Posted On: May 23, 2017
This is the ninth case review from my past practice. I am Dr. David Johnson a chiropractor and physical therapist in Highland Park and Lake Bluff. I am the director of North Shore Spinal and Sports Rehabilitation. I have practiced chiropractic and physical therapy on Chicago’s North Shore for almost 30 years. I started as a chiropractor in Lake Forest, Illinois in 1987. I integrated physical therapy into my practice in 1990.
This is case of a 14 year old, female basketball player who came to my Highland Park office with her mother complaining of lower back pain. She was suffering from lower back pain for 4 months and had already been to an orthopedic surgeon and another physical therapist in Highland Park.
She was an avid basketball player and was distraught because she couldn’t jump shoot and land without pain. She was a point guard for a local team and like many young athletes she played and trained all year.
Her pain was local to her back and she had no lower extremity pain. Neurologically she was intact. She had painful lumbar ranges of motion with extension being exquisitely painful. Palpation revealed that she had marked point tenderness over L5/S1 area on the left. I reviewed the x-rays from the previous providers and there were negative for fracture.
I sat down with the mother and daughter and I told them that I think she has an early stress fracture. The mother didn’t believe me. She protested that the x-rays were negative. I told her that x-rays don’t always show if there is an early fracture and that an MRI was a better choice. I also told her a high percent of young athletes with spine problems have these types of injuries. I pointed out that she had already been to physical therapy and it didn’t help.
I ordered the MRI of the lumbar spine. It came back and there was edema (excessive blood) in the left L5 pars interarticularis area. This is what one sees in early stress fracture. This can lead to a full facture. If the facture develops it is called a spondylolysis. If it happens on both sides it can allow for the vertebra to move forward and this is called a spondylolytic spondylolisthesis (Greek for spinal break and spinal slippage).
I had the patient not participate in basketball until the area was non-tender to palpation. We strengthened her with core exercises and stretched her hamstrings. She returned to training in 8 weeks and returned to play in 10 weeks. I saw her periodically over the years and she never developed a fracture.
North Shore, Dr. J and the staff were great. I started out with a pinched cervical nerve which was causing extreme pain and numbness in my arm. Surgery had been ruled out by the neurosurgeon after an MRI. My physical recommended a regimen of physical therapy which I undertook with NorthShore in November. At that time I had consistent pain in the range of 8-9 out of 10. I had trouble sleeping, driving and performing most normal daily activities due to the constant pain. I have now been through two series of physical therapy sessions with North Shore over a couple of months and the pain and numbness are completely gone. Based on my experience I would highly recommend North Shore for physical therapy treatment and the staff is extremely friendly and helpful as a bonus! Jon HeintzelmanJonathan Heintzelman
All aspects of the rehab program were done with professionalism. Intake evaluation, exercise program, massage therapy and exit evaluation were all excellent and yielded excellent results for me. All of the staff are friendly and efficient. Dr. Johnson, Jeannette, Cyprian and Mary are friendly and make an otherwise difficult experience much more tolerable. I have gone to them on two occasions over the last several years for different injuries and, in both instances, my problems were resolved. I highly recommend them.Lee Eddy
I was a patient 6 years ago, with lower back pain and herniation. My PT was excellent and I was back to exercise and resolution of pain and herniation. Recently I have had hip pain and and tingling down my leg. My evaluation with DR Johnson was very thorough and spot on. The PT with Dre was incredible. I am now pain free with a resolution of the tingling as well. I will definitely return for any future problems that may arise!Barbara Bank