of muscle fatigue and injury during high-repetition and heavy-load cyclic muscle actions. In view of this, the aim of the present study was to investigate the acute effect on muscle tone and stiffness, as well as bilateral muscle asymmetry, in high school rowers after a 2000-meter rowing ergometer test.

Methods

Twelve young male rowers (age = 17.1 ± 0.9 years, body weight = 73.5 ± 9.7 kg) were included in the study. The data of muscle tone (frequency) and stiffness of the posterior deltoids (PD), latissimus dorsi (LD), and rectus femoris (RF) (dominant and non-dominant side) before and after a 2000-m rowing ergometer test were collected using a handheld MyotonPRO device.

Results

After the rowing ergometer test, the muscle tone of dominant side PD, LD, and RF were significantly increased (p < 0.05). On the other hand, the muscle stiffness of the non-dominant side LD and RF, as well as the dominant side PD, LD, and RF were significantly increased after the rowing ergometer test (p < 0.05). The muscle tone and stiffness results showed that the dominant side PD, LD, and RF were all significantly higher than the non-dominant side after the rowing ergometer test (p < 0.05), where bilateral PD and RF exhibits moderate asymmetry (5% < symmetry index < 10%).

Conclusions

After a high-intensity and high-load 2000-m rowing ergometer test, PD, LD, and RF showed increases in muscle tone and stiffness, as well as changes in the symmetry of bilateral muscle mechanical properties.