ASK THE PHYSIO … OVERUSE INJURIES!

Overuse injuries…..recognition and prevention.

If you are taking on full time dance school this year you will probably increase the amount of dancing you are doing every week considerably. Your body may also notice this substantially!!!
Our resident expert Physiotherapist – Sally Harrison from Perfect Form Physio tells DanceLife what she sees in her practice …
‘I also lecture at a Sydney based full time dance school for young performers and I commonly see small injuries arising 1 month into training as the body tries to cope with a sudden increase in work load. These injuries and sore muscles are often termed overuse injuries. Quite simply the tissue (muscle, fascia, bone) has been loaded over its stress threshold. It can no longer tolerate the demands put upon it and reacts accordingly. We often perceive this reaction as tightness, pain, weakness or a reduced ability to ‘move well’.

WHY DOES IT HAPPEN?

An overuse injury can also be termed a repetitive strain injury. As this term suggests, injury to the body comes a result of repetition of a movement that the body is unable to tolerate at such a high volume.
This may be due to the fact that the movement is new, and there hasn’t been much time spent improving tissue tolerance to this activity. A good example here is with a lot of jumps and leaps.
If we suddenly change or increase our level of activity, such as going from part time to fulltime dance training, without slowly building up the stability, strength and movement skill required for such a sudden increase in exercise, the body may be unable to cope. It will lead to break down and we have……..an injury.
(Please refer to our previous DanceLife articles on shin splints & muscle strain for more specific examples of this. They are both examples of overuse injuries. Just type ‘Ask The Physio’ into our Search engine)
What we need to remember however that the body is naturally designed well to cope with movement and loading. It just needs time to adapt and change.

Furthermore, if the body is not moving in an ideal/optimal manner, we will be more prone to injury as our tissues are stressed over and beyond their normal functional role in order to cope. An example of this may be seen in adductor (inner thigh) or hamstring strains which are both common injuries for the dancer.
I hope this case study will give a good example.

Case study:

A full time dance student presents in clinic with inner thigh pain (adductors) on the right.  There is no real episode of injury in class. Her symptoms started with a ‘niggly pain’ and then progressed and worsened. She is unable to kick now or do the splits without pain.
Previously she danced part time about 15 hrs a week and now does 25hrs + and teaches also.
On assessment of her body and movement we noticed that her right foot was hyper pronated (rolled in) and her pelvis was rotated to the left and not stable when standing on 1 leg.  Her core muscles were not activating well on the right side either.
In order to continue dancing, despite having an unstable pelvis and foot, her body recruited more work from her adductors and hip flexors to help her remain stable enough to dance. Over time these muscles were over worked, fatigued and became symptomatic (painful & tight).

TREATMENT

Her treatment involved;

• relative rest ( avoiding high kicks and other aggravating movements)
• soft tissue release, massage and self-release with a foam roller
• pelvic treatment, hands on correction and manipulation of the joints and muscles
• core retraining;  from isolation to integration
• Movement retraining for the foot and hip/pelvis area to retrain her single leg stability.

RECOVERY

Her symptoms eased within a week but she continued with rehab for a number of sessions to ensure her strength and control was back to normal for dancing.

PREVENTION

• Adequate warm up and cool down every time (refer to previous articles)
• Good flexibility, strength and symmetry in the body left to right
• Good technique to avoid undue strain on the muscles
• Adequate and monitored increase in exercise load. Gradual increase is key.
• Avoid working one side of the body (always kicking on the R, tricking on the L etc). Vary your dance styles for good cross training.
• Good nutrition and hydration to keep the tissues healthy at a base level.

If you have any questions on the above information please feel free to contact us at Perfectformphysio. We’re here to help.

www.perfectformphysio.com

ph: 99227721