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Advances in Elastography for Applications in Rehabilitation, Physiotherapy, and Sports...
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Advances in Elastography for Applications in Rehabilitation, Physiotherapy, and Sports Sciences

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 1854

Special Issue Editors

Dr. Juan Antonio Valera-Calero

E-Mail Website
Guest Editor
VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain
Interests: ultrasound imaging; neck pain; low back pain; myofascial pain syndromes; elastography; science education; physiotherapy; undergraduate education; health occupations students
Special Issues, Collections and Topics in MDPI journals
Dr. Sandra Sanchez-Jorge

E-Mail Website
Guest Editor Assistant
Department of Physiotherapy, Faculty of Health, Francisco de Vitoria University, Pozuelo de Alarcón, Spain
Interests: musculoskeletal rehabilitation; muscle injuries; ultrasound imaging and shear wave elastography

Special Issue Information

Dear Colleagues,

This Special Issue, Advances in Elastography for Applications in Rehabilitation, Physiotherapy, and Sports Sciences, will explore the expanding role of elastography in the assessment, diagnosis, and management of musculoskeletal and functional conditions.

Elastography, including techniques such as shear wave elastography (SWE), has emerged as a valuable tool for quantifying tissue stiffness and mechanical properties in a non-invasive manner. This innovative imaging modality provides insights into the pathophysiology of soft tissue disorders, facilitating early detection, the monitoring of treatment efficacy, and enhanced precision in clinical decision-making.

In rehabilitation, physiotherapy, and sports sciences, elastography offers unique opportunities such as the following:

  • Characterize changes in muscle, tendon, and ligament properties due to injury or disease;
  • Evaluate tissue adaptations following rehabilitation interventions;
  • Guide clinical decisions in physiotherapy and sports performance;
  • Support injury prevention strategies and monitor recovery in athletes.

This Special Issue will gather original research articles, systematic reviews, and meta-analyses that investigate the application of elastography in the following areas:

  1. Assessing soft tissue changes in conditions such as low back pain, tendinopathies, and muscle injuries;
  2. Evaluating the effects of physiotherapy and rehabilitation interventions on tissue properties;
  3. Monitoring recovery processes in sports and musculoskeletal injuries;
  4. Developing standardized protocols for elastography in clinical practice and sports applications;
  5. Combining elastography with other imaging modalities to improve diagnostic precision and treatment planning.

Dr. Juan Antonio Valera-Calero
Guest Editor

Dr. Sandra Sanchez-Jorge
Guest Editor Assistant

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • elastography
  • shear wave elastography
  • ultrasound imaging
  • physiotherapy
  • rehabilitation
  • musculoskeletal system

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

12 pages, 2853 KiB  
Article
Quantifying Mechanical Properties of the Patellar and Achilles Tendons Using Ultrasound Shear Wave Elastography: A Pilot Study
by William A. Berrigan, Kevin Cipriano, Kirk A. Easley and Ken Mautner
Diagnostics 2025, 15(7), 879; https://doi.org/10.3390/diagnostics15070879 - 1 Apr 2025
Viewed by 627
Abstract
(1) Background: Patellar and Achilles tendon injuries have become increasingly prevalent, particularly among active populations and athletes, leading to significant functional impairments. While B-Mode ultrasound has been useful in the diagnosis of these injuries, its capacity to assess tendon mechanical properties, such [...] Read more.
(1) Background: Patellar and Achilles tendon injuries have become increasingly prevalent, particularly among active populations and athletes, leading to significant functional impairments. While B-Mode ultrasound has been useful in the diagnosis of these injuries, its capacity to assess tendon mechanical properties, such as stiffness, is limited. Shear wave elastography (SWE) offers a promising alternative by measuring tissue stiffness, which may enhance the evaluation of tendon health. Previous studies have established that SWE can differentiate healthy tendons from those with pathological changes. However, reference values for specific tendon types, including the patellar and Achilles tendons, remain limited. This study aims to provide preliminary baseline SWE values for these tendons in a healthy cohort. (2) Methods: In this cross-sectional study, healthy volunteers aged 18–65, with no history of lower extremity injury, were assessed using a Samsung RS85 Prestige ultrasound system with a 14L-2 MHz transducer. SWE measurements were obtained from the patellar tendon at a single location and from the Achilles tendon at both the midportion and insertional sites. All assessments followed a standardized protocol to ensure consistency and minimize variability. (3) Results: A total of 54 healthy adult participants were included. The mean SWE value for the patellar tendon was 96.3 (SD = 10.9 kPa), with males showing significantly higher stiffness than females (99.3 kPa vs. 93.8 kPa, p = 0.009). A higher BMI was associated with lower stiffness in the patellar tendon. The mean SWE values for the Achilles tendon were 101.7 (SD = 16.2 kPa) at the insertion and 145.6 (SD = 18.8 kPa) at the midportion. (4) Conclusions: This study provides SWE values for the patellar and Achilles tendons in healthy individuals, which can serve as a foundation for future research and clinical applications. These values may help in the comparison of healthy and pathological tendons, particularly in the context of tendinopathies, tendon tears, and treatment monitoring. While shear wave elasticity shows promise as a tool for diagnosing and monitoring tendon injuries and degeneration, more research is required to establish its precise reliability and validity in clinical practice. Full article
(This article belongs to the Special Issue Advances in Elastography for Applications in Rehabilitation, Physiotherapy, and Sports Sciences)
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12 pages, 1221 KiB  
Article
Impact of Pitching on Infraspinatus Muscle Elasticity in High School Baseball Pitchers: A Continuous Shear Wave Elastography Study
by Hitoshi Shitara, Ren Koda, Tsuyoshi Tajika, Tsuyoshi Sasaki, Masataka Kamiyama, Ryosuke Miyamoto, Yuhei Hatori, Koichiro Yanai, Kurumi Nakase, Fukuhisa Ino, Takuma Kachi, Yoshiki Yamakoshi and Hirotaka Chikuda
Diagnostics 2025, 15(6), 749; https://doi.org/10.3390/diagnostics15060749 - 17 Mar 2025
Viewed by 454
Abstract
Background/Objectives: The repetitive overhead throwing of baseball stresses the posterior shoulder, including the rotator cuff and capsule, causing stiffness, tissue thickening, and dysfunction. Previous studies on collegiate baseball players have linked these changes to glenohumeral internal rotation deficits, pain, and injuries. However, [...] Read more.
Background/Objectives: The repetitive overhead throwing of baseball stresses the posterior shoulder, including the rotator cuff and capsule, causing stiffness, tissue thickening, and dysfunction. Previous studies on collegiate baseball players have linked these changes to glenohumeral internal rotation deficits, pain, and injuries. However, these studies primarily used acoustic radiation force impulse-based shear wave elastography (SWE), which has limitations, including tissue heating and lack of portability. The acute effects of pitching on infraspinatus (ISP) muscle elasticity in high school pitchers remain unclear. Therefore, this study aimed to evaluate the acute impact of pitching on ISP muscle elasticity in high school baseball pitchers using continuous SWE (C-SWE), which is a safer and more portable method. The relationship between ISP muscle elasticity and pitching load was also examined. Methods: ISP muscle shear wave velocity (SWV), shoulder range of motion, and strength were evaluated in high school baseball pitchers. The participants were categorized into pitching and non-pitching groups based on whether they pitched with full effort on the day of their medical checkup. C-SWE was used to assess ISP muscle elasticity. Results: The pitching group had considerably higher ISP muscle SWV on the dominant side than the non-pitching group (p = 0.008). A significant positive correlation was observed between pitch and ISP muscle SWV (r = 0.467, p = 0.003). Conclusions: Repetitive pitching acutely increases ISP muscle stiffness in high school pitchers, contributing to posterior shoulder tightness. C-SWE is a safe and practical method for assessing tissue elasticity and developing injury prevention strategies. Full article
(This article belongs to the Special Issue Advances in Elastography for Applications in Rehabilitation, Physiotherapy, and Sports Sciences)
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12 pages, 4462 KiB  
Article
Reliability of Shear Wave Elastography for Measuring the Elastic Properties of the Quadratus Lumborum Muscle
by Mónica López-Redondo, Juan Antonio Valera-Calero, Javier Álvarez-González, Alberto Roldán-Ruiz, Sandra Sánchez-Jorge, Jorge Buffet-García, Germán Monclús-Díez and Davinia Vicente-Campos
Diagnostics 2025, 15(6), 722; https://doi.org/10.3390/diagnostics15060722 - 13 Mar 2025
Viewed by 562
Abstract
Background/Objectives: The quadratus lumborum (QL) muscle is a key structure involved in patients with low back pain (LBP). Since the discriminative capability of morphological descriptors is uncertain and considering the high prevalence of myofascial trigger points and the poor reliability of manual [...] Read more.
Background/Objectives: The quadratus lumborum (QL) muscle is a key structure involved in patients with low back pain (LBP). Since the discriminative capability of morphological descriptors is uncertain and considering the high prevalence of myofascial trigger points and the poor reliability of manual palpation in this condition, developing a reliable procedure for assessing the QL’s tenderness is needed for facilitating the diagnosis and monitoring changes over time. We aimed to analyze the intra- and inter-examiner reliability of SWE for calculating the QL tenderness in patients with LBP. Methods: Using a convex transducer, longitudinal shear wave elastography (SWE) images of the QL muscle were acquired bilaterally twice in 52 volunteers with moderate LBP and disability by one experienced examiner and one novel examiner to measure shear wave speed and Young’s modulus as stiffness metrics. Results: Intra-examiner reliability estimates demonstrated high consistency independently of the examiner’s experience (intraclass correlation coefficients (ICCs) > 0.930) for both metrics. However, experienced examiners showed smaller minimal detectable changes. Additionally, inter-examiner reliability was lower, with ICCs ranging from 0.57 to 0.68, and significant differences in mean values between examiners (p < 0.01) were found. Conclusions: This procedure exhibited excellent intra-examiner reliability for assessing QL muscle stiffness in patients suffering LBP, indicating high repeatability of measurements when performed by the same examiner. In addition, experienced examiners demonstrated greater sensitivity in detecting real changes not attributed to measurement errors. However, inter-examiner reliability was moderate, highlighting the need for consistent examiner use to avoid measurement variability and averaging multiple measurements to enhance the accuracy. Full article
(This article belongs to the Special Issue Advances in Elastography for Applications in Rehabilitation, Physiotherapy, and Sports Sciences)
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