the show must go on, and so will you
Dr. Chappell was the medical director for The Clinic for Science and Health in Artistic Performance (SHAPe Clinic) at Ohio University. SHAPe is a place where injured performing artists can be evaluated, treated and receive health and wellness advice from licensed athletic trainers who have the specialized equipment and knowledge to treat their injuries. Due to this experience, Dr. Chappell knows performing artists have many unique medical risks, expectations and needs which he can address by prescribing individualized treatment based on your injury and activity. This treatment includes comprehensive performance oriented medical evaluation and treatment of medical problems that occur in instrumentalists, singers, dancers and actors at all performance levels, including students, professionals and amateurs. In addition to a typical medical assessment, treatment includes an evaluation of the performer’s technique, physical conditioning, repertoire, instrument and emotional state in relation to the current medical problem.
Anterior impingement may develop when the tibia (shinbone) and the talus (main ankle bone) do not properly glide over one another, pinching the tissues on the front of your ankle. Over time this can cause biomechanical changes in the ankle that can be more difficult to overcome.
Posterior impingement is caused by inflamed soft tissue or bony compression in the back of the ankle. The muscles of the calf can become inflamed around and just above their attachment at the heel. Variations in bony anatomy can cause continued compression due to the amount of time the foot is in a pointed position with dance. These issues can cause a restriction in the pointing movement.
Knee pain can be from a few different causes. The most common knee injury in performing arts is patellofemoral pain syndrome, which is usually due to the patella (kneecap) not gliding smoothly along the femur (thigh bone). Pain is usually felt anywhere around the kneecap.
Over time, the cartilage beneath the patella can soften and wear away. This softening or wearing away of cartilage and the pain and inflammation associated with it are referred to as chondromalacia.
low back strain
A low back strain may involve injury to the joints of the back called the facet joints. The spinal muscles can be strained from overuse or being overstretched. In either case, protective muscle spasm, guarding and limited range of movement typically occur.
Shin splints involve pain and inflammation in the lower leg due to repetitive stresses. Pain is usually on the medial (inside) border of tibia due to irritation of the muscle attachments and/or periosteum (outside layer of bone) along the lower leg. If treatment or rest is not initiated, this can progress to a stress fracture.
Spondylolysis or spondylolisthesis
Spondylolysis is a stress fracture to the vertebra in the lower back known as pars interarticularis.
Spondylolisthesis is a stress fracture to the pars interarticularis, which includes anterior slippage of the vertebrae.
An ankle sprains is an acute injury that is common in all types of physical activity. It is the most common dance-related sprain/strain. The typical mechanism is "rolling over" the outside of the ankle (lateral sprain). In dance, this is usually caused by landing a jump, turning, or coming off your toe en point. The severity of an ankle sprain is graded first, second or third (mild, moderate or severe), depending on the extent of ligament injury.
Tendinitis is inflammation of a tendon, an overuse injury usually due to repetitive stress activities such as running and jumping. In chronic cases, the tendon composition changes over time, causing a thickening known as tendinosis. In severe/chronic cases, microtearing can occur and increase the risk of tendon rupture.
lateral hip or knee pain
Lateral knee or hip pain, known as iliotibial band syndrome or ITBS, occurs when the iliotibial band, which runs from the lateral hip down to the knee, becomes tight. This tightness can cause the tendon to "flip" over the outside bony prominence of the knee (lateral tibial tubercle) as the knee flexes. The "flip" can cause an audible "pop", which causes discomfort and pain. The tightness can also pull on the knee, affecting its mechanics.
Heel or arch pain is known as plantar fasciitis. It is an inflammation of the plantar fascia or irritation at its attachment on the medial (big toe side) aspect of the calcaneus (heel) often related to excessive weight-bearing.
Snapping hip may not cause pain when it occurs, but the tendon can become irritated if not addressed. It may be considered an injury if it occurs more frequently or becomes painful. It is very common among dancers and commonly occurs during grand battement developpé – especially à la seconde and rond de jambe en l’air.
Stress fracture is a chronic injury that is caused when a specific part of a bone experiences more repetitive load than it can tolerate. Although stress fractures can occur in any bone that bears repeated stresses, there are three common places where dancers and other performers experience a stress fracture:
Base of the second metatarsal (foot bone)Along the fifth metatarsal (foot bone along little toe side)Around the femoral neck (hip)Tibia (shin)