Quantifying Active and Passive Stiffness in Plantar Flexor Muscles Following Intermittent Maximal Isometric Contractions Using Shear Wave Elastography

Objective: This study aimed: (i) to investigate the impact of fatigue, triggered by maximal isometric contraction exercises, on the active and passive stiffness of plantar flexors (PF), and (ii) to examine the relationship between changes in mechanical parameters and neuromuscular alterations after fatigue. Methods: A healthy cohort (n = 12; age = 27.3 +/- 5.5 y; BMI = 24.4 +/- 2.35 kg/m(2)) was instructed to perform 60 isometric contractions, each lasting 4 s with a 1-s rest interval, using an ergometer. Several measures were taken before and after the fatigue protocol. First, the stiffness of the PF-tendon complex (PFC) was quantified during passive ankle mobilization both during and after the fatigue protocol using the ergometer. Additionally, from shear wave elastography, the active and passive stiffness of the gastrocnemius medialis (GM) were measured during passive ankle mobilization and isometric maximal voluntary contraction (MVC), respectively. Finally, the peak torque and the rate of torque development (RFD) of PF were assessed during the MVC using the ergometer. Ankle muscle activities (surface electromyograph [SEMG]) were recorded during all evaluations using electromyography. Results: After the fatigue protocol, the results revealed a decline in active stiffness, peak torque of PF, RFD and SEMG activity of the GM (p < 0.001). Furthermore, significant correlation was identified between the decrease of the peak torque of PF and the active stiffness of the GM (r = 0.6; p < 0.05). A decrease in the PFC stiffness (p < 0.001) and a decrease in the shear modulus of the GM at 20 degrees (p < 0.001) were also observed. Conclusion: Isometric fatiguing exercises modify the mechanical properties of both the contractile and elastic components. Notably, decreases in both passive and active stiffness may be critical for athletes, as these changes could potentially increase the risk of injury.