Author: Justin Mullner, MD
Editor: Kevin deWeber, MD, FAAFP, FACSM, RMSK
A 15 year-old Caucasian male football wide receiver presented with progressively worsening left-sided, non-radiating low back pain that began during football camp 1 month prior.
The patient denied any specific injury or trauma. The pain was sharp, 8/10 worse with cutting and pivoting motions during football practice and occasionally present at rest. He was still playing football but the pain had increased significantly over the last 4 days. Ibuprofen and ice helped relieve the pain.
ROS: He denies fever, weight loss, paresthesias or neurologic symptoms. PMH: spina bifida occulta; L5 pars fracture 2 years prior.
Vitals: afebrile, BP 100/58, pulse 66.
No visible deformities or scoliosis.
Tenderness to palpation over the left lower back just above the waistline.
Full ROM with flexion and extension of the back. Pain with hyperextension of the back. Pain with lateral bending to both sides as well as with rotation of the torso.
Positive stork test bilaterally, worse on the right.
Lower extermities: Tight hamstrings.
Patellar and Achilles tendon reflexes are 2+. Normal sensation in bilateral. Strength 5/5. Dorsalis pedis and posterior tibial pulses normal. Negative straight leg raise.
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