Author: Marc Raj, DO
Co Author #1: Nicholas Goyeneche, MD
Ochsner Sports Medicine
Co Author #2: Aaron M. Karlin, MD
System Chair -- Dept. of Physical Medicine & Rehabilitation
Section Head -- Pediatric Rehabilitation
Director -- Ochsner Concussion Management Program
Ochsner Clinic Medical Center
Editor: Michelle Szczepanik, MD
Patient presents to the training room after a football game, without new injury.
Patient is a 17-year-old Division 1 college committed right footed high school kicker/punter who presented to the training room after a Friday night football game. He complained of left sided lower back pain that started insidiously 3 months prior while attending a summer kicking camp. The pain is located over the left lower lumbosacral area. It is an intermittent deep sharp/achy pain that can radiate into left gluteal area. Pain is worse with the follow through of his kicking motion and, more recently, with running. The pain is improved with rest. He denies pain at night, lower extremity paresthesias, weakness, bowel/bladder dysfunction, muscle atrophy, or limb spasticity.
6 foot, 205-pound male. Visual inspection of the lumbar spine was unremarkable. Palpation of the lumbar spine revealed tenderness to palpation of the left lower lumbar paraspinals. There was no tenderness to palpation over the left sacroiliac (SI) joint. Range of motion (ROM) was within functional limits. Pain was reproduced with extension and left-sided facet loading. Popliteal angles were 30 degrees bilaterally. Flexion abduction and external rotation (FABER), flexion adduction and internal rotation (FADIR), straight leg raise (SLR), and log roll were negative bilaterally. Negative Trendelenburg noted to either side. Positive Stork test on the left. Muscle strength was 5/5 strength throughout both lower extremities. Muscle stretch reflexes 2+ throughout both upper and lower extremities.
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