In vivo ultrasonographic evidence that tensed calcaneofibular ligament consistently lifts the peroneal tendons
Abstract A recent cadaveric study demonstrated that when the calcaneofibular ligament (CFL) is tensed, it lifts the peroneal tendons, suggesting that the CFL acts as a mechanical tensioner to facilitate efficient transmission of peroneal muscle contractions. We investigated this phenomenon in vivo u...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-07-01
|
| Series: | Scientific Reports |
| Subjects: | |
| Online Access: | https://doi.org/10.1038/s41598-025-11004-y |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Abstract A recent cadaveric study demonstrated that when the calcaneofibular ligament (CFL) is tensed, it lifts the peroneal tendons, suggesting that the CFL acts as a mechanical tensioner to facilitate efficient transmission of peroneal muscle contractions. We investigated this phenomenon in vivo using a quantitative assessment with an ultrasound system equipped with strain elastography. Twenty-six ankles from 13 healthy participants were prospectively examined. A 20° inversion, intended to tense the CFL, was induced by tilting the lower leg and was compared to the neutral position. The distance between the peroneal tendons and a defined calcaneal reference point was significantly greater at 20° inversion than at neutral (P < 0.001), along with a significant increase in relative CFL stiffness as determined by strain elastography (P < 0.001) and varying degrees of deformation in the cross-sectional morphology of the peroneal tendons. These results strongly suggest that peroneal tendons are lifted by a tensed CFL in vivo. Notably, lifting was consistently observed in all the participants, indicating a reproducible and likely universal mechanism. This purely mechanical interaction may enhance muscular force transmission through tendon preloading, particularly under weight-bearing conditions, and increase the lever arm at the talocrural and subtalar joints, thereby improving the torque generation during movement. |
|---|---|
| ISSN: | 2045-2322 |