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This case presents symptom resolution for a long-distance runner with chronic Achilles tendinopathy (AT), following a partial tear of his Achilles tendon. The patient reported a sudden pain during a morning run, with preserved function. Three hours postinjury, he was reviewed in a musculoskeletal clinic. An ultrasound scan confirmed a partial Achilles tear, associated with significant Doppler activity. His index of AT severity The Victorian Institute of Sports Assessment - Achilles Questionnaire (VISA-A) 4 hours postinjury was markedly higher compared with 2 weeks preinjury, indicating reduced symptom severity. A follow-up scan 4 weeks postinjury showed minimal mid-portion swelling and no signs of the tear. His VISA-A score showed continued symptom improvement. This case represents resolution of tendinopathic symptomatology post partial Achilles tear. While the natural histories of AT and Achilles tears remain unknown, this case may indicate that alongside the known role of loading, inflammation may be a secondary mediator central to the successful resolution of AT pain.

Original publication

DOI

10.1136/bcr-2018-225823

Type

Journal article

Journal

BMJ Case Rep

Publication Date

19/09/2018

Volume

2018

Keywords

achilles tendinitis, sports and exercise medicine, tendon rupture, tendonopathies, Achilles Tendon, Adult, Aftercare, Humans, Male, Outcome Assessment, Health Care, Pain, Recovery of Function, Running, Tears, Tendinopathy, Ultrasonography, Doppler