Dr Iain Duncan

A recent review by Janne A. Peters and colleagues in the Journal of Science and Medicine in Sport looked at the available evidence for tendon injury prevention. They conducted a systematic literature review to identify articles that assessed prevention systematically. They found ten articles with a wide variety of preventive interventions, which they divided into categories: stretch and exercise interventions, shoe adaptations and other interventions.

They reached the following conclusions:

  1. There is limited evidence that a long-term intervention including balance training is effective in the prevention of patellar and Achilles tendinopathy.
  2. Shoe adaptations in the form of shock absorbing insoles could have a preventive effect on Achilles tendinopathy.
  3. Hormone replacement therapy seems to reduce the risk for structural Achilles tendon changes in active post-menopausal women.
  4. There is no evidence of a benefit from stretching exercises.
  5. Eccentric training and stretching can increase the risk of injury in asymptomatic players with patellar tendon abnormalities.

This is certainly food for thought but it should be borne in mind that the lack of evidence does not mean there is no benefit, just that the limited studies have been unable to demonstrate it. On a positive note there is evidence of the importance of footwear and indirectly podiatry intervention.