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Dancers Flashcards

1
Q

Two most common injuries categories

A
  • performance anxiety PA

- Performance- Related Musculoskeletal disorders PRMDs

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2
Q

Performance Anxiety PA

A
  • Beta blockers fro physical symptoms

- Psychotherapy (cognitive-behavioral therapy)

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3
Q

Performance -Related Musculoskeletal Disorders

A
  • chronic repetitive motion
  • chronic pain
  • risks: Previous injuries; female gender, instrument, sudden increase in practice, stress (PA),
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4
Q

Foot and ankle dance morphology requirements

A
  • 90 deg ER at each LE
  • 90 deg PF
  • 90-100 deg DF of the 1st MTP
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5
Q

Foot shape

- “normal”

A
  • navicular, medial cuneiform, 1st met in line with the head and neck of the talus
  • 1st MTP PF= DF
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6
Q

Foot shape

pes cavus

A
  • high arch, rigid

- dancers can get plantar fasciitis , stress fx, ankle sprain, anterior impingement

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7
Q

Foot Shape

pes planus

A 
- medial longitudinal arch drop common in dancers,
hypermobile foot (functional vs. actual)
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8
Q

Common acute injuries in dancers

A
  • 5th met fx: sickling
  • Lateral ankle sprain: sickling; Cuboid subluxation; Spiral fx of 5th
  • Achilles tendon rupture; Weekend warrior males
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9
Q

Overuse injuries in dancers:

Plantar fasciitis

A
  • high arch, male, stiff calf, excess pronation
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10
Q

Overuse injuries in dancers:

achilles tendinopathy

A
  • poor g/s flexibility, M, raked floor, after vacation
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11
Q

Overuse injuries in dancers:

1st MTP impingement

A
  • excessive 1st MTP DF,or “going over” MTP PF en pointe

- feel it in soft shoes, leads to hallux limitus then hallux rigidus

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12
Q

Overuse injuries in dancers:

-hallux valgus

A
  • F>M

- hypermobile winging feet, femoral IR

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13
Q

Overuse injuries in dancers:

-dropped 2nd/3rd metatarsal

A
  • excessive MTP DF in releves, excessive PF en pointe, hypermobile
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14
Q

Overuse injuries in dancers:

- sesamoid issues, sesamoiditis

A
  • contusions, stress fx, chondromalacia, simple fx

- osteonecrosis,sprains

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15
Q

Overuse injuries in dancers:

- interdigital neuritis/neuroma

A
  • plantar divisions of the posterior tibial nerve
  • grande -plies, rleeves: extreme DF of teh MTPs, nerve compressed over teh met heads
  • hypermobile: pronated foot flattens the transverse Met arch
  • hypomobile: hallux rigidus moves pressure to other MTPs
  • mortons Neuroma
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16
Q

Overuse injuries in dancers:

-chonic ankle stability

A
  • prior inversion sprains (ATFL, CFL)
  • hypermobility
  • subtalar instability
  • ant distal fibula position make a loose ATFL decr position sense in neutral
  • TC ant aglide 2/2 PF stiff post capsule
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17
Q

Overuse injuries in dancers:

-anterior impingement

A
  • pes cavus foot, rigid foot, pronation due to ligamentous laxity, poor calf eccentric control, calf stiffness, osteophyte development, excessive DF landing a high jump
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18
Q

Wall test

A
  • motor control of abs and extensibility of thoracolumbar and TFL
  • back to wall, plie 15 deg, heels 3” from wall, hold 10 sec, straighten and hold 10 sec, repeat with arms overhead
  • back stays on wall 10 reps
19
Q

Hip rotation control test

A
  • single limb parallel to lateral rotation 10-15 deg slowly, then do medial rotation
20
Q

lumbar provocation test

A
  • stork position extend and SB
21
Q

Dancer hip range

A
  • anteversion is same as non-dancers
  • 10 deg more ER in dancers. avg 50 deg
  • ballet and modern need more total ER: 70-90 deg, ext: 20deg
22
Q

Dance positions and what to look for

plie

A
  • keep same ER the whole tome no ant pelvic tilt, no excess paraspinal use no incr tibial ER in plie
23
Q

Dance positions and what to look for:

Tendu derriere and; arabesque

A

look at the standing hop for loss of ER/ABd, gesture leg timing of ant pelvic tilt, lumbar and thoracic extension and rotation

24
Q

Dance positions what to look for

developpe

A
  • gesture leg needs HS and adductor length, activation of LR, need a good psoas! Watch for TFL and rectus Femoris recruitment, try to inhibit activation
25
Q

standing drop leg test

A
  • functional leg hold and let go at the barre

- if leg drops strengthen via: long sit psoas, chair knee flexed psoas, sidelying developpe

26
Q

iliopsoas syndrome

A
  • tight and weak, long and weak
  • overuse
  • poor motor control of trunk, hip and pelvis
  • end-range compensations of QL, TFL, RF
  • -Treat: limit hip flexion in class to under 90 deg, address femoral-acetabular rhythm, manual release of psoas, recruitment in supine, sidelying, seated short, seated long, standing
27
Q

Snapping hip

– coxa saltans

A
  • 90% of dancers
  • ilopsoas on iliopectineal eminence (main one), femoral head, or lesser troch
  • ITB or gmax over gr troch
  • HS at ischial tub
  • osteochondral fx, labrla tears, loose bodies, synovial chondromatosis
  • –Test: snapping hip test, obers, demo of the snap, post hip glide, supine PROM log roll test
28
Q

trochanteric bursitis

A

overuse, over-recruitment, short TFL, ballet dancer doing parallel work

  • LLD, Q-angle, pronated feet, lumbopelvic malalignment
  • –Treat: control inflammation, repattern movement, provide alt. stance in parallel if tibial torsion exists
29
Q

anterior hip impingement busitis or capsulitis

A
  • cam, pincer, iliopsoas, OA, stiff posterior capsule, synovitis, capsulitis
  • check: hip flexion, flexion/adduction, posterior glide, inferior glide, medial glide, T12-L5, scour, quadrant
30
Q

acetabular labral tear

A
  • dislocation, sublaxation
  • repetive microtrauma and degeneration
  • structural: hip dysplasia, FAI from CAM, pincer

treat: hip stability, trunk control, NWB exs for acute

31
Q

test to provoke ant tear

A
  • FABER to ext, IR ADD
32
Q

test to provoke post tear

A
  • EXt, ABd ER to flex, ADD IR
33
Q

hamstring strain

A
  • dancers need > 110 deg
  • overuse HS trying to post tilt the pelvis with abs
  • lower abs are weak, so HS is used more
  • overstretching
  • poor recruitment
34
Q

treat for hamstring strain

A
  • control inflammation, re-pattering and strengthening, STM, stretch, neurodynamics, tape, isometric, isotonic, modified dance in PT aim for HS 110-120 deg
35
Q

Stress fratures

A
  • aacetabulum, intertroch, shaft, ASIS, spine apophysis, femoral neck, slipped femoral epiphysis, lesser troch
  • test palpation, hop test, hx of gradual onset
36
Q

tx of stress fracture

A

–tx: activation of deep rotators vs glute max.

  • deep rotators will lift the pelvis on a fixed femur, or distract the femur on a fixed pelvis vs. gmax will compress teh hip joint
37
Q

what dance movements will trigger patellofemoral pain syndrome

A
  • pain with demi-plie, jump landing, flexion-to-extension with the gesture leg
  • usually younger dancers
38
Q

what dance movements will trigger meniscal pain

A
  • twisting in demi or grande plie, landing a jump in a deep plie
39
Q

Modern dancers injuries

A
  • # 1 cause of injury is faulty techniques: due to fatigue, and decr in power
40
Q

noise induced hearing loss

A
  • affected by noise level: 85 dB and> leads to permanent hearing loss
  • NIHL leads to tinnitus and pitch perception problems
  • affected by stress -> incr cortisol, glutamate -> decr neuroprotectant of hair cells in chochlea
  • affected by exposure time
41
Q

What can we do about floors?

A
  • Raked: makes performers shift their weight back –> stiff hamstrings, LBP lifting
  • Hard: increase GRF
  • sprung: decr GRF
  • Sticky: increases torsion
  • Slippery increases falls
42
Q

how can costumes affect the dancers

A
  • headdress elevates the COG
  • incr IAP for high sopranos
  • if she can’t expand the chest,she may get a bladder prolapse
43
Q

NOTE to self: look at lectures slides for performers/dancers

A

Too many pictures and exercises to write flashcards

Special Topics (9 decks)

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