Roca-Espiau, Mercedes, Andrade-Campos, Marcio, Cebolla, Jorge J et al. · Journal of orthopaedic surgery and research · 2019 · DOI
This study looked at whether stiffness in tendons (the tissues connecting muscles to bones) might contribute to fatigue in patients with Gaucher disease, a genetic disorder. Researchers used an ultrasound technique to examine the Achilles tendon in 27 patients and found that over 60% had abnormal tendon stiffness. Patients with stiffer tendons reported worse quality of life, suggesting that tendon problems could be part of why these patients feel so tired.
While this study focuses on Gaucher disease, it highlights a potentially underexplored mechanism—muscle-tendon dysfunction—that could also be relevant to post-exertional malaise and fatigue in ME/CFS. The use of strain-elastography as a non-invasive method to detect subclinical structural changes in muscle-tendon units offers a potential tool for investigating similar pathophysiology in ME/CFS patients.
This study does not establish causation: correlation between tendon stiffness and reduced quality of life does not prove that tendon changes cause fatigue. The findings are specific to Gaucher disease patients and cannot be directly generalized to ME/CFS without independent validation. The cross-sectional design prevents assessment of whether tendon changes precede fatigue development or are a consequence of chronic illness and reduced activity.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Roca-Espiau, Mercedes, Andrade-Campos, Marcio, Cebolla, Jorge J, López de Frutos, Laura, Medrano-Engay, Blanca, López-Royo, Maria-Pilar, et al. (2019). Muscle-tendon weakness contributes to chronic fatigue syndrome in Gaucher's disease.. Journal of orthopaedic surgery and research. https://doi.org/10.1186/s13018-019-1452-y
BibTeX
@article{mecfsatlas-roca-espiau-2019-muscle-tendon,
author = {Roca-Espiau, Mercedes and Andrade-Campos, Marcio and Cebolla, Jorge J and López de Frutos, Laura and Medrano-Engay, Blanca and López-Royo, Maria-Pilar and Giraldo, Pilar},
title = {Muscle-tendon weakness contributes to chronic fatigue syndrome in Gaucher's disease.},
journal = {Journal of orthopaedic surgery and research},
year = {2019},
doi = {10.1186/s13018-019-1452-y},
note = {PubMed: 31752949},
url = {https://www.mecfsatlas.com/evidence/roca-espiau-2019-muscle-tendon},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-29. https://www.mecfsatlas.com/evidence/roca-espiau-2019-muscle-tendon
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