Musculo-skeletal   [back to the Category]

The principles of treatment   [read the french version]

Author :   Docteur Anne Thiescé

Symptomatic or first intention treatments:
Referring to analgesics, referring to anti-inflammatories, referring to healing.

These treatments are usually based on an association of analgesic medicines, and anti-inflammatories taken orally or applied locally with, in the first instance, cryotherapy or ice applications, muscle relaxants and, of course, relative or complete rest. Recourse to osteopathy is also possible at this point in the treatment but only after a thorough clinical examination and the completion of a complete physical X-ray examination. A kinesipathist is limited in his role here to using physiotherapy techniques such as – ultra-sound, ionization, electrotherapy - and relaxing massages.

Rest and immobilisation

Strapping

Plaster is not the only form of immobilisation, flexible materials can be used for an immobilisation which means that the peri-articular ligaments are not placed in a stretched position. Strapping is used for sprains as well as for tendinous pathologies, articular conflicts, proprioception support, fighting œdema, and has a prevent role.
The existence of a tendinous pathology requires a well positioned strapping, a passive support as well as a limitation to the stretching of the injured tendon.
Strapping can be used to limit osseous contact in the case of articular conflicts, especially of the ankle (tibio-talar conflict).
Hyper-stimulation due to the give in of the bandages means that the rapidity and the intensity of the vigilant, protective muscular contraction is increased.
Compression is one of the ways in which œdema can be avoided in the acute stage of the trauma.
Strapping is used in a preventive role in sports that include jumps and turns in order to limit trauma morbidity.

Recovery and reoccurrence prevention treatments

It is imperative, subsequent to the above treatments, to discover the reason for the symptoms and try to eliminate it.
This can be done by giving preventive advice – advice on limbering-up exercises, on musculation or on choice of equipment. It is also necessary to try to make up the deficits acquired by the dancers – deficits in mobility, stability, etc. Re-education is essential, carried out by kinesipathists who are attentive to specific problems resulting from ballet. A reoccurence is the inescapable result if this crucial re-education is not carried out.
The techniques used are:
- techniques of gentle articular mobilisation,
- techniques, essentially isometric, of muscular strengthening that do not, therefore, affect articular mobility,
- stretching exercises that generally use the contraction - relaxation method. These consist of
stimulating the muscle with one short static contraction of maximum muscle intensity, followed by the important secondary relaxation of this same muscle,
- techniques of proprioceptive strengthening or neuro-motor reprogramming which result in a better adjustment of tonus. Thus, articular functioning and stability are improved. These techniques are designed to create suitable reflexes in reply to imbalances and solicitations induced by the therapist.