Outside of foot pain after running. Clinical case

Outside of foot pain after running

A boy of 18 years. Complains of severe pain outside of foot after running and especially during weight-bearing exercise while walking. Had been bothering him for about a week, when in the evening, after a workout, there was pain on the outer edge of the foot below the ankle. The next day the pain on exertion was so intense that it prevented him from walking. Then he went to a trauma surgeon, had an X-ray taken: no abnormalities of hard tissues were found, but it was presumed that the ligaments had been sprained. A course of nonsteroidal anti-inflammatory drugs (Nimesil) was prescribed. After 5-6 days of treatment, pain persisted while walking (7 points out of 10), and running was impossible.

Objective examination: range of motion in the foot is normal. Dorsiflexion, eversion, inversion, pronation and supination are painless and complete. At the extremity of plantar flexion, combined with finger flexion, there is characteristic pain. On palpation, there is slight swelling and severe soreness (7-8 points out of 10) around the cuboid bone, especially the dorsal heel-cubic ligament. Mobilization of the fifth metatarsal bone relative to the cuboid bone allows for painless plantarflexion in its entirety.

Diagnosis: articular dysfunction of the tarso-metatarsal articulation, sprain of the dorsal calcaneocuboid ligament.

Treatment: articulation techniques and mobilization with movement for the affected tarso-metatarsal joints, deep Syriax transverse friction for the above-mentioned ligament.

Results: after the first session painless walking is restored, plantaflexion with effort and additional pressure does not cause pain.

Side of foot hurts after running. Conclusions.

Another interesting case of foot pain of a runner, showing the ineffectiveness of trying to solve the biomechanical problem chemically. Similarly futile are the attempts to eliminate with physical methods (manual therapy, exercises, physiotherapy) conditions in which they are not indicated or even contraindicated. Everything has its place and time.
What in the medical history itself suggests the functional nature of the disorder? Young age, extensive experience in running (8 years), recent onset of pain outside of foot and, perhaps most importantly, the absence of pain at rest and its provocation by a very specific movement with a load with manifestation in a local and well-defined area.