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Free to Fly: A Case of A Dancer’s Flexor Hallucis Longus Tendonitis

Journal: The AAO Journal Date: 2023/06, 33(2):Pages: 28. doi: Subito , type of study: case report

Full text    (https://meridian.allenpress.com/aaoj/article/33/2/20/493544/LBORC-NUFA-Poster-Abstracts-2023-Students)

Keywords:

case report [514]
cervical spine [210]
female [379]
flexor hallucis longus [1]
foot [54]
neck pain [132]
OMT [2951]
osteopathic manipulative treatment [2973]
tendonitis [2]
women [333]

Abstract:

Introduction/Background: Flexor hallucis longus (FHL) tendonitis, known as dancer’s tendonitis, results from repetitive plantarflexion. The FHL is vulnerable to tension in various areas, one being the intersection between the flexor digitorum longus (FDL) and FHL, known as “knot of Henry”. Standard conservative care with home exercises, physical therapy and anti-inflammatory medications has a 64% success rate. Limited OMT research discusses treating local somatic dysfunctions, but none highlight addressing the fascial meridians. Case: A 22-year-old female ballet dancer, presented with non-radiating neck pain rated as 8/10 with a secondary complaint of daily foot pain 7/10. Patient suffered MVA in 2019 causing neck pain. A bad landing practicing ballet en-pointe techniques April 2022 initiated the foot pain with daily spasms. Examination revealed tenderness on cervical & upper back paraspinals. Patient had L foot hypertonic knot of Henry, compressed by an IR navicular. Tenderness on 1st metatarsal, and taut plantar fascia were also present. OMM treatment plan focused on treating superficial back line (SBL) meridian with myofascial release and improving tarsal bone movement. A Lower extremity functional scale (LEFS) was obtained retroactively at the 5th session. Results: Over 5 months of treatment, foot spasm frequency decreased from daily to monthly, and neck pain to 0/10. The LEFS showed a 17.5% clinically important difference. As a result, patient’s dance endurance improved. This is due to relieving tension upstream, and downstream of SBL meridian for improvement of wholebody functionality. Discussion: Case study suggests a novel way to incorporate OMT into the standard care of treating FHL tendonitis. It demonstrates the impact that a “dropped” navicular bone can have in foot functionality. Case study limitation includes having the patient complete LEFS retroactively after treatment.


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