Educating the Achilles Patient, Activity Modification and Expectations

Education answers what is wrong with me by covering the individual's risk factors, such as load changes and metabolic, hormonal or biomechanical factors, an explanation of the tissue pathology that patients value, and the mismatch between pathology and pain. Pain is likely local and nociceptive but shaped by stress, attention, fear and expectations, and patients need to hear that pain is not damage, since many fear rupture. What can we do covers the benefits and harms of all treatments on offer, including injections and surgery. For a load intolerant patient the speaker reduces aggravating walking and running by 50% or stops it completely, using step data to stay objective, and explains that some pain during activity is acceptable, between avoiding pain and pushing through it. On expectations, most people improve by 12 weeks or six months, but better does not mean cured. The speaker gives patients about a 50% chance of full resolution, and warns that flare ups are normal.