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Here, we examined the effect of long-term stress relaxation on tendon extracellular matrix (ECM) by (1) an\n            <jats:italic>ex vivo<\/jats:italic>\n            stress relaxation test, (2) an\n            <jats:italic>in vitro<\/jats:italic>\n            tenocyte culture with stress relaxation and (3) an\n            <jats:italic>in vivo<\/jats:italic>\n            rabbit study. Time-dependent tendon lengthening and ECM alterations including crimp angle reduction and cleaved elastin were observed, which illustrated the mechanism of tissue lengthening behind the treatment\u2014a material-based crimp angle reduction resulted from elastin cleavage. Additionally,\n            <jats:italic>in vitro<\/jats:italic>\n            and\n            <jats:italic>in vivo<\/jats:italic>\n            results observed restoration of these ECM alterations along with increased elastin level after 7 days of treatment, and the existence of neovascularization and inflammation, indicating the recovery and adaptation from the tendon in reaction to the treatment. Overall, this study provides the scientific background and information that helps explain the Ponseti method.\n          <\/jats:p>","DOI":"10.1098\/rsif.2022.0712","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T07:11:42Z","timestamp":1684307502000},"update-policy":"https:\/\/doi.org\/10.1098\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Time-dependent extracellular matrix alterations of young tendons in response to stress relaxation: a model for the Ponseti method"],"prefix":"10.1098","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5970-2822","authenticated-orcid":true,"given":"Mu-Huan","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Materials, University of Oxford, Parks Road, Oxford OX1 3PH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hung-Pei","family":"Tsai","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Lavy","sequence":"additional","affiliation":[{"name":"Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, Botnar Research Centre, University of Oxford, Windmill Road, Oxford OX3 7LD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre-Alexis","family":"Mouthuy","sequence":"additional","affiliation":[{"name":"Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science, Botnar Research Centre, University of Oxford, Windmill Road, Oxford OX3 7LD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Czernuszka","sequence":"additional","affiliation":[{"name":"Department of Materials, University of Oxford, Parks Road, Oxford OX1 3PH, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"175","published-online":{"date-parts":[[2023,5,17]]},"reference":[{"key":"e_1_3_7_2_2","first-page":"CD008602","article-title":"Interventions for congenital talipes equinovarus (clubfoot)","author":"Gray K","year":"2012","unstructured":"Gray K, Pacey V, Gibbons P, Little D, Frost C, Burns J. 2012 Interventions for congenital talipes equinovarus (clubfoot). 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