Category
Poster - Applied
Description
Background: A twenty-two year old female collegiate swimmer presented with recurring, intermittent symptoms of bilateral anterior lower leg pain over the span of four years. The patient complained of pain walking, described soreness, diffused pain, inflammation, and point tenderness during and after plyometrics. Pain would persist for approximately two hours following exercise. The initial diagnosis of medial tibial stress syndrome (MTSS) was formed. Treatment: Bilateral x-rays revealed double stress reactions in both tibias. Patient returned to play (RTP) with a restrictive non-weight bearing (NWB) program and physical therapy (PT). Two years later, the athlete complained of severe bilateral lower leg pain and X-rays reported no abnormal findings. The athlete was referred back to the physician for testing and diagnosed with chronic bilateral compartment syndrome in the anterior and lateral compartments. Corrective surgery occurred September of 2019. Symptoms persisted. Testing revealed she presented with bilateral popliteal entrapment. The patient underwent bilateral corrective surgery to release the artery from being impinged within the medial gastrocnemius head. Uniqueness: Chronic exertional compartment syndrome is prevalent in about 14-27% of the population that report exercise induced lower leg pain. Popliteal entrapment is prevalent in approximately .17 - 3.5% of the general population. The incidence of MTSS, stress reactions, compartment syndrome, and popliteal entrapment would be even lower in a NWB swimmer. Therefore, the prevalence of both chronic exertional compartment syndrome and popliteal entrapment in a non-contact, low impact athlete is extremely unique. Conclusions: Previous training history and lower leg pain should be monitored by ATs to better manage lower leg pain. Sports medicine teams should continue to maintain an open line of communication and monitor ongoing and previous injuries. Despite the low incidence rate, clinicians should consider utilizing diagnostic imaging to rule out popliteal entrapment or compartment syndrome to avoid ongoing chronic pain in patients.
Persistent Bilateral Lower Leg Pain in a Collegiate Swimmer: A Case Study
Poster - Applied
Background: A twenty-two year old female collegiate swimmer presented with recurring, intermittent symptoms of bilateral anterior lower leg pain over the span of four years. The patient complained of pain walking, described soreness, diffused pain, inflammation, and point tenderness during and after plyometrics. Pain would persist for approximately two hours following exercise. The initial diagnosis of medial tibial stress syndrome (MTSS) was formed. Treatment: Bilateral x-rays revealed double stress reactions in both tibias. Patient returned to play (RTP) with a restrictive non-weight bearing (NWB) program and physical therapy (PT). Two years later, the athlete complained of severe bilateral lower leg pain and X-rays reported no abnormal findings. The athlete was referred back to the physician for testing and diagnosed with chronic bilateral compartment syndrome in the anterior and lateral compartments. Corrective surgery occurred September of 2019. Symptoms persisted. Testing revealed she presented with bilateral popliteal entrapment. The patient underwent bilateral corrective surgery to release the artery from being impinged within the medial gastrocnemius head. Uniqueness: Chronic exertional compartment syndrome is prevalent in about 14-27% of the population that report exercise induced lower leg pain. Popliteal entrapment is prevalent in approximately .17 - 3.5% of the general population. The incidence of MTSS, stress reactions, compartment syndrome, and popliteal entrapment would be even lower in a NWB swimmer. Therefore, the prevalence of both chronic exertional compartment syndrome and popliteal entrapment in a non-contact, low impact athlete is extremely unique. Conclusions: Previous training history and lower leg pain should be monitored by ATs to better manage lower leg pain. Sports medicine teams should continue to maintain an open line of communication and monitor ongoing and previous injuries. Despite the low incidence rate, clinicians should consider utilizing diagnostic imaging to rule out popliteal entrapment or compartment syndrome to avoid ongoing chronic pain in patients.
Comments
Graduate