IADMS Miami 2000   [back to the Category]

Forum: Low Back Injuries in Adolescent Dancers   [read the french version]

Author :   Lyle J. Micheli, M.D. and Ruth Solomon

Authors: Lyle J. Micheli, M.D., Division of Sports Medicine, Boston, MA, USA, and Ruth Solomon, Professor Emeritus, University of California, Santa Cruz, CA, USA

While the epidemiology of dance injuries is still being written, in a sports medicine clinic such as ours it is readily apparent that low back injuries are quite common in adolescent dancers. The vast majority of these injuries are the result of “overuse,” or repetitive microtrauma, and the differential diagnosis therefore usually falls into one of four categories: mechanical, discogenic, spondylolytic, or vertebral body fractures. The purely clinical aspect of this two-part presentation will discuss the etiology, diagnosis, and treatment of the major injuries in each of these categories. Some specific injuries to be discussed are: overgrowth syndrome, spondylolysis, spondylolisthesis, spinal deformities (scoliosis), herniated disc (including piriformis syndrome vs. sciatica), facet arthrosis, atypical Scheuermann’s disease, pedicle stress fracture, and pseudoarthrosis. The intention will be to enhance the dance community’s understanding of how the practice of dance precipitates these injuries, and to describe the various tools and techniques used by physicians to diagnose and treat them.
In the second part of the presentation the focus will shift to anatomical concepts in explaining how to offset the potentially injurious effects of dance training. Specifically, the role of the iliopsoas complex in maintaining proper biomechanics while in motion will be discussed as an antidote to low back injuries. A series of psoas-related exercises that can be used both to prevent such injuries and to rehabilitate them will be demonstrated with experiential audience participation. Emphasis will be on the principles of movement underlying the design of these specific exercises.
A team approach to dealing with low back injuries will be addressed, involving clinicians, therapists, and the dance teacher/artistic director. When the patient is a child or adolescent, his or her parents should also be part of this group effort. The goal is to return the dancer painlessly, safely, and effectively to dance, while dealing throughout with preventive measures that must be taken to avoid recurrence. This requires planning that is specific to both the discipline and the patient.

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).