quad pain w/o injury or cramping

[vabird]

17 yo daughter has had moderately severe quadriceps pain in one leg without muscle cramping for almost 1 year. The pain is not related to exercise and can wake her up in the middle of the night. Advil & tylenol tried. She has had a negative bone scan and leg mri. A back mri was denied. She has had pt of the leg and the back w/o results. She is now scheduled for a hip mri looking for a labrel tear. Any other thoughts?

[rosie40]

Hi, I just happened to come across your post... My 16 yr. old daughter is recovering nicely from a mean quad injury that is believed to have been a result of her SI misalignment.

One week ago she was in such bad shape they suspected a grade 2 plus tear. She was incredibly swollen and painful through the quad. Since her realignment and PT of the thigh (electical stimulation, ultrasound, etc.) she is now pain free and preparing to get back out on the volleyball court. Nothing short of miraculous if you had seen her a week ago. She couldn't even bend her knee for the first 2 days.

I won't go into detail about SI (Sacroiliac) joint dysfunction just in case you've already been down that avenue... You can also just do a Google search on it to explain it more clearly. This issue can manifest itself in so many different ways... back, thigh, leg, knee, ankle pain.

I am just so grateful that a very wise trainer, of all people, (not the orthopedist we had previously seen) discovered it could be her problem after doing an initial benign "long sitting test" I believe it's called. In doing so, one of her legs was 2 inches longer than the other, which suggested the SI problem... Her pelvis was rotated.

The body compensates putting strain on other areas that it wouldn't be if everything were properly aligned. It's extremely important to find someone who has a good understanding of this issue and is specifically trained to deal with it. It's not something you can identify through traditional methods of x-rays, etc.

We then saw a new othopedist and physical therapist whom have both worked with Olympic athletes and are very well versed on this dysfuntion, as well. We feel so fortunate to have such a great medical team working with her. She will continue to do core exercise to strengthen those innermost muscles in an effort to re-train her body to keep everthing in place....

[vabird]

Rosie - Thank you so much!!! It's funny that your daughter plays VB because that is my daughter's sport too. You can imagine that this is very frustrating at this time of year.

My daughter endured a hip mri with a painful arthrogram last week. One of her PT's diagnosed a shorter leg but pt didn't help. I will look into SI joint dysfunction. She has an appointment for a second opinion.

D's pain is a little different than your daughter's. There isn't any swelling and it comes and goes at one specific spot. I will still investigate the SI joint dysfunction, though. Thanks again.

[rosie40]

You're welcome.... I can relate to your daughter's frustration. I know mine isn't happy on the bench right now! It is amazing to me how many female athletes, particularly v-ball girls, we have come across recently with this SI issue. I think, in part, we are just fortunate that we're live in an area that there is increasing awareness about it.

The swelling this time was an unusual feature... We had a bit of a "perfect storm" of events leading up to that injury... She knew she had thrown her SI out a few days before v-ball tryouts. She heard the "pop" followed by the pinching pain. (They learn to recognize the signs and physical sensations. She can also feel that her walk is off.)

Her PT was out on maternity leave. We couldn't line up a new PT before try-outs that Monday, so of course, she proceeded anyway. Monday night she wasn't walking well, which she just chalked up to muscle fatigue. Tues am, after she found out that she had, in fact, made Varsity she was determined to persevere through practice. She was in much pain but pushed through on adrenaline... Bad idea.

The next morning she was a mess. We though for sure she had torn something. It was only after visiting this new PT and Orthoped., who specialize in this dysfunction, she was up and going in no time. His SI manipulation technique was fascinating.... It was because she put her body through so much when she was out of alignment that the Quad took on the strain.

I realize that this may not be what your daughter is dealing with but I would try to seek out someone who is truly familiar with this disorder, jic. There are many doc's/PT's who will dismiss the idea altogether just because they have no understanding of it, let alone the ability to successfully treat it. For those properly diagnosed and treated, the difference is night and day.

It still blows my mind how well her body works and how great she feels coming off of such a painful injury...

I wish your daughter the very best.... I sure would love to hear how things work out for her. I'm sorry she is dealing with this especially when she'd much rather be out there enjoying her sport. It's so hard for them.... Take care.

[vabird]

A visit to a second doctor gave us the diagnosis of a tight psoas muscle, apparently a very common injury in volleyball players. Daughter's pt had worked on loosening the muscle but this doctor believes you have to use physical exercise, not just therapy, to loosen and then strengthen the psoas. Interesting. We'll see how this works. At least daughter was able to go to practice tonight!!!

[rosie40]

That is interesting.... I'm so glad to hear she is back on the court. I would love to hear more about what they tell you and how it works out for her. It seems that we parents learn so much from each other when these unusual sports injuries occur, particularly in our girls.

My DD goes back in on Thursday for her 3 week check to see if she can be fully released back into the VB program. She's been doing some light practices and played a little in a game or two. She says she feels great... You just hate for them to do too much, too soon and regret it.

Please do post back and let me know if she gets some relief from her pain with their prescribed treatment.... Best of luck to her!!

[vabird]

Well, now we have a whole new diagnosis. The new pt thinks she does have some referred spinal nerve pain. He is loosening her back and correcting her posture for now. When her pain has disappeared for two weeks, he will strengthen her core muscles. I'll keep you posted.

[rosie40]

I know it must be so frustrating trying to figure out the source... Like looking for a needle in a haystack after all she's gone through. Just curious... Has she ever complained of lower back pain??