Achilles Tendinopathy in Runners: What a One-Year Prospective Cohort Found About Ankle Mechanics and Running Volume

Physical therapists and physical therapist assistants who treat runners and recreationally active adults with Achilles tendon pain, and who want a current read on which running mechanics and training habits were linked to new Achilles tendinopathy in a large prospective cohort.

Physical therapists and physical therapist assistants in outpatient orthopaedics, sports, and performance settings. Athletic trainers, exercise physiologists, and running coaches may also find the material relevant. Physical therapist assistants contribute to gait observation, training-load monitoring, and patient education under the direction of the supervising physical therapist, who retains evaluation, diagnosis, and plan-of-care decisions.

Intended audience

Physical Therapy

Level

Intermediate

Delivery format

Online, asynchronous, self-paced course: interactive reading with audio or video, and a scored post-test.

Based on

This course is an independent educational summary of one peer-reviewed article. All findings, figures, and conclusions described in the course come from that article.

Jandacka D, Skypala J, Plesek J, Urbaczka J, Golian M, Burda M, Šustek J, Zahradnik D, Elavsky S, Jandackova VK, Selbie S, Silvernail JF, Hamill J. Biomechanical insights into Achilles tendinopathy risk and protection in runners: a large prospective study 4HAIE. Br J Sports Med. 2026;60(3):186–197. doi:10.1136/bjsports-2025-110260. PMID 41672607; PMCID PMC13018850.

Scope note

This is an observational cohort study. It reports which baseline measurements were linked to a later diagnosis; it does not test a treatment or a gait-retraining programme, and nothing in this course is intended as clinical direction.

After completing this course, you will be able to:

1. Describe the design, population, and one-year follow-up procedures of the 4HAIE prospective cohort study of Achilles tendinopathy in runners and non-runners.
2. State which baseline ankle mechanics and which training-volume factor were linked to new medically confirmed Achilles tendinopathy, and in which direction each association ran.
3. Explain what the authors concluded about footfall pattern, biomechanical screening, and running-volume management, and name the main limitations they acknowledged.

1. Start Here: How This Course Works
2. The Podcast: Ankle Mechanics, Mileage, and Achilles Tendon Risk (about nine minutes)
3. What the 4HAIE Cohort Set Out to Answer, and Who Took Part
4. How the Researchers Measured Running Mechanics and Confirmed Diagnoses
5. Ankle Rotation, Inversion Moment, and Weekly Mileage: What the Data Showed
6. Footfall Pattern, Age, and Sex: The Links That Did Not Hold Up
7. What the Authors Say This Means for Screening and Load Management
8. Key Takeaways
9. Post-Test and Course Evaluation

Quinn Millington, PT, DPT, ECS is the instructor of record: the licensed clinician who reviewed this course and signed off on it. The name and credentials print on the certificate.

Disclosures. This course was developed by The ConEd Solution, which has a financial interest in its sale. No outside funding or sponsorship was received. The instructor of record has no affiliation with the authors of the source publication or their institutions.

This course awards 0.5 contact hours (30 min). How you earn them:

1. Complete the course. Every lesson, in order.
2. Pass the post-test. Score 80% or higher. Retakes are allowed.
3. Complete the evaluation. A short form rating each learning objective and the course.
4. Download your certificate. It is issued on completion and stays available in My Account.

The episode time is its measured length. Reading, post-test and evaluation times are estimates.

This course is designed to satisfy the quality requirements state boards set for continuing education. Requirements vary by state, and confirming that a course fits your renewal is up to you. Each state’s own acceptance statement is in the credit panel on this page.

1. This course is an independent educational summary of one peer-reviewed article. All findings, figures, and conclusions described in the course come from that article.
2. Jandacka D, Skypala J, Plesek J, Urbaczka J, Golian M, Burda M, Šustek J, Zahradnik D, Elavsky S, Jandackova VK, Selbie S, Silvernail JF, Hamill J. Biomechanical insights into Achilles tendinopathy risk and protection in runners: a large prospective study 4HAIE. Br J Sports Med. 2026;60(3):186–197. doi:10.1136/bjsports-2025-110260. PMID 41672607; PMCID PMC13018850.
3. Scope note
4. This is an observational cohort study. It reports which baseline measurements were linked to a later diagnosis; it does not test a treatment or a gait-retraining programme, and nothing in this course is intended as clinical direction.