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19 Do clinical measures relate to running asymmetries in patients with achilles tendinopathy?
  1. Patrick Corrigan,
  2. Karin Grävare Silbernagel
  1. University of Delaware, USA


Introduction Achilles tendinopathy is an overuse injury that commonly sidelines runners and has a reinjury rate of 44%. Aberrant loading patterns during the return-to-sports (RTS) phase may partially explain reinjury rates, but it remains unknown if clinical measures are associated with loading behaviors. Therefore, we aimed to establish relationships between side-to-side differences in running mechanics and side-to-side differences in clinical measures of pain, tendon structure, and calf muscle function.

Materials and methods 12 runners with Achilles tendinopathy were included (age:44±11 y; height:171±10 cm; mass:70±12 kg; VISA-A score:71±10; current mileage:40±29 km/wk). Participants completed a 7 min run at endurance pace (2.9±0.3 m/s) on an instrumented treadmill with retroreflective markers affixed to their lower extremities. After a 6 min familiarization period, marker trajectories and ground reaction forces were sampled. Sagittal plane ankle joint moments and powers were calculated and a musculoskeletal model was used to estimate Achilles tendon loads. Pain-pressure threshold, tendon geometry, and calf muscle endurance were measured bilaterally with algometry, ultrasound imaging, and the heel-rise endurance test, respectively.

Results Side-to-side differences in pain-pressure threshold were significantly related to side-to-side differences in Achilles tendon loading rate (r=0.62; p=0.03) and peak plantarflexion moment (r=0.58, p=0.05). Side-to-side differences in peak eccentric ankle joint power were significantly related to side-to-side differences in tendon thickness (r=0.59, p=0.04) and cross-sectional area (r=0.73; p=0.01). Side-to-side differences in calf muscle endurance was significantly related to Achilles tendon loading rate (r=0.64; p=0.03).

Conclusion Clinical measures of pain and calf muscle endurance relate to side-to-side differences in Achilles tendon loading rates during running, while tendon geometry relates to eccentric ankle joint power.

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