Prevalence and factors associated with asymptomatic Achilles tendon pathology in male distance runners

Phys Ther Sport. 2019 Sep;39:64-68. doi: 10.1016/j.ptsp.2019.06.006. Epub 2019 Jun 17.


Objectives: This study investigated the prevalence of tendon pathology and associated factors in experienced, high mileage male endurance runners with no history of Achilles tendon pain.

Design: Cross-sectional study.

Setting: Achilles tendinopathy is a debilitating running injury affecting 50% of distance runners over their lifetime. It is diagnosed through a clinical examination and imaging, usually grey scale ultrasound (US) imaging. US imaging studies have shown that pathological changes can occur in asymptomatic individuals with no tendon pain.

Participants: Thirty seven male runners who had never had Achilles tendon pain.

Main outcome measures: Participants completed a running history survey, had their height, body mass, waist circumference, and ankle dorsiflexion range of movement (ROM) measured, and their tendons were assessed (normal, abnormal) using US imaging.

Results: Almost half (46%) of these asymptomatic distance runners had at least one abnormal tendon. The runners with tendon pathology had significantly (p = 0.024) more years of running training (abnormal: median 20 years, interquartile range 6-25.5) than runners with no pathology (normal: median 7 years, interquartile range 5-15). No other significant differences between the groups were identified.

Conclusions: Asymptomatic male distance runners had a high incidence of tendon pathology. Increased running years was associated with pathology in the Achilles tendon...

Keywords: Achilles; Male; Running; Tendinopathy.

MeSH terms

  • Achilles Tendon / diagnostic imaging*
  • Adult
  • Asymptomatic Diseases*
  • Cross-Sectional Studies
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Running / injuries*
  • Tendinopathy / diagnostic imaging*
  • Ultrasonography