Background: Achilles tendinopathy is an overuse injury that often affects individuals engaged in recreational or competitive level activity. Although most patients experience satisfactory results with therapy, a substantial portion fail to respond to traditional treatment. The purpose of this case study is to describe the successful use of compression tack and flossing (CTF) with lacrosse ball massage (LBM) in the treatment of an adolescent athlete with Achilles tendinopathy who had failed to respond to traditional treatment. Case Description: The patient was a 14-year old female diagnosed with chronic Achilles tendinopathy. She presented with 8/10 left posterior ankle pain during activity and scored 66/80 on the Lower Extremity Functional Scale (LEFS). After six weeks of PT consisting of eccentric exercise, proprioceptive training, and iontophoresis, the patient continued to report pain during sport and no significant improvements on the LEFS. With traditional PT failing to resolve symptoms, the patient was treated with CTF and LBM. Outcomes: The outcomes of interest were the LEFS and the ability to participate in sport without pain. After only two sessions focusing on CTF and LBM, she had 0/10 pain during sport and scored a 79/80 on the LEFS. Patient was discharged to continue with a home exercise program consisting of CTF and LBM, and eccentric exercise. Discussion: The patient's outcomes significantly improved after CTF and LBM was added to eccentric exercise. These results suggest that this intervention may be a viable adjunct treatment for Achilles tendinopathy; however further research, including controlled clinical trials and long-term outcome data, are warranted.

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In the midst of polarization often linked to incivility and a 'call out' culture, this paper re-imagines the role of civility. Moving away from reductionist definitions that claim civility is either oppressive or merely politeness, the authors argue for a civility that invites dissent and generates discursive openings. In this sense, civility in dialogue and deliberation settings fosters the conditions for managing the dialectic of calling out and while calling in. Arguing discursive openings are a better guideline for productive dialogue than civility, the authors draw on their work to suggest two conditions that foster civility towards discursive opening in situ. First, dialogue and deliberation designers can invite gracious contestation into the conversation through ground rules that prepare participants for earnest disagreement. The second condition that fosters discursive opening through civil deliberation is to bring forth contested language particular to issues and identities, and allow participants to determine the meaning rather than prescribe meanings that ultimately influence identities and policy. In this conception civility is what is needed to incite constructive conflict rather than used to quell conflict. The most important question becomes not was the conversation civil? But, will the conversation continue?