title: Achilles tendon Doppler flow may be associated with mechanical loading among active athletes.
abstract: BACKGROUND
  Tendon Doppler flow may be associated with tendon pain in symptomatic patients, but the relationship between Doppler flow and pain among athletes who are still competing is unclear.
  
  
  OBJECTIVE
  Among active athletes, Doppler flow may partly reflect tendon adaptation to increased mechanical load and/or asymptomatic tendinopathy.
  
  
  METHODS
  Cross-sectional study; Level of evidence, 3.
  
  
  METHODS
  The Achilles tendons of 61 badminton players (24 elite, 37 recreational) were examined with gray-scale and color Doppler ultrasound. Achilles tendon pain and activity level (badminton training, badminton playing, badminton years) were measured.
  
  
  RESULTS
  Doppler flow was not associated with current Achilles tendon pain but was associated with an increased anteroposterior tendon diameter (an indicator of tendinopathy) (P = .02). Athletes who had been playing badminton for longer were more likely to have Doppler flow (P < .01), and there was a trend toward an association between a greater number of badminton playing hours per week and Doppler flow (P = .07).
  
  
  CONCLUSIONS
  Achilles tendon Doppler flow appears to be a sign of asymptomatic tendinopathy rather than pain among active athletes. The association between weekly badminton hours and badminton years and Doppler flow suggests that Doppler flow may be a response to mechanical load in this cohort.
authors.affiliation: School of Health Science and Social Care, Brunel University, Uxbridge, Middlesex, UK. peter.malliaras@brunel.ac.uk
authors.forename: Peter
authors.initials: P
authors.lastname: Malliaras
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Richards
authors.forename: Giorgio
authors.initials: G
authors.lastname: Garau
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
mesh_terms: D000125:Achilles Tendon / Q000098:blood supply* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D001696:Biomechanical Phenomena; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010146:Pain / Q000503:physiopathology*; D015865:Racquet Sports; D018615:Ultrasonography, Doppler, Color