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Originally researched and written by Liam Mannix of The Sydney Morning Herald Summarized below by Richelle Stevenson Read the full article here!
Ty Wall-King and Amber Scott in Sleeping Beauty CREDIT:KATE LONGLEY / AUSTRALIAN BALLET
This article from Sydney, Australia explores modern research into pain and highlights a new approach to treating back pain in company artists at the Australian Ballet. This approach focuses treatment on the nerves transmitting pain signals. While there is excellent information in this article, and a perspective which I think all dancers should consider, I must reinforce that dancers with any back pain should consult a health care professional for treatment. Your physical therapist, doctor, physiotherapist or athletic trainer will help you eliminate pain whether an Xray is needed or through therapuetic exercise. Back pain can often indicate serious injury and you should consult these licensed practitioners. Brain Control Ty King-Wall, a principal dancer with Australian Ballet, had to rebuild both his body and his mind to beat his back pain. When he began the rehabilitation process for his herniated disc, he was surprised to discover that there was a mental side to his treatment. King-Wall stated, "And it took me a little while to get the idea into my head that I could be increasing my experience of the pain through where my head was at.”
In fact, current research is beginning to unwrap the depth of control the brain has over pain management. The author quotes Professor Lorimer Moseley, a world-leading pain neuroscientist based at the University of South Australia. Lorimer explains, "It’s a vicious cycle. If you’re convinced pain equals damage, you get more pain, so you think you’re getting more damage, so your brain gives you more pain, so you think you’re getting even more damage." In other words, once the brain receives a pain signal it often remains on high-alert and continues to send signals of pain, even after physiologic healing has initiated or even concluded. Thus, part of rehabilitating an injury must include retraining the brain to refocus away from the site of previous injury. This is particularly the case for chronic injury and, as this article points out, especially true for back pain in general. In fact, numerous large scale studies show how people with significant back conditions (including bulging discs and degeneration) are completely asymptomatic (do not have any pain or ever realize they have a back condition). Check out a meta-analysis of research here!
Back pain can be very serious
So, what is the take away? Chronic back pain is quite common in dancers but it doesn't have to be career ending. Perhaps a new approach to movement, such as aquatic therapy (which was used to help King-Wall), and a new approach to treatment is the missing link to chronic back pain in dancers. This article reminds readers to not live-or-die by the Xray as research currently shows large portions of the population remain asymptomatic despite significant back injury. Nevertheless, THERE ARE INSTANCES WHERE IMAGING IS NECESSARY. I repeat, back pain should not be handled on your own! A very serious injury called a spondylolisis or spondylolisthesis fracture commonly occur in dancers and cheerleaders. This happens when dancers have a "broken back" and then continue doing excessive movement and the fractured vertebra actually slip out of position. Please, talk to a medical professional about your back pain.
Clinician's Corner
Hello Abs: An introduction to combating low back pain
by Richelle Stevenson, LAT
Abdominal strengthening is my first step to relieving pain in the back. For dancers particularly, I've found that deep core muscles are often not as strong as deep back muscles. Think about the number of arabesques and movements you do in a derrière position and compare that to the number of abdominal exercises you do every day. There are two elements to rehabilitating back pain in the programs I create for dancers. The first is to strengthen the core muscles and the second step is to maintain this strength with movement and even breathing. Let's take a look below at which abdominal muscles need to be strengthened and then learn how to maintain this stability.
What are the "abs"? First it's important to know there are multiple abdominal muscles, therefore, it is possible to get a "6 pack" while still having a weak core. This is one of the reasons elite athletes still have back pain. There are 4 abdominal muscles, but today we are most concerned with the deepest: the transverse abdominis (TrA). Notice in the second photo how it also resembles a corset, wrapping around the trunk. This is important because when the TrA is activated, it provides support to the entire body and alleviates pressure on the spine.
Check out this excellent video to learn 3 exercises for core stability. the instructor explains this principle in the first part of the video and helps isolate proper TrA activation. The second two exercises will show you how to incorporate core stability into movement. These exercises seem basic at first, but proper TrA can be difficult to maintain. *Be sure to notice if your hips wobble on the ground.*
Remember, please see a health care provider if you have any back pain. Sometimes it can be eliminated with a therapuetic exercise program and sometimes it requires more serious treatment. Either way, it is more complex than simply taking IBuprofen and should be handled by a medical professional.
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