Achilles Tendinitis

Subjective:

The patient will complain of heel pain or pain in the lower calf. The problem is common in track and field sports, dancers, and not uncommon in the majority of sports.

Assessment:

There will be improved ability to do pain-free, standing toe raises.

Light Treatment Plan:

Acute conditions can be treated with a total dose of 50 to 600 joules, with the primary focus being the site of the tendon strain, followed by painting over the general area. Treatment can be given every two to three days, decreasing treatment frequency as the condition heals. Direct the photons from posterior to anterior as well as from a lateral and medial position and at an anterior angle to the tendon to infiltrate its frontal aspect. If the patient has been treated surgically, treat in a similar manner as soon as possible, even daily, until swelling and pain have decreased.

Adjunctive Treatment Plan:

When the tendon has healed and the patient can walk pain-free, then gentle stretching of the calf but not the tendon should begin. Wearing heel lifts or high heels can reduce strain on an injured Achilles tendon. Reserve stretching of the tendon and gentle strengthening until the Achilles has fully healed and exercise can be performed without pain. Taping of the tendon can help stabilize the weakened tissue.

Anterior and Posterior Cruciate Ligament Injury

Subjective:

The patient often complains of a knee “popping,” “giving out” or becoming weak. There may be reports of a “click” or a straining sensation in the knee while playing sports that require “cutting” or jumping. The patient may be limping and usually complains that the knee is painful, stiff, and swollen. The severity of the subjective complaints is usually proportional to the degree of ligament strain or rupture.

Assessment:

Improvement will show as decreased pain and swelling, with improved range of motion. In milder cases, as symptoms improve, there will be less instability with the Lachman and Drawer tests.

Light Treatment Plan:

Acute conditions can be treated with a dose of 25 to 300 joules. O