Conservative management of a chronic recurrent flexor hallucis longus stenosing tenosynovitis in a pre-professional ballet dancer: a case report.

OBJECTIVE: To describe the successful conservative management of a chronic recurrent flexor hallucis longus (FHL) stenosing tenosynovitis. CLINICAL FEATURES: A 20-year-old female pre-professional ballet dancer presented with medial ankle and mid-foot pain of 7.5 months duration. Pain was constant but exacerbated with training and assuming the en pointe and demi-pointe dance positions. Plantar flexion of the great toe was pain provoking. Triggering of the great toe and audible and palpable crepitus were noted with active and passive great toe range of motion. A diagnosis of a chronic recurrent FHL stenosing tenosynovitis was made based on the history and physical exam. INTERVENTION AND OUTCOME: Soft tissue and joint mobilization and manipulation, laser therapy, kinesiology tape application and rehabilitative exercise was used over 4 months. The patient reported an 8-point decrease in her numeric pain rating scale score and a 15-point improvement in her Lower Extremity Functional Scale score.