Relationship between Connective Tissue Morphology and Lower-Limb Stiffness in Endurance Runners. A Prospective Study

Background: The lower limb behaves like a spring compressing and decompressing during running, where lower-limb stiffness is one of the most influential factors. This prospective observational study is aimed at examining the relationship between the connective tissue morphology and lower-limb stiffness and investigating whether the barefoot/shod condition influences on such relationship. Methods: 14 male amateur runners (10-km time trial <50′) were included. Data were recorded over one session, where participants ran 2 trials (i.e., barefoot and shod conditions) of 3 minutes at 12 km/h, where running spatiotemporal parameters and vertical (Kvert) and leg stiffness (Kleg) were obtained. Prior to testing trials, thickness and cross-sectional area (CSA) were recorded for Achilles (AT) and patellar tendons (PT) and plantar fascia (PF) with ultrasound. Results: Under barefoot condition, a positive correlation was found between Kleg and AT-thickness and CSA and PF-thickness; and between Kvert and AT-thickness and PF thickness. Under shod condition, a positive correlation was found between Kleg and PT-CSA and PT-thickness, and between Kvert and PT-CSA and PT-thickness. Conclusions: The results reveal a specificity of the relationship between the lower-limb stiffness and the morphology of the connective tissue. Greater tendon shows higher lower-limb stiffness when that tendon is specially demanded by the function.