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. 2011 Dec;55(4):269-79.

Chronic Achilles tendinopathy: a case study of treatment incorporating active and passive tissue warm-up, Graston Technique, ART, eccentric exercise, and cryotherapy

Andrew L Miners  1 , Tracy L Bougie
Affiliations

Chronic Achilles tendinopathy: a case study of treatment incorporating active and passive tissue warm-up, Graston Technique, ART, eccentric exercise, and cryotherapy

Andrew L Miners et al. J Can Chiropr Assoc. 2011 Dec.

Abstract
in English, French

Objective: To describe the subjective pain and functional improvements of a patient with chronic Achilles tendinopathy following a treatment plan incorporating active and passive tissue warm-up, followed respectively by soft tissue mobilization utilizing both Graston Technique(®) and Active Release Techniques(®), eccentric exercise, and static stretching in combination with cryotherapy.

Background: The primary characterization of chronic Achilles tendinopathy is gradual onset of pain and dysfunction focused in one or both Achilles tendons arising secondary to a history of repetitive use or excessive overload.

Intervention and outcome: Conservative treatment is commonly the initial strategy for patient management. Tissue heating, soft tissue mobilization, eccentric training, and static stretching with cryotherapy were implemented to reduce pain and improve function.

Summary: A specific protocol of heat, soft tissue mobilization, eccentric exercise, stretching, and cryotherapy appeared to facilitate a rapid and complete recovery from chronic Achilles tendinopathy.

Objectif: décrire la douleur subjective et les améliorations fonctionnelles d’un patient souffrant de tendinopathie achilléenne chronique qui suit un traitement comprenant le réchauffement des tissus actifs et passifs, suivi respectivement de la mobilisation des parties molles à l’aide de la technique Graston® et des techniques Active Release®, de l’exercice excentrique, et de l’étirement statique jumelé à la cryothérapie.

Information de base: la tendinopathie achilléenne chronique se caractérise principalement par une douleur et une dysfonction qui évoluent graduellement dans l’un des tendons d’Achille, ou les deux, suite à un usage répétitif ou une surcharge excessive.

Intervention et résultat: le traitement conservateur constitue la stratégie initiale de gestion des patients. Le réchauffement des tissus, la mobilisation des parties molles, l’exercice excentrique et l’étirement statique avec cryothérapie furent utilisés pour atténuer la douleur et améliorer les fonctions.

Sommaire: un protocole spécifique de chaleur, la mobilisation des parties molles, l’exercice excentrique, l’étirement et la cryothérapie semblent faciliter la récupération rapide et complète d’une tendinopathie achilléenne chronique.

Keywords: Achilles; Active Release Techniques; Graston Technique; cryotherapy; eccentric exercise; soft tissue therapy; tendinopathy; tendon pathology; thermotherapy.

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Figures

Figure 1
Figure 1
Active and passive tissue warm-up utilizing a heat pack in combination with stationary cycling.
Figure 2
Figure 2
Graston Technique® performed on the Achilles tendon.
Figure 3
Figure 3
Active Release Techniques® performed on the gastrocnemius muscle.
Figure 4
Figure 4
Eccentric calf strengthening exercise. a) Start position, b) End Position.
Figure 5
Figure 5
Static stretching with ice pack application. a) Gastrocnemius stretch, b) Soleus stretch.
See this image and copyright information in PMC

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