CASE STUDY: Achilles Tendinopathy

Mr X, a 43 year old banker visited the clinic complaining of Achilles heel pain after starting back at the gym the previous week and running hard on the treadmill for 30 minutes on consecutive days. He had not exercised much over the last few years but had previously been very sporty and was surprised to have a problem after what he would class as easy workout sessions. Mr X was now experiencing pain regularly when walking to work and had not been back to the gym for fear of making the symptoms worse.

A thorough examination in the clinic cleared other potential sources of heel pain and a diagnosis of reactive tendinopathy was made. Mr X was educated about the pathology and a load management plan was implemented which enabled him to continue exercising in the gym but with much reduced Achilles loading. He was given a heel raise for short term use in his shoes when walking to work and advised to approach his GP to discuss short term use of non-steroidal anti-inflammatory medication as their ability to impede healing is thought to help reduce abnormal changes in the tendon at this stage.

Mr X made a timely and successful graded return to running in the gym and experienced no further problems.

Over the subsequent weeks when the pain had subsided a biomechanical assessment was completed which amongst other tests included assessment of his running technique on the treadmill. Advice was given regarding running technique and footwear as well as some hip strengthening and calf stretching exercises.