The Case Of A Cross Country Runner's Immoveable Toe - Page #1

Author: Sabrina Silver, DO
Co Author #1: Dr. Laura McIntosh, MD 4671 West Lake Rd Erie, PA 16505 814-835-2035
Co Author #2: Dr. Laura McIntosh, MD 4671 West Lake Rd Erie, PA 16505 814-835-2035
Co Author #3: Dr. Laura McIntosh, MD 4671 West Lake Rd Erie, PA 16505 814-835-2035
Editor: Kathleen Lytal, MD
Senior Editor: Margaret E Gibson, MD

Patient Presentation:
22 year old female collegiate cross country runner presented with inability to flex the IP joint of her right great toe for the past 2 weeks.

Just over 2 weeks prior to her presentation in clinic she had noticed this deficit when trying to use her toe to push something on the floor. This was the afternoon after meet, but she did not remember any traumatic event to the toe or pain during the race. She did complain of having pain in her calf about 1 month prior to her presentation to the clinic, but this deficit had not been present. The pain had not changed after the race. She was being seen in physical therapy for her calf pain, and her therapist and suggested further evaluation of her toe problem. She had continued training and racing and was not having any pain or weakness since she noticed the deficit 2 weeks prior. She had in fact had a PR at a race the week prior. At the time of her visit she has a few weeks left in her senior running season with plan to run track in the spring.

Physical Exam:
Ankle exam was unremarkable with no pain along the FHL poster to medial malleoli. Mild tenderness with some crepitus noted at the mid arch just proximal to the MTP joint. No pain over the IP joint. No swelling in foot or other toes. Normal hind foot motion. Digits 2-5 on her right foot had full ROM and 5/5 strength in flexion and extension. She was able to extend her great to and had 5/5 strength at both the MTP and IP joint. She was able to flex her toe with 5/5 strength at the MTP joint but unable to actively flex her IP joint. Sensation grossly intact and 2/4 dorsals pedis pulse.

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