A 48-year-old gentleman who works as a recovery driver sustained a partial rupture of his R tendoachilles (TA) in March whilst he was stepping up into his van. The orthopaedic consultant made the decision to treat the injury conservatively, rather than surgically repair the TA. The patient was therefore placed in a series of below knee casts over a 3-month period, each one gradually allowing his ankle to return to the plantigrade position. Then the patient attended his first session with a physiotherapist in June.
He was due to start a phased return to work at the beginning of July. He complained that there was a 'lump' over the back of his R TA and that he was still experiencing the occasional ache in this area; he was still walking with a limp as he was having difficulty executing the heel-strike and toe-off phases of gait. He also demonstrated decreased proprioception on the R leg in…
