Quantitative ultrasound mapping of regional variations in shear wave speeds of the aging Achilles tendon

Objectives Evaluate the effects of aging on healthy Achilles tendon and aponeurosis shear wave speed (SWS), a quantitative metric which reflects tissue elasticity. Methods Shear wave elastography was used to measure spatial variations in Achilles tendon SWS in healthy young ( n = 15, 25 ± 4 years), middle-aged ( n = 10, 49 ± 4 years) and older ( n = 10, 68 ± 5 years) adults. SWS was separately measured in the free Achilles tendon, soleus aponeurosis and gastrocnemius aponeurosis in resting (R), stretched (dorsiflexed 15° from R) and slack (plantarflexed 15° from R) postures. Results SWS significantly increased with stretch and varied with age in all tendon regions. Slack free tendon SWS was significantly higher in older adults than young adults ( p = 0.025). However, stretched soleus aponeurosis SWS was significantly lower in older adults than young adults ( p = 0.01). Stretched gastrocnemius aponeurosis SWS was significantly lower in both middle-aged ( p = 0.003) and older ( p = 0.001) adults, relative to younger adults. Conclusion These results suggest that aging alters spatial variations in Achilles tendon elasticity, which could alter deformations within the triceps surae muscle–tendon units, thus affecting injury potential. The observed location- and posture-dependent variations highlight the importance of controlling ankle posture and imaging location when using shear wave approaches clinically to evaluate tendon disorders. Key Points • Shear wave elastography shows promise as a clinical quantitative ultrasound-based technique . • Aging induces location-dependent changes in Achilles tendon shear wave speed . • Spatial and postural dependence necessitates careful integration of this approach clinically .