title: Thicker Achilles tendons are a risk factor to develop Achilles tendinopathy in elite professional soccer players.
abstract: The primary aim of this prospective cohort study was to compare the incidence of Achilles tendinopathy symptoms in elite soccer players with and without baseline asymptomatic ultrasound abnormalities. This study also investigated the relationship between baseline tendon thickness and development of symptoms. Using ultrasonography, 18 players were examined in 2009 for the existence of hypoechoicity, paratenon blurring, focal thickening and/or neovascularisation, and anteroposterior tendon thickness was measured. Symptom development during the follow-up period was assessed by interview one year later. Baseline mid-tendon thickness was greater (p=0.041) in tendons that experienced symptoms [median (IQR): 0.53 (0.51-0.55) cm] in the following year than tendons remaining asymptomatic [0.48 (0.45-0.52) cm]. No association between the existence of baseline ultrasound signs and development of symptoms in the following year was observed (Chi-Square: 1.180, p=0.277). A thicker baseline mid-tendon thickness was identified as a risk indicator for the development of Achilles tendinopathy in elite soccer players.
authors.affiliation: Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, London, UK.
authors.forename: Sachin
authors.initials: S
authors.lastname: Jhingan
authors.forename: Mark
authors.initials: M
authors.lastname: Perry
authors.forename: Gary
authors.initials: G
authors.lastname: O'Driscoll
authors.forename: Colin
authors.initials: C
authors.lastname: Lewin
authors.forename: Raphael
authors.initials: R
authors.lastname: Teatino
authors.forename: Peter
authors.initials: P
authors.lastname: Malliaras
authors.forename: Nicola
authors.initials: N
authors.lastname: Maffulli
authors.forename: Dylan
authors.initials: D
authors.lastname: Morrissey
keywords: Achilles; football; sonography; tendinopathy; ultrasound