I hope everyone's Thanksgiving holidays were wonderful.... I am grateful to have all of you in my dance community!
The new website is nearly done.... hoping by the next newsletter it will be up and running!
Here's the question of the week...
My daughter is 14 and has been dancing for 10 years. She started a very intense dance schedule in June. She was dancing nearly 30 hrs, a week for the summer along with a 4 day intensive. She cut back to 21 hrs a week when school started and has been doing very well growing in her dance ability until now. She takes 3 ballet classes, 3 adv. pointe classes (all 1 1/2 hrs each), 4 jazz classes, 3 lyrical classes, salsa and conditioning. She recently started having pain in her right hip where the sciatic nerve runs. A teacher of her is a certified physical therapist. She felt around and noticed the nerves on both sides were moving and the muscles underneath were knotted up. The pain stayed right there and didn't travel so we ruled out sciatica. We have iced and heated the area for a week and rubbed out as many knots as possible. It seemed to help and then she went to a jazz class and over did it and now we can't get the pain to stop for very long. I can feel the knots and deep rubbing seems to help but only for a while. Once she wakes in the morning it starts all over again. What if anything else can we do for it? I know rest is needed but do you have any other advice for knotted muscles? Thank you for your time, Evie
I'm glad you have a physical therapist on board to help you out. I'm wondering whether your daughter could have something called piriformis syndrome. It's a condition where the piriformis muscles which is the largest of the 6 deep muscles that are the 'turnout' muscles irritates the sciatic nerve. Some people only feel pain in the buttock area (this could be your daughter) and sometimes it goes down into the leg,
which is referred pain from the sciatic nerve. The sciatic nerve typically passes underneath the piriformis muscle, but in about 15% of the population the nerve goes through the piriformis muscle increasing it's potential for trouble.
When dancers overwork the piriformis and the other deep rotators as they are trying to achieve more turnout then can create excessive tension in this muscle which presses or compresses on the nerve creating pain depending on where the nerve lies in relationship to the piriformis muscle.
For right now, let's treat your daughter as if she has really irritated both the sciatic nerve and that the turnout muscles are knotted up and very unhappy!
The massage you are doing is good for releasing tension in the gluteal area, as well as using a pinkie ball or a tennis ball to put between the buttock and the wall to do self-massage. With piriformis syndrome I personally would not use any heat - only ice on the area, and would have her ice as much as possible. This might be a time where a few days of an anti inflammatory such as ibuprofen could be helpful. The next thing I would do is to stretch, stretch, stretch, the turnout muscles to help them release from their painful spasm.
She can do this in a variety of ways. To the left is a sitting chair stretch that is very useful as she can easily do a stretch or two while in school! Another way would be the traditional sitting on the floor with the legs folded and rounding down over the legs, gently moving from side to side to feel the stretch at the back of the buttocks where her pain is. Make sure to switch which leg is in front as that will change the focus of the stretch to the other side.
Rest is the final part of the treatment program. It doesn't mean that she would have to take off from all of her dance classes - but it does mean she needs to significantly reduce the amount of classes that she is taking. Her first goal is to be pain free when she wakes up in the morning. If her pain is reduced by pulling back - or totally off classes, then she can slowly bring more classes back in. Working through the pain at this point will most likely increase the length of time for healing - and make for some poor muscle habits as she is trying to engage and work the turnout muscles while they are tender and tight.
Best wishes for a speedy recovery!
Deborah
2 comments:
Do you also recommend massage therapy and chiropractic care?
I have had this type of problem before, numerous times, and the only thing that made it completely go away was a visit to my massage therapist and chiropractor. :0)
I have had trouble with piriformis syndrome on and off for about 4 years. For some reason it really seems to flare up when I walk quickly or over long distances. In addition to the stretches mentioned here, my physical therapist gave me hamstring stretches with a flexed foot (with the irritated leg out in front, stretch over while pulling the toes back) and this same stretch lying on the back with the leg overhead. Make sure to do this forward stretch with the toes pulled back, perhaps with a towel pulled around the ball of the foot. It really helps!
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