Can we catch a break? Femoral neck stress fracture risks factors and clinical assessment. It’s not always the biomechanics at fault with running injuries. Remember our differential diagnoses and to treat the whole patient.
NOTES & REFERENCE
2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad:
Mary Jane De Souza, PhD, et al.
- The Female Athlete Triad is a medical condition often observed in physically active girls and women, and involves 3 components: (1) low energy availability with or without disordered eating, (2) menstrual dysfunction, and (3) low bone mineral density. Female athletes often present with 1 or more of the 3 Triad components, and an early intervention is essential to prevent its progression to serious endpoints that include clinical
- Best tests to rule out femoral neck stress fracture are Pubic Patellar Percussion Tests (PPPT) test and fulcrum test
Journal of Orthopaedic & Sports Physical Therapy 2018, 48:4, 343-343
-1 week history of right groin pain that had progressively worsened while training for a half-marathon; initial image at eval showed no fracture.
- At Physical therapy Eval, the patient presented with an antalgic gait pattern, difficulty getting up from a chair, severe pain during single-limb stance, and occasional night pain. The lumbar screen was noncontributory, and no red flags were noted. Palpation of the iliopsoas and hip adductors revealed muscle spasm and pain. Hip passive range of motion was not limited, but was painful at end range in all directions. Strength testing showed weak and painful hip flexors and adductors. The hip scour test and the “flexion, adduction, internal rotation” (FAIR) test were negative. Movement observation showed weight shift to the left during double-leg squat and inability to perform right single-leg hop due to pain.