Tendinous tissue properties after short and long-term functional overload: Differences between controls, 12 weeks and 4 years of resistance training

Aim - The potential for tendinous tissues to adapt to functional overload, especially after several years of exposure to heavy resistance training is largely unexplored. This study compared the morphological and mechanical characteristics of the patellar tendon and knee-extensor tendon-aponeurosis complex between young men exposed to long-term (4 years; n=16), short-term (12 weeks; n=15) and no (untrained controls; n=39) functional overload in the form of heavy resistance training. Methods - Patellar tendon cross-sectional area, vastus-lateralis aponeurosis area and quadriceps femoris volume, plus patellar tendon stiffness and Young's modulus, and tendon-aponeurosis complex stiffness, were quantified with MRI, dynamometry and ultrasonography. Results - As expected long-term trained had greater muscle strength and volume (+58% and +56% vs untrained, both P<0.001), as well as a greater aponeurosis area (+17% vs untrained, P<0.01), but tendon cross-sectional area (mean and regional) was not different between groups. Only long-term trained had reduced patellar tendon elongation/strain over the whole force/stress range, whilst both short-term and long-term overload groups had similarly greater stiffness/Young's modulus at high force/stress (short-term +25/22%, and long-term +17/23% vs untrained; all P<0.05). Tendon-aponeurosis complex stiffness was not different between groups (ANOVA, P = 0.149). Conclusion - Despite large differences in muscle strength and size, years of resistance training did not induce tendon hypertrophy. Both short-term and long-term overload, demonstrated similar increases in high force mechanical and material stiffness, but reduced elongation/strain over the whole force/stress range occurred only after years of overload, indicating a force/strain specific time-course to these adaptations.