Ann Rehabil Med.  2013 Dec;37(6):886-890. 10.5535/arm.2013.37.6.886.

Sciatic Nerve Injury Caused by a Stretching Exercise in a Trained Dancer

• Shim HY
• Lim OK
• Bae KH
• Park SM
• Lee JK
• Park KD

• KMID: 2266569
• DOI: http://doi.org/10.5535/arm.2013.37.6.886

Abstract

Sciatic nerve injury after stretching exercise is uncommon. We report a case of an 18-year-old female trained dancer who developed sciatic neuropathy primarily involving the tibial division after routine stretching exercise. The patient presented with dysesthesia and weakness of the right foot during dorsiflexion and plantarflexion. The mechanism of sciatic nerve injury could be thought as hyperstretching alone, not caused by both hyperstretching and compression. Electrodiagnostic tests and magnetic resonance imaging revealed evidence of the right sciatic neuropathy from the gluteal fold to the distal tibial area, and partial tear of the left hamstring origin and fluid collection between the left hamstring and ischium without left sciatic nerve injury. Recovery of motor weakness was obtained by continuous rehabilitation therapy and some evidence of axonal regeneration was obtained by follow-up electrodiagnostic testing performed at 3, 5, and 12 months after injury.

Keyword

Sciatic nerve lesion; Lower extremity; Muscle stretching exercise

MeSH Terms

Adolescent
Axons
Female
Follow-Up Studies
Foot
Humans
Ischium
Lower Extremity
Magnetic Resonance Imaging
Muscle Stretching Exercises
Paresthesia
Regeneration
Rehabilitation
Sciatic Nerve*
Sciatic Neuropathy

Figure

• 

  Fig. 1 FS T2 WI-axial scans. (A) FS T2 WI-axial scan at the level of the ischial spine shows stretching injury with abnormal high signal intensity in the right sciatic nerve, and left partial tear with high signal hemorrhagic fluid accumulation on left internal obturator muscle at insertion and the hamstring muscle origin. No definite mass lesion compressing or contacting the right sciatic nerve was found. Left sciatic nerve is contacting the above lesions, but not enlarged or edematous. (B) FS T2 WI-axial scan at the level of the mid femoral shaft shows continuous higher signal intensity through the right sciatic nerve, relative to left normal sciatic nerve with intermediate signal intensity. (C) FS T2 WI-axial scan at the level of the knee shows multiple denervation change with diffusely high signal intensity at the right distal biceps femoris muscle, right semitendinosus muscle, and both medial and lateral gastrocnemius muscles. FS, fat saturation; T2 WI, T2-weighted image.

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