{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T21:47:33Z","timestamp":1790372853371,"version":"4.1.0"},"reference-count":22,"publisher":"National Athletic Trainers' Association","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6]]},"abstract":"\n Context<\/jats:title>\n Ankle-foot injuries are ubiquitous in the US military, with Achilles tendinopathy a common condition that affects function and health-related quality of life.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the burden and associated factors of Achilles tendinopathy.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Descriptive epidemiology study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n The Defense Medical Epidemiological Database was used to identify relevant health care encounters.<\/jats:p>\n <\/jats:sec>\n \n Patients or Other Participants<\/jats:title>\n All active duty and reserve military members who served between 2006 and 2015 (officers = 2\u2009149\u2009887; enlisted = 9\u2009503\u2009995).<\/jats:p>\n <\/jats:sec>\n \n Main Outcome Measure(s)<\/jats:title>\n Multiyear prevalence of Achilles tendinopathy care episodes was calculated and compared by military rank, service branch, and year. Unadjusted and adjusted assessments of injury burden were calculated.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Officers incurred 37\u2009939 episodes at a prevalence of 17.65 per 1000 servicemembers (male officers = 18.20 per 1000 servicemembers, female officers = 14.80 per 1000 servicemembers). Among enlisted personnel, 116\u2009122 episodes of Achilles tendinopathy occurred in 12.22 per 1000 servicemembers (male enlisted = 12.07 per 1000 servicemembers, female enlisted = 13.22 per 1000 servicemembers). All officer specialties had a higher burden of Achilles tendinopathy episodes than the ground and naval gunfire officers (prevalence ratio [PR] = 1.04\u20131.43) except for aviation, which demonstrated a lower burden (PR = 0.65). Among enlisted occupations, maritime or naval specialties had a lower burden of Achilles tendinopathy than infantry (PR = 0.82) and all other specialties except for aviation, which had a higher burden (PR = 1.07\u20131.71). Multiple associated factors were identified: sex, age, rank, military occupation, and service branch.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Achilles tendinopathy was ubiquitous in the US military, with a progressive increase in prevalence during the study epoch. Sex, age, rank, military occupation, and service branch were identified as associated factors. These findings highlight the need for both prophylactic interventions and identification of the populations with the greatest need.<\/jats:p>\n <\/jats:sec>","DOI":"10.4085\/1062-6050-0182.23","type":"journal-article","created":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T23:36:01Z","timestamp":1695339361000},"page":"655-660","source":"Crossref","is-referenced-by-count":10,"title":["Burden and Risk Factors for Achilles Tendinopathy in the Military Population, 2006\u20132015: A Retrospective Cohort Study"],"prefix":"10.4085","volume":"59","author":[{"given":"Christopher K.","family":"Sullivan","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Naval Medical Center San Diego, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cory F.","family":"Janney","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Naval Medical Center San Diego, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Fraser","sequence":"additional","affiliation":[{"name":"Operational Readiness and Health Directorate, Naval Health Research Center, San Diego, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","reference":[{"issue":"5","key":"i1938-162X-59-6-655-b01","series-title":"Br J Sports Med","first-page":"260","article-title":"ICON 2019: International Scientific Tendinopathy Symposium consensus: clinical terminology","volume":"54","author":"Scott","year":"2020","unstructured":"Scott\n A,\n \n \n Squier\n K,\n \n \n Alfredson\n H,\n \n et al.\n ICON 2019: International Scientific Tendinopathy Symposium consensus: clinical terminology. Br J Sports Med. 2020;54(5):260\u2013262. doi:10.1136\/bjsports-2019-100885"},{"issue":"3","key":"i1938-162X-59-6-655-b02","series-title":"Foot Ankle Surg","first-page":"240","article-title":"Achilles tendinopathy","volume":"26","author":"Maffulli","year":"2020","unstructured":"Maffulli\n N,\n \n \n Longo\n UG,\n \n \n Kadakia\n A,\n \n \n Spiezia\n F.\n \n \n Achilles tendinopathy. Foot Ankle Surg. 2020;26(3):240\u2013249. doi:10.1016\/j.fas.2019.03.009"},{"issue":"13","key":"i1938-162X-59-6-655-b03","series-title":"Br J Sports Med","first-page":"1026","article-title":"Incidence of midportion Achilles tendinopathy in the general population","volume":"45","author":"de Jonge","year":"2011","unstructured":"de Jonge\n S,\n \n \n van den Berg\n C,\n \n \n de Vos\n RJ,\n \n et al.\n Incidence of midportion Achilles tendinopathy in the general population. 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Sports Med Int Open. 2017;1(4):E135\u2013E140. doi:10.1055\/s-0043-113814"},{"key":"i1938-162X-59-6-655-b21","series-title":"Foot (Edinb)","first-page":"44","article-title":"An investigation of the sex-related differences in the stiffness of the Achilles tendon and gastrocnemius muscle: inter-observer reliability and inter-day repeatability and the effect of ankle joint motion","volume":"41","author":"Ta\u015f","year":"2019","unstructured":"Ta\u015f\n S,\n \n \n Salk\u0131n\n Y.\n \n \n An investigation of the sex-related differences in the stiffness of the Achilles tendon and gastrocnemius muscle: inter-observer reliability and inter-day repeatability and the effect of ankle joint motion. 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