Dynamic Balance among Long-Distance Runners with Achilles Tendinopathy in High Altitude Training Camps in Western Kenya

Abstract

Achilles Tendinopathy (AT) is one of the leading causes of disability among athletes and often leads to an early exit from a sporting career. AT has been associated with intense, prolonged and repetitive functional demands exerted on the Achilles tendon. It is also thought to have an effect on the athletes’ dynamic balance ability and performance. Running involves movement of the body in a straight line, whereby balance in motion, horizontal component of momentum is very important for performance and injury prevention. While AT has been widely cited to be common among athletes, how and if it affects the dynamic balance ability of the runners has rarely been explored especially in the local setting, hence this study.This study determined the prevalence of AT among long-distance runners in high altitude training camps in Western Kenya. The exercise history and dynamic balance of those who had AT was also established and compared to the findings in the existing literature. A cross-sectional study was carried out in high altitude training camps of Western Kenya, among long-distance runners (N=410). The prevalence of AT was determined and exercise history of runners confirmed to be having AT, using subjective self-reported pain and palpation tests, was established through completion of self-administered questionnaire. Dynamic balance ability among those who had AT, was examined using the Star Excursion Balance Test (SEBT). The collected data was analysed using Statistical Package for Social Sciences (SPSS) Version 25.0. Descriptive and inferential statistics including measures of central tendency, proportions and frequency was used. The difference between dynamic balance in male and female athletes was assessed using independent t-test with a p-value of < 0.05 considered statistically significant. The results were presented in form of tables, figures and prose format. AT prevalence among the 410 long-distance athletes was 13.9% (n=57). The 57 long-distance athletes who had AT were assessed for dynamic balance using SEBT, of which 73.7% (n=42) were male. The median age of the participants was 27 years with 68.4% (n=39) being 30 years and below. On palpation test, 63.2% (n=36) and 40.4% (n=23) tested positive for AT on the right leg and left leg, respectively. Two (3.5%) had bilateral AT. The median number of competitions completed the previous 2 years was 5 with a maximum of 10 and minimum of 1 race. The mean number of kilometers covered per week in training was 170.0 km with an average pace of 3.3 minutes per kilometer. Most, 61.4% (n=35) covered 151-200 km per week, 21.0% (n=12) 101-150km per week, 12.3% (n= 7) 201-250 km per week, 3.5% (n=2) 51-100 km per week and 1 (1.8%) less than 51 km per week. The mean SEBT composite scores for dominant and non-dominant was 81.85%, and 82.42% respectively. Most athletes had composite scores of less than 94%. There were statistically significant mean differences in the dominant posterolateral and dominant posteromedial normalized scores and composite dominant scores between male and female athletes, with the scores being higher in male runners compared to females. Using the available composite score cut-off of 94%, most of the runners included in this study had impaired balance and were at risk of re-injury or getting new injuries. There appears to be differences in SEBT scores with regards to gender hence the need to develop reference scores taking into account the gender differences.