2 - Biomechanical and Biological Adaptation of Distal Lower Extremity Tendons to Stress and Exercise

This lecture aims to review the various effects of exercise on tendons surrounding the ankle at structural, cellular, and molecular levels. Under normal physiologic loading, tendons enhance their mechanical strength, but when excessive mechanical loading is repeatedly placed on the tendons, they undergo chronic injury resulting in tendon inflammation and/or tendon degeneration. Moreover, aging stresses tendons into degeneration and reduces their mechanical strength, predisposing to injury. On the other hand, exercise enhances tendon mechanical strength. Use of exercise as rehabilitation regimens for improving tendon structure and function surrounding the ankle are also suggested.