Intrinsic gait-related risk factors for Achilles tendinopathy in novice runners: a prospective study

Gait Posture. 2009 Apr;29(3):387-91. doi: 10.1016/j.gaitpost.2008.10.058. Epub 2008 Nov 29.


The purpose of this prospective cohort study was to identify dynamic gait-related risk factors for Achilles tendinopathy (AT) in a population of novice runners. Prior to a 10-week running program, force distribution patterns underneath the feet of 129 subjects were registered using a footscan pressure plate while the subjects jogged barefoot at a comfortable self-selected pace. Throughout the program 10 subjects sustained Achilles tendinopathy of which three reported bilateral complaints. Sixty-six subjects were excluded from the statistical analysis. Therefore the statistical analysis was performed on the remaining sample of 63 subjects. Logistic regression analysis revealed a significant decrease in the total posterior-anterior displacement of the Centre Of Force (COF) (P=0.015) and a laterally directed force distribution underneath the forefoot at 'forefoot flat' (P=0.016) as intrinsic gait-related risk factors for Achilles tendinopathy in novice runners. These results suggest that, in contrast to the frequently described functional hyperpronation following a more inverted touchdown, a lateral foot roll-over following heel strike and diminished forward force transfer underneath the foot should be considered in the prevention of Achilles tendinopathy.

MeSH terms

  • Achilles Tendon / injuries*
  • Adult
  • Biomechanical Phenomena
  • Cohort Studies
  • Cumulative Trauma Disorders / etiology
  • Female
  • Foot / physiology*
  • Gait / physiology*
  • Humans
  • Male
  • Prospective Studies
  • Risk Factors
  • Running / injuries*