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Pollo, Fabian
05-04-1999, 11:55 PM
Hello Researcher:

I have a young female patient who is a high caliber long distance runner.
She averages 70 miles per week and has had recurrent tibial stress
fractures. Currently she also has been complaining of right hip pain. She
has a 1 cm leg length discrepancy (left greater than right) which is mainly
at the tibia and is also internally rotated at both hips. The stress
fractures I am sure are simply the nature of the beast, (long distance
runner, female, diets, irregular mens, etc.), which could be helped by
substitutung some of her run trianing with biking or running in water and
also proper running shoes.
The hip pain, which is my main concern, I believe is entirely a result of
her leg length discrepancy. And I also believe the source of her pain is a
result of greater trochanteric bursitis, of which she has all the symptoms.
She has tried a 1/4" heel lift, which she claims give her lower back pain
when she runs, but says that she feel good when walking.

Would an entire 1/4" shoe lift have better effect than a 1/4" heel lift?
Biomechanically, it makes sense to raise the entire foot 1/4" instead of
just the heel, which places the ankle in some plantarflexion and may throw
off the forces up the extremity. Which she may not notice walking around,
but after several miles of running, this may become a problem.

Has anyone had any experience with a similar athlete or have any suggestions
on intervention to alleviate her hip pain?

Also, does anyone have any good running shoe recommendation to help with her
stress fractures?


Thank you in advance,

Fabian


Fabian E. Pollo, Ph.D.
Director, Motion and Performance Laboratory
Department of Orthopaedic Surgery
Baylor University Medical Center
3500 Gaston Avenue
Dallas, Texas 75246
Voice: (214) 820-6300
Fax: (214) 820-1988

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