Achilles tendonitis: treated with plantar orthoses and Stanish protocol
Pronation / Supination angles
Angle of attack
The podiatrist uses DigitsolePro.com® for the dynamic analysis (walking or running depending on the patient). He collects data on the patient’s walking or running
activity using the web interface available online at https://app.DigitsolePro.com. The results are then presented to the patient, allowing the patient to integrate them into the treatment process and facilitating acceptance.
Does the practitioner use other movement analysis systems?
The practitioner uses a camera to analyse the activity of athletes and movement analysis software in 2 dimensions of movement.
During the first examination, the patient complained of pain in the left Achilles tendon.
The pain increases when running and especially during stages of acceleration.
In the examination, the tendon is fusiform and does not have nodules, the pain is low and a slight bilateral decrease in the tibio-talar amplitude is observed. The stationary left foot is slightly varus.
During the second examination, the pain had disappeared, and the patient was able to resume his running sessions normally and was able to accelerate.
The Practitioner uses DigitsolePro for the dynamic analysis (walking or running depending on the patient). He collects data on the walking and running activity of the patient using the web interface available online at https://app.digitsolepro.com.
The results are then presented to the patient, medical staff and loved ones, allowing the patient to integrate them into the treatment process and facilitating acceptance.
Different parameters will be used to complete the clinical examination:
During the first exam, the goal was to see all the factors that could have an impact on the inflammation of the tendon:
When walking, left foot varus and rolling of the foot in supination, which increases the tension on the tendon. Foot orthotics intended to limit supination of the left foot will be made. They also support the midfoot and therefore help to relax the suro-achilles-plantar system
When running, the two feet have a supinator roll, but it is more pronounced in the right foot this time. Forefoot strike when running increases tension on the tendon.
The patient needs to adapt his way of running (strike more midfoot) in a manner that alleviates the tendon.
From certain information, we can also assess the patient’s pain.
Patients suffering greatly from the Achilles tendon often have decreased contact time in the heel and propel themselves differently.
The contact times correspond perfectly with the norms for this patient (colour green) with no significant difference.
Slight difference in propulsion between the two sides, with a left side that uses the plantar flexors more.
Summary of the first session:
The patient has pain with few implications for walking. In addition to the apparatus that will made for him, footwear recommendations will be provided to him (running shoes favouring midfoot support).
He will also be advised to see a physical therapist to begin a rehabilitation program.
During the second session, 10 months later, the patient no longer experiences pain. We observe the development of certain parameters:
10 months later
Between the two sessions, decrease in the supinator roll on both sides.
Midfoot striking rather than the previous forefoot striking, which is a good change in his running.
We note a positive development between the two analyses with a patient who uses his plantar flexors much more to propel on the left side. After questioning, the patient explains that he continued his rehabilitation at home (Stanish protocol), but that he only does the left side (the side with pain). In view of the results, the patient understands that he should also apply the same protocol to the right side (at least the strength training portion)
The objective was attained. The patient no longer has a painful tendon and can resume normal activity.
Digitsole Pro helped to identify what could increase or trigger inflammation of the Achilles tendon, and helped to monitor the evolution of all these parameters over time.
However, the fact that he stopped rehabilitation on the unaffected side created a disequilibrium at the time of propulsion. He should now work on the right side to obtain a more even foot propulsion ratio.
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