The advantages of multimodal therapy on Achilles tendinopathy in para-athletes: a case report

Abstract

Background: Approximately 52% of Indonesian athletes experience Achilles tendinopathy (AT) injuries, which are often accompanied by knee pain during running, walking, and jumping. This study sought to explore the most effective multimodal treatments for patients with AT.

Materials and Methods: The patient was a 28-year-old male para-athletic athlete with a primary diagnosis of AT, classified as T45/46/57. He completed 10 physical therapy sessions, each lasting approximately 120 minutes, twice a week over three weeks. The patient participated in a multimodal exercise program (exercises, extracorporeal shockwave therapy, stretching, muscle release, electrical stimulation, and cryotherapy). Outcomes were measured every week.

Results: Using the numeric rating scale (NRS) and manual muscle testing (MMT) outcomes, the patient reported the most significant improvement in pain (from 7 to 3). Additionally, the muscle strength of the ankle joint flexors and extensors increased from 4 to 5, respectively. Functional measurement using the victorian institute of sport assessment-achilles (VISA-A) Scale was initially 53% to 86%, with an interpretation below 60% of patients still experiencing problems in the Achilles tendon.

Conclusion: This was the first study to explore a multimodal treatment strategy aim to at managing progression in a patient diagnosed with AT. The use of multimodal methods had a positive effect on repairing the soft tissue of the AT, leading to improvements in the patient's reported pain levels, increased lower muscle strength, and enhanced functional abilities in the patient diagnosed with AT.