Question
I am a 24 year old female experiencing extreme muscle fatigue in my legs especially when I am running. I normally can run at least 2.5 miles on a bad day to 5 miles on a good day, however, lately I can barely run one without my legs feeling exhausted. This happened suddenly at the end of March (I ran a 5k in mid March and was fine). I have some lower back pain and some pains going down my legs. I had a lumbar spine xray but the doctor said it showed no abnormal pathology, however, did notice extreme tightness in my back muscles. My diet has remained the same. Do you have any suggestions please? I just want to enjoy running again!

Answer
Hi Shannon,

First, as you might discover from previous postings about back pain, x-rays are not advised and are not part of evidence based care for back pain.  You cannot determine what the problem is by taking an x-ray.  Just becuase your lumbar spine x-ray shows no fracture or tumor doesn't mean that you should be feeling 100% fine.  Doctors need to stop taking x-rays on everyone, and reserve this tool only for when there is suspician of something bad going on, e.g. fractures, tumors, etc.    Secondly, it might help to know a little more about your symptoms and history.  Nevertheless, for most young folks with symptoms like this, the first thing to do is to see if working out any adhesions in deep musculature and freeing-up any stuck joints immediately improves the symptoms.   This would involve finding a sports chiropractor that has skills in soft tissue therapy (see:  www.acbsp.com).   Also, a good functional physical exam that incorporates evaluation of function: movement, strength, balance, kinetic asymmetries might reveal some factors contributing to the symptoms.  A pathologic physical exam, looking for pathology (tumor, fracture, neurologic disease) is likely going to be negative in a 24 year old.  While this exam is important, it will not flush out the culprit for most musculoskeletal conditions.  

I hope this was helpful,

Dr. G