Sara Shupe, MSPT, Dip. MDT is a physical therapist specialist and founder of J.O.Y. Physical Therapy Inc, a mobile and tele-health physical therapy provider servicing the Twin Cities Metro Area and greater Minnesota. Sara has presented early access models of mechanical diagnosis and therapy (MDT) in the treatment of low back pain to the American Physical Therapy Association (APTA), National Association of Spine Society (NASS) and The international MDT Conference.
Perhaps you’re no Boris Becker (and for those that have to depend on our best friend Google to learn who this is, please cease reading, as you evidently do not have the privilege of middle age as I and my readers do!). However, you frequent the tennis courts for the friendly competition of beating-the-pants-off the guy in your office whose sole purpose in life appears to be delving out the verbal emesis detailing his “skills” that sets off your gag reflex. For the love of some guy named Pete, you need to pull this guy down a notch!
So you go. Amidst the 40-love final game point serve, you hear a POP! You knew the two of you weren’t friends, but you didn’t think he would literally shoot you in the foot!
How do I manage my Achilles injury?
Since the late 1990s, a series of exercise protocols have been tested in the literature to determine how to treat an Achilles injury. These injuries most commonly present in the otherwise healthy, middle-aged adult who over-loaded a very fatigued tendon (as in our Boris-wannabe). It is likely that it begins with micro-tearing, such as the fraying of a rope. From there, it climbs the stress-strain curve until it hits the cliff and progressed into a partial or full thickness tear. Most patients describe hearing an auditory POP and feeling something “shoot” them.
Eccentric training, or the progression of controlling the descension against gravity, has been the most commonly studied, with 31 random-controlled trials completed since 1998 (Editorial, JMMT Vol 26(3), 2018). The theory is that since the Achilles tendon is a large dynamic structure designed for load, it requires loading to restore it back to function. That theory has held true over the years. The question has become - what load? When?
The timing of loads.
Mechanical Diagnosis and Therapy (MDT) is a system of algorithmic tests of the Achilles to determine what stage it is in of the healing process. Along with tests specific to the patient complaint, MDT providers can determine which load is needed, when and what the prognosis for full recovery will be.
Boris, here we come!
Call 651-800-MYPT or make your appointment for your Achilles at www.joy-pt.com
Or call a MDT provider in your region www.mckenzieinstituteusa.org/findaprovider