Over the past year, fans in multiple NBA cities watched in horror as their stars went down with major lower leg injuries. And even though players like Tyrese Haliburton (ankle), Jayson Tatum (ankle) and Kyrie Irving (knee) will be back at some point, it’s quite possible they will never return to their prior peak, says the University of Delaware’s Dr. Karin Gravare Silbernagel. Dr. Silbernagel, an associate professor of physical therapy at UD, studies tendon injuries in the ankle and knee in elite athletes, especially Achilles ruptures and ankle function. She was quoted in an ESPN story on this topic at the end of last season and can specifically address the stars' injuries and what it might mean for their careers.
Her research shows that even after successful surgery, many players return to the court but not many among them return to peak explosiveness or durability.
Dr. Silbernagel, whose research on ankle and knee injuries dates back to the early 2000s, can also talk about the larger pattern of lower leg injuries reshaping the NBA. She consults with professional sports teams relating to tendon injuries and is a consultant to the NFL's Musculoskeletal Committee. To connect with Dr. Silbernagel directly and arrange an interview, visit her profile and click on the "contact" button. Interested reporters can also email MediaRelatons@udel.edu.
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The University of Delaware boasts several experts who can comment on health-related topics such as injuries and training and business-focused areas like marketing and team behavior as they relate to the 2024 Olympic Games in Paris.
Matt Robinson Professor, sport management Relevant expertise: Will be in Paris and can discuss the Olympics from an onsite perspective; can give the backstory on The International Coaching Enrichment Certificate Program (ICECP) and what’s new in the Paris Olympics.
Link to profile and contact Tom Kaminski Professor, kinesiology and applied physiology Relevant expertise: Can comment on the impact of heading in Olympic soccer and has studied the risks of concussions in sports for nearly three decades.
Link to profile and contact Karin Silbernagel Professor, physical therapy Relevant expertise: Research aims to advance the understanding of tendon and ligament injuries and repair. Can also discuss sailing.
Link to profile and contact Tim DeSchriver Associate professor, sport management Relevant expertise: Sport finance, economics and marketing
Link to profile and contact Other experts: INJURIES: Tom Buckley Associate professor, kinesiology and applied physiology Relevant expertise: Head impacts from boxing.
Stephanie Cone Assistant professor, biomedical engineering Relevant expertise: Studies the structure-function relationship that exists in tendons and ligaments with a special interest in changes in this relationship during growth and following injury.
Mike Eckrich Clinical instructor, physical therapy Relevant expertise: Weightlifting; can talk about the difference between men’s and women’s injuries and form in the sport.
Donald Ford Physical therapy Relevant expertise: Shoulder injuries/rehab expert Jeffrey Schneider Senior instructor, kinesiology and applied physiology Relevant expertise: Athletic training and injury prevention, with a particular interest in ice skating injuries.
Worked with athletes competing in Winter Olympics (2002, 2006) as a strength and conditioning coach and athletic trainer.
EVENTS: Jocelyn Hafer Assistant professor, kinesiology and applied physiology Relevant expertise: Race Walk events and how biomarkers are used in walking studies.
Airelle Giordano Associate professor, physical therapy Relevant expertise: Gymnastics; she was a collegiate gymnast
Kiersten McCartney Doctoral student Relevant expertise: Can chat about Paralympic Triathlon (running, hand cycling, swimming).
Steve Goodwin Associate professor, health behavior and nutrition sciences Relevant expertise: He is also in Paris leading a study abroad cohort. He has been to multiple Olympics, and can also speak to on-site experience, differences in games, etc.
George Edelman Adjunct professor, physical therapy Relevant expertise: How the "underwaters” technique gives Olympians an edge. BUSINESS: John Allgood II Instructor, sport management Relevant expertise: Sport business management, event management
SCIENCE: Joshua Cashaback Assistant professor, biomedical engineering Relevant expertise: Specializes in neuromechanics and control of human movement. His research falls under two major themes: The neuroplasticity and adaptation research line tests how reinforcement feedback can subserve our ability to acquire new motor skills.
Media
Social
Biography
Karin Grävare Silbernagel PT, ATC, PhD is a Professor & Associate Chair in the Department of Physical Therapy and the Director of the Center for Human Research Coordination at the University of Delaware, Newark, DE. She has been a Physical Therapist and Athletic Trainer for 30 years and performed research on tendon injuries for 20 years. Her expertise is in orthopaedics and musculoskeletal injury with a focus on tendon and ligament injury. At University of Delaware she is the principal investigator of the Delaware Tendon Research Group and the Delaware ACL Research Group. Her work has been directly integrated into the clinical guidelines for treatment of patients with tendon injuries. She has presented her research at numerous conferences and published in peer-reviewed journals (140+ published articles to date). She has also been invited to speak about her research at conferences nationally and internationally. As the principal investigator of Tendon Research Group at the University of Delaware she is working to advance understanding of tendon injuries and repair so that tailored treatments can be developed. Her research approach is to evaluate tendon health and recovery by quantifying tendon composition, structure, and mechanical properties, as well as patients’ impairments and symptoms. She consults with professional sports team relating to tendon injuries and she is a consultant to the NFL's Musculoskeletal Committee. Her research is funded by the NIH, Foundation for Physical Therapy, Swedish Research Council for Sport Science, and Swedish Research Council.
Industry Expertise
Health and Wellness
Areas of Expertise
Achilles Tendinopathy
Patellar Tendinopathy
Achilles Tendon Rupture
Tendon Rupture
Knee Injuries
Media Appearances
Matchmakers for research
University of Delaware online
2023-03-07
“Everyone wants a treatment for their problem,” said Karin Grävare Silbernagel, director of the University of Delaware’s Center for Human Research Coordination and professor in the Department of Physical Therapy in the College of Health Sciences. “Volunteers can be heroes by being part of the research.”
Does Early Mobilization Improve Achilles Tendon Outcomes?
Orrthopedics This Week online
2022-11-15
Study authors included Susanna Aufwerber, PT, Ph.D., Paul W. Ackermann, M.D., Ph.D. and Josefine E. Naili, PT, Ph.D., all from the Karolinska Institute, Stockholm, Sweden. Karin Grävare Silbernagel, PT, ATC, Ph.D. of the University of Delaware, Newark, also contributed to the study.
For her part, Dr. Karin Grävare Silbernagel, associate professor at the University of Delaware, analysed both tendinopathy and ruptures of the Achilles tendon. She explained that Achilles rupture occurs suddenly, has a cumulative incidence among athletes under 45 years of age of 5.4% and rarely presents previous symptoms.
“When it happens you feel a sharp pain, and often the person thinks someone hit them or stepped on them in the back of the Achilles tendon, you can also hear a loud pop that all the surrounding individuals will hear,” said Karin Grävare Silbernagel, PhD, a physical therapist and associate professor at the University of Delaware. “After the initial pain you actually have very minor symptoms and that is why this sometimes goes undiagnosed.”
NIH gives UD professor $2.3 million for study of Achilles injuries
University of Delaware online
2018-04-17
University of Delaware assistant professor Karin Grävare Silbernagel (Physical Therapy) received a five-year, $2.3 million Research Project Grant (R01) from the National Institute of Arthritis and Musculoskeletal and Skin Diseases to study Achilles tendinopathy. This overuse injury is most prevalent in active individuals between the ages of 35 and 55, but occurs in people of all ages and activity levels.
Differences in Recovery of Tendon Health Explained by Midportion Achilles Tendinopathy Subgroups: A 6-Month Follow-up
Journal of Orthopaedic & Sports Physical Therapy
2023
OBJECTIVES: To (1) evaluate whether the defining characteristics of previously reported Achilles tendinopathy subgroups were reproducible in a cohort with midportion Achilles tendinopathy and (2) compare recovery trajectories and outcomes. DESIGN: Prospective single cohort study. METHODS: Participants (n = 114; 57 women; age [mean ± standard deviation]: 47 ± 12 years) received the Silbernagel protocol and were evaluated at baseline, and at 8, 16, and 24 weeks. Subgroups were identified using mixture modeling. Main effects of group and time, and interaction effects were evaluated using linear mixed models for 23 outcome measures representing symptoms, lower extremity function, tendon structure, psychological factors, and patient-related factors. Recovery trajectories were reported descriptively to reflect clinically meaningful change for outcomes.
Challenging the assumption of uniformity in patellar tendon structure: Regional patellar tendon morphology and mechanical properties in vivo
Journal of Orthopaedic Research
2023
Patellar tendons are assumed to be uniform in morphology and mechanical properties despite a higher prevalence of tendinopathies observed in the medial region. The purpose of this study was to compare the thickness, length, viscosity, and shear modulus of the medial, central, and lateral regions of healthy patellar tendons of young males and females in vivo. B‐mode ultrasound and continuous shear wave elastography were performed on 35 patellar tendons (17 females, 18 males) over three regions of interest. A linear mixed‐effects model (α = 0.05) was used to determine differences between the three regions and sexes followed by pairwise comparisons for significant findings. The lateral region (mean (95% CI) = 0.34 (0.31‐0.37) cm) was thinner compared to the medial (0.41 (0.39‐0.44) cm, p < 0.001), and central (0.41 (0.39‐0.44) cm, p < 0.001) regions regardless of sex.
Presence of early radiographic features of osteoarthritis differs between subgroups 5 years after anterior cruciate ligament injury
Osteoarthritis and Cartilage
2023
Purpose: Outcomes after anterior cruciate ligament (ACL) rupture vary highly across individuals. Data suggests up to 35% of patients do not return to pre-injury sport, anywhere from 12-27% of patients sustain a second injury, and over 50% develop posttraumatic osteoarthritis (OA). These data suggest there may be subgroups that exist among those who have ruptured their ACL. Posttraumatic osteoarthritis (PTOA) in the knee joint is one of many concerning long-term outcomes facing individuals who have torn their ACL. Recent data suggest that 50-80% of individuals develop PTOA within 10 years of ACL reconstruction (ACLR). Most who undergo ACLR are young and active, leaving them at a high risk of developing PTOA in young adulthood. There is a need to identify characteristics of individuals who are at greater risk for negative long-term outcomes enabling insight into targeted treatments.
Overload in a Rat in Vivo Model of Synergist Ablation Induces Tendon Multi-scale Structural and Functional Degeneration
Journal of Biomechanical Engineering
2023
Tendon degeneration is typically described as an overuse injury with little distinction made between magnitude of load (overload) and number of cycles (overuse). Further, in vivo animal models of tendon degeneration are mostly overuse models, where tendon damage is caused with high number of load cycles. As a result, there is a lack of knowledge of how isolated overload leads to degeneration. A surgical model of synergist ablation (SynAb) overloads the target tendon, plantaris, by ablating its synergist tendon, Achilles. The objective of this study was to evaluate the structural and functional changes that occur following overload of plantaris tendon in a rat SynAb model.
Effect of Symptom Duration on Injury Severity and Recovery in Patients With Achilles Tendinopathy
Orthopaedic Journal of Sports Medicine
2023
Background: Achilles tendinopathy is a common overuse condition. Distinguishing between early- and late-stage tendinopathy may have implications on treatment decisions and recovery expectations. Purpose: To compare the effects of time and baseline measures of tendon health on outcomes among patients with varying symptom durations after 16 weeks of comprehensive exercise treatment.
Neuromuscular Electrical Stimulation for Achilles Tendon Rupture Rehabilitation
NIH NIAMS R21 AR077282
05/01/2021 - 04/30/2024
The objective of this study is to develop and evaluate a NMES rehabilitation protocol for surgically-treated Achilles tendon ruptures. This study is divided into two aims. Aim 1 will determine parameters of the NMES protocol based on measurements of tendon mechanical properties. Aim 2 will evaluate the feasibility and preliminary efficacy of NMES protocol as a self-applied intervention.
Recovery of symptoms, function, tendon structure and mechanical properties in patients with Achilles Tendinopathy: A comparison between men and women.
NIH NIAMS R01
04/01/2018 - 03/31/2024
The goal of this project is to evaluate the time-course of recovery in terms of tendon structure and viscoelastic properties along with symptoms and muscle-tendon function in 100 men and 100 women with Achilles tendinopathy treated with an exercise program
Accomplishments
Spotlight Speaker, Orthopaedic Research Society Annual Meeting
2023
Legacy Fund New Investigator Research Grant Award, American Academy of Sports Physical Therapy
2022
Nominated, UD Midcareer Research Excellence Award
2021
Selected to attend Faculty Success Bootcamp through National Center for Faculty Development and Diversity (NCFDD)
2020
Excellence in Research Award, College of Health Sciences, University of Delaware
2018
IJSPT Best Case Study Award
2015
EATA Research to Reality Award
2013
Education
Boston University
BS
Physical Therapy
1990
University of Gothenburg
MSc
Physical Therapy
2001
University of Gothenburg
PhD
Medicine (Orthopaedics)
2006
Affiliations
Delaware Tendon Research Group
National Athletic Trainers Association
European Society of Sports Traumatology, Knee Surgery and Arthroscopy
American Physical Therapy Association : National, Delaware Chapter, Orthopaedic, Sports Physical Therapy and Research section (Academy)
