Wednesday, 17 August 2016

Your Best Body: Dance Injuries Addressed

     Hey, everyone. I hope you all are having a lovely week at school, that is if you've started already. If you haven't, I sorta envy you. I'd love to have more time off of school but at the same time, I've been going stir crazy for the past few weeks waiting for school to start.
     Anywho, on to today's post. Now seems like the perfect time to do this post related to injuries because lately, it seems like everyone is getting injured. A friend of mine recently had ankle surgery, my sister has the same back injury I sustained in 2014 (L5 fracture) and I am in a cast for three weeks due to Hallux Rigidus (Stiff Big Toe) and Dancers Tendonitis (Flexor Hallucis Longus Tendonitis).
       It's so weird, being in a cast. Like not being able to point my foot. One of my friends had a lovely time drawing obscene things onto the sole of my cast. I can't even imagine how funny/awkward it's gonna be when my doctor sees my cast before it comes off...
     So here it is, all your dance injuries addressed. Hope this helps all the crippled dancers out there.
       (DISCLAIMER: I am not a medical professional nor am I claiming to be. I have taken two years of an Athletic Training class in which learning all about the human anatomy (bones, ligaments, tendons, muscles and how they work etc) was a huge part of our grade. With that said, I do know what I'm talking about but my advice should never be substituted for professional medical advice. If you think you may have one of these problems see your healthcare professional immediately). 
       And now, let's learn about the top six most common injuries in dancers (they are written about in no particular order).

Stress Fractures
What they are: Stress fractures are small cracks in the bone that occur when too much force goes through the bone. They’re commonly seen in the second and third metatarsals, but shin splints can also turn into stress fractures if you’re not careful. In dancers, a stress fracture in the fifth metatarsal is very common, so common it's known as Dancers Fracture. 
What you'll feel: The pain with stress fractures tends to flare up during exercise, such as running or jumping repeatedly (aka petite allegro) but the pain will subside when resting. When I had a stress fracture in my 1st metatarsal, I mainly felt the pain when walking, jumping and rising onto demi-pointe.
How to prevent them: Try not to do too much too soon especially when you're workload increased in a short amount of time. This is when you're the most vulnerable for a stress fracture. Slowly build up the number of classes you take, and try to limit the number of big jumps you do in one day. It’s important to get plenty of calcium and magnesium in your diet since they keep your bones strong. Foods like spinach, broccoli and dairy products will give you a boost.
How to treat them: Rest for 4 to 10 weeks. Your doctor might put you in a walking boot to protect the injury. If you start having tenderness in the middle of your shin or feel a bump on that bone, see a doctor right away. Tibia fractures will keep you from jumping for several weeks. RICE (Rest Ice Compression (from a cast) Elevation).

Dancer's Fracture
Tendonitis
What it is:
 Inflammation of the sheath around the tendon, or tendonitis is another overuse injury. Tendonitis among dancers is common in the Achilles, and the FHL (Flexor Hallucis Longus) tendon, which points the big toe. Patellar tendonitis aka Dancer's Knee is also common. As your quadricep muscles get tighter and tighter, they put tension on your kneecaps and pull the patella up toward the thigh which could also cause a dislocation of the patella.
What you'll feel: Tenderness to the touch wherever the inflamed tendon is. It may be painful to walk on or to point/flex the joint where the tendonitis is. 
How to prevent it: One of the most important ways to prevent tendonitis in the ankles is to practice good alignment. Be sure to relevé over the middle of your foot and ankle. All your weight needs to be as centered as possible when balancing in relevé. The more you wing your big toe, the more you overuse your FHL. Since the FHL muscle is deep in your calf, you can use a ball to massage it and release its pull on the tendon. For dancer’s knee, get into the quadriceps with a foam roller or a dense rubber ball—and then stretch.
How to treat it: When you have recurring tendinitis, make sure you find the underlying cause. Forcing your turnout and rolling in on your ankles will make your Achilles tendons tight. Physical therapy, ice, and anti-inflammatories can help reduce pain and swelling. (Slight patellar tendonitis is one of the causes of my knee problems).

ACL/Meniscus Knee Tears
What it is: The meniscus is a figure eight shaped cartilage that acts as a cushion between the head of the tibia and femur. The Anterior Cruciate Ligament or ACL is one (of two) ligaments within the knee that aids in the stability of the knee. This injury mostly happens when a jump is landed wrong and the knee is twisted. It happens very fast and it's hard to prevent. Both injuries are extremely painful and can keep dancers out for a long period of time.
What you'll feel: Pain in the knee, swelling, and a popping sensation during the injury. You may also have a difficulty bending and straightening the leg as well as a tendency for your knee to get "stuck" or lock up.
How to prevent it: Strengthening the core is so crucial to knee health. It lessens the burden on the knee, so you are not landing with so much force. Having correct turnout is also crucial to prevent knee problems. Remember that turnout comes from the hips, not the knee. Don't force your natural turnout if you want to prevent knee injuries.
How to treat it: You will be put in a knee brace by a doctor and surgery is most often required. Rehab can take anywhere from 6 months to a year, depending on the severity of the tear sustained and how fast you can recover (everyone's different so recovery times will look different for everyone.



Ankle Sprain
What it is: Ankle sprains catch you by surprise. One minute you’re fine, and the next you’ve twisted your foot and overstretched or torn ligaments around your ankle. The typical ankle sprain is in someone with a high arch because they tend to roll the ankle to the outside more. Ankle sprains in younger dancers are usually because of poor technique. One big tip I have is to never dance on an uneven surface, such as a lawn that has small holes in it due to pets. That's how I sprained my ankle.
What you'll feel: Lots of ankle pain around the area that got sprained. It will be really painful to walk on and you'll also see immediate swelling and bruising within a day.
How to prevent it: Strengthen the tendons on the outer sides of the ankles to provide more stability. Do Thera-Band exercises to practice winging and sickling the foot and multiple series of relevés with proper alignment.
How to treat it: PRICE (Protect, Rest, Ice, Compress, Elevate). A doctor might also put you in a walking boot or crutches for a few weeks. You want to make sure you’ve recovered fully before returning to the studio. Injuries that aren’t rehabbed all the way tend to reoccur.

Sesamoiditis
What it is: They are two bones underneath the ball of the foot at the head of the first metatarsal (big toe bone) called the sesamoid bones. These bones are only connected by tendons and can get inflamed due to repeated stress. This injury is very common in dancers, with high arches such as myself because when we  turn or balance on demi-pointe we are literally standing on the sesamoid bones. 
What you'll feel: Pain in the ball of the foot, right underneath the first metatarsal. Rising onto demi-pointe and balancing might be painful. You might describe it as feeling like your balancing with a pebble underneath your big toe. 
How to prevent it: Correct footwear is one of the best ways to prevent sesamoiditis. Your street shoes should give the feet enough room to move, allow the bones to line up correctly and have a wide toe box as to keep the toes from getting squished in there (the same thing applies to pointe shoes). 
Also, dancers want to be aware of overpronating, or rolling inwards of the foot (usually inwards towards the big toe). This is especially common when standing in first position and during balances on demi-pointe. You want to make sure your weight is centered, that is not too far to the left or the right (see my post on balancing as a reference). Overpronating is excessive rolling of the foot, which puts more pressure on the sesamoid bones. Street shoes with arch support with help with this. 
How to treat it: RICE obviously is the first step in treating any injury. A break from activity or modification of activity might also be helpful. Sometimes you'll be put in a boot cast with crutches for three to six weeks. 

The two white tendons near the big toe is what 
becomes inflamed in sesamoiditis. 


Lower Back Strain 
What it is: Many dancers experience lower back strains and tightness. Sometimes dancers may try to attain a certain line, like arabesque, and compress their lower backs in an attempt to get their legs up higher, especially during auditions, or master classes which dancers naturally want to impress the instructor.
What you'll feel: General pain in your lower back. It may hurt to arch your back and will feel good to round your lower back. Walking might also be difficult. In severe cases, you may get partial paralysis of your lower extremities due to a pinched nerve or a muscle spasm. 
How to prevent it: Lower back strains can be prevented by strengthening the core muscles. If your midsection is strong, you’ll engage your core muscles when you’re working instead of your back muscles.
How to treat it: I suggest getting a massage or try alternative medicine, like acupuncture. Dancers find that it decreases swelling and lessens pain. Gentle stretching, like yoga, might also help after a few days. 

Os Trigonum 
What it is: Os Trigonum is a small extra bone at the back of the ankle that is present in a small proportion of people. Some people are born with it, others develop it during adolescences. Most people don't have any problems with it unless you're a high impact athlete like a dancer, basketball player or swimmer. 
How to prevent it: There aren't any ways to prevent Os Trigonum, unfortunately. However, some methods such as wearing a boot cast, limiting trauma to the foot, and of course RICE, can help in preventing Os Trigonum from getting serious. 
What you'll feel: Pain, usually at the back of the ankle. The pain tends to be worse when plantarflexing the foot (pointing the toes) or during the push-off phase of jumping and eases with rest. Tenderness to touch near the area at the back and outer side of the ankle. General ankle swelling  may develop due to the inflammation of the soft tissues. Sometimes you may be able to feel a small, hard lump near the Achilles tendon. This is the unfused bone.
How to treat it: As I stated before, usually a rest from activity and being in a boot cast is the nonsurgical way to treat it. Some athletes will opt for surgery to remove the bone in order for them to get back into their athletic activities. 


This shows you where the Os Trigonum bone is and how
it get's trapped during plantarflexion or pointing the foot.


Bonus Tip: Here is some information on Heat or Ice.
                                          


I hope this blog post was helpful for you all. If it was, don't forget to give it a +1 on Google+, follow me on all my social media sites which will be linked below and let me know if you've experienced any of these injuries before or if there are other dance related injuries I've forgotten to add. I love you all!

~Poodle
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