Abstract
An 80-year-old female patient with insertional Achilles tendinopathy was seen for student physical therapy treatment for 11 sessions over the course of 8 weeks at an outpatient physical therapy clinic under the supervision of a licensed physical therapist. The patient was examined at the initial encounter with palpation, resistive testing, manual muscle testing (MMT), goniometry, the Numeric Pain Rating Scale (NPRS), the Lower Extremity Functional Scale (LEFS), and the Victoria Institute of Sport Assessment-Achilles (VISA-A) and a plan of care was established to address Achilles tendon insertion pain, dorsiflexion range of motion deficits, plantar flexor weakness, lower extremity function limitation, and restrictions in traveling with family and going on daily walks. Main goals for the patient were to decrease pain, and to increase ankle strength and range of motion in order to improve overall lower extremity function so she could return to daily activities without difficulty. Main interventions used were eccentric plantar flexion exercises and soft tissue mobilization of the Achilles tendon, gastrocnemius, and soleus as well as general foot and ankle strengthening and plantar flexor stretching. The patient achieved the goals of decreasing heel pain, improving plantar flexion strength, improving lower extremity function, and improving participation in recreational activities. The patient was discharged to continue living at home with the prescription of a home exercise program.