Exploración de los factores biomecánicos que contribuyen a las rupturas del tendón de Aquiles
DOI:
https://doi.org/10.47197/retos.v79.118164Palabras clave:
Contracción excéntrica , fenómenos biomecánicos, fuerza muscular, lesiones de los tendones, lesiones del Tendón de Aquiles, rehabilitaciónResumen
Antecedentes: Las roturas del tendón de Aquiles constituyen un problema musculoesquelético relevante, especialmente entre atletas y personas físicamente activas. Su aparición está influida por diversos factores biomecánicos que reducen la resistencia del tendón y aumentan su susceptibilidad a la lesión.
Objetivo del estudio: Este estudio tiene como objetivo analizar los principales factores biomecánicos intrínsecos y extrínsecos que contribuyen a la rotura del tendón de Aquiles y aclarar cómo su interacción conduce a la lesión.
Metodología: Se realizó una revisión sistemática estructurada de la literatura científica utilizando criterios predefinidos de búsqueda, selección y síntesis para identificar estudios sobre los determinantes biomecánicos de la rotura del tendón de Aquiles.
Resultados: La evidencia identifica factores intrínsecos como cambios estructurales asociados a la edad, diferencias por sexo, variaciones del arco plantar, desequilibrios musculares y patología tendinosa previa. Entre los factores extrínsecos destacan cargas de entrenamiento inadecuadas, calzado inapropiado, características de la superficie y exigencias mecánicas del deporte. La rotura suele producirse durante cargas excéntricas elevadas o movimientos rápidos que superan la capacidad del tendón.
Discusión: Los hallazgos indican que la rotura resulta de la interacción entre vulnerabilidad intrínseca y estrés mecánico externo. El riesgo aumenta cuando las cargas superan la tolerancia estructural del tendón, lo que subraya la importancia de considerar tanto la susceptibilidad individual como las condiciones de carga.
Conclusión: Comprender estos factores biomecánicos interrelacionados puede mejorar la identificación del riesgo, orientar estrategias preventivas y optimizar la rehabilitación para favorecer un retorno seguro a la actividad física.
Referencias
Benjamin, M., Kaiser, E., & Milz, S. (2008). Structure-function relationships in tendons: a review. Journal of anatomy, 212(3), 211–228. https://doi.org/10.1111/j.1469-7580.2008.00864.x
Bohm, S., Mersmann, F., & Arampatzis, A. (2015). Human tendon adaptation in response to mechanical loading: a systematic review and meta-analysis of exercise intervention studies on healthy adults. Sports medicine - open, 1(1), 7. https://doi.org/10.1186/s40798-015-0009-9
Choi, Y. H., Kwon, T. H., Choi, J. H., Han, H. S., & Lee, K. M. (2024). Factors associated with Achilles tendon re-rupture following operative fixation. Bone & joint research, 13(7), 315–320. https://doi.org/10.1302/2046-3758.137.BJR-2023-0258.R1
Della Villa, F., Buckthorpe, M., Tosarelli, F., et al. (2022). Video analysis of Achilles tendon rupture in male professional football (soccer) players: Injury mechanisms, patterns and biomechanics. BMJ Open Sport & Exercise Medicine, 8(1), e001419. https://doi.org/10.1136/bmjsem-2022-001419
Egger, A. C., & Berkowitz, M. J. (2017). Achilles tendon injuries. Current Reviews in Musculoskeletal Medicine, 10(1), 72–80. https://doi.org/10.1007/s12178-017-9386-7
Fariño Cortez, J. E., Montero Figueroa, H. E., González Kalil, E. F., & Valle Flores, J. A. (2025). Functional and biomechanical predictors of pain and grip width in male Crossfit athletes. Retos, 71, 977-987. https://doi.org/10.47197/retos.v71.117424
Fonseca, R., Casimiro, G., Brandão Pinto de Castro, J., Alonso, L., Lima, B., Filho, G., Nunes, R., & Vale, R. (2022). Analysis of vertical jump, rating of perceived exertion, delayed-onset muscle soreness, and muscular peak power in young male Brazilian football players submitted to plyometric and semi-squat training with weights. Retos, 46, 613–621. https://doi.org/10.47197/retos.v46.94085
Freedman, B. R., Gordon, J. A., & Soslowsky, L. J. (2014). The Achilles tendon: fundamental properties and mechanisms governing healing. Muscles, ligaments and tendons journal, 4(2), 245–255.
Gracey, E., Burssens, A., Cambré, I., Schett, G., Lories, R., McInnes, I. B., Asahara, H., & Elewaut, D. (2020). Tendon and ligament mechanical loading in the pathogenesis of inflammatory arthritis. Nature reviews. Rheumatology, 16(4), 193–207. https://doi.org/10.1038/s41584-019-0364-x
Grassi, A., Caravelli, S., Fuiano, M., D'Hooghe, P., Filippini, M., et al. (2022). Epidemiology of Achilles Tendon Rupture in Italian First Division Football (Soccer) Players and Their Performance After Return to Play. Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine, 32(1), e90–e95. https://doi.org/10.1097/JSM.0000000000000879
Jadue Arriaza, S., Ergas Schleef, D. I., Reyes Sanchez, Y. Y., Bustos Barahona, R. B., & Tauda Tauda, M. E. (2025). Quantitative analysis of joint forces and musculoskeletal reactions in squat variations: a systematic review. Retos, 74, 1012-1025. https://doi.org/10.47197/retos.v72.116926
Janssen, R., Gustafsson, A., Jönsson, V., Grassi, L., Pierantoni, M., & Isaksson, H. (2025). Investigating Achilles tendon adaptation to mechanical load: a computational model integrating collagen fibre orientation heterogeneity. Biomechanics and modeling in mechanobiology, 24(6), 1959–1972. https://doi.org/10.1007/s10237-025-02002-0
Jung, H. J., Fisher, M. B., & Woo, S. L. (2009). Role of biomechanics in the understanding of normal, injured, and healing ligaments and tendons. Sports medicine, arthroscopy, rehabilitation, therapy & technology: SMARTT, 1(1), 9. https://doi.org/10.1186/1758-2555-1-9
Kharazi, M., Bohm, S., Theodorakis, C., Mersmann, F., & Arampatzis, A. (2021). Quantifying mechanical loading and elastic strain energy of the human Achilles tendon during walking and running. Scientific reports, 11(1), 5830. https://doi.org/10.1038/s41598-021-84847-w
Hewett, T. E., Lavender, C. D., & Schaver, A. L. (2024). An apparent Achilles heel of the NFL: Have Achilles tendon injuries significantly increased to unacceptably high incidence levels in the NFL and if so, why? A clinical insight. International Journal of Sports Physical Therapy, 19(2), 145–147. https://doi.org/10.26603/001c.92082
Kongsgaard, M., Aagaard, P., Kjaer, M., & Magnusson, S. P. (2005). Structural Achilles tendon properties in athletes subjected to different exercise modes and in Achilles tendon rupture patients. Journal of Applied Physiology, 99(5), 1965–1971. https://doi.org/10.1152/japplphysiol.00384.2005
Leppilahti, J., Puranen, J., & Orava, S. (1996). Incidence of Achilles tendon rupture. Acta Orthopaedica, 67(3), 277–279. https://doi.org/10.3109/17453679608994688
Maas, H., Arndt, T., & Franz, J. R. (2021). Editorial: Tendon structure–function relationship in health, ageing, and injury. Frontiers in Sports and Active Living, 3, 701815.
https://doi.org/10.3389/fspor.2021.701815
Magnusson, S. P., & Kjaer, M. (2019). The impact of loading, unloading, ageing and injury on the human tendon. The Journal of physiology, 597(5), 1283–1298. https://doi.org/10.1113/JP275450
Malisoux, L., Chambon, N., Urhausen, A., & Theisen, D. (2016). Influence of the Heel-to-Toe Drop of Standard Cushioned Running Shoes on Injury Risk in Leisure-Time Runners: A Randomized Controlled Trial With 6-Month Follow-up. The American journal of sports medicine, 44(11), 2933–2940. https://doi.org/10.1177/0363546516654690
Mansfield, K., Dopke, K., Koroneos, Z., Bonaddio, V., Adeyemo, A., & Aynardi, M. (2022). Achilles tendon ruptures and repair in athletes—A review of sports-related Achilles injuries and return to play. Current Reviews in Musculoskeletal Medicine, 15(5), 353–361. https://doi.org/10.1007/s12178-022-09774-3
Marrone, W., Andrews, R., Reynolds, A., Vignona, P., Patel, S., & O’Malley, M. (2024). Rehabilitation and return to sports after Achilles tendon repair. International Journal of Sports Physical Therapy, 19(9), 1152–1165. https://doi.org/10.26603/001c.122643
Medina Pabón, M. A., & Naqvi, U. (2023, August 17). Achilles tendinopathy. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538149/
Müller, S. A., Evans, C. H., Heisterbach, P. E., & Majewski, M. (2018). The Role of the Paratenon in Achilles Tendon Healing: A Study in Rats. The American journal of sports medicine, 46(5), 1214–1219. https://doi.org/10.1177/0363546518756093
Ochen, Y., Beks, R. B., van Heijl, M., Hietbrink, F., et al. (2019). Operative treatment versus nonoperative treatment of Achilles tendon ruptures: systematic review and meta-analysis. BMJ (Clinical research ed.), 364, k5120. https://doi.org/10.1136/bmj.k5120
Osorio-Torres, W., Venegas de la Paz, M., Vargas-Foitzick, R., & Arias-Álvarez, G. (2025). Effectiveness of blood flow restriction in lower limb tendons: a systematic review. Retos, 72, 654-663. https://doi.org/10.47197/retos.v72.99681
Petway, A. J., Jordan, M. J., Epsley, S., & Anloague, P. (2022). Mechanisms of Achilles tendon rupture in National Basketball Association players. Journal of Applied Biomechanics, 38(6), 398–403. https://doi.org/10.1123/jab.2022-0088
Powell, H., Silbernagel, K. G., Brorsson, A., Tanberg, R., & Willy, R. W. (2017). Individuals post Achilles tendon rupture exhibit asymmetrical knee and ankle kinetics and loading rates during a drop countermovement jump. Journal of Orthopaedic & Sports Physical Therapy, 48(1), 34–43. https://doi.org/10.2519/jospt.2018.7684
Preciado Martinez, D. C., Bustamante Garrido, A.., & Sanjuanelo Corredor, D. W.. (2024). Isokinetic dynamometry and segmental anthropometry as parameters for shoulder rotator Muscles injury in athletes. Retos, 51, 6-17. https://doi.org/10.47197/retos.v51.99498
Raikin, M. (2014). Epidemiology of Achilles tendon rupture in the US. Lower Extremity Review Magazine. https://lermagazine.com/article/epidemiology-of-achilles-tendon-rupture-in-the-us
Roberts, T. J., & Konow, N. (2013). How tendons buffer energy dissipation by muscle. Exercise and sport sciences reviews, 41(4), 186–193. https://doi.org/10.1097/JES.0b013e3182a4e6d5
Rosso, C., & Valderrabano, V. (2010). Biomechanics of the Achilles tendon. In Current concepts in orthopaedics: Achilles tendinopathy (1st ed.). DJO Publications.
Rowson, S., McNally, C., & Duma, S. M. (2010). Can footwear affect Achilles tendon loading? Clinical Journal of Sport Medicine, 20(5), 344–349. https://doi.org/10.1097/JSM.0b013e3181ed7e50
Sánchez-Gómez, Ángela., Domínguez, R., Sañudo, B.., & San Juan, A. F.. (2023). Effects of 8 weeks of eccentric exercise and extracorporeal shockwave therapy on tendon tissue, perceived pain, and muscle power and strength in athletes diagnosed with patellar tendinopathy: A longitudinal study. Retos, 47, 1-11. https://doi.org/10.47197/retos.v47.93378
Sankova, M. V., Beeraka, N. M., Oganesyan, M. V., Rizaeva, N. A., et al. (2024). Recent developments in Achilles tendon risk-analyzing rupture factors for enhanced injury prevention and clinical guidance: Current implications of regenerative medicine. Journal of orthopaedic translation, 49, 289–307. https://doi.org/10.1016/j.jot.2024.08.024
Scott, A., Squier, K., Alfredson, H., Bahr, R., et al. (2020). ICON 2019: International Scientific Tendinopathy Symposium Consensus: Clinical Terminology. British journal of sports medicine, 54(5), 260–262. https://doi.org/10.1136/bjsports-2019-100885
Sepúlveda-González, S., Tejo-Cárdenas, J., Araya-Ibacache, M., Mardones-Delgado, L., Pardo-Tamayo, C., Brito, C. J., Aedo-Muñoz, E., & Bustamante-Garrido, A. (2025). Viscoelastic adaptations of Achilles and patellar tendons in elite athletes: a cross-sport myotonometry study. Retos, 73, 258-268. https://doi.org/10.47197/retos.v73.117202
Shamrock, A. G., Dreyer, M. A., & Varacallo, M. A. (2023). Achilles tendon rupture. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430844/
Sinclair, J.K., & Sant, B. (2016). The effects of CrossFit and minimalist footwear on Achilles tendon kinetics during running. The Foot and Ankle Online Journal, 9 (4): 2.
Svedman, S., Marcano, A., Ackermann, P. W., Felländer-Tsai, L., & Berg, H. E. (2024). Acute Achilles tendon ruptures between 2002-2021: sustained increased incidence, surgical decline and prolonged delay to surgery-a nationwide study of 53 688 ruptures in Sweden. BMJ open sport & exercise medicine, 10(3), e001960. https://doi.org/10.1136/bmjsem-2024-001960
Svensson, R. B., Hansen, P., Hassenkam, T., Haraldsson, B. T., Aagaard, P., Kovanen, V., Krogsgaard, M., Kjaer, M., & Magnusson, S. P. (2012). Mechanical properties of human patellar tendon at the hierarchical levels of tendon and fibril. Journal of applied physiology (Bethesda, Md.: 1985), 112(3), 419–426. https://doi.org/10.1152/japplphysiol.01172.2011
Thorpe, C. T., & Screen, H. R. (2016). Tendon Structure and Composition. Advances in experimental medicine and biology, 920, 3–10. https://doi.org/10.1007/978-3-319-33943-6_1
Thorpe, C. T., Karunaseelan, K. J., Ng Chieng Hin, J., Riley, G. P., Birch, H. L., Clegg, P. D., & Screen, H. R. (2016). Distribution of proteins within different compartments of tendon varies according to tendon type. Journal of anatomy, 229(3), 450–458. https://doi.org/10.1111/joa.12485
van der Vlist, A. C., Breda, S. J., Oei, E. H. G., Verhaar, J. A. N., & de Vos, R. J. (2019). Clinical risk factors for Achilles tendinopathy: A systematic review. British Journal of Sports Medicine, 53(21), 1352–1361. https://doi.org/10.1136/bjsports-2018-099991
Wang, C., Jiang, Z., Pang, R., Zhang, H., Li, H., & Li, Z. (2023). Global trends in research of Achilles tendon injury/rupture: A bibliometric analysis, 2000–2021. Frontiers in Surgery, 10, 1051429. https://doi.org/10.3389/fsurg.2023.1051429
Wang, J. H., Guo, Q., & Li, B. (2012). Tendon biomechanics and mechanobiology--a minireview of basic concepts and recent advancements. Journal of hand therapy: official journal of the American Society of Hand Therapists, 25(2), 133–141. https://doi.org/10.1016/j.jht.2011.07.004
Wertz, J., Galli, M., & Borchers, J. R. (2013). Achilles tendon rupture: Risk assessment for aerial and ground athletes. Sports Health, 5(5), 407–409. https://doi.org/10.1177/1941738112472165
Wilharm, N., Fischer, T., Hayn, A., & Mayr, S. G. (2022). Structural Breakdown of Collagen Type I Elastin Blend Polymerization. Polymers, 14(20), 4434. https://doi.org/10.3390/polym14204434
Wong, M., Jardaly, A. H., & Kiel, J. (2023, August 8). Anatomy, bony pelvis and lower limb: Achilles tendon. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499917/
Wukich, D. (2025). Achilles tendon injuries: Why do they take so long to heal? Orthopaedics. https://utswmed.org/medblog/achilles-tendon-injuries-rehab/
Xergia, S. A., Tsarbou, C., Liveris, N. I., Hadjithoma, Μ., & Tzanetakou, I. P. (2023). Risk factors for Achilles tendon rupture: an updated systematic review. The Physician and sportsmedicine, 51(6), 506–516. https://doi.org/10.1080/00913847.2022.2085505
Descargas
Publicado
Número
Sección
Licencia
Derechos de autor 2026 Aida Bendo, Anxhela Ahmataj
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
Los autores que publican en esta revista están de acuerdo con los siguientes términos:
- Los autores conservan los derechos de autor y garantizan a la revista el derecho de ser la primera publicación de su obra, el cuál estará simultáneamente sujeto a la licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores pueden establecer por separado acuerdos adicionales para la distribución no exclusiva de la versión de la obra publicada en la revista (por ejemplo, situarlo en un repositorio institucional o publicarlo en un libro), con un reconocimiento de su publicación inicial en esta revista.
- Se permite y se anima a los autores a difundir sus trabajos electrónicamente (por ejemplo, en repositorios institucionales o en su propio sitio web) antes y durante el proceso de envío, ya que puede dar lugar a intercambios productivos, así como a una citación más temprana y mayor de los trabajos publicados (Véase The Effect of Open Access) (en inglés).
Esta revista sigue la "open access policy" de BOAI (1), apoyando los derechos de los usuarios a "leer, descargar, copiar, distribuir, imprimir, buscar o enlazar los textos completos de los artículos".
(1) http://legacy.earlham.edu/~peters/fos/boaifaq.htm#openaccess
