Physiotherapy   [back to the Category]

Ballet dancing and kinesitherapy, the importance of prevention.   [read the french version]

Author :   Mr Gilles SCHIRR

Ballet dancing and kinesitherapy, the importance of prevention.
A theoretical view point.

Kinesitherapists use movement for characterizing the human organism and balance for characterizing the state of health. Male and female dancers are concerned with body movement and balance within space. Kinesitherapists are concerned with much more subtle types of movement and balance, those found within the body.

The two main complaints expressed by dancers are pain and the difficulty they might have when carrying out a particular movement. Two results of musculoskeletal system pathologies.

1)pain: pain appraisal has three stages:

--pain appears in a part of the body, it can be significant but only last for 1 or 2 days before disappearing completely. This is stiffness. It is benign and does not require treatment. Advice is sufficient.

--the pain leaves clinical, palpable and perceptible evidence. It is coupled with movement limitation but is not apparent on x-rays. This is a functional injury. Treatment is necessary. Example: a lumbar point, low and on one side, without irradiation, the x-ray is normal. Total recovery can be achieved with solely physical treatment.

--the pain is coupled with an injury to an organ, meaning that it is perceptible on x-rays and the scanner (spondylolysthesis, muscle strain, etc.). Recovery will not be complete and recurrence is likely. Recovery consists of a multi-disciplinary treatment with doctors, kinesitherapists, etc. all working together.

2)difficulty with a particular movement, the feeling of stagnation, pain reappearing after practise sessions or always with the same figure, a fall, etc. Movement pathology, in this case, is of a more practical nature. 2 types of injuries are involved:

--a “primary” injury: occuring straight off (the dancer fell, made an “awkward movement”, etc.). Movement difficulty is considerable but only on one level. Recovery is possible with no after-effects.

--a “secondary” or adaptive injury. Occurring progressively, movement loss is not so obvious, it can be stagnation or a fault noticed by the ballet instructor which does not go away, etc. It is to be found on several levels, movement difficulty is inconsistent, appearing for a movement which did not previously give any pain or during additional practises, etc. It generally results in a loss of compensation. Compensation is physiological when it is not pushed to the limit. The organism adapts itself in order to preserve the balance, comfort and no pain trilogy. Unfortunately, the adaptation has a limit in time or for a performance. It can come from an irreversible phenomenon, being hereditary or anatomical but the phenomenon can also be reversible as is the accumulation of the previously described injuries. Compensation becomes established in time and can also change to accommodate the adaptive injury. In this case, the dancer needs support and encouragement, practice sessions must be controlled and a self-re-education programme suggested.