17/09/2019
I'm going to kick off my first injury post with some humor. It's one of the cases that I worked on a couple of months ago.
Female in her early 20s, non-athletic, came complaining of left-sided posterior leg pain when traveling. She actually called her problem 'London Syndrome', it seemed that every time she travels to London, she develops the symptoms, and then they'd relatively subside on her return. The pain would start a day after landing, not before that.
She was getting quite anxious about it at that point, and she'd be worried if the pain will start again if she were to travel.
So I took her relevant history, asked her about the duration and when it had started, I asked about a traumatic incident, but everything seemed unremarkable. On physical examination, she had tight hamstrings, but no difference in strength between both sides. I examined her hips, knees, and ankles for ROM but everything checks out. She had no apprehension to any of the tests that I conducted.
At first, it seemed like distal hamstring tendinopathy, but it didn't fit the picture at all, no overuse, young, and conditional on traveling. So I dug into her daily and travel habits more.
Turns out that she sits in extreme knee flexion positions on chairs, and she does so for prolonged hours on end, then when the hamstrings are used a bit, the pain would develop.
So I had her walk for 25 minutes the first day to provoke symptoms, then I did some soft tissue manipulation.
On the second day, she could walk up to 30ish minutes or so before pain had developed. I did more soft tissue manipulation.
And you get the picture. within a weeks time, her pain had resolved completely. It was cool when she told me that she traveled and had no pain whatsoever.