INTRODUCTION Achilles tendinopathies (AT) are common in runners, but prospective data assessing running mechanics associated with developing AT are limited. Asymmetry in running mechanics is also considered a risk factor for injury, although it is unknown if the problematic mechanics occur on the injured limb only or are present bilaterally. PURPOSE This study aimed to prospectively identify differences in preinjury running biomechanics in collegiate runners who did and did not develop AT and determine if between-limb asymmetries were associated with which limb developed AT. METHODS Running gait data were obtained preseason on healthy collegiate cross-country runners, and AT incidence was prospectively recorded each year. Spatiotemporal, ground reaction forces, and joint kinematics and kinetics were analyzed. Linear mixed-effects models assessed differences in biomechanics between those who did and did not develop AT during the subsequent year. Generalized linear mixed-effects models determined if the asymmetry direction was associated with which limb developed an AT, with odds ratios (OR) and 95% confidence intervals (95% CI) reported. RESULTS Data from 106 runners were analyzed and 15 developed AT. Preinjury biomechanics of runners who developed AT showed less peak knee flexion (noninjured: 45.9° (45.2°-46.6°), injured: 43.2° (41.5°-44.9°), P < 0.001), ankle dorsiflexion (noninjured: 28.7° (28.0°-30.2°), injured: 26.0° (23.8°-28.3°), P = 0.01), and knee extensor moment (noninjured: -2.18 (N·m)·kg -1 (-2.24 to -2.12 (N·m)·kg -1 ), injured: -2.00 (N·m)·kg -1 (-2.17 to -1.84 (N·m)·kg -1 ), P = 0.02). The limb demonstrating less peak knee flexion had greater odds of sustaining an AT (OR, 1.29 (1.00-1.65), P = 0.05). CONCLUSIONS Knee and ankle kinematics, in addition to knee kinetics, were associated with developing an AT. Monitoring these mechanics may be useful for prospectively identifying runners at risk of developing AT.

中文翻译：

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患有跟腱病的大学跑步者在跑步过程中受伤前的膝盖和脚踝力学性能会降低。


简介 跟腱病 (AT) 在跑步者中很常见，但评估与发生 AT 相关的跑步力学的前瞻性数据有限。跑步力学的不对称也被认为是受伤的危险因素，尽管尚不清楚问题力学是否仅发生在受伤肢体上还是双侧存在。目的本研究旨在前瞻性地确定发生和未发生 AT 的大学跑步者在受伤前跑步生物力学上的差异，并确定肢体间不对称是否与发生 AT 的肢体相关。方法在季前赛中获取健康大学越野跑运动员的跑步步态数据，并每年前瞻性记录 AT 发生率。分析了时空、地面反作用力以及关节运动学和动力学。线性混合效应模型评估了在接下来的一年中发生和未发生 AT 的人之间生物力学的差异。广义线性混合效应模型确定不对称方向是否与发生 AT 的肢体相关，并报告了比值比 (OR) 和 95% 置信区间 (95% CI)。结果 对 106 名跑步者的数据进行了分析，其中 15 名跑步者开发了 AT。发生 AT 的跑步者受伤前的生物力学显示膝关节屈曲峰值较小（未受伤：45.9°（45.2°-46.6°），受伤：43.2°（41.5°-44.9°），P < 0.001），踝关节背屈（未受伤：28.7°（ 28.0°-30.2°)，受伤：26.0° (23.8°-28.3°)，P = 0.01)，膝关节伸肌力矩（未受伤：-2.18 (N·m)·kg -1 (-2.24 至 -2.12 (N) ·m)·kg -1 )，受伤：-2.00 (N·m)·kg -1 (-2.17 至 -1.84 (N·m)·kg -1 )，P = 0.02)。膝关节屈曲峰值较小的肢体维持 AT 的几率更大（OR，1.29（1.00-1.65），P = 0.05）。 结论 除了膝关节动力学之外，膝关节和踝关节运动学也与 AT 的发展相关。监测这些机制可能有助于前瞻性地识别有发生 AT 风险的跑步者。