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CASE REPORT
Partial mid-portion Achilles tear resulting in substantial improvement in pain and function in an amateur long-distance runner
  1. Michal Marek Woyton1,
  2. Stefan Kluzek2,
  3. Thamindu Wedatilake3,
  4. Madeleine A M Davies4,5
  1. 1Department of Medical Sciences, University of Oxford, Oxford, UK
  2. 2The Botnar Research Centre (NDORMS), Oxford University Hospitals, Oxford, UK
  3. 3Nuffield Orthopaedic Centre, Oxford, UK
  4. 4Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
  5. 5Department for Health, University of Bath, Bath, UK
  1. Correspondence to Mr Michal Marek Woyton, michal.woyton{at}worc.ox.ac.uk

Summary

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.

  • tendonopathies
  • sports and exercise medicine
  • achilles tendinitis
  • tendon rupture
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Footnotes

  • Contributors MMW was the primary investigator. He was behind the drafting of the article and its subsequent revision. SK was behind the concept of the article. He identified the case, collected the data required and approved the final version. TW was involved in the care of the patient and subsequent recruitment of the patient alongside gathering data for the case report. He performed the ultrasound scans of the patient and supplied the patient and technical information for the study. MAMD was responsible for revising the article, in particular the discussion section. She also played a key role in the literature review, and edited and approved the final version of the draft.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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