Biomechanics associated with Achilles tendinopathy Dr Melinda Franettovich Smith UQ Development Fellow Collaborators: Dr Mark Creaby, Prof Kay Crossley, Dr Anthony Schache, Narelle Wyndow, Mr Conor Honeywill Achilles tendinopathy in runners Prevalence 6 - 10% Incidence 9-14% (Lopes 2012; Van Ginckel 2009; Hein 2014) General population 6% Elite runners 36-52% (Kujala 2005) Runners 30x more likely Why? (other) Extrinsic Intrinsic factors Footwear factors Surface Relative load Distance Frequency Speed Type Achilles tendinopathy Intrinsic risk factors (Brukner & Khan 2016) Strength knee flexors, PFs DF ROM Foot posture Central adiposity Increased Biomechanics BMI Intrinsic factors Diabetes Age? mellitus Exposure to Genetics medications Biomechanical factors - running Kinematics Kinetics Neuromotor Biomechanical factors – what evidence? Becker 2017 AJSM Creaby 2017 MSSE Biomechanical factors - running Kinematics Kinetics Neuromotor Biomechanical factors - running Frontal plane rearfoot kinematics Biomechanical factors - running Leg muscle activity Biomechanical factors - running Azevedo 2009 No difference hip kinematics Knee flexion (foot contact & midstance) Kinematics No Kinetics difference GRF Neuromotor Joint moments? Gluteus medius & rectus femoris Post-heel strike