Dade MM, Broecker JD. Myofascial Release for Vulvar Pain and Pubic Shear After a Straddle Injury in a 3-Year-Old Girl. J Am Osteopath Assoc 2019;119(11):768–771. doi: https://doi.org/10.7556/jaoa.2019.127.
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Pelvic malalignment is a somatic dysfunction that can lead to pelvic discomfort, despite normal genital examination findings. A 3-year-old girl presented with vulvar discomfort after a straddle injury sustained while riding a tricycle. The symptoms persisted despite standard medical treatment for vulvovaginitis and chronic vulvar irritation. An osteopathic structural examination revealed distortions of the bony pelvis, often associated with genitourinary complaints. After 5 osteopathic manipulative treatment sessions, the patient experienced significant relief. With persistent vulvar pain, somatic dysfunction should be considered in the differential diagnosis. A brief musculoskeletal examination of the pubic tubercles, iliac crest, and iliac spines can help to identify somatic dysfunction in a gynecologic patient with symptoms that are unresponsive to standard treatments.
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