Achilles Tendinopathy Case Study

Gender: Female
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?

Footwear? Orthotics?

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

NAD (me!)

 

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.

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