There are currently no generally accepted, consistent results that clearly characterize factors causing Achilles tendon pain (AT) in runners. Therefore, we carried out a prospective study to evaluate the multifactorial influence of clinical, biomechanical (isometric strength measurements and three-dimensional kinematics) and trainingrelated risk factors on the development of AT. Two hundred sixty-nine uninjured runners were recruited and underwent an initial examination. One hundred fortytwo subjects completed their participation by submitting training information on a weekly basis over a maximal period of 1 year. Forty-five subjects developed an overuse injury, with 10 runners suffering from AT. In an unin- Scand J Med Sci Sports 2014: 24: e201-e212

Twelve weeks of exercise therapy in hip osteoarthritis patients of normal vitality reduced pain and improved physical function. No significant improvement was found in these patients' general health-related quality of life.

The Tübingen exercise therapy approach has shown to have a significant positive effect on HMS. Its implementation has shown to be feasible and safe according to the percentage of exercise participation and the absence of sustainable adverse events.

Stiffness, pain, and hip muscle strength are associated with self-reported PD in hip OA. It is imperative that exercise treatments for hip OA include strategies to modify these factors. Further research should evaluate their role in preventing hip OA.

BackgroundOsteoarthritis is the most common reason for pain in older adults, and the individual and economic burden of this disease is immense. The chronic character of osteoarthritis requires a long-term therapeutic treatment. In this regard life-style interventions such as physical exercises that can be carried out by the patient himself are recommended as first line treatment. There is evidence for the short-term benefit of exercise therapy in terms of pain reduction and physical functioning. Nonetheless research agendas highlight the need for multifaceted interventions that incorporate exercise strategies into patient care. Studies should be conducted with appropriate sample sizes and should allow statements on long-term effects as well as cost-utility and safety. These open questions are under the scope of this study.Methods/designThis is a controlled study in the context of health services research. The study population consists of n = 1400 subjects with hip or knee osteoarthritis. The intervention group will be recruited from participants of a country-wide health insurance offer for people with hip or knee osteoarthritis. Potential participants for the control group (ratio 10:1 (control vs. intervention) will be filtered out from the insurance data base according to pre-defined matching criteria and asked by letter for their participation. The final statistical twins from the responders (1:1) will be determined via propensity score matching. The progressive training intervention comprises 8 supervised group sessions, supplemented by home exercises (2/week over 11 weeks). Exercises include mobilization, strengthening and training of postural control. Primary outcomes are pain and function measured with the WOMAC Index immediately after the intervention period. Among other things, health related quality of life, self-efficacy, cost utility and safety will be evaluated as secondary outcomes. Participants will be followed up 6, 12 and 24 month after baseline.DiscussionResults of this trial will document the effects of clinical as well as economic outcomes in a regular health care setting on the basis of a large sample size. As such, results of this trial might have great impact on future implementations of group- and home-based exercises in hip or knee osteoarthritis.Trail registrationGerman Clinical Trial Register DRKS00009251. Registered 10 September 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3030-0) contains supplementary material, which is available to authorized users.