{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T11:39:06Z","timestamp":1786448346174,"version":"build-2736575974"},"reference-count":43,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T00:00:00Z","timestamp":1765065600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","award":["CZ.02.01.01\/00\/22_008\/0004583"],"award-info":[{"award-number":["CZ.02.01.01\/00\/22_008\/0004583"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","award":["CZ.10.03.01\/00\/22_003\/0000003"],"award-info":[{"award-number":["CZ.10.03.01\/00\/22_003\/0000003"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2025,11,9]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate whether lower limb biomechanics in runners and non-runners are risk factors for the onset of Achilles tendinopathy, and to assess the contributions of age, sex, running distance and injury history to the onset of Achilles tendinopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study used quota sampling stratified by age, sex, region and physical activity status (runner, non-runner). Baseline assessments included questionnaires on running history and Achilles tendinopathy symptoms, running biomechanics, MRI and dual-energy X-ray absorptiometry. Participants were followed for 1\u2009year using a Fitbit device and a custom mobile application for weekly injury reporting and orthopaedic diagnoses. Binary logistic regression identified risk factors (OR, 95% CI). Primary biomechanical variables included ankle, knee and hip kinematics and kinetics during the stance phase of running. The main outcome was a medically confirmed diagnosis of Achilles tendinopathy within 1\u2009year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Our study included 911 adults (mean age 37.7\u00b112.5 years; 429 (47%) females; 528 (58%) runners) followed for 1 year. A higher peak ankle inversion moment (OR 0.33, 95%\u2009CI 0.17 to 0.61) during the stance phase decreased the odds of developing Achilles tendinopathy, while a lower peak ankle external rotation angle (OR 2.20, 95%\u2009CI 1.23 to 4.03) and greater running distance (OR 1.67, 95%\u2009CI 1.23 to 2.22) increased the odds of onset. The findings were consistent across the full cohort and runners.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We identified a lower peak ankle inversion moment, a lower peak ankle external rotation angle and a greater running volume as significant predictors of the onset of Achilles tendinopathy. Targeting biomechanical factors and running volume may help prevent Achilles tendinopathy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2025-110260","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T15:18:25Z","timestamp":1765552705000},"page":"186-197","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Biomechanical insights into Achilles tendinopathy risk and protection in runners: a large prospective study 4HAIE"],"prefix":"10.1136","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2653-2569","authenticated-orcid":false,"given":"Daniel","family":"Jandacka","sequence":"first","affiliation":[{"name":"Department of Human Movement Studies, University of Ostrava, Ostrava, Czech 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