Physiotherapy   [back to the Category]

Dance And Lower Back Pain   [read the french version]

Author :   Errol Toran, D.C

This case en pointe concerns a ballet student who presented to the office with acute lower back pain. She came in unable to bend forward and back. Left arabesque was impossible and her right leg was low. Lifting the left leg to front, and sustaining the leg devant to develope from attitude was intolerable. Bending to the side was also very painful. She had been trained in classical dance, and was known for her meticulous form and clean lines. The pain gradually onset, getting stronger over a period of months until she could no longer take class. She had several minor pain episodes for years prior to this most severe flair-up. Previously, she was able to stretch out the lower back and take time off to rest, thus tempering the symptoms. There was nothing that she could do to reduce the pain this time.

This case was especially interesting because she had come into my office four years earlier. At that time she was a visiting scholarship student with some minor back pain. I performed an exam and discovered a developing scoliosis (lateral spinal curvature). She was not aware of the problem prior to the exam. After a short period of treatment, the symptoms were alleviated. Her NYC scholarship was over and she went back to her home state. When she returned to the office four years later, the scoliosis had progressed further and was the cause of her pain.

We re-shot a spinal x-ray series and measured the curves. The first goal was to reduce the pain and increase the flexibility. That was done using decompression of the lower spine, trying to stretch and straighten the spinal curves. In addition we used muscle stimulation and ice. The acute pain was soon reduced and she began taking class. She was given special instructions on which movements she could perform and which she had to mark. We went over a stretching and flexibility regimen that would prepare her body for full level dance. Special cable weight exercises were prescribed to help assist as she practiced lifting her leg.

The real goal of this case was to prevent further flair-ups by straightening the curves. A straighter spine is more stable and less prone to injury. In addition to the decompression work, we began a stretching and strengthening program using a physio-ball. The curves are opened and stretched over the ball as the patient lies on her side. The muscles around the outside of the curve are strengthened with exercise to keep the curve open.

The dancer is now dancing "full out". She continues the stretching and strengthening program presently, as she will for the next several years. With the proper maintenance, the curves should be able to be kept open and straight. Further re-injury due to the spinal curves should be reduced and her condition should not prevent her from pursuing a professional career.