Did you know this term I have been going to ballet classes?! I am not yet graceful, I do not look beautiful and elegant and there is no gliding across the dance floor to speak of. I am clumsy, I have 2 right feet (or is that left) and seem to keep adding moves where there shouldn’t be any! However, everyone else in class is going through the same thing so I am determined to continue and give it a real go! Luckily I treat ballet dancers a whole lot more confidently that I execute the moves.
When I was going through university one of my house mates was studying ballet so right from the word go I have been interested in the musculoskeletal effects of dancing. Here are some of the common problems that ballet dancers face, if caught early they are all treatable and manageable.
Anterior hip pain and ‘snapping’ hip
This happens when the head of the femur (thigh bone) is sitting too far forward inside the acetabulum (hip bone). It can result in pain at the front of the hip, a snapping sound when lowering the leg or circling the leg and long term can place undue stress on the labrum (a ligament that helps to hold the head of the femur inside the acetabulum) leading to labral tearing. If you have any of these symptoms you should get assessed as soon as you can and start a program to help move the head of the femur back to its rightful resting place.
In Myotherapy we would first assess through movement and palpation that the femur is indeed moving in the wrong direction inside the hip joint. We would check that the acetabulum is not a possible cause at this point but if so refer you on for further investigation. We would then release and stretch any tight muscles found that relate to the problem and go through exercises to strengthen the long or weak muscles present as well as give motor learning type exercises to re educate the joint. We would also consider your full body posture and make sure that something else in the body was not contributing to the problem to prevent future occurrences.
This usually happens from all the kicks and leaps in ballet. Similar to in football the quads are dominant over the hamstrings in terms of strength and sometimes due to inadequate warm up, kicking or jumping beyond limitations, or dehydration the hamstrings can grab on when they should be letting go and bang…at worst a hamstring strain or tear that takes around 6 weeks to heal (sometimes longer) and at best some micro tearing that takes a few days to heal.
Myotherapy can help with both of these scenarios. Dry-needling and Electro-needling is particularly helpful but the best part, like with the hip pain, is the assessment. To discover why something might have happened in the first place is very valuable so that you can fix the problem and stop reoccurring episodes. Unfortunately once you have strained your hamstring once you are more likely to repeat it, treatment can help break this cycle.
This can occur for 2 main reasons and is often misdiagnosed. Firstly in ballet, particularly if tired (or lazy – yes this happens!), when practicing a skill or learning a new skill it is easy to use the wrong muscles. Especially when there are 20 people or so in a class, the teachers eyes can’t be everywhere at once. In ballet it is important to keep the hips facing forward and to keep them level for most of the moves but it’s common to see people letting one hip hike up instead of working the extra bit to keep them level especially during side kicks or prances and when bringing the foot back to its start position. Not holding the correct posture can cause overuse of the back muscles and the deep gluteal muscles. Either one on their own can cause back pain and sciatica symptoms, both together they can feel like you’ve compressed a nerve! It is very unpleasant! Having said that some of the forward bends if done incorrectly could cause a nerve compression. Furthermore the sciatic nerve also exits through the piriformis in some people which means if the muscle gets tight, the nerve gets compressed.
For the reasons mentioned above it is very important to get this properly assessed to find the true cause of your pain. Myotherapy can absolutely help you. Personally this is one of my favourite things to treat having suffered with it in the past myself. As a Myotherapist we will do some assessment to determine exactly where the problem lies, treat accordingly and give you exercises and advice to heal quickly and get you back to ballet ASAP!
Shoulder impingement syndrome
In ballet our arms are always rounded at the front of our bodies which over time can lead to rounded shoulders if not done correctly. Unfortunately most people at ballet I have seen are using the wrong muscles to make this happen. Similar to the hip problem mentioned above, this continued incorrect posture leads to certain muscles shortening and others lengthening which allows the head of the humerus (top of the arm bone) to sit incorrectly inside the glenoid fossa (shoulder socket). Another way the shoulder can become impinged is by the scapula (shoulder blade). If the scapular doesn’t move through it’s normal range then the shoulder socket won’t be pointing in the right direction for the arm to be able to lift properly. In both scenarios we usually end up with pain when trying to lift the arm to the front or to the side of the body. Sometimes this pain can also refer down the arm or into the neck and long term it can do damage to the rotator cuff tendons so get this one looked at as soon as possible.
Don’t panic! Myotherapy can absolutely help. This is another one of my favourite things to treat! Shoulders are so multifaceted that many practitioners shy away from them but I love the investigatory work that goes into ‘getting the bones back in the right place’. We would start by assessing the problem, diagnosing the first layer (there may be multiple layers), doing some treatment and reassessing. If there is still some limitation or pain we would then look for the second layer and so on until your range of movement is back to full and pain free. This sometimes happens in the span of one session but often happens over a few sessions. We would prescribe strength, stretching and motor learning exercises and educate you on how to engage the correct muscles.
Those are some pain conditions that you really want to get looked at, however Myotherapy is great for treating tight muscles from all types of exercise including from ballet and other forms of dance. So even if you are just feeling tighter in your muscles compared to usual it’s worth having a treatment, you will feel so much better for it! As always if you have any questions please feel free to comment or email us at [email protected]