Diagnosis and treatment of 2 adolescent female athletes with transient abdominal pain during running

Context: Transient abdominal pain commonly occurs during running. There is limited information to guide the physical examination and treatment of individuals with this transient pain with running (TAPR). The purposes of this report are to describe the movement-system examination, diagnosis, and treatment of 2 female adolescent athletes with TAPR and highlight the differences in their treatment based on specific movement impairments. Study Design: Case series. Diagnosis: The movement diagnosis determined for both patients was thoracic flexion with rotation. The key signs and symptoms that supported this diagnosis included (1) alignment impairments of thoracic flexion and posterior sway and ribcage asymmetry; (2) movement impairments during testing and running of asymmetrical range of motion for trunk rotation, side bending, and flexion of the thoracic spine; and (3) reproduction of TAPR. Discussion: Musculoskeletal impairments related to the trunk muscles combined with the mechanical stresses of running could contribute to TAPR. Treatment in each of the patients was focused on patient education regarding correction of alignment, muscle, and movement impairments of the extremities, thoracic spine, and ribcage. A strategy was determined for correcting motion during running to reduce or abolish the TAPR. Outcomes were positive in both patients. Differences in specific impairments in each patient demonstrate the need for specificity of treatment. These 2 patients illustrate how developing a movement diagnosis and identifying the contributing factors based on a systematic examination can be used in individuals with TAPR.