Researcher(s)
- Samantha Huerta, Exercise Science, University of Delaware
Faculty Mentor(s)
- Karin Silbernagel, Physical Therapy, University of Delaware
Abstract
Background: Achilles tendinopathy (AT) is a common musculoskeletal injury characterized by localized pain and functional impairment related to repetitive overloading of the Achilles tendon. AT affects both active and sedentary patients, with recovery taking up to a year or more. There is a lack of research exploring the differences between those with AT and different activity levels. Understanding how these groups differ in symptoms and lower extremity function may provide clinical insights. The objective of this study is to examine functional and pain differences between runners/jumpers (RJ) and non-runners/jumpers (NRJ) with midportion AT.
Methods/design: Data from 104 RJ (55F, 44.3±12.0 yrs, 26.4±4.1 kg/m2) and 78 NRJ (50F, 51.6±12.3 yrs, 32.2±7.1 kg/m2) with midportion AT were included in this study. Patient reported outcome measures including the Victorian Institute of Sport Assessment – Achilles (VISA-A), Tampa Scale for Kinesiophobia-17 (TSK), and Patient Reported Outcomes Measurement Information System (PROMIS-29) were collected and assessed symptom severity, kinesiophobia, and pain interference, respectively. Functional testing includes drop counter movement jump (Drop CMJ) and the heel rise endurance test (HR). Maximal Drop CMJ height, HR work, and submaximal HR power (average power from the first five reps) were used for analysis. Achilles tendon pain was self-reported after each functional test. One-way ANOVAs were performed to detect differences between groups. Alpha was set to 0.05.
Results: There were statistically significant differences between the groups in the following variables: VISA-A (RJ: 53.9±17.4 pts, NRJ: 43.6±16.9 pts, p<0.001), HR pain (1.8±2.4 pts, 2.8±2.9 pts, p=0.009), PROMIS- Pain Interference t-score (52.6±7.3, 55.9±7.0, p=0.003), HR work (1802.7±804.8 J, 1165.1±639.1 J, p<0.001), HR concentric average power (131.6±40.7 W, 117.1±40.6 W, p=0.025), Drop CMJ Height (7.0±3.9 cm, 3.3±3.2 cm, p<0.001), There were no differences between groups in TSK scores (37.6±5.1, 37.6±5.3, p=0.223).
Discussion: Individuals with midportion Achilles tendinopathy who identify as runners and/or jumpers show better functional performance and report less symptom severity and pain interference than those who do not identify as runners or jumpers. However, both groups had high level of kinesiophobia (i.e. fear of movement). This indicates that activity identity may be linked to distinct experiences of disability and pain in midportion Achilles tendinopathy. Understanding these distinctions can help tailor rehabilitation approaches.
Conclusion: Despite the prevalence of Achilles tendinopathy in running/jumping sports the findings in this study illustrate that those who identify as runners/jumpers have less symptoms and better performance on functional testing than those who do not identify as runners/jumpers.