Archive for DR-R
February 18, 2008 at 9:39 pm · Filed under dance, injuries, DR-R, hamstring, anatomy
All athletes at some time in their career tend to injure, strain, pull their hamstring muscle.
In high school I played hockey and basketball. Unfortunately, my coaches had no idea of how to prepare the body for athletic performance and how to stretch after activity. This led to chronic hamstring tightness and pain for three days after every game. My hamstrings are tight to this day, 20 years later!
Most dancers will not have very tight hamstrings, however, their incidence of hamstring pulls and tears are high due to there constant lunging, running and jumping.
The key to decreasing the incidence of injury is to be aware of mild hamstring strains and tightness in the muscle. It is also important to stretch correctly and to have balance between the quadriceps (anterior thigh) and hamstrings (posterior thigh).
In this article I am going to discuss the basic anatomy of the hamstring, symptoms of injury, stretching and ways to decrease the incidence of injuries.
Lets begin with anatomy. The hamstring muscles are located in your posterior thigh. They consist of three muscles: the Semimembranosis, Semitendonosis and the Biceps Femoris (long and short heads). They originate from the Ischial Tuberosity of the the pelvis and part of the femur and attach to various portions of your knee, Tibia and Fibula.
Because they span the hip and knee joints, they have two functions; one, to extend the thigh (such as arabesque position), and two, to flex the leg.
Two extremely important structures that are overlooked in hamstring strains are the SACROTUBEROUS LIGAMENT AND THE SACROSPINOUS LIGAMENTS. To some these ligaments are an extension of the muscles. Many times the hamstrings will not release and repair, if there is dysfunction in these two ligaments. Sometimes scar tissue develops between the muscle attachment and the ligament. Stretching the muscle will never get rid of this scar tissue. I have seen immediate benefits and an immediate increase in range when releasing adhesions between these structures utilizing Active Release. (unfortunately you can’t stretch and work these ligaments by yourself).
This is a great picture of the 2 ligaments.
One more important anatomical fact: The Sciatic nerve, which is a combination of the lumbar and sacral spinal nerves, runs down your posterior thigh. Many times muscle spasm in the hamstring can pinch or irritate the sciatic nerve, thereby mimicking a disc herniation with nerve root irritation.
How do you know if it is your hamstring that is causing that posterior thigh pain or that chronic back pain. Remember, the hamstrings attach to your pelvis, which attaches to the spine. A constant pull on the pelvis can cause a low back syndrome.
An easy test for tightness is to try and touch your toes. This is a simple test to check for flexibility of the hamstring..
2 activities which may lead to pain and signal the hamstring as the culprit are the following: 1) Do you have pain in the leg or back when rising from a seated position?
2) Is there pain in the leg or back when walking up stairs?
These two activities cause the hamstring to contract and can give valuable information regarding the muscle.
Stretches
This is a great warm up stretch. Keep your feet shoulders width apart. Bend forward from the hips. Keep your back straight. Do not let your back curve. Hold for 7-10 seconds. If you are doing this correctly, you will feel it in your legs.
This exercise is based on the pilates move. Keep your leg flexed, then slowly extend the leg. Do not rush or bounce this stretch. Nice steady movement, and hold for 5 seconds.
To all those non-dancers. Sitting at a desk for long periods during the day is a prime reason for hamstring tightness. You must try to get up and move 2-3 times an hour. A great stretch for the average office worker is the first standing one. Do that a few times a day to stay loose.
Next month QUADRICEPS
Recent Posts by drdavid
January 7, 2008 at 8:43 pm · Filed under dance, injuries, health, stretching, psoas, DR-R, dr. david rosenthal, injury prevention, exercises
The Psoas Syndrome
Happy new year to all. I hope you all had a wonderful holiday season.
I wanted to start the new year off with one of the most common sites of injuries for dancers. I am talking about the most powerful hip flexor in the body as well as a powerful trunk flexor, the ILIOPSOAS.
Injury, shortening and contracture of this muscle can cause lowback pain, hip pain, sacroiliac pain, mid back pain, clicking hip and pain down the leg. It is commonly misdiagnosed as a low back strain or a disc bulge or herniation.
It kind of makes you feel that you are off. You seem to walk unbalanced. Common causes of injury are repetitive hip flexion. sleeping in the fetal position, lifting incorrectly, and in a dancers case the constant hip flexion and external rotation seen in a grand plie and a demi-plie.
A brief anatomy lesson of the iliopsoas. The Iliopsoas is made up of the iliacus muscle and the psoas muscle. It attatches from the the lumbar spine and iliac fossa to the lesser trochanter of the hip. It actually connects to your lumbar spine. If this muscle is contracted and is pulling on your spine you can develop a low back pain syndrome.
One way which I check for psoas shortening is the following: You need 2 people for this. Have the patient lie on there back. Have them bring there hands above their head fingers touching. Usually the problematic side will show that one of your arms is shorter than the other. Your fingers won’t meet at the tips. The short side is the dysfunctional one. There are other orthopedic tests for the psoas but that is for the doctors office.
A common release stretch for psoas shortening.
This is a stretch I recommend to my patients for psoas dysfunction (this is not medical advice, please see your doctor before doing any of this)
What is the best treatment for a psoas problem?
The muscle is not outwardly palpable such as the hamstring or biceps muscle. You really need to dig deep to get to the psoas. Stretching helps but rarely eliminates the problem. I have found Active Release Technique to be the most successful treatment in the case of Psoas dysfunction. ART allows you to fully stretch the muscle while breaking down scar tissue and adhesions that develop from repetitive use.
IMPORTANT TIPS
Situps- Make sure to isolate your abs. Many times you recruit the hip flexor or psoas and it takes away from the Abs. This improper situp can cause injury to the psoas. How do I do that?
Place both feet on a wall and do a crunch. Feel the difference.
In cases of LOW BACK PAIN, MAKE SURE YOU GET YOUR PSOAS CHECKED. If you are being treated for Low back pain with adjustments, electric stim, ultrasound, pt, stretching, etc and you are not feeling better after 4 or 5 visits, LOOK TO THE GREAT PRETENDER, THE PSOAS.
Recent Posts by drdavid
November 26, 2007 at 6:32 pm · Filed under dance, injuries, new york, chiropractor, DR-R, achilles, calf, tendonitis
Sorry it took so long for my first post. 2 offices, 4 kids and a wife are taking up most of my time.
My posts will be brief but full of useful info. The shorter it is, the more you will retain. Enjoy!
Achilles Tendonitis
Achilles Tendonitis or AT is a condition affecting the tendon of the Triceps Surae. The Triceps Surae are the two thick muscles in the posterior calf, the Gastrocnemius and the Soleus. The AT is the tendon of these two muscles or the tail of the calf muscles. It inserts onto the Calcaneus or heel bone. The tendon helps in the push off phase of gait. In otherwords, every time you jump or stand on your toes, the Achilles is working.
As a group, dancers commonly complain of pain in the heel, calf or area of the tendon. Many times it gets inflamed and is painful to the touch. Traditional treatment has included; ice, stretching, taping, and heel cups. Corticosteroids are not recommended due to recent studies indicating weakness of the tendon when injected.
Massage directly on the tendon is not recommended due to the possibility of injuring it further. When working the tendon, it is best to come at it from the side and work anteriorly.
I have found that in all cases of AT, one must look at the two calf muscles, the Gastroc and Soleus. The two calf muscles are constantly being contracted, and in time will develop muscular contractions or trigger points. These trigger points will stress the tendon and in many cases cause pain. I have seen many cases where treating the Gastroc and Soleus eliminate the tendon and heel pain.
There are other causes of AT including; inflammation of the bursa or fluid filled sac between the tendon and calcareous, bony spurs, and tears of the tendon. These injuries usually need physical therapy, anti-inflammatory meds, stretching and strengthening.
Remember, LOOK TOWARDS THE CALF MUSCLES.
I hope this was helpful.
DR. R
Recent Posts by drdavid
November 8, 2007 at 7:09 pm · Filed under dance, injuries, doctors, welcome, wingers, chiropractor, DR-R
Hello Wingers,
I’d like to introduce you to the newest member of our Winger family, Dr. David Rosenthal. Dr. R is a chiropractor and certified Active Release Practitioner and has worked with dancers from many different New York-based companies and schools. Here he is, above, with a dancer from the Alvin Ailey School.
He wrote a fantastic introduction for his profile page about what he does and what he wants to share with us - I don’t think I could say it any better myself!
From Dr. R…
Hello to all. My name is Dr. David Rosenthal and I am a Chiropractor in New York City. I am extremely excited to be a contributor to the Winger. I have been practicing for 10 years and have been treating dancers for years. I treat performers from many Broadway shows such as “Chicago”, “Grease”, and “A Chorus Line”. I have also treated dancers from schools such as Alvin Ailey and the New Dance Group.
As dancers, you are some of the most agile athletes in the world. The daily grind of jumping, twisting and turning take a serious toll on your body. My goal is to give you information about different conditions that can affect your body. For example, I have experienced that knee pain does not necessarily mean you have a “knee problem”. Many times the pain can be referred from muscular dysfunction in the hip or thigh. I want to increase your “body awareness”. I want you to be able to identify a problem and know when treatment is necessary. With this information, you will have healthier dance lives and longer careers.
There is also an important disclaimer about his participation on The Winger that you will find on his profile page, but I will post it here as well:
This information and advice published or made available through the Winger web site is not intended to replace the services of a physician, nor does it constitute a doctor-patient relationship. Information on this web site is provided for informational purposes only and is not a substitute for professional medical advice. You should not use the information on this web site for diagnosing or treating a medical or health condition. You should consult a physician in all matters relating to your health, and particularly in respect to any symptoms that may require diagnosis or medical attention
Welcome Dr. R!
Recent Posts by kristin sloan
