{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T10:04:56Z","timestamp":1789639496209,"version":"4.0.0"},"reference-count":64,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T00:00:00Z","timestamp":1722211200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T00:00:00Z","timestamp":1722211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sports Med"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Tendons play fundamental roles in the execution of human movement and therefore understanding tendon function, health and disease is important for everyday living and sports performance. The acute mechanical behavioural and physiological responses to short-term loading of tendons, as well as more chronic morphological and mechanical adaptations to longer term loading, differ between sexes. This has led some researchers to speculate that there may be a sex-specific injury risk in tendons. However, the link between anatomical, physiological and biomechanical sex-specific differences in tendons and their contributory role in the development of tendon disease injuries has not been critically evaluated. This review outlines the evidence surrounding the sex-specific physiological and biomechanical responses and adaptations to loading and discusses how this evidence compares to clinical evidence on tendon injuries and rehabilitation in the Achilles and patellar tendons in humans. Using the evidence available in both sports science and medicine, this may provide a more holistic understanding to improve our ability to enhance human tendon health and performance in both sexes.<\/jats:p>","DOI":"10.1007\/s40279-024-02056-7","type":"journal-article","created":{"date-parts":[[2024,7,29]],"date-time":"2024-07-29T18:02:14Z","timestamp":1722276134000},"page":"2467-2474","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Female Tendons are from Venus and Male Tendons are from Mars, But Does it Matter for Tendon Health?"],"prefix":"10.1007","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4852-9988","authenticated-orcid":false,"given":"Gerard","family":"McMahon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Cook","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,29]]},"reference":[{"key":"2056_CR1","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1111\/j.1365-2613.2007.00551.x","volume":"88","author":"SP Magnusson","year":"2007","unstructured":"Magnusson SP, Hansen M, Langberg H, Miller B, Haraldsson B, Kjoeller Westh E, et al. The adaptability of tendon to loading differs in men and women. Int J Exp Pathol. 2007;88:237\u201340. https:\/\/doi.org\/10.1111\/j.1365-2613.2007.00551.x.","journal-title":"Int J Exp Pathol"},{"key":"2056_CR2","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1152\/japplphysiol.00797.2006","volume":"102","author":"BF Miller","year":"2007","unstructured":"Miller BF, Hansen M, Olesen JL, Schwarz P, Babraj JA, Smith K, et al. Tendon collagen synthesis at rest and after exercise in women. J Appl Physiol. 2007;102:541\u20136.","journal-title":"J Appl Physiol"},{"key":"2056_CR3","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1152\/japplphysiol.91341.2008","volume":"106","author":"BE Sullivan","year":"2009","unstructured":"Sullivan BE, Carroll CC, Jemiolo B, Trappe SW, Magnusson SP, D\u00f8ssing S, et al. Effect of acute resistance exercise and sex on human patellar tendon structural and regulatory mRNA expression. J Appl Physiol. 2009;106:468\u201375.","journal-title":"J Appl Physiol"},{"key":"2056_CR4","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1111\/j.1600-0838.2007.00638.x","volume":"18","author":"E Westh","year":"2008","unstructured":"Westh E, Kongsgaard M, Bojsen-Moller J, Aagaard P, Hansen M, Kjaer M, et al. Effect of habitual exercise on the structural and mechanical properties of human tendon, in vivo, in men and women. Scand J Med Sci Sports. 2008;18:23\u201330.","journal-title":"Scand J Med Sci Sports"},{"key":"2056_CR5","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1519\/JSC.0000000000000361","volume":"28","author":"MF Joseph","year":"2014","unstructured":"Joseph MF, Lillie KR, Bergeron DJ, Cota KC, Yoon JS, Kraemer WJ, et al. Achilles tendon biomechanics in response to acute intense exercise. J Strength Cond Res. 2014;28:1181\u20136.","journal-title":"J Strength Cond Res"},{"key":"2056_CR6","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1177\/0363546504270454","volume":"33","author":"\u00d8B Lian","year":"2005","unstructured":"Lian \u00d8B, Engebretsen L, Bahr R. Prevalence of jumper\u2019s knee among elite athletes from different sports: a cross-sectional study. Am J Sports Med. 2005;33:561\u20137.","journal-title":"Am J Sports Med"},{"key":"2056_CR7","doi-asserted-by":"publisher","first-page":"1906","DOI":"10.1177\/0363546511408877","volume":"39","author":"M H\u00e4gglund","year":"2011","unstructured":"H\u00e4gglund M, Zwerver J, Ekstrand J. Epidemiology of patellar tendinopathy in elite male soccer players. Am J Sports Med. 2011;39:1906\u201311.","journal-title":"Am J Sports Med"},{"issue":"3","key":"2056_CR8","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1016\/j.smhs.2022.03.003","volume":"4","author":"Y Wang","year":"2022","unstructured":"Wang Y, Zhou H, Nie Z, Cui S. Prevalence of Achilles tendinopathy in physical exercise: a systematic review and meta-analysis. Sports Med Health Sci. 2022;4(3):152\u20139.","journal-title":"Sports Med Health Sci"},{"key":"2056_CR9","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1007\/s00421-002-0744-8","volume":"88","author":"K Kubo","year":"2003","unstructured":"Kubo K, Kanehisa H, Fukunaga T. Gender differences in the viscoelastic properties of tendon structures. Eur J Appl Physiol. 2003;88:520\u20136.","journal-title":"Eur J Appl Physiol"},{"key":"2056_CR10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0197852","volume":"13","author":"G McMahon","year":"2018","unstructured":"McMahon G, Morse CI, Winwood K, Burden A, Onamb\u00e9l\u00e9 GL. Gender associated muscle-tendon adaptations to resistance training. PLoS ONE. 2018;13: e0197852.","journal-title":"PLoS ONE"},{"key":"2056_CR11","doi-asserted-by":"publisher","first-page":"510","DOI":"10.1002\/jor.20768","volume":"27","author":"KE Burgess","year":"2009","unstructured":"Burgess KE, Graham-Smith P, Pearson SJ. Effect of acute tensile loading on gender-specific tendon structural and mechanical properties. J Orthopaed Res. 2009;27:510\u20136.","journal-title":"J Orthopaed Res"},{"key":"2056_CR12","doi-asserted-by":"publisher","first-page":"3070","DOI":"10.1519\/JSC.0000000000002386","volume":"32","author":"AS Lepley","year":"2018","unstructured":"Lepley AS, Joseph MF, Daigle NR, Digiacomo JE, Galer J, Rock E, et al. Sex differences in mechanical properties of the Achilles tendon: longitudinal response to repetitive loading exercise. J Strength Cond Res. 2018;32:3070\u20139.","journal-title":"J Strength Cond Res"},{"key":"2056_CR13","first-page":"92","volume":"16","author":"C Ganderton","year":"2016","unstructured":"Ganderton C, Semciw A, Cook J, Pizzari T. The effect of female sex hormone supplementation on tendon in pre and postmenopausal women: a systematic review. J Musculoskelet Neuronal Interact. 2016;16:92.","journal-title":"J Musculoskelet Neuronal Interact"},{"key":"2056_CR14","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1002\/jor.21584","volume":"30","author":"A Four\u00e9","year":"2012","unstructured":"Four\u00e9 A, Cornu C, McNair PJ, Nordez A. Gender differences in both active and passive parts of the plantar flexors series elastic component stiffness and geometrical parameters of the muscle\u2013tendon complex. J Orthopaed Res. 2012;30:707\u201312.","journal-title":"J Orthopaed Res"},{"key":"2056_CR15","doi-asserted-by":"publisher","first-page":"888","DOI":"10.1136\/bjsports-2011-090744","volume":"46","author":"AM Fearon","year":"2012","unstructured":"Fearon AM, Stephens S, Cook JL, Smith PN, Neeman T, Cormick W, et al. The relationship of femoral neck shaft angle and adiposity to greater trochanteric pain syndrome in women: a case control morphology and anthropometric study. Br J Sports Med. 2012;46:888\u201392.","journal-title":"Br J Sports Med"},{"key":"2056_CR16","doi-asserted-by":"publisher","first-page":"2074","DOI":"10.1096\/fj.12-225599","volume":"27","author":"KM Heinemeier","year":"2013","unstructured":"Heinemeier KM, Schjerling P, Heinemeier J, Magnusson SP, Kjaer M. Lack of tissue renewal in human adult Achilles tendon is revealed by nuclear bomb 14C. FASEB J. 2013;27:2074\u20139.","journal-title":"FASEB J"},{"key":"2056_CR17","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1111\/sms.12491","volume":"26","author":"SI Docking","year":"2016","unstructured":"Docking SI, Cook J. Pathological tendons maintain sufficient aligned fibrillar structure on ultrasound tissue characterization (UTC). Scand J Med Sci Sports. 2016;26:675\u201383.","journal-title":"Scand J Med Sci Sports"},{"key":"2056_CR18","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1002\/tsm2.148","volume":"3","author":"AL Sprague","year":"2020","unstructured":"Sprague AL, Awokuse D, Pohlig RT, Cortes DH, Gr\u00e4vare SK. Relationship between mechanical properties (shear modulus and viscosity), age, and sex in uninjured Achilles tendons. Transl Sports Med. 2020;3:321\u20137.","journal-title":"Transl Sports Med"},{"key":"2056_CR19","doi-asserted-by":"publisher","first-page":"1635","DOI":"10.1002\/jor.20404","volume":"25","author":"GN Onambele","year":"2007","unstructured":"Onambele GN, Burgess K, Pearson SJ. Gender-specific in vivo measurement of the structural and mechanical properties of the human patellar tendon. J Orthop Res. 2007;25:1635\u201342.","journal-title":"J Orthop Res"},{"key":"2056_CR20","doi-asserted-by":"publisher","first-page":"427","DOI":"10.1007\/s11357-011-9248-y","volume":"34","author":"G Onambele-Pearson","year":"2012","unstructured":"Onambele-Pearson G, Pearson S. The magnitude and character of resistance-training-induced increase in tendon stiffness at old age is gender specific. Age (Dordr). 2012;34:427\u201338. https:\/\/doi.org\/10.1007\/s11357-011-9248-y.","journal-title":"Age (Dordr)"},{"key":"2056_CR21","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1111\/apha.12159","volume":"209","author":"KM Hicks","year":"2013","unstructured":"Hicks KM, Onambele-Pearson GL, Winwood K, Morse CI. Gender differences in fascicular lengthening during eccentric contractions: the role of the patella tendon stiffness. Acta Physiol. 2013;209:235\u201344.","journal-title":"Acta Physiol"},{"key":"2056_CR22","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1111\/j.1600-0838.2011.01340.x","volume":"21","author":"OR Seynnes","year":"2011","unstructured":"Seynnes OR, Koesters A, Gimpl M, Reifberger A, Niederseer D, Niebauer J, et al. Effect of alpine skiing training on tendon mechanical properties in older men and women. Scand J Med Sci Sports. 2011;21:39\u201346.","journal-title":"Scand J Med Sci Sports"},{"key":"2056_CR23","doi-asserted-by":"publisher","first-page":"1907","DOI":"10.1152\/japplphysiol.00059.2008","volume":"105","author":"CC Carroll","year":"2008","unstructured":"Carroll CC, Dickinson JM, Haus JM, Lee GA, Hollon CJ, Aagaard P, et al. Influence of aging on the in vivo properties of human patellar tendon. J Appl Physiol. 2008;105:1907\u201315.","journal-title":"J Appl Physiol"},{"key":"2056_CR24","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1111\/j.1469-7580.2010.01218.x","volume":"216","author":"TD O\u2019Brien","year":"2010","unstructured":"O\u2019Brien TD, Reeves ND, Baltzopoulos V, Jones DA, Maganaris CN. Muscle\u2013tendon structure and dimensions in adults and children. J Anat. 2010;216:631\u201342.","journal-title":"J Anat"},{"key":"2056_CR25","doi-asserted-by":"publisher","first-page":"2950","DOI":"10.1519\/JSC.0000000000004288","volume":"36","author":"G McMahon","year":"2022","unstructured":"McMahon G. No strain, no gain? The role of strain and load magnitude in human tendon responses and adaptation to loading. J Strength Cond Res. 2022;36:2950\u20136.","journal-title":"J Strength Cond Res"},{"key":"2056_CR26","doi-asserted-by":"publisher","first-page":"723","DOI":"10.3389\/fphys.2020.00723","volume":"11","author":"A Arampatzis","year":"2020","unstructured":"Arampatzis A, Mersmann F, Bohm S. Individualized muscle-tendon assessment and training. Front Physiol. 2020;11:723.","journal-title":"Front Physiol"},{"key":"2056_CR27","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.1002\/bit.24809","volume":"110","author":"T Wang","year":"2013","unstructured":"Wang T, Lin Z, Day RE, Gardiner B, Landao-Bassonga E, Rubenson J, et al. Programmable mechanical stimulation influences tendon homeostasis in a bioreactor system. Biotechnol Bioeng. 2013;110:1495\u2013507.","journal-title":"Biotechnol Bioeng"},{"key":"2056_CR28","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1114\/1.1569267","volume":"31","author":"TAL Wren","year":"2003","unstructured":"Wren TAL, Lindsey DP, Beaupr\u00e9 GS, Carter DR. Effects of creep and cyclic loading on the mechanical properties and failure of human Achilles tendons. Ann Biomed Eng. 2003;31:710\u20137.","journal-title":"Ann Biomed Eng"},{"key":"2056_CR29","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1186\/s40798-023-00627-y","volume":"9","author":"F Mersmann","year":"2023","unstructured":"Mersmann F, Domroes T, Tsai M-S, Pentidis N, Schroll A, Bohm S, et al. Longitudinal evidence for high-level patellar tendon strain as a risk factor for tendinopathy in adolescent athletes. Sports Med Open. 2023;9:83.","journal-title":"Sports Med Open"},{"key":"2056_CR30","doi-asserted-by":"publisher","first-page":"2561","DOI":"10.1111\/sms.14483","volume":"33","author":"T Domroes","year":"2023","unstructured":"Domroes T, Weidlich K, Bohm S, Arampatzis A, Mersmann F. Effect of sex on muscle\u2013tendon imbalances and tendon micromorphology in adolescent athletes: a longitudinal consideration. Scand J Med Sci Sports. 2023;33:2561\u201372.","journal-title":"Scand J Med Sci Sports"},{"key":"2056_CR31","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsem-2020-000979","volume":"7","author":"H Alfredson","year":"2021","unstructured":"Alfredson H, Masci L, Spang C. Ultrasound and surgical inspection of plantaris tendon involvement in chronic painful insertional Achilles tendinopathy: a case series. BMJ Open Sport Exerc Med. 2021;7: e000979.","journal-title":"BMJ Open Sport Exerc Med"},{"key":"2056_CR32","doi-asserted-by":"publisher","first-page":"1189","DOI":"10.1152\/japplphysiol.00283.2005","volume":"99","author":"KK Kalliokoski","year":"2005","unstructured":"Kalliokoski KK, Langberg H, Ryberg AK, Scheede-Bergdahl C, Doessing S, Kjaer A, et al. The effect of dynamic knee-extension exercise on patellar tendon and quadriceps femoris muscle glucose uptake in humans studied by positron emission tomography. J Appl Physiol. 2005;99:1189\u201392.","journal-title":"J Appl Physiol"},{"key":"2056_CR33","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1111\/j.1469-7793.1999.00299.x","volume":"521","author":"H Langberg","year":"1999","unstructured":"Langberg H, Skovgaard D, Petersen LJ, B\u00fclow J, Kj\u00e6r M. Type I collagen synthesis and degradation in peritendinous tissue after exercise determined by microdialysis in humans. J Physiol. 1999;521:299\u2013306.","journal-title":"J Physiol"},{"key":"2056_CR34","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1113\/jphysiol.2005.093690","volume":"567","author":"BF Miller","year":"2005","unstructured":"Miller BF, Olesen JL, Hansen M, D\u00f8ssing S, Crameri RM, Welling RJ, et al. Coordinated collagen and muscle protein synthesis in human patella tendon and quadriceps muscle after exercise. J Physiol. 2005;567:1021.","journal-title":"J Physiol"},{"key":"2056_CR35","doi-asserted-by":"publisher","first-page":"R119","DOI":"10.1152\/ajpregu.90607.2008","volume":"296","author":"JK Lemoine","year":"2009","unstructured":"Lemoine JK, Lee JD, Trappe TA. Impact of sex and chronic resistance training on human patellar tendon dry mass, collagen content, and collagen cross-linking. Am J Physiol Regul Integr Comp Physiol. 2009;296:R119\u201324.","journal-title":"Am J Physiol Regul Integr Comp Physiol"},{"key":"2056_CR36","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1016\/j.jht.2011.07.004","volume":"25","author":"JHC Wang","year":"2012","unstructured":"Wang JHC, Guo Q, Li B. Tendon biomechanics and mechanobiology: a minireview of basic concepts and recent advancements. J Hand Ther. 2012;25:133\u201341.","journal-title":"J Hand Ther"},{"key":"2056_CR37","doi-asserted-by":"publisher","first-page":"1543","DOI":"10.1016\/j.jbiomech.2004.01.005","volume":"37","author":"G Yang","year":"2004","unstructured":"Yang G, Crawford RC, Wang JHC. Proliferation and collagen production of human patellar tendon fibroblasts in response to cyclic uniaxial stretching in serum-free conditions. J Biomech. 2004;37:1543\u201350.","journal-title":"J Biomech"},{"key":"2056_CR38","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/S1297-319X(02)00369-X","volume":"69","author":"J Gon\u00e7alves-Neto","year":"2002","unstructured":"Gon\u00e7alves-Neto J, Witzel SS, Teodoro WR, Carvalho-Junior AE, Fernandes TD, Yoshinari HH. Changes in collagen matrix composition in human posterior tibial tendon dysfunction. Jt Bone Spine. 2002;69:189\u201394.","journal-title":"Jt Bone Spine"},{"key":"2056_CR39","doi-asserted-by":"publisher","first-page":"1352","DOI":"10.1016\/S0736-0266(02)00064-5","volume":"20","author":"HA Eriksen","year":"2002","unstructured":"Eriksen HA, Pajala A, Leppilahti J, Risteli J. Increased content of type III collagen at the rupture site of human Achilles tendon. J Orthopaed Res. 2002;20:1352\u20137.","journal-title":"J Orthopaed Res"},{"key":"2056_CR40","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1136\/ard.53.6.359","volume":"53","author":"GP Riley","year":"1994","unstructured":"Riley GP, Harrall RL, Constant CR, Chard MD, Cawston TE, Hazleman BL. Tendon degeneration and chronic shoulder pain: changes in the collagen composition of the human rotator cuff tendons in rotator cuff tendinitis. Ann Rheum Dis. 1994;53:359\u201366.","journal-title":"Ann Rheum Dis"},{"key":"2056_CR41","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1152\/physrev.00031.2003","volume":"84","author":"M Kjaer","year":"2004","unstructured":"Kjaer M. Role of extracellular matrix in adaptation of tendon and skeletal muscle to mechanical loading. Physiol Rev. 2004;84:649\u201398.","journal-title":"Physiol Rev"},{"key":"2056_CR42","doi-asserted-by":"publisher","first-page":"1549","DOI":"10.1177\/0363546507301885","volume":"35","author":"M de Mos","year":"2007","unstructured":"de Mos M, van El B, DeGroot J, Jahr H, van Schie HTM, van Arkel ER, et al. Achilles tendinosis: changes in biochemical composition and collagen turnover rate. Am J Sports Med. 2007;35:1549\u201356.","journal-title":"Am J Sports Med"},{"key":"2056_CR43","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/S0945-053X(01)00196-2","volume":"21","author":"GP Riley","year":"2002","unstructured":"Riley GP, Curry V, DeGroot J, van El B, Verzijl N, Hazleman BL, et al. Matrix metalloproteinase activities and their relationship with collagen remodelling in tendon pathology. Matrix Biol. 2002;21:185\u201395.","journal-title":"Matrix Biol"},{"key":"2056_CR44","doi-asserted-by":"publisher","first-page":"159","DOI":"10.1016\/S0945-053X(01)00128-7","volume":"20","author":"D Ireland","year":"2001","unstructured":"Ireland D, Harrall R, Curry V, Holloway G, Hackney R, Hazleman B, et al. Multiple changes in gene expression in chronic human Achilles tendinopathy. Matrix Biol. 2001;20:159\u201369.","journal-title":"Matrix Biol"},{"key":"2056_CR45","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1034\/j.1600-0838.2002.120205.x","volume":"12","author":"S Rosager","year":"2002","unstructured":"Rosager S, Aagaard P, Dyhre-Poulsen P, Neergaard K, Kjaer M, Magnusson SP. Load-displacement properties of the human triceps surae aponeurosis and tendon in runners and non-runners. Scand J Med Sci Sports. 2002;12:90\u20138.","journal-title":"Scand J Med Sci Sports"},{"key":"2056_CR46","doi-asserted-by":"publisher","first-page":"1965","DOI":"10.1152\/japplphysiol.00384.2005","volume":"99","author":"M Kongsgaard","year":"2005","unstructured":"Kongsgaard M, Aagaard P, Kjaer M, Magnusson SP. Structural Achilles tendon properties in athletes subjected to different exercise modes and in Achilles tendon rupture patients. J Appl Physiol. 2005;99:1965\u201371.","journal-title":"J Appl Physiol"},{"key":"2056_CR47","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1007\/s00167-009-1006-7","volume":"18","author":"K Knobloch","year":"2010","unstructured":"Knobloch K, Schreibmueller L, Kraemer R, Jagodzinski M, Vogt PM, Redeker J. Gender and eccentric training in Achilles mid-portion tendinopathy. Knee Surg Sports Traumatol Arthrosc. 2010;18:648\u201355.","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"2056_CR48","doi-asserted-by":"publisher","first-page":"e161","DOI":"10.1097\/JSM.0000000000000749","volume":"31","author":"LM Rabello","year":"2021","unstructured":"Rabello LM, Dams OC, van den Akker-Scheek I, Zwerver J, O\u2019Neill S. Substantiating the use of ultrasound tissue characterization in the analysis of tendon structure: a systematic review. Clin J Sport Med. 2021;31:e161\u201375.","journal-title":"Clin J Sport Med"},{"key":"2056_CR49","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1136\/bjsports-2013-092713","volume":"49","author":"SD Rosengarten","year":"2015","unstructured":"Rosengarten SD, Cook JL, Bryant AL, Cordy JT, Daffy J, Docking SI. Australian football players\u2019 Achilles tendons respond to game loads within 2 days: an ultrasound tissue characterisation (UTC) study. Br J Sports Med. 2015;49:183\u20137.","journal-title":"Br J Sports Med"},{"key":"2056_CR50","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1111\/sms.12469","volume":"26","author":"SI Docking","year":"2016","unstructured":"Docking SI, Rosengarten SD, Cook J. A chilles tendon structure improves on UTC imaging over a 5-month pre-season in elite Australian football players. Scand J Med Sci Sports. 2016;26:557\u201363.","journal-title":"Scand J Med Sci Sports"},{"key":"2056_CR51","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1016\/j.jmbbm.2015.04.009","volume":"52","author":"CT Thorpe","year":"2015","unstructured":"Thorpe CT, Godinho MSC, Riley GP, Birch HL, Clegg PD, Screen HRC. The interfascicular matrix enables fascicle sliding and recovery in tendon, and behaves more elastically in energy storing tendons. J Mech Behav Biomed Mater. 2015;52:85\u201394.","journal-title":"J Mech Behav Biomed Mater"},{"key":"2056_CR52","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1111\/j.1600-0838.2006.00522.x","volume":"17","author":"H Langberg","year":"2007","unstructured":"Langberg H, Ellingsgaard H, Madsen T, Jansson J, Magnusson SP, Aagaard P, et al. Eccentric rehabilitation exercise increases peritendinous type I collagen synthesis in humans with Achilles tendinosis. Scand J Med Sci Sports. 2007;17:61\u20136.","journal-title":"Scand J Med Sci Sports"},{"key":"2056_CR53","doi-asserted-by":"publisher","first-page":"2093","DOI":"10.1002\/jor.25532","volume":"41","author":"SE Szczesny","year":"2023","unstructured":"Szczesny SE, Corr DT. Tendon cell and tissue culture: perspectives and recommendations. J Orthopaed Res. 2023;41:2093\u2013104.","journal-title":"J Orthopaed Res"},{"key":"2056_CR54","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1046\/j.1469-7580.1998.19340481.x","volume":"193","author":"M Benjamin","year":"1998","unstructured":"Benjamin M, Ralphs JR. Fibrocartilage in tendons and ligaments: an adaptation to compressive load. J Anat. 1998;193:481\u201394.","journal-title":"J Anat"},{"key":"2056_CR55","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1114\/1.1509765","volume":"30","author":"LJ Soslowsky","year":"2002","unstructured":"Soslowsky LJ, Thomopoulos S, Esmail A, Flanagan CL, Iannotti JP, Williamson JD, et al. Rotator cuff tendinosis in an animal model: role of extrinsic and overuse factors. Ann Biomed Eng. 2002;30:1057\u201363.","journal-title":"Ann Biomed Eng"},{"key":"2056_CR56","doi-asserted-by":"publisher","first-page":"1470","DOI":"10.1249\/01.MSS.0000139895.94846.8D","volume":"36","author":"N Maffulli","year":"2004","unstructured":"Maffulli N, Testa V, Capasso G, Ewen SW, Sullo A, Benazzo F, et al. Similar histopathological picture in males with Achilles and patellar tendinopathy. Med Sci Sports Exerc. 2004;36:1470\u20135.","journal-title":"Med Sci Sports Exerc"},{"key":"2056_CR57","doi-asserted-by":"publisher","first-page":"1322","DOI":"10.1136\/bjsports-2014-093593","volume":"48","author":"MA Bahr","year":"2014","unstructured":"Bahr MA, Bahr R. Jump frequency may contribute to risk of jumper\u2019s knee: a study of interindividual and sex differences in a total of 11 943 jumps video recorded during training and matches in young elite volleyball players. Br J Sports Med. 2014;48:1322\u20136.","journal-title":"Br J Sports Med"},{"key":"2056_CR58","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1111\/sms.12172","volume":"25","author":"I Janssen","year":"2015","unstructured":"Janssen I, Brown NAT, Munro BJ, Steele JR. Variations in jump height explain the between-sex difference in patellar tendon loading during landing. Scand J Med Sci Sports. 2015;25:265\u201372.","journal-title":"Scand J Med Sci Sports"},{"key":"2056_CR59","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1007\/s40279-015-0438-0","volume":"46","author":"M Simpson","year":"2016","unstructured":"Simpson M, Rio E, Cook J. At what age do children and adolescents develop lower limb tendon pathology or tendinopathy? A systematic review and meta-analysis. Sports Med. 2016;46:545\u201357.","journal-title":"Sports Med"},{"key":"2056_CR60","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1302\/0301-620X.99B1.BJJ-2016-0434.R1","volume":"99","author":"U Sheth","year":"2017","unstructured":"Sheth U, Wasserstein D, Jenkinson R, Moineddin R, Kreder H, Jaglal SB. The epidemiology and trends in management of acute Achilles tendon ruptures in Ontario, Canada: a population-based study of 27 607 patients. Bone Jt J. 2017;99:78\u201386.","journal-title":"Bone Jt J"},{"key":"2056_CR61","doi-asserted-by":"publisher","first-page":"232596711880823","DOI":"10.1177\/2325967118808238","volume":"6","author":"NJ Lemme","year":"2018","unstructured":"Lemme NJ, Li NY, DeFroda SF, Kleiner J, Owens BD. Epidemiology of Achilles tendon ruptures in the United States: athletic and nonathletic injuries from 2012 to 2016. Orthop J Sports Med. 2018;6:2325967118808238.","journal-title":"Orthop J Sports Med"},{"key":"2056_CR62","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1177\/1938640009355191","volume":"3","author":"GW Hess","year":"2010","unstructured":"Hess GW. Achilles tendon rupture: a review of etiology, population, anatomy, risk factors, and injury prevention. Foot Ankle Spec. 2010;3:29\u201332.","journal-title":"Foot Ankle Spec"},{"key":"2056_CR63","doi-asserted-by":"publisher","first-page":"e133","DOI":"10.1111\/sms.12253","volume":"25","author":"I Lantto","year":"2015","unstructured":"Lantto I, Heikkinen J, Flinkkil\u00e4 T, Ohtonen P, Leppilahti J. Epidemiology of Achilles tendon ruptures: increasing incidence over a 33-year period. Scand J Med Sci Sports. 2015;25:e133\u20138.","journal-title":"Scand J Med Sci Sports"},{"key":"2056_CR64","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1152\/japplphysiol.00849.2014","volume":"118","author":"OR Seynnes","year":"2015","unstructured":"Seynnes OR, Bojsen-M\u00f8ller J, Albracht K, Arndt A, Cronin NJ, Finni T, et al. Ultrasound-based testing of tendon mechanical properties: a critical evaluation. J Appl Physiol. 2015;118:133\u201341.","journal-title":"J Appl Physiol"}],"container-title":["Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40279-024-02056-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40279-024-02056-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40279-024-02056-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,10]],"date-time":"2024-10-10T19:11:00Z","timestamp":1728587460000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s40279-024-02056-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,29]]},"references-count":64,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["2056"],"URL":"https:\/\/doi.org\/10.1007\/s40279-024-02056-7","relation":{},"ISSN":["0112-1642","1179-2035"],"issn-type":[{"value":"0112-1642","type":"print"},{"value":"1179-2035","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,29]]},"assertion":[{"value":"21 May 2024","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 July 2024","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"No sources of funding were used to assist in the preparation of this article.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Funding"}},{"value":"Gerard McMahon and Jill Cook have no conflicts of interests that are directly relevant to the content of this article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Not applicable.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"Not applicable.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Availability of data and material"}},{"value":"Not applicable.","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Code availability"}},{"value":"Conceptualisation: GM; literature Search; GM, JC; writing, drafting, review and editing; GMM, JC. All authors read and approved the final version.","order":9,"name":"Ethics","group":{"name":"EthicsHeading","label":"Author contributions"}}]}}