The Need for Manual Therapy to Keep the Dancer Dancing

Hunter, Robin A.DC, Ohio State University, Columbus, OH, United States; Morant, Ricky, ATC, MS, BalletMet, Columbus, Columbus, OH, United States

Injury rates are documented to be 93.1% annually for the professional ballet dancer.  Typically, the majority of dance injuries are overuse in nature, particularly to the foot/ankle/ lower leg complex and the hip/low back.

The purpose of this presentation is to explore manual methods in the treatment, intervention, prevention and performance enhancement for the professional ballet dancer. 

Understanding the kinetic chain and movement dysfunction patterns is essential when working with the dancer. When biomechanical and biokinetic stressors cause overload in the dancer; adaptions, compensations, then decompensations occur that cause movement dysfunction. These dysfunctional patterns take place in predictable patterns. These can cause joint restriction, myofascial fibrous formation and, contractions.

Overload usually starts as tightness, typically with the psoas muscle in the pelvic girdle, in particular.  The tightness syndrome can then involve the deep plantar flexors, iliotibial band, hamstring, and quadratus lumborum muscles. Reciprocal inhibition of the antagonists occurs causing weaknesses in the anterior tibialis/ peroneals, vastus medialis, gluteus medius, and the transverse abdominus/core muscles.   Restoring and maintaining kinetic chain functioning in the dancer is the goal.

Manual Therapy.

Manual therapy for joint restriction and damage to myofascial tissues can and should be an integral part of the dancer?s treatment regime. Addressing these components of injury MUST precede the functional progression of rehabilitation and return to danced.  Re-activation of the kinetic chain is the focus.

The presentation will cover impingement syndromes of the foot/ankle complex, and in the hip, in light of restricted subtalar glide in the ankle and restricted intrinsic hip movements.  Myofascial release of the lower leg compartments, iliotibial band and hip flexors will also be covered, as myofascial problems can be a major part of the dysfunction occurring in the dancer.