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I feel like I’m missing something obvious

Exit forum ID Forum Discussion I feel like I’m missing something obvious

This topic contains 0 replies, has 1 voice, and was last updated by   Brandon Cohen DC, CSCS December 18, 2017 at 8:05 pm.

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    Brandon Cohen DC, CSCS
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      35 year old female

      Left hip pain since August.

      Location: left lateral hip pain (TFL area pain)

      quality: dull

      Intensity: 6/10

      Provocative: running, and going up stairs, laying on the left side.

      Palliative: avoidance of provocative factors (not moving, rest, going up stairs one at a time with the right lead.)

      Went to the ortho, and was diagnosed with myofascial.

      Soreness in the right sided lower lumbar spine since running yesterday.

      Patient was running up to 2-3 miles up to 4 times/week

      No imaging

      Exam:

      SLR: 90 degrees bilaterally with tension in the posteiror thigh bilaterally.

      SHF: 1 finger on the left, thigh to the ribs won the right with anterior hip pinching bilaterally.

      SLPF: fingers to the toes, palliative

      QLF: extended from 0-2.5″ (60%)

      KHE: 13″ on the left, 16″ on the right with anterior hip tension on the left when performed bilaterally.

      There’s not much that really stands out to me with this information. She has has a bad qlf and decreased SHF and some symptoms.

      Dx is adhesion, but there are  couple of concerning things for me. Disc seems likely, but the referral pattern to the lateral hip and sitting not being provocative put it lower on my list. Hip pathology/morphology is on the list due to the palliative/provocative, but the function is really high.

      I’ve done some treatment under the hip morphologly + adhesion, and lumbar disc + adhesion with minimal change in sx. Tests only marginally improved.

      Suggestions?

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