VCOM Louisiana Research Day Program

Clinical & Case Studies

Joseph Stringfellow, OMS-II*; Jacob Turnbull, DO*; Omowunmi Jolaoso, ATC** Edward Via College of Osteopathic Medicine-Louisiana; Grambling State University 31 ANTERIOR THIGH PAIN IN A COLLEGE SOCCER GOALTENDER

A division 1 women’s soccer player presents to the team medical staff complaining of unilateral right anterior thigh pain. Upon obtaining a thorough history, her pain had a gradual onset that was first experienced during the last game of the previous season. She denied any trauma or specific mechanism of injury but did notice minimal swelling above her knee. She stated that punting the soccer ball worsens the pain, but the pain does not radiate. On physical exam, it was noted that she was able to perform body weight squats without pain. There was no bruising, swelling, or notable muscle defects on palpation. No official diagnosis was made at this time and she was recommended to rest and follow up for further workup. However, the patient was not able to follow up until 3 months later following returning home for summer break. During this time, she experienced increased pain with kicking, and was seen by a doctor overseas. After obtaining an MRI overseas, she was diagnosed with a right partial quadriceps tendon rupture. The incidence of a partial quad tear is very low, which adds to the importance of this case. Is surgery the best option for treatment? Due to the time between the injury overseas and her follow up with the medical staff following summer break, it was clear that surgical options would be limited due to the now chronic nature

of the injury. Instead, her treatment and rehab were focused on quad strengthening and improving hamstring flexibility and balance. She was able to progress to 80% quad strength with full range of motion and normal balance before returning to full competition. In this case, the timing of events adds to the complexity of an already rare case. The fact that her injury was worsened overseas and was then a chronic injury by the time she returned to the medical staff also adds to the complexity. The complexity of this case makes it relevant to everyday practice. For this patient, surgery was not utilized to treat the tendon rupture because of the added complexity of the events. Surgery can be a good treatment for many diagnoses, but this case can be used to show that there are other, less invasive, ways to treat musculoskeletal injuries.

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