A recent study in the British Journal of Sports Medicine looked at whether ultrasounds can help predict tendon injuries in elite athletes. The researchers focused on three common areas: the patellar tendon, Achilles tendon, and plantar fascia. These parts are often stressed in high-level sports like Division I college athletics.
What Are Tendon Injuries?
Tendon injuries – tendinopathies – happen when tendons get inflamed or worn out. This usually comes from doing too much too fast, or not resting enough between workouts. Even everyday athletes can get them, but elite athletes are at greater risk because they push their bodies harder.
At Threshold Physical Therapy, we often help athletes recover from these injuries—and more importantly, we work to help prevent them through smart recovery and training strategies.
How Are These Injuries Usually Detected?
Physical therapists use different tests to check for tendon problems. These include:
- Palpation
- Strength tests
- Sport-specific tests like single-leg single-hop or triple-hop tests
MRIs are often used to look at the tendon quality as well, and is often considered the gold-standard for tendinopathy diagnosis. However, even with these tools, it’s hard to predict when a tendon problem will happen.
What This Study Looked At
Researchers used ultrasound to scan the patellar tendon, Achilles tendon, and plantar fascia in NCAA college athletes from three schools. They looked for:
- Hypoechogenicity (signs of swelling or tissue damage)
- Tendon or fascia thickening
- Neovascularity (new blood vessels that suggest healing or injury)
Then, they followed the athletes for a year to see who developed pain and had to miss practice or games.
What They Found
- Good news: If the ultrasound looked normal, the athlete probably wouldn’t get a tendon injury. That means ultrasound might be a good way to rule out future problems.
- Less helpful: If the ultrasound showed something unusual, it didn’t always mean the athlete would get hurt. Even the strongest link (neovascularity) still wasn’t a clear predictor.
Things to Keep in Mind
- Few athletes got hurt: Only 4.8% had patellar tendon pain, 2.3% had Achilles pain, and 0.8% had plantar fascia pain.
- Most came back fast: On average, injured athletes only missed one day of sports. But this might be due to the pressure to keep playing, even while in pain.
- Only college athletes were studied: In general, division one athletes will have more resources for rehabilitation compared to the general population. More research is needed for a wider variety of athletes—like track, long-distance running, or recreational athletes with higher injury risks.
What This Means for You
Ultrasound may not predict every tendon injury, but it can still be a helpful tool—especially when used alongside smart physical therapy care. If you are having these problems, considering ultrasound or other diagnostic imaging, we can help!
At Threshold Physical Therapy, we stay current on the latest research so we can give our athletes the best chance to stay healthy and on the field. Whether you’re a college athlete or just love to stay active, we can help you recover—and prevent injuries before they start.
👉 Ready to take the next step? Schedule your evaluation with one of our clinicians today!