1 Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC, Canada.
2 School of Health, Concordia University, Montreal, QC, Canada.

Introduction: The Achilles tendon (AT) plays a crucial role in force transmission and movement efficiency, and greater tendon stiffness may enhance elastic energy storage and improve performance in explosive movements. Shear-wave elastography (SWE) enables reliable, non-invasive assessment of tendon stiffness, yet its associations with other ultrasound (US)-derived properties and functional outcomes remain insufficiently defined in athletes. Limited normative data exists for university-level basketball players, despite the relevance of tendon adaptations and asymmetries in this population. Therefore, this study aimed to examine AT stiffness, thickness, echo intensity (EI), and fibrillar pattern in male and female university basketball athletes, and to explore their associations with ROM, injury history, and performance measures.

Methods: Thirty-one university basketball athletes participated in this cross-sectional study. US imaging and SWE measured AT stiffness, thickness, and EI in both the dominant jumping leg (DJL) and the non-dominant jumping leg (NDJL). Functional assessments included a single-leg vertical jump, heel raise (HR) test, and ankle dorsiflexion ROM. Participants also provided demographic information and injury history data.

Results: Female players had lower AT thickness compared to males and showed a trend toward lower stiffness. No significant differences in stiffness, thickness, or EI were observed between the dominant and non-dominant jumping legs. Male players with a prior lower-body injury exhibited lower AT stiffness. Correlation analyses revealed no consistent associations between AT properties and performance or ROM, although a strong negative correlation between AT thickness and EI emerged in both sexes.

Discussion: Considering sex and injury history when interpreting tendon properties is crucial, and future larger-scale, longitudinal studies are needed to better understand how tendon characteristics evolve and inform training and injury prevention strategies.