Hip Flexor Extensibility and Its Correlation to Hip
Hip Flexor Extensibility and Its Correlation to Hip Hyperextension and Lower Back Pain in Dancers Tessa Richards Health and Human Performance Introduction Methods Continued In the world of ballet, flexibility and strength are keys to success. Dancers have two main goals: a high arabesque and a 180 degree turn out. In order to achieve these goals, dancers rotate their pelvises incorrectly to compensate for lack of turn out. This can lead to significant lower back pain (LBP). • Patrick Test: subject lies supine with ankle crossed over opposite knee; visual positive/negative test Results Continued Correlation between hip hyperextension and daily pain (p=0. 048) • Link between arabesque height and daily LBP • With one scale increase in pain, arabesque height decreases by 2. 5 degrees Compared to other regions of the body, dancers tend to have lower back pain. LBP onset may occur as early as the teen years, when more advanced moves are introduced. If not addressed, LBP will continue and become severely debilitating, even career-ending. This objective of this research was to: • Measure hip extensibility, arabesque height, and LBP in dancers • Focus on the iliopsoas muscles and their link to LBP • Pain scale: measured from 0 (no pain) to 10 (most pain) in the following situations then averaged for each situation • Regular day • Before, during, and after dance class Correlation between iliopsoas tightness and class-related pain (p=0. 049) • Link between iliopsoas tightness and LBP during dance class • Less extensible iliopsoas muscles lead to LBP Methods Subjects: Subjects were recruited from advanced ballet and jazz dancers from Missoula area Measurements: • Modified Thomas Test: subject lies supine with one leg relaxed over the edge of exam table; angle of knee flexion is measured Results • 17 advanced females dancers aged 16. 29± 4. 33 years • Average years of dance: 12. 4± 4. 76 years Low Back Pain Averages • Lowest Pain on Regular Day: 1. 18± 1. 70 • Highest Pain on Regular Day: 4. 29± 2. 54 • Pain for Dance-Related Classes: 2. 70± 1. 89 • Thomas Test: subject lies supine with both legs on exam table; angle of relaxed knee is measured Modified Thomas Test: 127. 74± 15. 85 degrees Thomas Test: 4. 09± 3. 07 degrees Hip Hyperextension ROM: 23. 47± 9. 95 degrees Patrick Test: 10 negative bilateral, 6 positive bilateral, 1 positive unilateral • Negative: ability to reach parallel and no pain; no tight hip flexors • Positive: inability to reach parallel or pain; tight hip flexors Conclusion Lower back pain and hip extensibility has a significant link to iliopsoas tightness in dancers. If left untreated, this pain cause further health issues and can ultimately end a dancer’s career and her passion for the art. To avoid pain dancers should focus their stretching efforts on the hip flexors, specifically the iliopsoas muscles. Good iliopsoas extensibility can not only decrease lower back pain, but prolong a dance career that would have otherwise been finished. Special Thanks To: • Hip Hyperextension ROM: subject lies prone and extends leg without use of back muscles; angle from neutral to leg is measured Advisors Lori Mitchell and Colin Henderson, Michele Antonioli, Kristi Moore and Alpine Physical Therapy, On Center Performing Arts, and Ballet Arts Academy Funding provided by: the Davidson Honors College.
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