<p>We describe a case of first recognition of tethered cord syndrome (TCS) with trauma in a young woman. This is the first detailed description of trauma-exacerbated tethered cord syndrome in a previously unrecognized case. A physically active 17-year-old woman presented with severe ataxia and painful tingling in both legs after a fall related to laxative use to treat constipation with onset two years prior. She had a congenital erythematous patch on her midline lower back. This was found to be associated with a dermal sinus tract, lipomatous filum, and low-lying conus medullaris indicating TCS as her underlying condition. This fully resolved with elective surgical detethering a few weeks later and time. All new cases of otherwise unexplained bladder or bowel dysfunction should undergo examination of the lower back for any signs of a possible underlying congenital spinal defect that may warrant MRI to rule out a tethered spinal cord.</p>