New Detective Helps Soccer Players
Soccer players are often benched because of tendon problems. Sometimes they have to quit playing altogether. The Achilles (heel) tendon and patellar (knee) tendon are the most commonly affected. When changes start to occur, the tendon begins to thicken and become spindle-shaped. This is called tendinosis.

At first, tendinosis is silent, without any symptoms for the player. The danger is that the tendon can rupture without warning. Coaches and players would like to be able to predict which players might have these problems during the season.

New technology has made this possible. High-frequency sound waves allow doctors to take pictures of the tendons. By bouncing sound waves off the tissue, a picture of the area is seen on a screen. This use of sound waves is called ultrasonography. A special probe is used against the skin to direct the sound waves through the area. This testing doesn't need surgery and isn't expensive.

It is also very accurate. Tendon changes that are present before injury or rupture are seen early with ultrasonography. Over half of the players tested for tendinosis got better with treatment or by themselves. One-third of the cases ruptured during the season.

Ultrasound can detect tendon changes that can be treated. The tissue still has a chance to heal and may do so on its own. Doctors aren't able to predict who will rupture a tendon. However, for the first time, they are able to see which players are at risk for a serious tendon injury. Future studies will look for ways to prevent tendinosis and rupture.
Ulrich Fredberg, MD, and Lars Bolvig, MD. Significance of Ultrasonographically Detected Asymptomatic Tendinosis in the Patellar and Achilles Tendons of Elite Soccer Players: A Longitudinal Study. In The American Journal of Sports Medicine. July/August 2002. Vol. 30. No. 4. Pp. 488-491.