Burden and risk factors for Achilles tendinopathy in the military population from 2006 to 2015. A retrospective cohort study.

BackgroundAnkle-foot conditions are ubiquitous in the US Military. The objective of this study was to evaluate the burden and associated factors of Achilles tendinopathy (AT). MethodsThe Defense Medical Epidemiology Database was used to identify all diagnosed AT in military personnel from 2006 to 2015. Prevalence of AT was calculated and compared by year, service branch, and military rank. Unadjusted and adjusted assessment of injury risk were calculated. ResultsOfficers incurred 37,939 episodes at a prevalence of 17.65 per 1000 (male officers: 18.20 per 1000; female officers: 14.80 per 1000). Among enlisted personnel, there were 116,122 episodes of AT that occurred in 12.22 per 1000 (male enlisted: 12.07 per 1000; female enlisted: 13.22 per 1000). All officer specialties had significantly higher risk of AT episodes compared to the ground and naval gunfire officers (PR: 1.04-1.43), with aviation demonstrating a significant protective effect (PR: 0.65). Among enlisted specialties, maritime/naval specialties had reduced risk (PR: 0.82), with all specialties (except aviation) having increased risk of AT compared to infantry (PR: 1.07-1.71). There were multiple associated factors identified, to include sex, age, rank, military occupation, and service branch. ConclusionsAT was ubiquitous in the US military, with a progressive increase in prevalence during the study epoch. There were multiple associated factors identified, to include sex, age, rank, military occupation, and service branch. These findings highlight both the need for prophylactic interventions and identification of the populations with the greatest need.