Research Review: Neuromotor Control of Gluteal Muscles in Runners with Achilles Tendinopathy

By Jinny McGivern PT, DPT

Edited by Amy Martinez DPT, PT

and Brent Brookbush DPT, PT, COMT, MS, PES, CES, CSCS, ACSM H/FS

Original Citation: Franettovich, M. S., Honeywill, C., Wyndow, N., Crossley, K. M., & Creaby, M. W. (2014). Neuromotor control of gluteal muscles in runners with achilles tendinopathy. Medicine and science in sports and exercise, 46(3), 594-599. - ABSTRACT

Introduction: 

Achilles tendinopathy (AT) is a condition resulting in foot and ankle pain, accounting for 8-15% of all injuries in recreational runners (1-3). While previous studies have demonstrated a relationship between individuals with AT and a significant reduction in amplitude of gluteus medius (GMED) activity after heel strike, hip muscle activation timing patterns have not been studied (4). This 2014 study by U.S. researchers demonstrated a correlation between delayed, shorter duration activity of the gluteus maximus (GMAX) and GMED in runners with AT. Human movement professionals should consider assessing GMAX and GMED strength/re-activity, and address any noted weaknesses in those exhibiting signs of AT.

Achilles Tendinopathy Achilles tendinopathy. (Image: Courtesy http://www.getactivephysio.com.au/conditions-treated/achilles-tendinopathy/)

Study Summary

Study DesignCross-Sectional Correlation Study
Level of EvidenceIIB Evidence from at least one quasi-experimental study
Participant CharacteristicsDemographics

  • Age:

    • Achilles tendinopathy (AT) study group: 43 +/- 8 years
    • Uninjured control group: 37 +/- 8 years

  • Gender: male
  • Number of participants: 33

    • 14 in the study group
    • 19 in the control group

  • Runners: with AT and healthy controls

Inclusion Criteria:

  • Both groups:

    • Male, older than 18 years and currently running ≥ 20 kilometers (km)/week

  • AT study group:

    • No other lower limb injury at the time of testing or in the past 12 months aside from symptoms of midportion AT, which include: Achilles tendon pain with running, hopping and palpation; morning stiffness; and symptoms affecting exercise activity
    • Confirmation via diagnostic