The effects of aponeurosis geometry on strain injury susceptibility explored with a 3D muscle model.

In the musculoskeletal system, some muscles are injured more frequently than others. For example, the biceps femoris longhead (BFLH) is the most commonly injured hamstring muscle. It is thought that acute injuries result from large strains within the muscle tissue, but the mechanism behind this type of strain injury is still poorly understood. The purpose of this study was to build computational models to analyze the stretch distributions within the BFLH muscle and to explore the effects of aponeurosis geometry on the magnitude and location of peak stretches within the model. We created a three-dimensional finite element (FE) model of the BFLH based on magnetic resonance (MR) images. We also created a series of simplified models with a similar geometry to the MR-based model. We analyzed the stretches predicted by the MR-based model during lengthening contractions to determine the region of peak local fiber stretch. The peak along-fiber stretch was 1.64 and was located adjacent to the proximal myotendinous junction (MTJ). In contrast, the average along-fiber stretch across all the muscle tissue was 0.95. By analyzing the simple models, we found that varying the dimensions of the aponeuroses (width, length, and thickness) had a substantial impact on the location and magnitude of peak stretches within the muscle. Specifically, the difference in widths between the proximal and distal aponeurosis in the BFLH contributed most to the location and magnitude of peak stretch, as decreasing the proximal aponeurosis width by 80% increased peak average stretches along the proximal MTJ by greater than 60% while slightly decreasing stretches along the distal MTJ. These results suggest that the aponeurosis morphology of the BFLH plays a significant role in determining stretch distributions throughout the muscle. Furthermore, this study introduces the new hypothesis that aponeurosis widths may be important in determining muscle injury susceptibility.