Achilles Tendon and Patellar Tendon Structure in Combat Soldiers Following Prevention Exercises

Nili Steinberg, Shani Funk, Aviva Zeev, Gordon Waddington, Shany Svorai-Litvak, Michal Pantanowitz

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Introduction: Military training that increases physical stress on musculoskeletal morphology also increases the risk of orthopedic injuries. Somatosensory prevention programs that reduce stress and improve functionality could be beneficial for better organization of tendon structure. The aim of this study was to investigate the impact of a somatosensory prevention exercise on the tendon structure (percentage of echo-type fibers; A-P and M-L diameters and cross-sectional area) of the Achilles tendon and patellar tendon among combat soldiers. Materials and Methods: These tendons of male Infantry soldiers aged 18-21 were screened before and after a 14-week training course. The intervention group, who performed preventative exercises, included 108 soldiers (BMI = 23.85 ± 2.76), while the control group, who participated in the same military course without these exercises, included 98 soldiers (BMI = 24.26 ± 4.03). Ultrasound scanning for tendon structure included percent of echo-type I-IV fibers, A-P diameter, M-L diameter, and cross-sectional area parameters. Results: Time by group interaction was found for echo-type I and II in both tendons. No significant differences were found between the two groups in the pretesting percentage of echo-type IV fibers of the Achilles tendon (P =. 522), in echo-type III fibers of the Achilles tendon (P =. 833), and echo-type IV fibers of the patellar tendon (P =. 162). Greater pre-post differences in echo-type III and IV fibers were found in the control group compared with the intervention group for both the Achilles tendon (P =. 021, P =. 002) and the patellar tendon (P <. 001, P <. 001). Conclusion: Increased damaged fibers (echo-type III and IV) of both tendons were found among the control group, yet not among soldiers who performed prevention exercises.

Original languageEnglish
Pages (from-to)678-688
Number of pages11
JournalMilitary Medicine
Issue number3-4
Publication statusPublished - 4 Feb 2022


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