Asymmetric running is associated with pain during outdoor running in individuals with Achilles tendinopathy in the return-to-sport phase

Review written by Dr Teddy Willsey info

Key Points

  1. Recreational runners with Achilles tendinopathy demonstrate altered mechanics well into their return-to-sport phase of rehabilitation.
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BACKGROUND & OBJECTIVE

Achilles tendinopathy (AT) prevalence amongst runners is as high as 10%, with recurrence rates approaching 27% (1, 2). In 2020, Paavola et al. published a sobering long term follow up paper on AT showing despite 94% of subjects eventually returning to prior activity levels, 41% went on to experience symptoms on the contralateral side, and side-to-side differences persisting at the eight-year mark (3).

Exercise, loading, and incremental activity progression have long been established as the most effective means to rehabilitate pathological tendons that routinely undergo high levels of load (4). For runners with AT, this process includes a long return-to-sport (RTS) phase operationally defined as the point of no symptoms with activities of daily living (ADLs) to one year symptom free with running (5).

Despite concerns over asymmetrical loading during AT RTS, previous research in laboratory settings under relatively short durations have not illuminated asymmetries (6). The primary purpose of this study was to characterize the relationship between AT pain and loading asymmetry, looking at longer duration outdoor running. The secondary goal was to determine the relationship between number of running bouts and symptom severity.

Achilles tendinopathy prevalence amongst runners is as high as 10%, with recurrence rates approaching 27%.
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Anyone rehabilitating a tendon should take 2-3 days recovery between bouts of intense exercise while their tendons are still recovering.

METHODS

17 recreational runners (defined as running unbroken for 30 minutes, minimum of 2 x week) in late-stage AT RTS (defined above) completed this two week outdoor running prospective observational study wearing accelerometers on their shoelaces to quantify ground contact time

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