GP Notes

Patient presents with pain along the Achilles tendon Also complains of the following symptoms: -Swelling of the skin over the tendon with warmth, redness and tenderness -Pain when rising up on the toes and pain with pushing off on the toes -Painful heel for the first few minutes of walking and waking up in the morning -Stiffness of the ankle which improves with mild activity On Examination: Patient has tenderness to palpation over the Achilles tendon Clinical impression: Achilles tendinitis Management: 1. gentle calf stretching 2. strengthening of the Achilles tendon 3. Eccentric calf raises 4. May need to consider heel raise or orthotics if pain does not settle 5. as symptoms resolve, resumed normal weight-bearing activities gradually 6. avoid running until the tenderness is gone. Swimming or cycling in low gear a good replacement activities Prevention of Achillies Tendonitis: - do strengthening and stretching exercises to keep calf muscle strong and flexible - Keep yo

Painful red rash Site: Duration: Examination: Vescicular rash in the distribuation of: Reason for visit: Shingles Management: 1. Antiviral medication as prescribed 2. Rest 3. Paracetamol and Ibuprofen prn 4. Moisturisers for rash prn Return if deterioration or concerns Keywords: +shingles

Patient presents with discomfort and pain in the jaw in front of the ear, especially when eating Examination: tendernesss to palpation over the TMJ on the left side Management: Advised to: - When eating, avoid opening your mouth wider than the thickness of your thumb and cut all food into smallpieces - Do not bite any food with your front teeth—use small bite-size pieces - Avoid eating food requiring prolonged chewing such as hard crusts of bread, tough meat, raw vegetables - Avoid chewing gum - Always try to open your jaw in a hinge or arc motion - Do not protrude your jaw - Avoid clenching your teeth together—keep your lips together and your teeth apart. - Try to breathe through your nose at all times. - Do not sleep on your jaw—try to sleep on your back. - Practice a relaxed lifestyle so that your jaws and face muscles feel relaxed. For a nagging problem Once the acute phase has settled, it is best to strengthen the muscles and joints by performing a set of exer