Journal of Back and Musculoskeletal Rehabilitation - Volume 5, issue 3
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Journal of Back and Musculoskeletal Rehabilitation is a journal whose main focus is to present relevant information about the interdisciplinary approach to musculoskeletal rehabilitation for clinicians who treat patients with back and musculoskeletal pain complaints. It will provide readers with both 1) a general fund of knowledge on the assessment and management of specific problems and 2) new information considered to be state-of-the-art in the field. The intended audience is multidisciplinary as well as multi-specialty.
In each issue clinicians can find information which they can use in their patient setting the very next day. Manuscripts are provided from a range of health care providers including those in physical medicine, orthopedic surgery, rheumatology, neurosurgery, physical therapy, radiology, osteopathy, chiropractic and nursing on topics ranging from chronic pain to sports medicine. Diagnostic decision trees and treatment algorithms are encouraged in each manuscript. Controversial topics are discussed in commentaries and rebuttals. Associated areas such as medical-legal, worker's compensation and practice guidelines are included.
The journal publishes original research papers, review articles, programme descriptions and cast studies. Letters to the editors, commentaries, and editorials are also welcomed. Manuscripts are peer reviewed. Constructive critiques are given to each author. Suggestions for thematic issues and proposed manuscripts are welcomed.
Abstract: A simple, reliable, replicable technique, which takes but moments to perform, is available to quantify ankle plantarflexion. The ability to accurately measure plantarflexion enables a normal value of plantarflexion to be placed upon the professional dancer's ankle. Values are set forth for both male and female dancers, based on n = 811. Common and less common complaints in the dancer's foot and ankle are described in relation to deviations from this norm, as an aid in diagnosis, treatment and prognosis.
Abstract: Posterior ankle pain in dancers and equinus athletes is often caused by the extreme plantarflexion requirements of their activity. Differentiation between true posterior ankle pain and Achilles tendon pain is discussed. Signs and symptoms of posterior ankle pain are specific to the flexor hallicus tendon on the medial side or impingement when on the lateral side. Surgical exploration as well as conservative treatment is discussed.
Abstract: Minor leg length discrepancies may not pose much of a problem in the general population, but in the dance population they should not be overlooked as a predisposing factor in overuse syndromes commonly found among dancers. The popular treatment of prescribing lift therapy is often inappropriate in this population as the patient may not wear a shoe during dance or may refuse a lift in their shoe as it interferes with the ‘feel’ of the floor. The key to successful treatment in the dancer is a thorough biomechanical evaluation and analysis of compensatory mechanisms. In this article, clinical evaluation of…leg length discrepancy, common compensatory mechanisms, and clinical management in the dancer are discussed. An illustrative case study is presented to highlight some of the points made.
Keywords: Leg length discrepancy, Dancer, Overuse syndromes, Scoliosis
Abstract: Musculoskeletal injuries to the spine and pelvis are common in dancers. These injuries are associated with mechanical dysfunctions that impair spinal adaptation to the movement demands of the art form. This article introduces the biomechanical asymmetry corrector (BAC), a dynamic assessment and treatment tool, designed to restore normal spinal mechanics and functional movement patterns in dancers. A discussion of lumbo-pelvic mechanics and dance injury provides a theoretical context for describing exercises on the BAC.
Abstract: Sacroiliac dysfunction occurs frequently in professional classical dancers and appears to be linked to the movement demands of the artform and the natural, or acquired, ligamentous laxity of its participants. Successful intervention focuses on removal of soft tissue and articular restrictions accompanied by the appropriate home program. Many treatment adaptations are possible and/or necessary when managing the thin, well defined, hypermobile classical dancer.
Abstract: Low back pain is a rather common problem for the dancer, it can account for as much as 25% of all dance injuries. Within dance, injury to the piriformis muscle can be either due to a single traumatic incident or more commonly from overuse factors involved from repetitive micro trauma. The piriformis is of clinical importance in classical dance as regards to both low back and leg pain because of its close relationship anatomically to the sciatic nerve and biomechanically because it is the primary muscle responsible for external rotation of the leg, the turnout in dance. Symptoms arising from…an involvement of the piriformis muscle syndrome are often muddled and often mimic other causes of mechanical low back pain. The dancer can either be affected acutely or chronically. It can present itself as either low back pain, buttock pain or leg pain, or any combination of these. Specific considerations may contribute to this syndrome (a) myofascial pain referred from trigger points in the piriformis muscle; (b) nerve and vascular entrapment by the piriformis muscle at the greater sciatic foramen; and (c) dysfunction of the SI joint. Diagnosis is based on evaluating both the static and kinetic functions of the low back and pelvis as well as the biomechanics specific to dance. The therapeutic aim of conservative treatment of the piriformis syndrome in dancers is aimed at relieving pain, reducing the hypertonicity of the piriformis muscle, restoring the biomechanics of the SI joint and lumbar spine, and having the dancer return to dance with little or no down time. A comprehensive protocol for the conservative treatment of the piriformis syndrome is outlined and presented.
Keywords: Piriformis and lowback pain, Piriformis syndrome, Dancing, Treatment piriformis
Abstract: The biomedical perspective on management of pain, illness, and disability is analyzed and discussed. Pain and pain behavior are delineated. The distinction between acute and chronic pain, and the potential impact of social and environmental factors on pain behavior are reviewed. Distinctions between pain and suffering and between specific and non-specific pain are drawn and implications for the diagnostic process are considered. The importance of viewing clinical pain in biopsychosocial terms is emphasized and implications of that conceptual shift are reviewed. Attending to the social/environmental context in which patients function leads to an analysis of the social contract between individual…and society. Implications of the concept of ‘effort-related’ on clinician as well as patient is considered. Clinician potential for stifling patient effort is reviewed. Finally implications of a biopsychosocial perspective on facilitation of return to work is considered.