Pain In A Collegiate Tennis Player - Page #1

Author: Matthew Leiszler, MD
Co Author #1: Stephanie Chu, DO, CAQSM, Assistant Professor, Primary Care Sports Medicine, University of Colorado School of Medicine
Co Author #2: Sourav Poddar, MD, CAQSM, Director of Primary Care Sports Medicine Program, University of Colorado School of Medicine

Patient Presentation:
A 22 year old female Division I collegiate tennis player presents to the training room with with 4-6 weeks of right foot pain.

The patient initially had pain only while playing tennis and running, but now walking is also causing pain. She had no inciting trauma or injury, and has no pain at rest or at night. The pain is most prominent over the navicular and second metatarsal base. She has not tried any over-the-counter medications for pain. She had already been seen by her trainer for ultrasound treatments, which had neither helped nor worsened the pain. She was started in a long leg walking boot on the day prior to initial examination. The walking boot helped decrease but did not resolve the pain. She has normal menstrual periods on an oral contraceptive pill, and has no history of stress fractures. Otherwise her past medical, family, and social histories are negative.

Physical Exam:
Athletic 22 year old female. Examination of the right foot reveals no warmth or erythema. There is a palpable raised area on the dorsal aspect of the foot in the area of the second metatarsal-navicular joint. She has tenderness at the base of the second metatarsal and over the navicular. There is no arch pain on palpation, and she has a cavus foot. She has good range of motion in the ankle and foot with normal strength testing.

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