The clinical impression gathered leads to a second degree Achilles Tendinitis disorder. Tendinitis is inflammation of the tendon. Thus, Achilles Tendinitis is an inflammation of the Achilles tendon. The primary symptoms were pain and inflammation localized to the back of the lower leg closer to the heel than to the muscles of the calf (appendix 1). Pain was reported upon contraction of the calf muscles effecting ROM and gait. The aetiology to its development is secondary to a multifactor of the clients training errors such as poor lower limb flexibility, poor footwear, sudden training intensity, terrain surfaces along with faulty lower limb biomechanics primarily pronation.
Plan Conservative treatment is recommended initially with surgical exploration if unsuccessful (Densted 1979). The plan was broken down into short, intermediate and long term goals which where discussed and agreed with the client. Effective treatment required immediate withdrawal from all activities that induce symptoms. Crutch immobilization followed by gradual return to weight bearing activities. NSAIDs, could be taken according to directions which can be found in the British National Formulary 2000, along with ice treatment progressing to contrast baths and massage. Supplement normal training with swimming as it is non-weight bearing and allows for gentle motion of the feet at the ankle and weight training to minimize the decline in fitness.
The client should wear well-designed and fitted footwear following gradual transition from one shoe to another. Correcting faulty foot biomechanics with prescribed orthotic devices which correct heel and forefoot misalignments and heel lifts to reduce strain on the tendon could be considered (Bates et al). The client will adhere to a consistent gradual training programme, without sudden changes in training intensities consisting of a daily program of lower leg mobility, strength training and flexibility exercises.
Treatment Strategy for Achilles Tendininitis Brief Summary The SOAP notes format provided a systematic approach that allowed the Sports rehabilitator to assemble enough information through elimination to form a clinical impression, thus allowing both parties to formulate a treatment plan. It also was the start of professional relationship with the client.
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