Hip muscle strength is decreased in middle-aged recreational male athletes with midportion Achilles tendinopathy: A cross-sectional study.
OBJECTIVE
Investigating differences in hip muscle strength between athletes with Achilles tendinopathy (AT) and asymptomatic controls.


METHODS
Cross-sectional case-control study.


METHODS
Sports medical center.


METHODS
Twelve recreational male athletes with mid-portion AT and twelve matched asymptomatic controls.


METHODS
Isometric strength of the hip abductors, external rotators, and extensors was measured using a handheld dynamometer. Functional hip muscle performance was evaluated with the single-leg squat. The Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire was completed to determine clinical severity of symptoms.


RESULTS
Compared to controls, participants with AT demonstrated 28.9% less isometric hip abduction strength (p = 0.012), 34.2% less hip external rotation strength (p = 0.010), and 28.3% less hip extension strength (p = 0.034) in the injured limb. Similar differences were found for the non-injured limb (26.7-41.8%; p < 0.03). No significant differences were found in functional hip muscle performance between the injured and non-injured limb or between the groups, and no significant correlation was found between hip muscle strength and VISA-A scores.


CONCLUSIONS
Recreational male athletes with chronic mid-portion AT demonstrated bilateral weakness of hip abductors, external rotators, and extensors compared to their asymptomatic counterparts. These findings suggest that hip muscle strength may be important in the assessment and rehabilitation of those with AT.
Papendal Sports Medical Center, Papendallaan 7, 6816 VD, Arnhem, The Netherlands; Physiotherapy Science, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Rehabilitation, Nursing Science and Sport, Rudolf Magnus Institute of Neurosciences, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands. Electronic address: b.habets@smcp.nl.
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Habets
Department of Rehabilitation, Nursing Science and Sport, Rudolf Magnus Institute of Neurosciences, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands. Electronic address: H.W.Smits@uu.nl.
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HW
Smits
Department of Rehabilitation, Nursing Science and Sport, Rudolf Magnus Institute of Neurosciences, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands. Electronic address: F.J.G.Backx@umcutrecht.nl.
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FJG
Backx
Papendal Sports Medical Center, Papendallaan 7, 6816 VD, Arnhem, The Netherlands; HAN University of Applied Sciences Nijmegen, Research Group Musculoskeletal Rehabilitation, Nijmegen, The Netherlands. Electronic address: r.vancingel@smcp.nl.
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REH
van Cingel
Department of Rehabilitation, Nursing Science and Sport, Rudolf Magnus Institute of Neurosciences, University Medical Center Utrecht, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands. Electronic address: B.M.A.Huisstede@umcutrecht.nl.
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BMA
Huisstede
D000125:Achilles Tendon / Q000473:pathology*; D000328:Adult; D056352:Athletes; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D006615:Hip; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000503:physiopathology*; D016059:Range of Motion, Articular; D052256:Tendinopathy / Q000503:physiopathology*
Achilles tendon; Hip; Muscle strength; Tendinopathy