Lower-Limb Pain Differentiation by a Physical Therapist in an Amateur Cyclist: A Case Report

Abstract

Background Cycling is one of the most popular sports worldwide, and cycling-related injuries often involve overuse of the musculoskeletal system. However, cyclists who have been referred to a physical therapist may also present with nonmusculoskeletal conditions. Case Presentation A 57-year-old recreational amateur cyclist presented with a 2-month history of thigh and leg pain. At the clinical examination, a positive pedal plantar flexion test, a reduced 6-minute walk test, and a reduced ankle brachial index confirmed a vascular impairment. Therefore, the patient was referred to a vascular surgeon, and his symptoms were resolved with angioplasty. Outcome and Follow-Up After 3 months of physical therapy treatment, all screening tests showed normal values. The ankle brachial index value for the left lower extremity was normal. The Medical Outcomes Study 36-Item Short-Form Health Survey and the Vascular Quality of Life questionnaire showed large improvements in all domains. Discussion Clinicians should consider vascular conditions, even in endurance sports, to differentiate between musculoskeletal and nonmusculoskeletal conditions and refer patients to the appropriate health care professional. JOSPT Cases 2021;1(2):114–123. doi:10.2519/josptcases.2021.10089