Osteochondritis Dissecans
Dancing Smart Newsletter
September 9, 2005
Announcements
First, the special introductory offers on my DVDs and book end on September 30th. Go to my website for more details and to order.
Second, I want to announce a new service that I am offering in response to the increase in the number of questions and emails I am receiving. For those who would like a more in depth answer to their questions, especially when it has to do with a challenge that you or one of your students is going through, I will offer telephone consultations for $80 and a half hour consultation for $45. The way it will work is you send me an email outlining your question or concern, including your time zone, and general availability. I will email you/call back so we can set up an appointment. I am not a physician, and cannot (and will not) diagnose over the phone, but based on my years of experience know I can give excellent suggestions and guidance based on my unique history of being so intimately connected with the field of dance as a dancer, teacher, and neuromuscular educator. For right now, email me at DeborahVogel@thebodyseries.com to set up an appointment while I work to get this new product on the website.
Please do continue to send your questions in for the newsletter; I am working on collating past and current newsletters into a printed bound form for those who want an indexed copy of the newsletters that I broken into chapters by body parts. I will let you know when it is ready for purchase.
Next announcement. (September is always filled with lots of new beginnings, yes?) I am waiting for a sample of balls to arrive and evaluate, as my old supplier of pinkie balls is no longer carrying them. As soon as I have a reliable source of balls, I will place these on the website for purchase. For those of you who have already contacted me about purchasing balls, I will email you directly as soon as I have enough to ship out. Working with the balls can be truly life altering. If you have not attended one of my workshops on ballwork, please check out my DVD on Ballwork.
Here's a recent email I received. Thanks, Roberta!
I took your workshops at the Dance Teacher Magazine conference (I'm the one who bought 30 pinky balls!) and put it all into practice in my own 5-day summer workshop. We did the testing assessments first, (using your form) then worked with the pinky balls and stretching all week, paying particular attention to tight areas, and then re-tested on the last day. The results were dramatic! The girls were so amazed that one-week could make such a difference! They loved the pinky ball work (I put them in teams and they had to come up with a name for their team...one group called themselves the pinkie balls, they liked them so much!)
Thank you so much for all your information. We had a great time with it all and I plan to use it with all my older classes this year.
Roberta Humphrey, Dance for Joy, Mohegan Lake, NY
Question of the Week
Loved your book!
My question is, I have a 10-year-old student who dances for 1.5 hours a week and skates 2 days a week. She developed knee pain and her Mom took her to a doctor and he said she had osteochondritis dissecans. I asked her Mom what the Doctor said caused it, she said he didn't say. I asked what should she do to prevent it once the pain is gone, she said he didn't say. SO that's why I am writing to you. It seems Doctors just treat the symptom and they don't always try to help with prevention!
She went to the Doctor over the summer, so she wasn't even dancing at the time. The Doctor did say that she couldn't dance or skate again until at least January. I haven't found out what her recovery regime is yet, I will see her in 2 weeks when my classes start.
Thank you so much for all of your help.
Linda
Deb's Answer
Let's start with a simplified explanation of Osteochondritis Dissecans. At the ends of each bone there is a layer of cartilage, which acts to smooth out the movement, decreasing friction at the joint. Osteochondritis Dissecans is a condition where a fragment of cartilage separates from the joint surface. The loose piece may stay in place, or fall into the joint space. The most common joint to be affected is the knee, with the elbows next in line.
Patients with this diagnosis are generally in their teenage years, with more men than women being affected in the past, although that seems to be changing because of the increase of athletic activities of females. Generally, patients will describe symptoms as achy knees and swelling, not pinpointed to one area. If the cartilage has become a loose body they may talk about the knee locking or giving away. Twisting motions, especially inward rotation of the tibia can exacerbate it. (This motion would probably happen more in her skating that in dancing)
Doctor's don't know what causes OCD, but they suspect trauma, such as repetitive strain (hmm.dancing and skating could certainly fall under repetitive strain, yes?) The anatomy of the knee with its many variations may be associated. For example, they find more OCD associated with knock knees and bowlegs.
The goal behind the rehab is to reduce pain, restore good joint function, and decrease the possibility of future degenerative joint disease. Usually the treatment for young patients first involves activity restriction, and then a gradual return to their activities. Younger patients have a much better prognosis than older patients because the have not finished growing, and their growth plates are still open.
I hope that the physical therapist or doctor looks closely at the potential mechanical stresses that dance and skating have on your student when the time comes for her to return to activities. As her dance teacher keep an eagle eye out for her hip, knee, ankle alignment. I would suspect a pattern or tendency of knee torque, especially during standing in first position. If she is able to return to dance, begin with first just the warm up part of class, slowly working in more movement. Leaping and jumping would be the last to be added in. Her skating instructor is going to need to do the same. Even though your student is quite young, a few sessions on the Pilates reformer could be very useful to repattern any inefficient alignment that may be occurring at the knee.
Best wishes for a speedy recovery for this young girl!
Until next week,
On with the dance!
Deborah