It takes two to solve mysteries of athletic injury: Staying in the Game

One injury may lead to another.

Detective work is how I describe developing an initial diagnosis and the best treatment plan to help my patients. Taking a detailed history of the injury is where it all starts.

The history is where I need the help of my patients. In the case of an athletic injury I need to know how the injury occurred and whether my patient had any similar injuries in the past.

I will want you to describe the type of pain you are experiencing. Is the pain dull, sharp, constant or intermittent? Does it radiate or is it localized? This is just the beginning of the process. It is important for my patient to be as descriptive as possible.

Such is the case of one 16-year-old boy. He’s brought into the office by his mother. They tell me last summer he was playing in a lacrosse game in Harvard Stadium on artificial turf.

He was running with the ball along the sideline and planted his right foot to stop from going out of bounds. An opposing player hit him lightly from the back. At the moment of impact his right femur (thigh bone) snapped in two.

He was taken to Boston Children’s Hospital where he underwent surgery. The surgeon placed a titanium rod down his leg. The material of this rod would allow the leg to continue to grow like his left leg. The procedure worked beautifully.

He followed up with physical therapy to restore the strength of his leg. His recovery went very well and he was allowed to return to running and playing competitive sports within a year of his injury.

After returning to the field he started to experience non-radiating lower back pain. This is why his mother brought him to my office. The pain was primarily in the center of his lower back and on the right side. Running and prolonged sitting aggravate the pain.

My examination revealed tenderness over the scars from his surgery in his buttocks. His postural examination showed his right hip to be rotated and slightly lower than his left.

There was a loss of motion of the right sacroiliac (hip) and muscle spasms in the lower back. There were no neurological findings to indicate a disc injury.

My diagnosis was mechanical low back pain as a result of compensating for his leg injury. The joints of his lumbar vertebrae and his hip were not in normal alignment and did not have a normal range of motion.

I recommended a short series of chiropractic adjustments combined with exercises to restore and maintain his alignment and motion of his joints. He responded well and was able to attend a weeklong soccer camp after a few visits to my office.

His parents would make sure he got follow-up care as needed when they returned to Boston for the school year.

Injuries can come in all shapes and sizes. It is important that you address them quickly and appropriately.

Your body can be described as one long kinetic chain. This means if there is a kink in the chain in one location of the body you compensate for this injury. This may result in another injury somewhere else.

This is why it is so important that I understand everything that is going on with my patient. After my examination, I want my patient to have a complete understanding of the injury and my treatment recommendations.

I want my patients to play an active role in their recovery. I cannot do it alone.

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