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dance medicine
dance medicine is a branch within physical therapy that specializes in the evaluation and treatment of dancers, investigates causes of injuries to dancers, promotes prevention, and a safe return to work.
dancing is a form of artistic expression and communication that involves patterned and rhythmic movements. In order to obtain the elegance that such movements require, the dancer works diligently to maintain flexibility; however, there is a possible risk that joints may become unstable. At Sovereign Rehabilitation's (SR) the physical therapist’s role is to help the dancer retain the normal functional excursion needed for the artistic expression, while generating adequate neuromuscular control for dynamic stability at end range positions.
dance injuries
the prevalence of injuries in dancers range between 65-80%, 50% occur in the lower extremities, of which 30% are stress fractures. Risk factors include: anatomy, fatigue, diet, technique, floor type, and choice of shoes.
- Spine: scoliosis (prevalence in dancers is 24-50% versus the average population at 3.9%), sprain, degenerative joint disease, disc herniation, sacroiliac joint instability.
- Hip: tendonitis, fracture, snapping-hip syndrome
- Knee: sprains, patella tendonitis.
- Leg: shin splints.
- Foot and ankle: bunions and Achilles tendonitis, stress fractures
- Neck: cervical strain
- Upper extremities: shoulder strain
- Degenerative joint disease: prevalent in older dancers.
- Inadequate nutrition:
- Females: avg.11% below ideal body weight, resulting in low calcium intake, increasing the risk of stress fractures.
- Secondary amenorrhea due to low estrogen
- Other metabolic disorders
The SR physical therapist assists with injury prevention via:
- Education
- Instruction in optimal training regimens (involving frequency, duration, intensity, and rest
- Encourage adequate nutrition
- Early diagnosis and treatment
- Options in floor covering and mats for training.
At SR, the physical therapist will initially conduct a subjective examination (interview) of the dancer’s medical history. This process is guided by the individual’s complaints and symptoms. The purpose of this process is to establish functional limitations, rule out serious pathology, and identify a treatment diagnosis. This will direct therapy interventions, and define a baseline of function in order to monitor progress.
The objective assessment, on the other hand, is guided by the dancer’s history and will use certain quantifiable measurements to guide diagnosis, and to document progress. The system or area being managed will dictate what particular regimen will be used. For a musculoskeletal exam, the joint range of motion, muscle power, tissue mobility, neuromuscular control, core muscle activation patterns and posture will be tested.
Directed by the assessment findings, the physical therapist will then develop and facilitate a treatment plan, and may include various therapeutic-treatment techniques, depending on the dysfunction or impairment.
- Joint mobilization and/or manipulation
- Muscle energy techniques
- Neuromuscular reeducation
- Electrophysiological agents (i.e. ultrasound, electrical stimulation, iontophoresis)
- Return to dancing: dance-specific exercises and neuromuscular reeducation are designed to build speed, power and balance. Often techniques, such as proprioceptive neuromuscular facilitation (PNF), are used to achieve normal function, and core muscle strengthening is an integrated part in the dancer’s recovery.
At SR, a licensed physical therapist (specializing in the treatment and management of musculoskeletal disorders unique to dancers) will provide treatment.
We recommend comfortable clothing with an elastic waistline, such as shorts, and sports bras for women. This will allow the therapist to more easily evaluate and treat the patient. Jogging suits and dance shoes are also suitable.
(REFERENCE: Journal of Dance Medicine &Science, Volume 4, No.1 and 2, 2000.
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