Joel, 56 y. o.

cc: chronic pain and swelling in left achilles and heel bone.

Hx: A former college runner has been suffering from swelling and pain that occurred 5 months ago due to intensive training for triathlon. He limps after running or getting up in the morning. Running is the most painful event. Goal is to compete in 3 weeks.

Exam: Slight limp. Heel swollen and painful to touch. Decreased dorsiflexion.

Assessment: Achilles tendinitis; Achilles calcification; Heel spur

Plan: MCT 2x Wk for 2 wks.

Goal: pain and swelling reduction; improved ADL; finish race in 3 weeks. September 12 in Pacific Grove, CA