Achilles Tendinopathy Case Study
AGE: 54years old
BMI = 22
L/Mid Portion Achilles pain which has been present for approximately 4months.
Recently a grandmother (3months) and baby sits 4 times a week.
Pain described as an ache most of the time with occasional sharp grab.
VAS: 6/10 most of the time, 9/10 at worst, 2/10 at best
Exercise: Walk/Jog x3 weekly
Pump Class x3 weekly
Swimming x1 weekly
No further information has been collected.
What is your qualification?
B.App.Sc (Comp Med) M.Osteo
Specialised or unique case history approach
Aggravating factors? Relieving factors?
What causes it to grab?
Is it worsening/improving/staying the same?
Distance running/walking? Onset of pain when running/walking? Or relief with these activities?
History of Achilles? Any previous issues?
Any previous treatment?
Specialised or unique assessment procedures
Pain with gait/single leg stance/bilateral or unilateral calf raises?
Pain with stretch of Achilles?
Pain with palpation or squeeze of Achilles
Over lower extremity biomechanics assessment- Ie. Arches etc
Palpation/resting tone of leg muscles
Active and passive foot and ankle ROM
Specialised or unique equipment for assessment and treatment
Specialised or unique treatment types/approaches
Soft tissue massage to calf/feet/leg muscles
Dry needling to calf muscles/leg muscles
Articulation to ankle and foot
Lifestyle modifications- identify aggravating factors and modify them to an asymptomatic level. For example; modifying running/walking surface/distance/intensity, footwear advice etc.
Treatment targets and criteria for prognosis, referral and management outcomes
Try a combination of manual therapy and lifestyle modification for a period of 6-8 weeks, if there is no change or worsening of symptoms then re-assess for other intervention. This may include- orthotics, anti-inflammatories, cortisone/PRP, shock-wave therapy etc.