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"Better health leads to better dancing."
(Allen, 1999)
An exploration into typical dance related shoulder injuries. Using somatic theory to find appropriate ways of releasing tension whilst also finding strengthening exercises for shoulder dislocation.
LOWER EXTREMITY INJURIES ARE MORE COMMON!
'If all the bones involved in the shoulder girdle were extended laterally , we wouldn't be able to walk through a door!'
(Olsen, 1998)
Key concepts:
Mobility/stability
Force couples
•Upper/lower body connection
The bones of the shoulder complex include the:
• 2 scapulae
• 2 clavicles
• 1 sternum
• 2 humerus bones
Other Important Features:
Glenohumeral Joint
(Where the head of the humerus meets glenoid cavity)
A ball and socket joint with a shallow cavity
There a THREE planes of movement
1) Sagittal 2) Frontal 3)Transverse
Capability of: Flexion, Extension, Abduction, Adduction & Internal and External Rotation
Scapulothoracic Joint
(Where the scapula meets the thoracic spine)
Not a true anatomical joint- considered an articulation
Slides freely over the back of the rib cage (scapula)
Capabiliy of: Elevation, Depression, Protraction,
Retraction & Upward and Downward Rotation
Strengthening exercises are key in the rehabilitation of a dislocated shoulder.
Some examples of strengthening exercises are:
• Fill ¾ of a 1.5 l water bottle with water.
• Pick up the bottle with your right hand and stretch your arm straight out in front of you.
• Make sure your hand is at the height of your shoulder and your arm is straight. Now try to hold the bottle steady.
• Hold this position for 30 to 60 seconds, then switch sides and repeat the exercise. Do three sets per side.
• Lie on your stomach with your arms by your sides.
• Place a pillow under your forehead for comfort, if required.
• Gently draw your shoulder blades together and down your back as far as possible.
• Ease about halfway off from this position and hold for 10 seconds.
• Relax and repeat 10 times.
Rotator Cuff Tendonitis and Impingement:
-This injury can become common in dancers due to the overuse of raising the arms.
Shoulder Dislocation
-This injury occurs when the humerus is completely or partially out of the glenoid. When this is only partial, it is known as a subluxation.
Rotator Cuff Tear
-This injury occurs when the rotator cuff tendons are fully or
partially torn.
Shoulder Dislocation
Anterior and Posterior Dislocations
1) In BOTH types of dislocation there is usually a severe bone defecton on the humeral and glenoid side
2) Ususally only present with mild pain but significant loss of motion
3) CAN casue signifcant bone & cartilage deconstruction as well as scar formation in soft tissues
4) Lead to instability which causes repeated dislocations
Role of the Glenohumeral Joint in dislocation and sublaxtion
-Large range of motion but limited stability- shallow socket
-Reliance on capsule & ligament structures as well as the rotator cuff group (for stability)
Many somatic practices to help with shoulder tension, mending and release.
Can stretch from simple breathing exercises, floor work, own movement analysis and functional integration.
Each practice has a different approach to helping shoulders.
Functional integration is good for bringing awareness to anatomy of the shoulders & discovering how tight/loose they are.
Breathing exercises are very good for releasing tension.
ADDRESSING OUR CURIOSITY...
Using 2 methods as a way of building strength and bringing awareness to the shoulder girdle.
Exercise 1) Feldenkrais & Functional Integration
Exercise 2) Wall Press
Aware that releasing tension is not suitable when dealing with a dislocation, we still undertook the exercise based on the
fact dancers hold unnecessary tension.
It is not useful to push through muscle tension ,
it will only generate more tension
(Olsen, 1998)
Feldenkrais
Feldenkrais. Including own awareness of movement and functional integration.
One person on their side on the floor, the other in full control of their shoulder joint.
The person in control of the shoulder joint will move the shoulder around, the person laying on the floor discovers how much mobility/ tension they have.
An addition to this is to feel around the person's shoulder blade, the person laying down can locate where that is too.
WALL PRESS
An important part of treating instability and reoccurring dislocations is through retraining the scapula
ISOMETRIC SHOULDER EXERCISES ARE KEY TO RECOVERY
1) This particular exercise is a form of isometric flexion
2) Muscles are worked without moving the joint- static exercise
3) These muscles include the deltoid major and minor- an important adductor
4) Important in the prevention of sublaxtion and dislocation due to a high role of stabilizing the joint.
5) Avoidance of elevation subsequent to recent dislocation
6) Involves protraction and retraction which in favour
prevents scapular winging
Feldenkrais has helped in the past.
Our shoulders feel a lot less tense, we are a lot more aware of the positioning of our shoulders.
Wall presses are helpful in the rehabilitation of a dislocated shoulder and can help to build strength in the joint to prevent further injury.
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Martel, J. (2017). Rotator Cuff Tendinitis: Symptoms, Diagnosis, and Treatments. [online] What You Need to Know About Rotator Cuff Tendinitis. Available at: https://www.healthline.com/health/rotator-cuff-tendinitis [Accessed 8 Feb. 2020]
surviving dance. (n.d.). Shoulder. [online] Available at: http://www.survivingdance.ca/shoulder.html [Accessed 14 Feb. 2020].
Walden, M. (2019). Dislocated Shoulder Exercises - Mobility, Strengthening & Functional. [online] Sportsinjuryclinic.net. Available at: https://www.sportsinjuryclinic.net/sport-injuries/shoulder-pain/acute-shoulder-injuries/dislocated-shoulder-strengthening-exercises [Accessed 15 Feb. 2020].
Haas, J. (2010). Dance Anatomy. USA: Courier Corporation, pp.73-85.
Imhoff, A. and Savoie III, F. (2017). Shoulder Instability Across the Life Span. Germany: Springer, p.278.
Olsen, A. (1998). Bodystories: A Guide to Experiential Anatomy. Lebanon: University Press of New England, pp.65-67.
Shoaf, L. and Steel, J. (n.d.). Integrating the Shoulder Complex to the Body as a Whole: Practical Applications for the Dancer. [online] IADMS International Association for Dance Medicine & Science. Available at: https://cdn.ymaws.com/www.iadms.org/resource/resmgr/resource_papers/shoulder-complex.pdf [Accessed 17 Feb. 2020].
Haas, J. (n.d.). Dance anatomy. 2nd ed. Human Kinetics, pp.111-141.