Running-related Achilles tendon injury: a prospective biomechanical study in recreational runners

Review written by Dr Carlo Wood info

Key Points

  1. A more flexed knee at initial contact and at the midstance phase of running were significant predictors for developing Achilles tendon (AT) pain.
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Achilles tendon (AT) pain occurs in 22% of running-related injuries. Overload is believed to be the cause with more dorsiflexion and eversion in the loading phase. Another associated issue is knee flexion. However, this demonstrates inconsistent results in cross sectional and retrospective studies and creates difficulty understanding if the biomechanics of the ankle and knee are the cause or the consequence. The literature lacks quality prospective studies to determine the factors associated with AT injury.

This study aimed to determine whether biomechanical variables were related to the incidence of AT pain for one year in low-volume runners.

Achilles tendon pain occurs in 22% of running-related injuries.
Strengthening the gluteus maximus and retraining it so a 10° forward lean is achieved, will bring the knee backwards, decreasing the external moment arm and the strain on the AT.


The study included 108 runners. Participants who had a previous running injury or ran more than 51 km/week were excluded. Runners aged 18–65 years were included. Weekly data was collected over one year on injury incidence. A running-related AT injury

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