Asymptomatic Achilles tendon pathology in male runners

Which factors are associated with asymptomatic Achilles tendon pathology?

This study found that 46% of asymptomatic male distance runners had at least one pathological Achilles tendon (AT).

Increased years of running training was the only factor with a significant difference between runners with normal and abnormal training.

The authors therefore recommend that running history should be considered when interpreting AT ultrasound (US) findings.

Given the cross-sectional nature of the study, the authors highlight that further research is needed to determine if the AT changes identified are transient, irreversible, or predictive of future symptoms.

Nevertheless, a high percentage of asymptomatic runners still show AT abnormalities on US, with years of running training being the only variable differing between runners with normal and abnormal tendons.

> From: Lieberthal et al., Phys Ther Sport 39 (2019) 64-68 (Epub ahead of print). All rights reserved to Elsevier Ltd. Click here for the online summary.

Expert opinion

This study is interesting, as not only it once again shows the lack of association between structural changes and symptoms, but it also shows how tendons adapt to years of chronic load without leading to pain.

The findings mean that the interpretation of ultrasound findings, especially in runners, should be done with care when using these changes to explain the source of pain.

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