Thigh Pain In A Collegiate Cross-country Runner - Page #1

Author: Jeff Fleming, DO
Co Author #1: Jeff Fleming, DO
Co Author #2: Cody Clinton, DO
Senior Editor: Carolyn Landsberg, MD
Editor: Jessalynn Adam, MD

Patient Presentation:
A 19-year-old Division-III, female cross-country runner presented to the varsity athletic training room with a 3 month history of gradually worsening right thigh pain. Symptoms were exacerbated by running and typically were most noticeable about two miles into a run. Mild pain was appreciated at rest.

The runner reported that the pain became significantly more severe after increasing her weekly mileage from 50 to 70 miles per week during pre-season conditioning. Shortly after increasing her training volume, the runner developed antalgic gait and radiation of the pain into the right hip, which prompted her to seek medical evaluation. She reported no recent trauma, prior bone stress injuries, or special diets.

No significant past medical history.

Physical Exam:
Inspection: No muscle edema, ecchymosis, or erythema. No limb length discrepancy.

Palpation: Mild tenderness to palpation over proximal anteromedial right thigh.

Range of Motion: Full. Mild pain with right hip adduction.

Strength: 5/5 hip flexion, extension, abduction, adduction, internal, and external rotation bilaterally

Special Tests: Hop Test (+), Fulcrum Test (+), Hip Scour Test (-), FABER (-), FADIR (-), Log Roll (-)

Neurovascular: Sensation and distal pulses intact.

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