Specific osteopathic diagnosis of unilateral knee pain in an elite sprinter: a case report

Abstract

This publication presents the case of a 25-year-old French high-level sprinter. He was referred for left gonalgia (knee pain), which had appeared during training a few weeks earlier and for which there was no clear traumatic cause. The athlete's medical team initially thought that he had suffered damage to his infrapatellar tendon. Despite implementing a combination of physiotherapy and allopathic medicine, the pain persisted and ultimately led to a state of disability. During the initial osteopathic consultation, the clinical examination was not very informative and did not reveal any pathognomonic signs. However, it appeared that the patient had external rotation of the tibia below the femur on the left, firmly maintained by a clear asymmetry of tone between the biceps femoris and the other left hamstrings. In the search for an aetiology, this asymmetry was explored with the sprinter's physical training staff. The athlete and his team of physical trainers determined that he was approaching curved trajectories with the left foot a little too wide open, causing shearing of the knee joint complex. Remediation of the running movements subsequently resolved the pain. The authors advocate for greater emphasis on functional diagnosis in osteopathic treatment.