Dr. Henry Pang - Doctor
Translation: Stacey Yeung - Dance Science Researcher
17 February 2020
Low back pain is common, with reported lifetime prevalence up to 50-80% in various studies. Dancers are not immune to low back pain despite their relatively stronger physique. In fact, they are at risk of certain types of low back pain given the high physical demand on spinal motions. There are numerous causes of low back pain in dancers, ranging from simple muscle strains to serious nerve or spinal cord compression. To better understand low back pain in dancers, we discuss some causes of low back pain and their management using a 3P approach (Presentation, Pathology, Prevention, and treatment)
Soft tissue: Muscle strain/sprain and muscle imbalance
An acute onset of localized tenderness over paraspinal muscles. The pain usually increases with motion but can be improved by stretching, rest and massage. On-and-off back pain with a flare-up, especially with improper postures or exertion (such as during showcases or competitions).
It is caused by excessive stress on lower back soft tissues, especially at the extreme lower back closed to buttocks. Since many dance forms encourage a hyperlordotic (arched back) and anteriorly tilted hip posture, it increases the stress on the lower back. Some dancers may experience pain because of the underlying lower cross syndrome, which is characterized by tight back extensors (erector spinae) and hip flexors (iliopsoas), as well as weak abdominal muscles (rectus) and hip extensors (gluteus). This muscle imbalance combined with training behaviors can or overload certain muscles and reduce the flexibility of the lower back.
Prevention and treatments:
In addition to rest, massage and medications (oral and topical) that can help relieve the muscle tightness, a more important aspect is to correct the underlying muscle imbalance. To prevent further muscle strain/ sprain, stretching of tight muscle and muscle reconditioning targeting at abdominal and gluteus muscles are essential as well.
Intervertebral discs: Discogenic back pain
Chronic low back pain that is axial in nature, and worsens with activities that increase the disc pressure (e.g. sitting/ bending forward, coughing/squeezing and straining).
An intervertebral disc is the shock absorber located between adjacent vertebrae. Repetitive stress and loading would lead to wear and tear of disc fibres, resulting in disc-related back pain. Badly executed dance moves that bring sudden or unaccustomed loading to the spine, alongside weak core muscles, may cause accelerated disc degeneration.
Prevention and treatments:
For short term treatment, medications and passive physiotherapy (e.g., therapeutic ultrasound, transcutaneous nerve stimulation (TENS), and massage) can help to relieve discogenic back pain. Braces/orthoses are sometimes used to help support the back temporarily and to limit motions that may induce pain in the acute phase. Nevertheless, long term usage of braces may cause reliance and further weakening of core muscles. The ultimate treatment for discogenic back pain is core muscle strengthening because strong abdominal and low back muscles can unload intervertebral discs, and lower the risk of early disc degeneration, discogenic back pain, and its recurrence.
中文翻譯： 楊子慧 - 舞蹈科學研究員
軟組織： 肌肉勞損／ 扭傷和肌肉失衡
因下背部（尤其在末端位置）的軟組織承受過大壓力引起。由於許多舞種中都鼓勵舞者使用脊柱前凸過度(向後拱)和髖關節前傾的姿勢，繼而增加舞者下背部的壓力。 另外有些舞者可能曾經體驗過下背痛，這也歸因於潛在的下交叉症候群，其特徵是後背伸肌(豎脊肌) 和髖屈肌(髂腰肌)繃緊，以及腹肌(直腸)和髖伸肌(臀肌) 無力。這種長期的肌肉失衡加上訓練習慣或超負荷會導致下背部缺乏柔韌性。
除了透過休息、按摩和藥物治療(口服及外用藥物) 幫助緩解肌肉繃緊外，更重要的是糾正潛在的肌肉失衡。為了防止進一步的肌肉拉傷/ 扭傷，伸展緊繃的肌肉和針對調節腹肌和臀肌也是必不可少的。
1 Lic. Rik Op De Beeck Dr. Veerle Hermans. European Agency for Safety and Health at Work. Research on work-related low back disorders at work. 2000.
2. Swain, C. T., Bradshaw, E. J., Whyte, D. G., & Ekegren, C. L. (2018). The prevalence and impact of low back pain in pre-professional and professional dancers: A prospective study. Physical Therapy in Sport, 30, 8-13.
This article was accomplished by the author in his/her personal capacity. The opinions expressed in this article do not reflect the view of the official statement of CUHK and HKADMS. It is intended for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with an appropriate professional for specific advice related to your situation.
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