IADMS Miami 2000   [back to the Category]

Clinical Research in Dance Medicine: Osteopathic Manual Treatment of the Dancer’s Hip Impingem   [read the french version]

Author :   Dr. Roger Hobden, M.D.

Author: Roger Hobden, M.D., Dipl. Sport Medicine, Department of Family Medicine, University of Montreal, Montreal, Canada

The dancer’s hip impingement syndrome is a very common dance problem that affects mainly adolescent dance students but also dance professionals. This syndrome often ends professional dance training during the teen-age years if not corrected. Clinical practice has shown that there is a consistent relationship between loss of mobility of the ipsilateral sacroiliac joint and the hip impingement syndrome. This loss of mobility at the sacroiliac joint is frequently associated with loss of normal joint motion at the lower lumbar area and the thoracolumbar junction. Thus problems of the lower lumbar and thoracolumbar areas seem to affect the dancer’s ability to control her hip. Research clarifying the exact physical mechanisms by which these events operate would help not only the therapist but also the dance teacher to prevent such a chain of events from happening in the dance class.

The aim of this research will be to demonstrate that osteopathic manual medicine applied to the pelvis and lumbar spine can improve hip function in professional dancers and dance students. Recent research on the pelvis and the spine and clinical observations point to a model where loss of motion in the sacroiliac joint causes reflex inhibition of the trunk muscles, pelvic girdle muscles, and hip flexor muscles. Weakness of the psoas in particular causes the other hip flexors to work in excess, which eventually leads to pain. Restoration of proper joint play of the sacroiliac joint creates an immediate return of pelvic and trunk muscle strength and normal hip firing patterns. The initial research question will be: Can osteopathic manual medicine restore normal hip firing patterns in dancers with the anterior hip impingement syndrome? Subsequent research will try to identify the optimal treatment maneuvers and maneuver sequence that leads to correction of this syndrome.

The research design will be a randomized blinded trial. Subjects that satisfy the inclusion criteria will be randomized into two groups. One group will receive a non-osteopathic manual treatment (massage therapy) and the other will receive osteopathic manual medicine using maneuvers that have demonstrated their usefulness in this condition in everyday clinical practice The exact maneuvers will be recorded on videotape and this data will help to understand the effects of each maneuver and to plan following studies. The outcome variables will be categorical and continuous. Categorical variables will consist of before and after movement analyses of a dance movement, the développé à la seconde, by an expert dance teacher. Continuous variables will consist of before and after movement analysis of the développé à la seconde using 3D videotaping before and after treatment.

Clarification of the underlying biomechanical and neurophysiological causes will help to prevent and treat this syndrome. Thus teachers and therapists alike will receive benefits from the result of this research. Also demonstration of a link between sacroiliac joint function and hip function may help to shed light on hip conditions affecting the general population. Thus medical research on osteoarthritis of the hip could benefit from research done in dance medicine.

This is the abstract of a paper presented at the Tenth Annual Meeting of the International Association for Dance Medicine and Science, held 27-29 October 2000 in Miami, Florida, USA. All rights are reserved by the individual author(s).