The patient arrived today looking better than the previous week when his mood was low, because of a recent break up with his girlfriend. He said that he was feeling better and we had a chat which I believed my age and past experience of relationships came in handy as I was able to relate and give some positive recommendation to him. I asked about his eating habits and whether he was getting enough nutrition in, he said that he was working long days as a newly qualified GP and therefore he had to result to microwave meals and takeaways. I suggested doing meal prep the night before when he cooked his dinner to make him prepared and to avoid the takeaways as his eating could have been contributing towards his low moods and energy levels. He was given exercises for his mid portion achilies tendinopathy in the previous appointment and he explained that his symptoms and pain had gone down a week after performing the exercises. Because of the injury being that of a tendon, I thought back to the work done by Cook & Purdum in their original paper in 2009 and how a tendon reacts to too much stress. I believed the tendon was at the active to disrepair stage and therefore that was why I chose eccentric heavy loading through the tendon.
The patient was asked to perform 10 calf raise which he significantly had improved from the last appointment, in which he struggled to get 8 reps. He completed these without any shaking or discomfort.
The exercise appeared to be working and therefore the patients exercises were progressed with weights of 10kg and was told to carry of doing them unilaterally and in a eccentric manner for 3 days a week and to increase the weight gradually over time.
Cook and Purdum 2009