Case 01
Left Achilles Tendinopathy
Musculoskeletal; unilateral load asymmetry secondary to pain inhibition
08/11/2025 VALD ForceDecks
Peak Landing Force — Without Brace
22%
R-side asymmetry (offloading L Achilles)
Peak Landing Force — With Brace
2%
Near-symmetric loading restored
Landing Force — Change
↓91%
Reduction in asymmetry score
Concentric RFD — Without Brace
11% L
Mild L-side inhibition (pain guarding)
Concentric RFD — With Brace
73% L
Pain inhibition reduced — L leg fires harder
Measurement 01
Peak Landing Force Asymmetry [% L, R]
Range: 1 R – 31 R Average: 12 R CoV: 107% SD: 13
Without Brace Test 1
22
✓ With Brace Test 2
2
R-side dominance (patient offloading L)
Near-symmetric (with brace on L)
Measurement 02
Concentric RFD Asymmetry [% L, R]
Range: 25 L – 98 L Average: 42 L CoV: 123% SD: 51
← L Dominant R Dominant →
Without Brace Test 1
−11
✓ With Brace Test 2
−73
Slight L asymmetry (without brace)
Strong L output (brace removes pain inhibition)
Clinical Interpretation

Peak landing force: Without the brace, the patient offloads the injured left Achilles with a 22% rightward asymmetry — a classic pain-avoidance pattern. With the brace on the left leg, asymmetry collapses to 2%. This is near-perfect bilateral symmetry restored by a single intervention within a single session. The brace is reducing the painful load sufficiently for the patient to trust the limb again.

Concentric RFD: The −73% L-dominant result with the brace is not a negative finding — it is the mechanism explained. Without the brace, the patient is only mildly L-dominant (−11%) because they are pain-inhibiting the L Achilles and guarding during push-off. With the brace reducing load on the injured tendon, the neural inhibition resolves and the left leg fires concentrically at full capacity, producing a −73% L-dominant result. This is evidence of reduced pain inhibition, not increased impairment. It should be read alongside the landing force data, which simultaneously shows near-symmetric bilateral loading.

Methodology Note

All measurements were taken using VALD ForceDecks bilateral force plate system during standardised jump/landing and concentric push tasks. This data is clinician-collected post-study application testing and is not part of the University of Queensland validation study. The within-session toggle design (no brace → brace → no brace) controls for learning effects and fatigue by demonstrating the reversibility of the finding when the brace is removed. Asymmetry values are expressed as percentage difference between limbs relative to the higher-force limb. Positive values indicate R-dominance; negative values indicate L-dominance. Individual patient consent obtained for clinical data sharing.

These are individual clinical cases. The UQ group-mean study data is available on the Clinicians page alongside full methodology.

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