•  
  •  
 

Keywords

Emotional wellness and mental health, comorbidities, college and university patient population

Abstract

The following case investigates insidious onset of shin pain in a Division I female cross-country runner. Though her initial evaluation revealed early onset medial tibial stress syndrome, the sequence of events that occurred immediately afterwards is what makes this case unique. As the student-athlete underwent lower extremity rehabilitation to increase her mileage, she reported that her pain had plateaued. The initial x-ray revealed a periosteal reaction of the posterior left tibia. After adhering to the treatment plan for four weeks, the student-athlete continued to report significant bouts of pain as demonstrated by the Visual Analog Scale. A follow-up x-ray revealed a transverse fracture through the proximal tibia. It was discovered through teammates that she was exercising at the university’s recreation center for up to three extra hours per day, despite set limitations by the athletic trainers, team physician, and coaches. Her roommate also confided in the coaching staff that there were instances of the student-athlete deliberately skipping meals, and even conducted bouts of binging and purging. The student-athlete was immediately removed from team activities and referred to the team physician, who reviewed her case and relevant medical history. Further, she was referred to additional behavioral counseling for disordered eating, obsessive compulsive tendencies, and her idealization of weight and excessive exercise. Although true exercise addiction is rare, the comorbidity rate in patients with disordered eating is clinically relevant. The Exercise Addiction Inventory is a simple and reliable questionnaire for healthcare providers to utilize during pre-participation examinations as a way of identifying athletes who may have a related medical history, and greater risk of developing comorbidities.

Download

Share

COinS