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360 Neuromuscular Therapy

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24

Achilles Tendinosis

Presentating symptoms

achillesA 50 year-old male was referred by his podiatrist for Achilles tendinosis. The doctor wanted him to receive NMT treatment in conjunction with a course of physical therapy.

Evaluation, clinical reasoning & treatment strategizing

360 NMT communicated with the patient’s physical therapist to coordinate care. Postural analysis and muscle testing revealed that the tendon was under additional load from faulty knee/hip alignment due to hip muscle weakness. The Achilles tendon was palpated and found to be very tender and swollen.

Treatment

NMT application focused on decreasing muscle density and trigger point activity in the calf (especially the distal soleus) and foot muscles. Cross-friction work to the tendon was performed to tolerance. Four neuromuscular treatments helped alleviate local calf tenderness and swelling at the Achilles tendon. Next, the external hip rotators and muscles behind the knee were examined. Weakness was found in the hip along with the faulty knee alignment pattern. Both added to the strain on his Achilles tendon. Eight more weeks of combined PT and NMT treatment to the entire lower extremity resolved this issue.

Outcomes and follow-up

This collaboration between massage therapy and physical therapy produced positive and speedy patient outcomes. 360 NMT focused on treating the soft-tissue dysfunction in the lower extremity while physical therapy concurrently worked to strengthen the calf and hip muscles.

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