PDF herunterladen
Int J Sports Med 2012; 33(07): 561-566
DOI: 10.1055/s-0031-1301330
Orthopedic & Biomechanics
© Georg Thieme Verlag KG Stuttgart · New York

Joint Range of Motion and Patellofemoral Pain in Dancers

N. Steinberg
1   Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
,
I. Siev-Ner
3   Orthopedic Rehabilitation Department, Sheba Medical Center, Tel-Hashomer, Israel
,
S. Peleg
1   Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
,
G. Dar
4   Department of Physical Therapy, Faculty of Social Welfare & Health Studies, University of Haifa, Haifa, Israel
,
Y. Masharawi
5   Department of Physiotherapy, School of Health Professions, Tel Aviv University, Israel
,
A. Zeev
2   The Zinman College of physical Education and Sports Sciences at the Wingate Institute, Netanya, Israel
,
I. Hershkovitz
1   Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
› Institutsangaben
Weitere Informationen

Publikationsverlauf



accepted after revision 30. Dezember 2011

Publikationsdatum:
04. Mai 2012 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Abstract

The aim of the present study was to determine the association between joint range of motion (ROM) and patellofemoral pain syndrome (PFPS) in young female dancers. The study population included 1 359 female dancers, aged 8–20 years. All dancers were clinically examined for current PFPS, and their joint ROM was measured at the lumbar spine and the lower extremities. 321 of the 1 359 dancers (23.6%) experienced PFPS. Prevalence of the syndrome increased with the dancer’s age (p<0.001). Dancers with hypo ROM in hip external rotation, ankle plantar-flexion, ankle/foot pointe, hip abduction, hip extension, and limited hamstrings and lumbar spine were significantly less prone to developing PFPS compared to dancers with average ROM: 19.2% vs. 26.2% (p=0.014); 13.7% vs. 26.1% (p<0.001); 12.2% vs. 26.2% (p<0.001); 10.0% vs. 25.3% (p<0.001); 12.6% vs. 24.2% (p<0.001); and 9.3% vs. 28.2% (p<0.001), respectively. The group with the smallest prevalence of PFPS (10.2%) manifested restricted ROM at both the hip and ankle/foot joints. Dancers with decreased hip and ankle/foot joints ROM are less prone to develop PFPS. When making an association between joint ROM and injuries, not only the ROM at the targeted joint should be considered, but also the ROM at neighboring joints.

Key words

injuries - dance - knee joint - joint range of motion - patellofemoral pain syndrome
 

  • References

  • 1 Aalto T, Airaksinen O, Härkönen TM, Arokoski JP. Effect of passive stretch on reproducibility of hip range of motion measurements. Arch Phys Med Rehabil 2005; 86: 549-557
    CrossrefPubMedSuche in Google Scholar
  • 2 Bennell K, Khan KM, Matthews B. Hip and ankle range of motion and hip muscle strength in young novice female ballet dancers and controls. Br J Sports Med 1999; 33: 340-346
    CrossrefPubMedSuche in Google Scholar
  • 3 Bennell KL, Khan KM, Matthews BL, Singleton C. Changes in hip and ankle range of motion and hip muscle strength in 8-11 year old novice female ballet dancers and controls: a 12 month follow up study. Br J Sports Med 2001; 35: 54-59
    CrossrefPubMedSuche in Google Scholar
  • 4 Coplan J. Ballet dancer’s turnout and its relationship to self-reported injury. J Orthop Sports Phys Ther 2002; 32: 579-584
    CrossrefPubMedSuche in Google Scholar
  • 5 Dwyer MK, Boudreau SN, Mattacola CG, Uhl TL, Lattermann C. Comparison of lower extremity kinematics and hip muscle activation during rehabilitation tasks between sexes. J Athl Train 2010; 45: 181-190
    CrossrefPubMedSuche in Google Scholar
  • 6 Echegoyen S, Acuña E, Rodríguez C. Injuries in students of three different dance techniques. Med Probl Perform Art 2010; 25: 72-74
    PubMedSuche in Google Scholar
  • 7 Foss KD, Ford KR, Myer GD, Hewett TE. Generalized joint laxity associated with increased medial foot loading in female athletes. J Athl Train 2009; 44: 356-363
    CrossrefPubMedSuche in Google Scholar
  • 8 Gamboa JM, Roberts LA, Maring J, Fergus A. Injury patterns in elite preprofessional ballet dancers and the utility of screening programs to identify risk characteristics. J Orthop Sports Phys Ther 2008; 38: 126-136
    CrossrefPubMedSuche in Google Scholar
  • 9 Garrick JG, Requa RK. The relationship between age and sex and ballet injuries. Med Probl Perform Art 1999; 12: 79-82
    PubMedSuche in Google Scholar
  • 10 Gilbert CB, Gross MT, Klug KB. Relationship between hip external rotation and turnout angle for the five classical ballet positions. J Orthop Sports Phys Ther 1998; 27: 339-347
    CrossrefPubMedSuche in Google Scholar
  • 11 Grieg V. Inside Ballet Technique: Separating Anatomical Fact from Fiction in the Ballet Class. Pennington, NJ: Princeton Book Co,; 1994
    PubMedSuche in Google Scholar
  • 12 Hamill J, Knutzen KM. Biomechanical Basis of Human Movement. Baltimore: Williams & Wilkins; 2009
    Suche in Google Scholar
  • 13 Hamilton D, Aronsen P, Loken JH, Berg IM, Skotheim R, Hopper D, Clarke A, Briffa NK. Dance training intensity at 11-14 years is associated with femoral torsion in classical ballet dancers. Br J Sports Med 2006; 40: 299-303
    CrossrefPubMedSuche in Google Scholar
  • 14 Harriss DJ, Atkinson G. Update – Ethical standards in sport and exercise science research. Int J Sports Med 2011; 32: 819-821
    Thieme ConnectPubMedSuche in Google Scholar
  • 15 Hincapié CA, Morton EJ, Cassidy JD. Musculoskeletal injuries and pain in dancers: a systematic review. Arch Phys Med Rehabil 2008; 89: 1819-1829
    CrossrefPubMedSuche in Google Scholar
  • 16 Hoppenfeld S. Physical examination of the spine and extremities. Connecticut: Appleton-Century-Crofts/Norwalk; 1976
    Suche in Google Scholar
  • 17 Ibrahim A, Murrell GAC, Knapman P.. Adductor strain and hip range of movement in male professional soccer players. J Orthop Surg 2007; 15: 46-49
    PubMedSuche in Google Scholar
  • 18 Khan K, Roberts P, Nattrass C. Hip and ankle range of motion in elite classical ballet dancers and controls. Clin J Sport Med 1997; 7: 174-179
    CrossrefPubMedSuche in Google Scholar
  • 19 Koutedakis Y, Sharp NC. (eds.). The Fit and Healthy Dancer. John Wiley & Sons Ltd; England: 1999
  • 20 Liederbach M, Dilgen FE, Rose DJ. Incidence of anterior cruciate ligament injuries among elite ballet and modern dancers: a 5-year prospective study. Am J Sports Med 2008; 36: 1779-1788
    CrossrefPubMedSuche in Google Scholar
  • 21 McCormack M, Briggs J, Hakim A, Grahame R. Joint laxity and the benign joint hypermobility syndrome in student and professional ballet dancers. J Rheumatol 2004; 31: 173-178
    PubMedSuche in Google Scholar
  • 22 Mcmullen J, Uhl TL. A kinetic chain approach for shoulder rehabilitation. J Athl Train 2000; 35: 329-337
    PubMedSuche in Google Scholar
  • 23 Miller EH, Schneider HJ, Bronson JL, McLain D. A new consideration in athletic injuries: the classical ballet dancer. Clin Orthop 1975; 111: 181-191
    PubMedSuche in Google Scholar
  • 24 Myer GD, Ford KR, McLean SG, Hewett TE. The effects of plyometric versus dynamic stabilization and balance training on lower extremity biomechanics. Am J Sports Med 2006; 34: 445-455
    PubMedSuche in Google Scholar
  • 25 Negus V, Hopper D, Briffa NK. The relationship between turnout and lower extremity injuries in classical ballet dancers. J Orthop Sports Phys Ther 2005; 35: 307-318
    CrossrefPubMedSuche in Google Scholar
  • 26 Nilsson C, Leanderson J, Wykman A, Strender LE. The injury panorama in a Swedish professional ballet company. Knee Surg Sports Traumatol Arthsc 2001; 9: 242-246
    PubMedSuche in Google Scholar
  • 27 Oatis CA. Kinesiology – The Mechanics and Pathomechanics of Human Movement. Baltimore: Williams & Wilkins; 2009
    Suche in Google Scholar
  • 28 O’Loughlin PF, Hodgkins CW, Kennedy JG. Ankle sprains and instability in dancers. Clin Sports Med 2008; 27: 247-262
    CrossrefPubMedSuche in Google Scholar
  • 29 Orchard J, Marsden J, Lord S, Garlick D. Preseason hamstring muscle weakness associated with hamstring muscle injury in Australian footballers. Am J Sports Med 1997; 25: 81-85
    CrossrefPubMedSuche in Google Scholar
  • 30 Orishimo KF, Kremenic IJ, Pappas E, Hagins M, Liederbach M. Comparison of landing biomechanics between male and female professional dancers. Am J Sports Med 2009; 37: 2187-2193
    CrossrefPubMedSuche in Google Scholar
  • 31 Reid DC, Burnham RS, Saboe LA, Kushner SF. Lower extremity flexibility patterns in classical ballet dancers and their correlation to lateral hip and knee injuries. Am J Sports Med 1987; 15: 347-352
    CrossrefPubMedSuche in Google Scholar
  • 32 Salter RB. Textbook of Disorders and Injuries of the Musculoskeletal System. Baltimore: Williams & Wilkins; 1999
    Suche in Google Scholar
  • 33 Siev-Ner I, Barak A, Heim M, Azaria M. The value of screening. J Dance Med Sci 1997; 1: 87-92
    PubMedSuche in Google Scholar
  • 34 Steinberg N, Hershkovitz I, Peleg S, Dar G, Masharawi Y, Heim M, Siev-Ner I. Range of joint movement in female dancers and nondancers aged 8 to 16 years: anatomical and clinical implications. Am J Sports Med 2006; 34: 814-823
    CrossrefPubMedSuche in Google Scholar
  • 35 Stephens RE. The etiology of injuries in ballet. In: Ryan AJ, Stephens RE. eds. Dance Medicine: A Comprehensive Guide. Chicago: Pluribus Press; 1987
    Suche in Google Scholar
  • 36 Stregiou N, Bates BT, Kurz MJ. Subtalar and knee joint interaction during running at various stride lengths. J Sports Med Phys Fit 2003; 43: 319-326
    PubMedSuche in Google Scholar
  • 37 Thijs Y, De Clercq D, Roosen P, Witvrouw E. Gait-related intrinsic risk factors for patellofemoral pain in novice recreational runners. Br J Sports Med 2008; 42: 466-471
    CrossrefPubMedSuche in Google Scholar
  • 38 Uhorchak JM, Scoville CR, Williams GN, Arciero St RA, Pierre P, Taylor DC. Risk factors associated with non-contact injury of the anterior cruciate ligament: a prospective four-year evaluation of 859 West Point cadets. Am J Sportd Med 2003; 31: 831-842
    PubMedSuche in Google Scholar
  • 39 Van Dillen LR, Bloom NJ, Gombatto SP, Susco TM. Hip rotation range of motion in people with and without low back pain who participate in rotation-related sports. Phys Ther Sport 2008; 9: 72-81
    CrossrefPubMedSuche in Google Scholar
  • 40 Visser JJ, Hoogkamer JE, Bobbert MF, Huijing PA. Length and moment arm of human leg muscles as function of knee and hip-joint angles. Eur J App Physiol 1990; 61: 453-460
    CrossrefPubMedSuche in Google Scholar
  • 41 Wallace LA. The knee. In: Gould J, Davies GJ. eds. Orthopaedic and Sports Physical Therapy. St. Louis: Mosby; 1985
    Suche in Google Scholar
  • 42 Witonski D, Goraj B. Patellar motion analyzed by kinematic and dynamic axial magnetic resonance imaging in patients with anterior knee pain syndrome. Arch Orthop Trauma Surg 1999; 119: 46-49
    CrossrefPubMedSuche in Google Scholar
  • 43 Witvrouw E, Bellemans J, Lysens R, Danneels L, Cambier D. Intrinsic risk factors for the development of patellar tendinitis in an athletic population. A two-year prospective study. Am J Sports Med 2001; 29: 190-195
    PubMedSuche in Google Scholar
  • 44 Witvrouw E, Danneels L, Asselman P, D’Have T, Cambier D. Muscle flexibility as a risk factor for developing muscle injuries in male professional soccer players. A prospective study. Am J Sports Med 2003; 31: 41-46
    CrossrefPubMedSuche in Google Scholar
  • 45 Zajac FE. Understanding muscle coordination of the human leg with dynamical simulations. J Biomech 2002; 35: 1011-1018
    CrossrefPubMedSuche in Google Scholar