Incidence of Achilles tendinopathy and associated risk factors in recreational runners: a large prospective cohort study

Review written by Dr Seth O’Neill info

Key Points

  1. Achilles tendinopathy is common among runners registering for events between 5-42km.
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In one of my previous reviews I stated, “There are many studies examining risk factors for Achilles tendinopathy (AT). Of all the published studies there are many employed methodologies – some methods allow for accurate conclusions to be made relative to a risk factor and tendinopathy, whilst others do not”.

This paper is one of the studies that does allow conclusions around risk to be determined (it is prospective and large). Most importantly it has a large number of follow ups and high enough incidence rate to make meaningful conclusions. The primary aim of the paper was to determine the incidence of AT, and the secondary aim was to ascertain the risk factors associated with AT.

Achilles tendinopathy is one of the most common ankle/foot overuse injuries.
Encourage 2 weeks at each new training stage of a runners’ programme, as this allows time for positive adaptation.


This study recruited Dutch runners registering for events ranging from 5-42km (3 miles/park run distance up to full marathons). The study used a digital questionnaire to collect data at 4 time points: < 2 months and 2 weeks pre-event; 1

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