Abstract
English
Highlights
Achilles tendinopathy is a common overuse injury in runners and related to maladaptation of the Achilles tendon
The purpose of the present review is to provide an overview of the healthy adaptation mechanisms of Achilles tendon to running and on the other hand, maladaptations caused by overloading of the tendon that lead to Achilles tendinopathy
Six out of seven studies found a larger Achilles tendon cross-sectional area (CSA) in runners compared with non-runners[7,8,11,12,13], sometimes this difference was only present in specific parts of the Achilles tendon[7,12] or only if the Achilles tendon CSA was normalised to body weight[8]
Summary
Achilles tendinopathy is a common overuse injury in runners and related to maladaptation of the Achilles tendon. In the 18– 36 h after exercise, there is a negative net balance in collagen levels (catabolic state so loss of collagen), which after 36 h turns positive up to 72 h after exercise (anabolic state so regeneration of collagen)[6]. These data suggest that apart from the level of strain, sufficient rest between training sessions needs to be respected in order to reduce the net loss of collagen content, which may lead to tendon injury. It seems that there is a subtle balance between loading and overloading a tendon, depending on several factors including training volume, type of loading and recovery time[6]
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