Physical Therapy Evaluation and Treatment of Achilles Tendinopathy in a Runner [Case Study]
Click HERE to Download the Achilles Tendinopathy Evidence Based "Cheat Sheet"
Physical Therapy Evaluation and Treatment of Achilles Tendinopathy in a Runner [Case Study]
- 2:01 - Subjective Examination - Age, Background, Experience, Goals
- 8:37 Objective Examination - Strength, range of motion, regional interdependence
- 11:35 Objective Examination - Running Analysis
- 15:14 Objective Examination - Imaging, palpation, special tests
- 18:18 Plan of Care - Education, Strengthening, training modifications
- 21:44 Plan of Care - Technique modifications, cadence, shoewear
- 24:42 Plan of Care - Programming, running surface modification, hills
- 26:53 Plan of Care - What does the strength program look like?
- 28:38 How to progress strengthening over time
- 30:09 How to implement and progress impact / plyometrics
- 32:25 Stretching and mobility plan
- 32:41 Return to running program
- 35:20 Programming considerations: Polarized / 80:20 training
- 39:44 Long term planning and yearly periodization
- 41:29 Discharge planning and future injury prevention
- 46:45 References
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Show Notes / Relevant Articles:
- FPF Mini Course - 7 Reasons Why Injuries Happen in the Gym and What to do About it
- Achilles Tendinopathy Physical Therapy Exercises (strength)
- Achilles Tendinopathy Plyometric Exercises
- Achilles Tendinopathy - 4 Keys to Diagnosing Achilles Tendinopathy
- Isometrics for Achilles Tendinopathy
- Evidence Based Guide to Lateral Epicondylalgia (Tennis Elbow)
- Evidence Based Guide to Patellofemoral Pain Syndrome
- Evidence Based Guide to Stretching
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Thank you!
Dan Pope DPT, OCS, CSCS
References:
Lorimer AV, Hume PA. Stiffness as a Risk Factor for Achilles Tendon Injury in Running Athletes. Sports Med. 2016 Dec;46(12):1921-1938. doi: 10.1007/s40279-016-0526-9. PMID: 27194434. - soft surface AT
Lyght M, Nockerts M, Kernozek TW, Ragan R. Effects of Foot Strike and Step Frequency on Achilles Tendon Stress During Running. J Appl Biomech. 2016 Aug;32(4):365-72. doi: 10.1123/jab.2015-0183. Epub 2016 Mar 8. PMID: 26955843.
Rice H, Patel M. Manipulation of Foot Strike and Footwear Increases Achilles Tendon Loading During Running. Am J Sports Med. 2017 Aug;45(10):2411-2417. doi: 10.1177/0363546517704429. Epub 2017 May 1. PMID: 28460179.
de Vos R, van der Vlist AC, Zwerver J, et al. Dutch multidisciplinary guideline on Achilles tendinopathy British Journal of Sports Medicine 2021;55:1125-1134
Silbernagel KG, Thomeé R, Eriksson BI, Karlsson J. Continued sports activity, using a pain-monitoring model, during rehabilitation in patients with Achilles tendinopathy: a randomized controlled study. Am J Sports Med. 2007 Jun;35(6):897-906. doi: 10.1177/0363546506298279. Epub 2007 Feb 16. PMID: 17307888.
Zwerver, Johannes et al. “ICON 2019-international scientific tendinopathy symposium: building an ICONic tendon tower-launching a new era in clinical tendinopathy research.” British journal of sports medicine vol. 54,8 (2020): 442-443. doi:10.1136/bjsports-2019-101214
Challoumas D, Biddle M, Millar NL. Recent advances in tendinopathy. Fac Rev. 2020;9:16. Published 2020 Nov 19. doi:10.12703/b/9-16
Millar NL, Silbernagel KG, Thorborg K, Kirwan PD, Galatz LM, Abrams GD, Murrell GAC, McInnes IB, Rodeo SA. Tendinopathy. Nat Rev Dis Primers. 2021 Jan 7;7(1):1. doi: 10.1038/s41572-020-00234-1. Erratum in: Nat Rev Dis Primers. 2021 Feb 3;7(1):10. PMID: 33414454.
Muñoz I, Seiler S, Bautista J, España J, Larumbe E, Esteve-Lanao J. Does polarized training improve performance in recreational runners? Int J Sports Physiol Perform. 2014 Mar;9(2):265-72. doi: 10.1123/ijspp.2012-0350. Epub 2013 May 22. PMID: 23752040.
Carnes AJ, Mahoney SE. Polarized vs. High Intensity Multimodal Training in Recreational Runners. Int J Sports Physiol Perform. 2018 Jun 28:1-28. doi: 10.1123/ijspp.2018-0040. Epub ahead of print. PMID: 29952662.
Röhrken G, Held S, Donath L. Six Weeks of Polarized Versus Moderate Intensity Distribution: A Pilot Intervention Study. Front Physiol. 2020 Nov 12;11:534688. doi: 10.3389/fphys.2020.534688. PMID: 33281607; PMCID: PMC7689383.
Ramskov D, Rasmussen S, Sørensen H, et alRun Clever – No difference in risk of injury when comparing progression in running volume and running intensity in recreational runners: A randomised trialBMJ Open Sport & Exercise Medicine 2018;4:e000333. doi: 10.1136/bmjsem-2017-000333
Möck S, Hartmann R, Wirth K, Rosenkranz G, Mickel C. Correlation of dynamic strength in the standing calf raise with sprinting performance in consecutive sections up to 30 meters. Res Sports Med. 2018 Oct-Dec;26(4):474-481. doi: 10.1080/15438627.2018.1492397. Epub 2018 Jul 2. PMID: 29963928.
van Oeveren BT, de Ruiter CJ, Beek PJ, van Dieën JH. Optimal stride frequencies in running at different speeds. PLoS One. 2017 Oct 23;12(10):e0184273. doi: 10.1371/journal.pone.0184273. PMID: 29059198; PMCID: PMC5653196.