June 20, 2008

Dancing Smart Newsletter: 6/20/08

Greetings!
Hope everyone is enjoying their summer activities! Right to the questions for the week…


I
have had an uncomfortable tightness and pain in my left hip area for about a year. My hips easily pop now. When doing anything that involves the left leg, it won't go as high and feels like it wants to give out. I feel a little pain when stretching in side splits and leaning to the left and trying to stretch the leg in arabesque. I have seen two orthopedic surgeons with two opinions. One said it was a definite labral tear (no MRI) and the other said it was tight hip flexors. Is there a way to distinguish between the kinds of pain or area each would cause so I know how to fix this problem?
Thank you, Jaime

Jaime, I'm not sure how the definite labral tear was diagnosed without an MRI. Since the fix for a labral tear is surgery – I would certainly want that confirmed before going further.

Tight hip flexors are easy enough to address physically through stretching and massage work. If you stretch and release the hip flexors – do you feel a difference in the hip? It should be a pretty straight-forward even if it doesn't hold for long. It takes time to truly change any tight muscle.

What I would suggest is doing the rehab for a tight hip flexor and if that isn't helping think about getting an MRI done to more accurately assess the joint.

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I have just had a student diagnosed with Scheuermann's Kyphosis, which I don't know much about and am currently researching. Do you know anything about the condition and how it will affect the student's ability to dance.

Her mother is concerned that the doctors will suggest that she give up dancing. I think that in the case of Kyphosis, dancing will help to keep the spine loose and help to control the progression?

Any help would be greatly appreciated, both by myself and my dancer!
Jane

Scheuermann's kyphosis is an abnormal rounding of the upper back. Think of a very elderly person who is walking stooped over with just their head picking up. That would be a potential end point for someone with Scheuermann's. With your student being young – hopefully without back pain and a mild curve – there is much they might do. I imagine they will give her a brace to keep her spinal alignment upright and put her in some type of physical therapy. Pilates on the equipment with a knowledgeable physical therapist is one such possibility. It's quite possible that dance has been a very positive activity for her already! We know that spine health means maintaining your ability to flex, extend and rotate. I can't think of a better activity that dance which involves all of those motions of the spine!

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My 12-year old daughter loves modern dance, but she often has pain in her right ankle and foot. Her right arch provides very little support so that she pronates when she walks. From the back her right foot and leg look very similar to the photo that accompanied your May 2 post. I would very much like to know what we should do now to: 1. Minimize her pain 2. Not injure her ankle/foot 3. Make sure that she does not have problems as she gets older. My family doctor grudgingly gave me a prescription for orthotics, but without better understanding of the problem (she has a terrible time turning out at all and could have issues higher up in her legs and hips), it seems foolish to just go for the orthotics. What would you suggest? I am based in central Pennsylvania. It strikes me as ironic that we have orthodontists who fixate on kid's teeth, but I'm having a hard time finding someone who can help with my daughter's feet and legs. Thanks for the wonderful newsletter!
Rebecca

It sure can be frustrating to find practitioners who understand what you are going through. Often I counsel my students to find the closest, largest dance studio and see where their dancers go. For you that might the Central Pennsylvania Youth Ballet.

Another way would be to poll the local soccer athletes and runners who they go to. Sports medicine physicians and therapists might not be dance savvy – but they are movement savvy.

As far as your questions you're on the right track with first and foremost getting her some orthotics. This will accomplish a multitude of issues with correcting the pronation and giving the muscles around the ankle a chance to redevelop balance. In fact, I would have her practice balancing on one foot, while in her orthotics, tossing a ball back and forth between her hands to challenge herself. See if she can stay on one foot for between 1-3 minutes.

She's 12 – so that means she is growing and moving into the sometimes awkward teenage years. Once you find a practitioner that is versed in sports or arts medicine have them keep checking her leg length. When there is one ankle or foot that hurts – I'm always suspicious that there is something going on above that is creating a weight imbalance - like a long leg or a pelvic/torso shift.

If the foot that hurts is on the side that she has less turnout – then she needs to decrease her first position until she is able to line up the ankle/knee/hip more accurately. She might want to read my Tune Up Your Turnout book for more exercises – and – to understand more appropriately how to create turnout at the hip.

Best wishes for a safe and speedy recovery!

Happy Solstice everyone!

Deborah

"Education is the key to injury prevention"