#tendinopathy

Case Study: Tibialis Anterior Tendinopathy

The boy came to me with right foot dragging (foot drop), an inability to lift his toes, and with leg and lower back pain.

Note: Patients are typically referred to me after exhausting other therapy options, as a final resort before considering surgical interventions. These cases often serve as valuable case studies and occasionally become subjects for further research.

Initially, the symptoms suggested neural issues such as sciatica, which were addressed over several sessions, alleviating the back and leg pain. However, persistent numbness in the foot indicated fibular nerve (peroneal) dysfunction.

Our conversation unfolded as follows:

Me: Your back and thigh pain have significantly improved, but the issue with your foot is neural. It’s imperative to consult a neurosurgeon for further evaluation and potential treatment.

Patient: I prefer to continue with you. Please.

Me: While I understand your reluctance, it’s crucial to involve an expert. Treatment may not necessarily involve surgery; it could be as simple as medication. Nonetheless, the decision ultimately rests with you.

Patient: Can I continue with your therapy a bit longer?

After a couple of additional sessions:


Me: It appears that the neural issues has caused serious issues with you Tibialis Anterior tendon. Alongside neural stimulation issues, there’s evidence of tendonitis.

Patient: What are my options?

Me: Physical therapy remains an option, although its effectiveness is uncertain. Consulting a doctor may lead to consideration of minor surgical intervention.

Me: Look, we have identified the nerve. We know the point where nerve is becoming dysfunctional. We know the issue with the tendon. Its best if you seek a doctors intervention. It will be quick.

Patient: I prefer to pursue physical therapy.
Me: Very well.

Today, witnessing the same foot that once dragged now confidently kicking a 7.5 kg medicine ball like a footballer fills me with joy.

Video:
First half – After 4 weeks of therapy & training.
Second half – After an additional 4 weeks.

A total of 8/10 weeks of therapy & training, potentially averting the need for surgery. I am not sure how long before he can come back to normal but its a relief seeing him come this far. The injury almost caused him depression.