Exertional Leg Pain In A Long-distance Athlete - Page #1

Author: Daniel Clearfield, DO, MS

Patient Presentation:
PB is a 47 year old long distance runner and triathlete who presents with complaints of bilateral calf pain while running. The pain started roughly two months prior to presentation and had an insidious onset. He describes it as excruciating pain that starts when he is about 4 miles into a run and escalates with continued activity. The pain diminishes with walking and goes away shortly after cessation of activity.

PMHx: PB is a 47yo Caucasian male, no chronic medical conditions
Surgical Hx: none
Past orthopedic problems: occasional ankle sprains while competing as Division I collegiate wrestler, never required surgical intervention. No history of fracture or stress fracture
Medications: multivitamins
Activity level: he typically runs ~30 miles/week and cross-trains with cycling and swimming; he was training for a half-marathon at presentation to our clinic

Physical Exam:
General, HEENT, cardiovascular, respiratory, abdominal, and neurovascular exams all WNL
Lower extremity strength, range of motion, and sensation were all WNL
Structural exam of the lower extremities: tight heel cords bilaterally bilateral navicular drop with calcaneal valgus, myofascial restriction notably in right anterior compartment and in left deep posterior compartment, no fascial herniations noted

Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.

© The American Medical Society for Sports Medicine
4000 W. 114th Street, Suite 100
Leawood, KS 66211
Phone: 913.327.1415

Website created by the computer geek