This is a questionnaire that determines the severity of your Achilles tendinopathy. In this questionnaire, the term pain referred specifically to pain in Achilles tendon region
Question 1 :
For how many minutes do you have stiffness in the Achillies region on the first getting up?
- 0 – 100 minutes
- For every 10 minutes, you get 1 point, Point scale 1 to 10 (maximum 10 points)
Question 2 :
Once you are warmed up for the day, do you have pain when stretching Achilles tendon fully over the edge of a step? (keeping the knee straight)
- On a scale from 0 to 10, what would you rate your pain after this activity? Point scale 1 to 10 (maximum 10)
- 1 = Strong severe pain, and 10= No pain
Question 3 :
After walking on Flat Ground for 30 minutes, you have been with in the next 2 hours?
- If you are unable to walk on Flat Ground for 30 minutes because of pain, score 0 for this question
- On a scale from 0 to 10, what would you rate your pain after this activity? Point scale 1 to 10 (maximum 10)
- 1 = Strong severe pain, and 10= No pain
Question 4
Do you have pain walking down stairs with a normal gait cycle?
- On a scale from 0 to 10, what would you rate your pain after this activity? Point scale 1 to 10 (maximum 10)
- 1 = Strong severe pain, and 10= No pain
Question 5
Do you have pain during or immediately after doing 10 (single leg) heel rises from a flat surface?
- On a scale from 0 to 10, what would you rate your pain after this activity? Point scale 1 to 10 (maximum 10)
- 1 = Strong severe pain, and 10= No pain
Question 6
How many single leg hops can you do without pain?
- Count from 1 to 10. Point scale 1 to 10 (maximum 10)
- 1 Point for every hop completed without pain.
Question 7
Are you currently undertaking sports or other physical activity?
Points allocated per description:
0 – not at all
4 – modified training or modified competition
7 – full training competition but not at same level as when symptoms began
10 – Competing at the same or higher level as when symptoms began
Question 8
Please complete either A, B or C in the following section:
Section A
If you have no pain while undertaking Achilles tendon loading sports, for how long can you train or practice?
Points allocated on the left:
0 – Nil
7 – 1 to 10 minutes
14 – 11 to 20 minutes
21 – 21 to 30 minutes
30 – more than 30 minutes
Section B
If you have some pain or while undertaking Achilles tendon loading sports, but it does not stop you from reaching your training or practice for how long can you train or practice?
0 – Nil
7 – 1 to 10 minutes
14 – 11 to 20 minutes
21 – 21 to 30 minutes
30 – more than 30 minutes
Section C
If you have pain that stops you from completing your training or practice in Achilles tendon loading sports, for how long can you train for practice?
0 – Nil
7 – 1 to 10 minutes
14 – 11 to 20 minutes
21 – 21 to 30 minutes
30 – more than 30 minutes
Results :
A score of 100 is considered normal, the lower the score the higher the possibility of a Achilles tendinopathy.
If you do not participate in any sporting activities you will not score higher than 70.