Sex Differences in Mechanical Properties of the Achilles Tendon: Longitudinal Response to Repetitive Loading Exercise
Abstract
Lepley, AS, Joseph, MF, Daigle, NR, Digiacomo, JE, Galer, J, Rock, E, Rosier, SB, and Sureja, PB. Sex differences in mechanical properties of the Achilles tendon: Longitudinal response to repetitive loading exercise. J Strength Cond Res 32(11): 3070–3079, 2018—Sex differences have been observed in the mechanical properties of the Achilles tendon, which may help to explain the increased risk of injury in men. However, the response and recovery of tendon mechanics to repetitive loading exercise, as well as sex-dependent responses, are not well understood. The purpose of our study was to compare Achilles tendon mechanical properties between men and women before, immediately after, and 60 minutes after a repetitive loading exercise. Seventeen female (age: 24.0 ± 3.9 years; height: 167.4 ± 6.9 cm; and mass: 64.9 ± 8.5 kg) and 18 male (age: 23.9 ± 2.4 years; height: 179.2 ± 5.09 cm; and mass: 78.4 ± 8.7 kg) recreationally active individuals volunteered. Using isokinetic dynamometry and diagnostic ultrasound, baseline levels of Achilles tendon force, elongation, stiffness, stress, strain, and Young's modulus were assessed before 100 successive calf-raise exercises using a Smith machine at 20% of participant body mass. Outcomes were reassessed immediately and 60 minutes after exercise. Women exhibited less Achilles tendon force, stiffness, stress, and modulus compared with men, regardless of time point. Both sexes responded to repetitive loading exercise similarly, with immediate decreases in mechanical properties of the Achilles tendon from baseline to immediately after exercise. Tendon properties were observed to be equal to baseline values at 60-minute postexercise. Baseline differences in tendon properties may help to explain the disparity in injury risk because both sexes responded to and recovered from exercise similarly. Future research should aim to include additional time points (both leading up to and after 60 minutes), and assess tendon responses to more sport-specific activities, while also including patients diagnosed with Achilles tendon injuries.
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Males have longer and larger skeletal structure than females, creating advantages in sports where levers influence force application, longer limb/digit length is favorable, and height, mass and proportions are directly responsible for performance capacity.
“longer and larger skeletal structure, which creates advantages in sports where levers influence force application, where longer limb/digit length is favorable, and where height, mass and proportions are directly responsible for performance capacity”
From Transgender Women in the Female Category of Sport: Perspectives on Testosterone Suppression and Performance Advantage (2021) · cites this paper as [34]
Males have reduced fat mass and different distribution of body fat and lean muscle mass compared with females, which increases power to weight ratios and upper to lower limb strength.
“reduced fat mass, and different distribution of body fat and lean muscle mass, which increases power to weight ratios and upper to lower limb strength in sports where this may be a crucial determinant of success”
From Transgender Women in the Female Category of Sport: Perspectives on Testosterone Suppression and Performance Advantage (2021) · cites this paper as [34]
Males have larger and denser muscle mass, and stiffer connective tissue, with associated capacity to exert greater muscular force more rapidly and efficiently than females.
“Males have: larger and denser muscle mass, and stiffer connective tissue, with associated capacity to exert greater muscular force more rapidly and efficiently”
From Transgender Women in the Female Category of Sport: Perspectives on Testosterone Suppression and Performance Advantage (2021) · cites this paper as [34]
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References 34 · Cited by 31
- Authors
- Lepley, A. S., Joseph, M. F., Daigle, N. R., Digiacomo, J. E., Galer, J., Rock, E., Rosier, S. B., & Sureja, P. B.
- Affiliations
- University of Connecticut (US)
- Corresponding author
- Lepley, Adam S.
- Venue
- Journal of Strength and Conditioning Research
- Published
- 2018-11
- Volume
- 32
- Issue
- 11
- Pages
- 3070-3079
- ISSN
- 1064-8011 (ISSN-L)
- OpenAlex
- W2790195922
- Cited by
- 31
- References
- 34
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 7 · 2023: 5 · 2022: 2 · 2021: 6 · 2020: 3 · 2018: 1
- FWCI
- 2.73
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Strength and Conditioning Research (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Tendon Structure and Treatment
- Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Ultrasound Imaging and Elastography
- Keywords
- Achilles tendon, sex differences, tendon biomechanics, calf raise, tendon stiffness, tendon force, post-exercise recovery, Young's modulus, tendon strain
- MeSH terms
- Achilles Tendon, Adult, Biomechanical Phenomena, Female, Humans, Male, Sex Characteristics, Ultrasonography, Exercise, Muscle Strength Dynamometer, Elastic Modulus, Young Adult
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