Dear List:
A 20 year old female ballet dancer complained of acute pain in her right
paravertebral muscle in the T12-L3 segment. Pain is felt primarily when
doing the cambré movement in the fifth position with the left leg in front
(it hurts in all position but more in this one) but also when doing a high
arabesque and when seated or standing for long periods of time. The pain
started in February 1999. Rest was indicated for one month and she was
refered for physical therapy. Treatment consisted in myofascial release and
a lumbar spine stabilization program. The pain almost resolved by week 6
when she started rehearsing again and the pain came back. By this time
X-rays where performed with negative results. Physical therapy continued
for three more weeks and strech exercises where increased for the
paravertebral muscles with no results. The physiatrist then perfomed a nerve
block with bupivicaine. The pain stopped inmediatly and she started
rehearsing again full-time. Last week she came to the unit complaining about
the pain again. There´s pain on palpation of the right paravertebral muscles
in the segment mentioned above. Postural evaluation from the side reveals an
increased lumbar lordosis. Thomas and Ely´s test are negative. Active
movents of the spine are not painful except when doing extension and
rotation to the right. Extension and rotation alone are not painful. MRI was
ordered. We expect to have the results for these week or the next.
For those of you who aren´t usd to ballet terminology the cambré movement
starts with flexion of the spine and then it goes into extension and
rotation to one side (including extension of the cervical spine). The lower
limbs are mantained in one of the five clasicall ballet positions. In the
fifth position each hip is rotated 90 deegres and the feet are placed in
front and parallel to the other so the medial arch of one feet contats the
lateral side of the other..
Any ideas?
Nelson Rodríguez, PT
Ballet Nacional de Caracas
Teatro Teresa Carreño
Caracas, Venezuela.
______________________________________________________
Get Your Private, Free Email at http://www.hotmail.com
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|