Analysis of hereditary and medical risk factors in Achilles tendinopathy and Achilles tendon ruptures: a matched pair analysis.
ABSTRACT In Achilles tendon injuries, it is suggested that a pathological continuum might be evident from the healthy Achilles tendon to Achilles tendinopathy to Achilles tendon rupture. As such, risk factors for both tendinopathy and rupture should be the same.
Hereditary and medical risk factors for Achilles tendinopathy and Achilles tendon rupture are the same to a similar extent in a matched pair analysis.
Matched pair study; level of evidence: 3.
Recreational sportsmen as well as athletes on national level.
566 questionnaires were analysed. 310 subjects were allocated to 3 groups (A, B, C) after matching the pairs for age, weight, height and gender: (A) healthy Achilles tendons (n = 89, age 39 ± 11 years, BMI 25.1 ± 3.9, females 36%), (B) chronic Achilles tendinopathy (n = 161, age 41 ± 11 years, BMI 24.4 ± 3.7, females 34%), (C) acute Achilles tendon rupture (n = 60, age 40 ± 9 years, BMI 25.2 ± 3.2, females 27%).
We found a positive family history of Achilles tendinopathy as a risk factor for Achilles tendinopathy (OR: 4.8, 95% CI: 1.1-21.4; p = 0.023), but not for Achilles tendon rupture (OR: 4.0, 95% CI 0.7-21.1, p = 0.118). Smoking and cardiac diseases had a lower incidence in Achilles tendinopathy than in healthy subjects (both p = 0.001), while cardiovascular medication did not change the risk profile.
Identifying risk factors associated with Achilles tendon disorders has a high clinical relevance regarding the development and implementation of prevention strategies and programs. This cross-sectional study identified a positive family history as a significant solitary risk factor for Achilles tendinopathy, increasing the risk fivefold. However, in this matched pair analysis excluding age, weight, height and gender as risk factors no further factor necessarily increases the risk for either Achilles tendinopathy or Achilles tendon rupture.
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ABSTRACT: Recreational running is an activity with multiple reported health benefits for both sexes, however, chronic injuries caused by excessive and/or repetitive loading of the Achilles tendon are common. Males have been identified as being at an increased risk of suffering an injury to the Achilles tendon and as such, knowledge of differences in loading between the sexes may provide further information to better understand why this is the case. The aim of the current investigation was to determine whether gender differences in the Achilles tendon load exist in recreational runners. Fifteen male (age 26.74 ± 5.52 years, body height 1.80 ± 0.11 m and body mass 74.22 ± 7.27 kg) and fifteen female (age 25.13 ± 6.39 years, body height 1.68 ± 0.12 m and body mass 67.12 ± 9.11 kg) recreational runners volunteered to take part in the current investigation. Participants completed 10 trials running at 4.0 m·s-1 ±5% striking a force platform (1000 Hz) with their right foot. Ankle joint kinematics were synchronously recorded (250 Hz) using an optoelectric motion capture system. Ankle joint kinetics were computed using Newton-Euler inverse-dynamics. Net external ankle joint moments were then calculated. To estimate Achilles tendon kinetics the plantarflexion moment calculated was divided by an estimated Achilles tendon moment arm of 0.05 m. Differences in Achilles tendon kinetics were examined using independent sample t-tests (p<0.05). The results indicate that males were associated with significantly (p<0.05) greater Achilles tendon loads than females. The findings from this study support the notion that male recreationa lrunners may be at greater risk of Achilles tendon pathology.Journal of Human Kinetics 12/2014; 44:155-159. DOI:10.2478/hukin-2014-0121 · 0.70 Impact Factor
Journal of physical activity & health 01/2014; DOI:10.2478/bjha-2014-0018 · 1.95 Impact Factor
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ABSTRACT: With the increased prevalence of obesity, there has been a parallel rise in musculoskeletal disorders. However, the effect of body mass index (BMI) on pathology of the hindfoot and ankle is scarcely understood. The purpose of the present report was to compare the number of tendinous and ligamentous pathologies within the hindfoot and ankle between overweight (BMI ≥ 25.00 kg/m(2)) and nonoverweight (BMI < 25.00 kg/m(2)) atraumatic patients. We hypothesized that overweight patients would demonstrate more tendinous and ligamentous pathologies compared with their nonoverweight counterparts. Five hundred consecutive magnetic resonance images were reviewed. One hundred eight patients met the inclusion and exclusion criteria. Sixty-six patients were overweight and 42 patients were nonoverweight. Ninety-eight percent of overweight patients demonstrated pathology of a tendinous or ligamentous nature, whereas 62% of nonoverweight patients demonstrated pathology of a tendinous or ligamentous nature. Thus, the prevalence of pathology was 1.59 times higher among overweight patients compared with nonoverweight patients. Moreover, controlling for age, overweight patients demonstrated approximately twice as many tendinous and ligamentous pathologies compared with nonoverweight patients (adjusted mean ± SD = 4.44 ± 2.14 vs 1.98 ± 2.07, respectively), which was statistically significantly different (P < .001). To definitively assess causation and the clinical evolution of hindfoot and ankle pathology, prospective, longitudinal cohort studies are warranted.Foot & Ankle Specialist 07/2014; DOI:10.1177/1938640014539805