Case studyTreatment of chronic Achilles tendon pain by Kinesio taping in an amateur badminton player
Introduction
Achilles tendon injuries occur frequently among athletes participating in running, orienteering, badminton, tennis, soccer, and volleyball (Fahlström, Lorentzon, & Alfredson, 2002), as well as in the general population (Maffulli & Kader, 2002). Badminton in particular is a sport that involves repeated, rapid forward lunges; the dominant leg bears a greater load, and tendons are heavily strained (Boesen, Boesen, Koenig, Bliddal, Torp-Pedersen, & Langberg, 2011).
The nomenclature for disorders of the Achilles tendon is important, as the treatment is dependent on the underlying tendon pathology (Macintyre & Joy, 2000). When acute tendonitis occurs, the inflammation is most often characterized by swelling, local pain, and occasionally crepitus (Macintyre & Joy, 2000). At this stage, symptomatic treatments such as rest, non-steroidal anti-inflammatory drugs, heel lifts, and local physical therapy are used to control the inflammation and heal the injured tendon (Macintyre & Joy, 2000). Achilles tendon conditions such as tendinosis are chronic, but generally not inflammatory, although the area can be painful to touch, and this condition is characterized by tendon degeneration (Maffulli, Khan, & Puddu, 1998). Based on the etiology, Achilles tendinosis can be caused by a combination of failure of the normal healing mechanisms and repeated trauma (Costa et al., 2006, Schepsis et al., 2002). At this stage, pathological processes including localized painful thickening of the tendon increase (Ohberg, Lorentzon, & Alfredson, 2004). Ultrasonography has been used to quantify Achilles tendon degeneration (Fredberg and Bolvig, 2002, Grechenig et al., 2002, Macintyre and Joy, 2000). Painful phases of chronic Achilles tendon disorders prolong the healing time (Alfredson and Lorentzon, 2000, Macintyre and Joy, 2000).
The use of Kinesio Taping (KT) for the treatment of joint sprains and instability, soft tissue inflammation, and muscle pain and weakness (Jaraczewska & Long, 2006) is gradually increasing in sport medicine and orthopedics (Yasukawa, Patel, & Sisung, 2006). However, the effect of KT on various sports injuries has not been sufficiently studied. This case report is the first to describe the results of KT on a patient with chronic Achilles tendon pain.
Section snippets
Case description
A 22-year-old male amateur badminton player slipped on the ground as he landed after jumping while playing badminton 6 months previously, resulting in pain in the Achilles tendon of the dominant (right) leg. The pain was slightly relieved after receiving therapeutic ultrasound, undergoing transcutaneous electrical nerve stimulation (TENS), and stopping sports activity that might provoke pain. However, he was not able to undergo continuous treatment. Within a month, he developed severe pain
Results
As shown in Table 1, after one week of ATT intervention, the ADF and APF angles were increased to 20° and 40°, respectively. The VISA-A questionnaire was increased to a score of 72. The load-induced pain assessment was decreased to a score of 2; the pain threshold increased to 3.5 kg; and tenderness at 3 kg, assessed on a numeric rating scale, was decreased to 3. After two weeks of ATT intervention, the VISA-A questionnaire was increased to a score of 86. The load-induced pain assessment was
Discussion
While running and jumping, the Achilles tendon is subjected to loads as high as 6–12 times the body weight. Such high repetitive loading is considered to be one of the main pathological stimuli to the Achilles tendon (Paavola, Kannus, Järvinen, Khan, Józsa, & Järvinen, 2002). Badminton is a sport that requires jumps, lunges, quick hand motions, and changes in direction in a wide variety of postural positions (Shariff, George, & Ramlan, 2009). When landing after a jump while playing badminton,
Conclusion
We applied ATT with Kinesio tape to our patient, who was not able to perform sports activities because of the limited range of motion in the ankle joint due to tenderness and pain in the Achilles tendon. We verified the effect with an increase in the active ankle joint range of motion and the VISA-A questionnaire score, which was achieved by a decrease in tenderness and pain from repeated ATT application. Further research should be performed to strengthen the validity and credibility of the
Acknowledgements
This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (No. 2011-0005580).
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