All right, Mike, we're going to get in a little bit of a physical exam now. So really what I'm going to try and do is challenge both Achilles in a way where maybe we pick up differences side to side, maybe we pick up a little bit of pain. And that's going to help us understand maybe what we can do in your home program to get you stronger and work on that kind of stuff.
So let's just do some basic balance here. First we can start, um, let's start with the right side and just balance on one leg for me. And I imagine this should be no problem for you. So we'll do this real quick. And then, um, can you go ahead and close your eyes and keep your balance?

Should get more challenging. Okay.

Okay. That's fine. And then let's go. Eyes open on your left side. Okay. No pain with that on the right. No pain.

Good. And then whenever you're ready. Eyes closed.

All right. Well, you've rehabbed pretty well. I mean, that left side. What did you feel? Different side to side. Yeah, like more stable. Like just all that toe yoga you do at the beginning and stuff like that. Yeah. So there's a little bit of a difference. And I guess maybe the good news is, is that your surgical side looks maybe a little bit more stable than your other surgical, but, um, so that's a win coming off of a rupture for sure.
Let's let's go ahead and just put two fingers on here. And I just want to see if you can go all the way up and down on your toes. We'll do like 15 really rep it out. And I just want to see if this causes any discomfort or if it feels different at all. Side to side.

No problems there. No problems. Just, uh. Yeah.

So fatigue is there? No. Just work. Yeah. Just work. And then like, lack of range of motion. Yeah. We're working on strength. Okay. Let's try the right side out. Same thing. Two fingers.

Okay, so more motion on that side for sure. Yeah.

Strength difference side to side that you can feel or not so much besides a lot stronger. So.

Okay. So a little stronger a little more range of motion but a little bit maybe more stable on that left side. Um, let's go ahead and hop on this foam here real quick

and we'll just go. Eyes open. Balance on the right leg first.

Good. Let's increase that challenge. Let's go ahead and look to your right. Keep your balance.

Look to your left.

Look to your right.

Okay. That's fine. And then let's go. We'll go on the left. We'll just see if there's any different side to side here. So just balance normal first.

And go ahead and look to your right.

Look to your left.

Look to your right.

Look to your left.

Okay, you can relax. That was pretty similar to that first one. What was. What do you feel that I'm able to stabilize a little bit better on my left? Yeah, a little bit. Okay. That's good. What are we looking for? Is just maybe where the asymmetries are. And that'll help us maybe know where to start. You on some rehab for that right ankle?
Sounds like you've got the left one. That's your. You're happy with how it's progressing and more of your nervousness and fear is is a little bit on the right. Is that when I'm picking up okay. Um, we're going to do a quick little hop. So maybe for about 15 seconds I'll time you. We'll go. No hands, but on the right side, I want you to get that foot off the ground and we'll hop on one leg here

whenever you're ready. Good one.

All right. Good. You can relax. Let's go into that left one.

Oh, we don't like that one as much, do we? It's a little tougher, but.

Okay, you can relax. Was there a pain with either of those? Yeah. A little bit of discomfort on my right, which I've noticed lately. I like pain, yeah. Pain on the right. But, like, no, no pain on the left. Just more difficult. And is that pain that you're getting? The same thing you came back from your golf trip with?
Is that kind of the area? Okay. Um, and then is there anything since your golf trip? Well, okay. You said hiking is one of the things that still brings it on. On the right as well. Okay. All right, um, let's do one little quick test here. I'm going to have you scoot back just a bit. You're going to start maybe with your heel level with the table.
And I just want you to jump a distance that you're comfortable with. But on that on one side we'll just do a broad jump on one leg, and your only requirement is that you stick the landing without falling over, and then we'll just switch and we'll, um, we'll do the other side. So maybe just pick an arbitrary line here so we know we're being even.
We can compare. You feel comfortable confident in this I do yeah I'll get out of your way.

Nice landing. Okay. And then let's go again on the right side.
Okay. Any different side to side with that? Um, yeah. Just a little more discomfort in that. Right. Little pain on the right. Okay. The distance was a little bit more on the right. Just subtly but a little bit more pain as well. Okay. That's helpful to know. It's just kind of we're trying to just find your limit of when that, that pain comes on.
Um, let's get you laying down on your belly now and we'll take a look at those. Achilles. Perfect.
Achilles Tendon Physical Examination In this clinical video, a practitioner guides a patient named Mike through a physical examination to evaluate and compare the functional capacity of both Achilles tendons. The assessment aims to identify asymmetries and pain triggers, specifically contrasting the patient's left surgical Achilles with the right non-surgical side. Key Highlights Balance Assessments: The exam begins with single-leg balance tests on flat ground and a foam pad, incorporating eye closures and head movements to challenge stability. The patient notes that his left surgical side actually feels more stable than the right, attributing this to his previous rehabilitation routine. Strength and Mobility: During a test of 15 single-leg calf raises, the right ankle demonstrates greater strength and range of motion. The left surgical side shows expected fatigue and reduced motion as the patient continues to work on strength recovery. Dynamic Stress Testing: The practitioner introduces higher-level dynamic tests, including 15-second continuous single-leg hops and single-leg broad jumps where the patient is required to stick the landing. Identifying Pain Limits: The dynamic tests successfully reproduce the patient's right-sided discomfort, which is consistent with the pain he recently experienced while hiking and during a golf trip. While the left side finds the dynamic hopping more difficult to execute, it remains entirely pain-free. Transition to Imaging: After establishing the functional differences and isolating the pain triggers on the right side, the practitioner transitions the patient to lay on his belly for a follow-up ultrasound evaluation of the Achilles tendons.