Activity-Induced Increase in Achilles Tendon Blood Flow Is Age and Sex Dependent

Background: Previous research of a young adult population identified a lower increase in Achilles tendon blood flow immediately after a running activity as a significant predictor for the development of Achilles tendinopathy (AT). Furthermore, advancing age is often mentioned as a risk factor for the development of AT, and the highest incidence for AT is reported to occur in middle-aged recreational male athletes. Purpose: To investigate the effect of age, sex, and type of physical activity on the increase in Achilles tendon blood flow. Study Design: Controlled laboratory study. Methods: Blood flow measurements of 33 subjects aged 18 to 25 years and 30 subjects aged 40 to 55 years were obtained before and after 4 physical activities performed in randomized order: running, cycling, dynamic stretching, and rope skipping. Blood flow measurements of the Achilles tendon were performed before, immediately after, 5 minutes after, and 10 minutes after the physical activities. The effect of age, sex, and physical activities on the increase in blood flow was investigated with linear mixed models. Results: The results of this study identified that running, rope skipping, and cycling resulted in a significant increase in tendon blood flow (P <=.001), whereas stretching did not. Prominent was the finding that the increase in blood flow after activity was significantly lower in the older population as compared with the younger population (P<.001). Furthermore, male participants in the older group showed a significantly lower increase in tendon blood flow than did their female counterparts (P=.019). Conclusion: This study identified that sex and age significantly influence the increase in blood flow after activity, possibly explaining the increased risk for AT among middle-aged recreational athletes.