Interaction of foot and hip factors identifies Achilles tendinopathy occurrence in recreational runners

Ferreira, Victor; Oliveira, Rodrigo Ribeiro de; Nazareno, Thamiris Silva; Freitas, Lucas Valentim de; Mendonça, Luciana De Michelis

doi:10.1016/j.ptsp.2020.06.006

Cited by 13 publications

(13 citation statements)

References 57 publications

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“…A total of 769 participants were included across all 20 reports (19 experimental study populations). Seven studies included specifically male participants ( 34 , 39 – 41 , 43 , 45 , 48 ), a single study investigated females only ( 44 ), 9 experiments studied both males and females ( 32 , 33 , 36 , 37 , 42 , 46 , 47 , 49 , 50 ), and three studies did not report the sex of participants ( 23 , 35 , 38 ). The average age of all participants included was 38 years, with a large range from 18.5–50.5 years.…”

Section: Resultsmentioning

confidence: 99%

“…All participants were considered athletic (ranging from recreational to elite), based upon inclusion criteria highlighted within the methodology. The majority of the included studies investigated runners exclusively ( n = 16) ( 32 , 33 , 45 – 47 , 34 – 40 , 42 ), whereas three studies included running and other sports, such as basketball, soccer, tennis, volleyball, long jump, high jump and ice hockey ( 23 , 43 , 49 ), and a single study examined female dancers only ( 44 ). Methods of diagnosis for AT varied substantially, whereby ten studies identified “Achilles tendinopathy” ( 23 , 32 – 34 , 37 , 38 , 41 , 42 , 44 , 49 ), five studies diagnosed unilateral “mid-portion Achilles tendinopathy” ( 35 , 36 , 43 , 48 , 50 ), three studies identified “mid-portion Achilles tendinopathy” without reference to side ( 39 , 40 , 45 ), and two studies included patients with both “insertional and mid-portion Achilles tendinopathy” ( 46 , 47 ).…”

Section: Resultsmentioning

confidence: 99%

“…Eight of the studies investigated “Isolated joint strength” ( 32 , 43 , 45 – 50 ), and reported on a wide range of biomechanical strength variables. Measurement techniques varied, including isokinetic dynamometry ( 46 , 48 , 50 ), handheld dynamometry ( 43 , 47 ) and other custom made devices ( 32 , 45 , 49 ). Subject positioning also differed between studies to a large degree, depending on apparatus used and the joint of interest.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Biomechanics and lower limb function are altered in athletes and runners with achilles tendinopathy compared with healthy controls: A systematic review

Quarmby

Mönnig

Mugele

et al. 2023

Front. Sports Act. Living

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Achilles tendinopathy (AT) is a debilitating injury in athletes, especially for those engaged in repetitive stretch-shortening cycle activities. Clinical risk factors are numerous, but it has been suggested that altered biomechanics might be associated with AT. No systematic review has been conducted investigating these biomechanical alterations in specifically athletic populations. Therefore, the aim of this systematic review was to compare the lower-limb biomechanics of athletes with AT to athletically matched asymptomatic controls. Databases were searched for relevant studies investigating biomechanics during gait activities and other motor tasks such as hopping, isolated strength tasks, and reflex responses. Inclusion criteria for studies were an AT diagnosis in at least one group, cross-sectional or prospective data, at least one outcome comparing biomechanical data between an AT and healthy group, and athletic populations. Studies were excluded if patients had Achilles tendon rupture/surgery, participants reported injuries other than AT, and when only within-subject data was available.. Effect sizes (Cohen's d) with 95% confidence intervals were calculated for relevant outcomes. The initial search yielded 4,442 studies. After screening, twenty studies (775 total participants) were synthesised, reporting on a wide range of biomechanical outcomes. Females were under-represented and patients in the AT group were three years older on average. Biomechanical alterations were identified in some studies during running, hopping, jumping, strength tasks and reflex activity. Equally, several biomechanical variables studied were not associated with AT in included studies, indicating a conflicting picture. Kinematics in AT patients appeared to be altered in the lower limb, potentially indicating a pattern of “medial collapse”. Muscular activity of the calf and hips was different between groups, whereby AT patients exhibited greater calf electromyographic amplitudes despite lower plantar flexor strength. Overall, dynamic maximal strength of the plantar flexors, and isometric strength of the hips might be reduced in the AT group. This systematic review reports on several biomechanical alterations in athletes with AT. With further research, these factors could potentially form treatment targets for clinicians, although clinical approaches should take other contributing health factors into account. The studies included were of low quality, and currently no solid conclusions can be drawn.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Biomechanics and lower limb function are altered in athletes and runners with achilles tendinopathy compared with healthy controls: A systematic review

Quarmby

Mönnig

Mugele

et al. 2023

Front. Sports Act. Living

View full text Add to dashboard Cite

show abstract

“…Individual variability in biomechanics, such as anatomical differences, malalignment, neuromuscular capacity, weakness or strength, foot structure, flexibility, repeated training errors, and movement kinetics and kinematics may lead to repetitive, excessive, or compressive loading on tendons (Benjamin et al, 2008;Sharma and Maffulli, 2008;Dean et al, 2017;Ferreira et al, 2020). In patellar tendinopathy, almost 37 different individual biomechanical risk variables have been identified in relation to jump-landing strategy alone (Harris et al, 2020).…”

Section: Individual Factorsmentioning

confidence: 99%

Autoregulation in Resistance Training for Lower Limb Tendinopathy: A Potential Method for Addressing Individual Factors, Intervention Issues, and Inadequate Outcomes

Burton

2021

Front. Physiol.

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Musculoskeletal disorders, such as tendinopathy, are placing an increasing burden on society and health systems. Tendinopathy accounts for up to 30% of musculoskeletal disorders, with a high incidence in athletes and the general population. Although resistance training has shown short-term effectiveness in the treatment of lower limb tendinopathy, more comprehensive exercise protocols and progression methods are required due to poor long-term outcomes. The most common resistance training protocols are predetermined and standardized, which presents significant limitations. Current standardized protocols do not adhere to scientific resistance training principles, consider individual factors, or take the importance of individualized training into account. Resistance training programs in case of tendinopathy are currently not achieving the required intensity and dosage, leading to high recurrence rates. Therefore, better methods for individualizing and progressing resistance training are required to improve outcomes. One potential method is autoregulation, which allows individuals to progress training at their own rate, taking individual factors into account. Despite the finding of their effectiveness in increasing the strength of healthy athletes, autoregulation methods have not been investigated in case of tendinopathy. The purpose of this narrative review was 3-fold: firstly, to give an overview and a critical analysis of the individual factors involved in tendinopathy and current resistance training protocols and their limitations. Secondly, to give an overview of the history, methods, and application of autoregulation strategies both in sports performance and physiotherapy. Finally, a theoretical adaptation of a current tendinopathy resistance training protocol using autoregulation methods is presented, providing an example of how the method could be implemented in clinical practice or future research.

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“…Recently, the extent of heterogeneity within tendinopathy populations has been highlighted, with a host of individual factors been shown to influence risk and onset of tendinopathy, as well as outcomes to treatment such as resistance training (Steinmann et al 2020). Therefore, the response of individuals to exercise interventions can be diverse and multifactorial, due to the interactions of a plethora of factors (Ferreira et al 2020;Dean et al 2017).…”

Section: Introductionmentioning

confidence: 99%

The implementation of resistance training principles in exercise interventions for lower limb tendinopathy: A systematic review

Burton

McCormack

2021

Physical Therapy in Sport

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Interaction of foot and hip factors identifies Achilles tendinopathy occurrence in recreational runners

Cited by 13 publications

References 57 publications

Biomechanics and lower limb function are altered in athletes and runners with achilles tendinopathy compared with healthy controls: A systematic review

Biomechanics and lower limb function are altered in athletes and runners with achilles tendinopathy compared with healthy controls: A systematic review

Autoregulation in Resistance Training for Lower Limb Tendinopathy: A Potential Method for Addressing Individual Factors, Intervention Issues, and Inadequate Outcomes

The implementation of resistance training principles in exercise interventions for lower limb tendinopathy: A systematic review

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