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Theresa M. Spitznagle and Shirley Sahrmann

Context:

Transient abdominal pain commonly occurs during running. There is limited information to guide the physical examination and treatment of individuals with this transient pain with running (TAPR). The purposes of this report are to describe the movement-system examination, diagnosis, and treatment of 2 female adolescent athletes with TAPR and highlight the differences in their treatment based on specific movement impairments.

Study Design:

Case series.

Diagnosis:

The movement diagnosis determined for both patients was thoracic flexion with rotation. The key signs and symptoms that supported this diagnosis included (1) alignment impairments of thoracic flexion and posterior sway and ribcage asymmetry; (2) movement impairments during testing and running of asymmetrical range of motion for trunk rotation, side bending, and flexion of the thoracic spine; and (3) reproduction of TAPR.

Discussion:

Musculoskeletal impairments related to the trunk muscles combined with the mechanical stresses of running could contribute to TAPR. Treatment in each of the patients was focused on patient education regarding correction of alignment, muscle, and movement impairments of the extremities, thoracic spine, and ribcage. A strategy was determined for correcting motion during running to reduce or abolish the TAPR. Outcomes were positive in both patients. Differences in specific impairments in each patient demonstrate the need for specificity of treatment. These 2 patients illustrate how developing a movement diagnosis and identifying the contributing factors based on a systematic examination can be used in individuals with TAPR.

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Marcie Harris-Hayes, Shirley A. Sahrmann and Linda R. Van Dillen

Context:

Hip function has been proposed to be related to low back pain (LBP) because of the anatomical proximity of the hip and lumbopelvic region. To date, findings have been inconclusive, possibly because the samples studied were heterogeneous. Subgrouping samples based on characteristics such as activity demand, LBP classification, and sex might clarify research findings.

Objective:

To describe and summarize studies that examine 3 factors proposed to be important to the study of the hip–LBP relationship.

Design:

Review of cross-sectional studies.

Setting:

Academic healthcare center and research laboratory.

Subjects:

3 groups: athletes with a history of LBP who regularly participate in rotation-related sports, athletes without a history of LBP who are active but do not regularly participate in rotation-related sports, and athletes without a history of LBP who participate in rotation-related sports.

Main Outcome:

Hip range of motion and hip–lumbopelvic region coordination.

Measures:

Hip range of motion was measured with an inclinometer. Coordination was examined based on kinematics obtained with a 3-dimensional motion-capture system.

Result:

Differences among groups were found based on activity demand, LBP classification, and sex.

Conclusion:

When assessing athletes with and without LBP, characteristics such as activity demand, LBP classification, and sex should be considered.