Hamstring Injury
Dancing Smart Newsletter
May 20, 2005
Right to the question of the week!
Hi Deborah,
Iam a fourteen-year-old dancer who spends anywhere from 10 to 15 hours a week atthe studio. During the first weekof April, I pulled my left hip flexor muscle. I was in the middle of high school dance team tryouts, aswell as rehearsals for a competition that upcoming weekend, so I continued todance. Three days later, I jumpedinto my right splits, and my left hip flexor gave out, allowing the back of myright hip to slam onto the ground. I felt several things pop, and was unable to stand up. I iced it for nearly an hour, and thenwent to our FirstMed clinic where they did x-rays and concluded there was noproblem with my bone. Theirdiagnosis was that I strained the upper part of my hamstring, while tearingsome of the fibers of my ligament away from the bone. I was unable to compete that weekend and did not dance fortwo weeks. Last week, I began toparticipate in minor aspects of class. However, I still cannot lift my right leg above ninety degrees, and myhip flexor is still sore. Istarted physical therapy yesterday. Do you have any recommendations as to how I could decrease my healingtime? It has been a month since myinjury, and though it is improving, it is healing more slowly than my doctorprojected. It is very importantthat I return fully to dance as soon as I can, but I know from past experiencethat returning too early can only cause re-injury. Are there any specific exercises, stretches, or othermethods that could help me? Iappreciate your thoughts on this.
Thanks,
Caitlin
Dear Caitlin,
Your rehabilitation time is going to go slowly. I wouldn't be surprised if itultimately takes 6 months to come back from an injury such as this. Let's make fall the goal for gettingback into full dancing form, and look at using the summer months as your timefor rehabilitation and resolving the underlying issues that caused thisinjury.
Your injury is a good example of how the body compensatesimmediately for areas that are strained. The first piece of the injury was the left hip flexor strain. I have found hip flexor strains to beincredibly tenacious in how long they can hang out and influence your movement. Realize that the hip flexor is moreeasily strained when it is chronically tight (which it often is), and then onceyou've strained it, getting over the strain is the first part, and the secondpart is achieving more stretch in that area, which takes time. Time is what you didn't have inApril. Hindsight is always 20/20,but I want to encourage other dancers to take their strains and other bodymessages seriously, especially during the growth years when bone grows fasterthan muscles.
When you went into the right splits 3 days later because ofthe initial strain the hip flexors would not allow your left leg to slidebehind you as it normally would I imagine it threw your pelvis off to the rightand shifted your balance on the way down, allowing your weight to drop ontointo the right hamstring and tearing it's attachment to the ischial tuberosity,otherwise known as the sits bone.
I'm very happy to hear that you have started physicaltherapy. The PT's will be able toguide you with appropriate stretching and strengthening. I'm sure you are already focusing onconsistent and gentle iliopsoas and hamstring stretching. They probably will doultrasound if there is still inflammation in the area. I imagine that the doctors put you onsome type of anti-inflammatory medication to initially help, the PT's shouldhelp guide you in their continued use.
If your physical therapists don't do a lot of manual work, Iwould suggest that you get yourself to a good massage therapist. You want to find someone who has hadmedical massage training. Theremay be someone in your area already working with dancers that you couldutilize. My favorite therapistsare the ones who became massage therapists after being dancers, but I know theyare hard to find.
Releasing the surrounding muscle tension with rolling on apinkie ball or tennis ball would be something you could do for yourself outsideof therapy. My DVD Ballwork:Releasing Muscular Tension would be good for this. (There is going to be a special introductory offer next weekwhen my book comes out – watch for the announcement)
Your rehab must look at both hips and both sides of thehips. Your goal is to even out theflexibility between the hamstrings and the iliopsoas and their strength. The common pattern is to have tighterand stronger hip flexors, and more flexible, weaker hamstrings. We need both flexible and strongmuscles, not only around the hip joint, but at all the other joints of thebody.
I don't want to sound like your mother, but you want toobserve your nutritional intake, making sure there are good sources of protein,fiber, vitamins and minerals in your food. I don't promote one type of diet over another, it has a lotto do with your metabolic type, but you can't go wrong with trying to eat aslittle processed food as possible and increasing your intake of fruits,vegetables and good protein and limiting breads, grains and sugars. It is so easy to forget that food isour fuel, the building blocks for our body, and the quality of the buildingblocks will help the healing process greatly.
You'll want to listen carefully, Caitlin, to the messagesyour body gives you as you go through your rehab. You are already ahead of the game by wisely stating that youknow going back too soon will leave you vulnerable to more injuries. That is very true.
Taking 3 to 6 months to take exquisite care of your body maymean that you can't do the competitions you'd like to be involved in thissummer,but on the other hand, taking the time to truly rehab from this injurycould improve your future dancing immensely. Often rehabilitation is a time where we can take great leapsforward in our understanding of our body. I trust that your time over the next few months will be well spent, andI wish you the speediest and healthiest of returns to dancing.
Warm regards,
Deborah