Recently a 37-year-old man came to our Physiotherapy clinic in Etobicoke, he experienced a workplace injury while descending from a forklift, initially feeling mild pain that intensified over time. Subsequently, he developed a noticeable limp, as observed in the beginning of the video. The pain intensity during activities peaked at 7 out of 10, while at rest, it was a mild 1 out of 10.
The pain exacerbated during activities like walking, with ascending stairs proving more challenging than descending. Discomfort intensified when entering or exiting the car and while remaining stationary, including morning pains. However, pain gradually subsided throughout the day and improved with movement.
Certain ankle movements, such as pointing toes upwards and downwards, triggered pain. Tenderness was noted at the Achilles tendon insertion point, accompanied by moderate swelling and an absence of bruising, indicating a specific area of discomfort without external signs of injury.
The patient displayed an antalgic gait pattern, indicative of discomfort. Manifesting a noticeable limp, the individual consciously limited weight-bearing on the afflicted foot, swiftly transferring it to the non-painful leg. While walking, an inability to place the heel on the affected leg was observed, with a preference for keeping it elevated. This intentional gait modification aimed to prevent undue stretching of the healing Achilles tendon, minimizing pain during ambulation. In addition to gait adjustments, the patient received specific recommendations for footwear. Wearing high-heeled shoes and work boots was advised to maintain a slightly dorsiflexed position, aiding in the avoidance of excessive tension on the healing tendon. This was emphasized as a supportive measure to facilitate the healing process and reduce strain on the Achilles tendon, contributing to overall recovery and enhanced mobility for the patient.
Returning to regular hours with modified duties, the patient took precautions to safeguard the healing tendon from potential harm. An Achilles tendon supportive brace was provided, offering crucial support and alleviating walking discomfort. The brace, constructed from compressive fabric, not only provided stability but also contributed to reducing post-shift swelling, enhancing overall comfort and aiding in the ongoing recovery process.
Treatment Administered at Get Back Physiotherapy Etobicoke Clinic
- The treatment involved hands-on mobilization techniques, enhancing flexibility and joint movement in the ankle and foot areas.
- Calf muscles received therapeutic soft tissue release, targeting tension and promoting relaxation for improved flexibility and pain relief.
- Cross-friction massage focused on the Achilles tendon insertion, promoting healing and reducing tension, promoting recovery and alleviating discomfort.
- Ultrasound therapy (US) was administered to the affected area, aiming to diminish inflammation and expedite the healing process of the tendon for enhanced recovery and pain relief.
- Interferential Current (IFC) was applied to the ankle and calf, effectively reducing muscle spasms and alleviating pain for therapeutic relief.
- Focused stretching exercises targeted the calf muscles, promoting flexibility and mitigating discomfort, ultimately enhancing mobility and contributing to pain relief.
- Patient was instructed in intrinsic foot and ankle muscle strengthening exercises, facilitating improved stability, resilience, and overall strength to support the healing process and prevent future issues.
- A personalized home exercise program was recommended, ensuring continuity of care.
