{
  "abstract": "Objective This study aimed to evaluate whether lower limb biomechanics in runners and non-runners are risk factors for the onset of Achilles tendinopathy, and to assess the contributions of age, sex, running distance and injury history to the onset of Achilles tendinopathy.Methods This prospective cohort study used quota sampling stratified by age, sex, region and physical activity status (runner, non-runner). Baseline assessments included questionnaires on running history and Achilles tendinopathy symptoms, running biomechanics, MRI and dual-energy X-ray absorptiometry. Participants were followed for 1 year using a Fitbit device and a custom mobile application for weekly injury reporting and orthopaedic diagnoses. Binary logistic regression identified risk factors (OR, 95% CI). Primary biomechanical variables included ankle, knee and hip kinematics and kinetics during the stance phase of running. The main outcome was a medically confirmed diagnosis of Achilles tendinopathy within 1 year.Results Our study included 911 adults (mean age 37.7±12.5 years; 429 (47%) females; 528 (58%) runners) followed for 1 year. A higher peak ankle inversion moment (OR 0.33, 95% CI 0.17 to 0.61) during the stance phase decreased the odds of developing Achilles tendinopathy, while a lower peak ankle external rotation angle (OR 2.20, 95% CI 1.23 to 4.03) and greater running distance (OR 1.67, 95% CI 1.23 to 2.22) increased the odds of onset. The findings were consistent across the full cohort and runners.Conclusion We identified a lower peak ankle inversion moment, a lower peak ankle external rotation angle and a greater running volume as significant predictors of the onset of Achilles tendinopathy. Targeting biomechanical factors and running volume may help prevent Achilles tendinopathy.",
  "authors": [
    {
      "affiliations": [
        "Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic"
      ],
      "name": "Daniel Jandacka"
    },
    {
      "affiliations": [
        "Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic"
      ],
      "name": "Jiri Skypala"
    },
    {
      "affiliations": [
        "Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic"
      ],
      "name": "Jan Plesek"
    },
    {
      "affiliations": [
        "Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic",
        "Faculty of Physical Education and Sport, Charles University, Prague, Czech Republic"
      ],
      "name": "Jan Urbaczka"
    },
    {
      "affiliations": [
        "Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic",
        "Department of Diagnostic Radiology, Hospital Agel Ostrava-Vitkovice, Ostrava, Czech Republic"
      ],
      "name": "Milos Golian"
    },
    {
      "affiliations": [
        "Institute for Research and Applications of Fuzzy Modelling, University of Ostrava, Ostrava, Czech Republic"
      ],
      "name": "Michal Burda"
    },
    {
      "affiliations": [
        "Institute for Research and Applications of Fuzzy Modelling, University of Ostrava, Ostrava, Czech Republic"
      ],
      "name": "Jan Šustek"
    },
    {
      "affiliations": [
        "Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic"
      ],
      "name": "David Zahradnik"
    },
    {
      "affiliations": [
        "Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic"
      ],
      "name": "Steriani Elavsky"
    },
    {
      "affiliations": [
        "Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic",
        "Department of Epidemiology and Public Health, University of Ostrava, Ostrava, Czech Republic"
      ],
      "name": "Vera Kristyna Jandackova"
    },
    {
      "affiliations": [
        "HAS-Motion, Kingston, Ontario, Canada"
      ],
      "name": "Scott Selbie"
    },
    {
      "affiliations": [
        "Department of Kinesiology and Nutrition Sciences, UNLV, Las Vegas, Nevada, USA"
      ],
      "name": "Julia Freedman Silvernail"
    },
    {
      "affiliations": [
        "Department of Human Movement Studies, University of Ostrava, Ostrava, Czech Republic",
        "Dept of Kinesiology, University of Massachusetts, Amherst, Massachusetts, USA"
      ],
      "name": "Joseph Hamill"
    }
  ],
  "title": "Biomechanical insights into Achilles tendinopathy risk and protection in runners: a large prospective study 4HAIE",
  "uid": "a16b6dc2-0b98-578b-bcd7-73298300b0dc"
}