Prevalence and factors associated with asymptomatic Achilles tendon pathology in male distance runners

Objectives
This study investigated the prevalence of tendon pathology and associated factors in experienced, high mileage male endurance runners with no history of Achilles tendon pain.

Design
Cross-sectional study.

Setting
Achilles tendinopathy is a debilitating running injury affecting 50% of distance runners over their lifetime. It is diagnosed through a clinical examination and imaging, usually grey scale ultrasound (US) imaging. US imaging studies have shown that pathological changes can occur in asymptomatic individuals with no tendon pain.

Participants
Thirty seven male runners who had never had Achilles tendon pain.

Main outcome measures
Participants completed a running history survey, had their height, body mass, waist circumference, and ankle dorsiflexion range of movement (ROM) measured, and their tendons were assessed (normal, abnormal) using US imaging.

Results
Almost half (46%) of these asymptomatic distance runners had at least one abnormal tendon. The runners with tendon pathology had significantly (p = 0.024) more years of running training (abnormal: median 20 years, interquartile range 6–25.5) than runners with no pathology (normal: median 7 years, interquartile range 5–15). No other significant differences between the groups were identified.

Conclusions
Asymptomatic male distance runners had a high incidence of tendon pathology. Increased running years was associated with pathology in the Achilles tendon...