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…