Abstract
The Achilles tendon, though the strongest in the human body, is the most commonly ruptured and frequently affected by tendinopathy, particularly in athletes. Achilles tendinopathy (AT) impacts approximately 8% of sports participants, with a lifetime incidence of over 50% in runners. Characterized by pain and tenderness, AT significantly compromises quality of life and functional performance. This narrative review explores biomechanical factors contributing to AT, focusing on both kinematic and kinetic parameters and their clinical relevance, providing a review of AT biomechanics literature, nonoperative interventions, and exercises targeting specific biomechanical risks. Studies have linked abnormal motion to AT. Key biomechanical factors include decreased plantar flexion strength, reduced gluteus medius and maximus activity, decreased peak ankle dorsiflexion, altered peak knee flexion, and decreased forward progression of the center of force, which may increase mechanical load and microtrauma, ultimately resulting in tendon damage. The effectiveness of various interventions was examined, emphasizing the integration of specific exercises aimed at addressing distinct biomechanical deficits. Effective management of AT requires addressing strength deficits and biomechanical abnormalities. Traditional rehabilitation protocols focus on strengthening but often neglect critical biomechanical issues. This review highlights the importance of incorporating specific exercises targeting kinematic and kinetic deficiencies. Level of Evidence V; Expert Opinion .