PROFESYONEL BALE DANSÇILARI İÇİN OLASI SAKATLANMALARIN ANATOMİK KONUMLARININ BELİRLENMESİ

Öz

Klasik bale, dansçılarda sakatlanmalarla sonuçlanan, yoğun pratik gerektiren, yüksek fiziksel talepleri olan popüler bir dans türüdür. Bu çalışma, sağ kalça ve dizinde şiddetli ağrı ile ortopedi kliniğine başvuran 20 yaşındaki bir bale öğrencisini anlatıyor. Klinik ve MRI incelemesinde kemik iliği ödemi sendromu ortaya çıkmıştır. Kemik iliği ödeminin temel nedeni, üç yıl önce "rond de jambe en l'air" hareketini yaparken kalçada meydana gelen yaralanmadır. Olgu, hareket sırasında kalça abdüksiyonu sırasında yoğun ağrı hissettiğini belirtmiştir. 12 haftalık destek egzersizlerinden sonra ağrı skoru 8 puandan 3 puana düşmüştür. Literatürde bale hareketi etiyolojisine sahip kemik iliği ödemi vakası yoktur. Bu raporda, herhangi bir steroid ve cerrahi tedavi olmaksızın şikayetleri azaltmak için belirlenen anatomik yapıların kas ve eklemlerini destekleyecek doğru egzersizlerin planlanabilmesi için yaralanmanın anatomik lokasyonunun belirlenmesinin önemi vurgulanmıştır. Bu çalışmanın, bale eğitimi sırasında olası yaralanmaları önleme bilincine ve bale öğrencilerinde bireysel gelişimin tıbbi takibinin önemini anlamaya katkı sağlayacağını düşünmekteyiz.

Anahtar Kelimeler

• anatomi
• bale
• sakatlanma

DETERMINING THE ANATOMICAL LOCATIONS OF POSSIBLE INJURIES FOR PROFESSIONAL BALLET DANCERS

Abstract

Classical ballet is a popular type of dance with high physical demands requiring intensive practice with eventual overuse injuries in dancers. This case report describes a 20-year-oldballet student who referred to the orthopedic clinic with severe pain on right hip and knee. The clinical and MRI examination revealed bone marrow edema syndrome. The main reason for bone marrow edema is injury in hip while performing the "rond de jambe en l’air" movement three years ago.The case stated that she felt intense pain during hip abduction while movement was realized. After12-weeks of supportive exercises, the pain score decreased from 8 to 3 points. In the literature, there is no bone marrow edema case with the etiology of ballet movement. In this report, the importance of determining the anatomical location of the injury is emphasized so that correct exercises to support the muscles and joints of the determined anatomic structures can be planned to reduce the complaints without any steroid and surgical treatment. This study will contribute to awareness of preventing possible injuries during ballet training and to understand the importance of medical follow-up of individual development in ballet students.

Keywords

• anatomy
• ballet
• injury

References

1. Albisetti, W., Perugia D., De Bartolomeo O., Tagliabue L., Camerucci E., Calori G.M. (2010). Stress fractures of the base of the metatarsal bones in young trainee ballet dancers. Int Orthop, 34(1):51-5. doi: 10.1007/s00264-009-0784-3.
2. Curtiss, P.H., Kincaid, W.E. (1959). Transitory demineralization of the hip in pregnancy. A report of three cases. J Bone Joint Surg Am, 41-A:1327-33. PMID: 13849487.
3. Dabak, T., Sertkaya, K., Sertkaya, Ö. (2010). Ağrılı kemik iliği ödemi: Erken evre avasküler nekroz mu? Türk Ortopedi ve Travmatoloji Birliği Derneği Dergisi 9(1):19-23.
4. Denys, J. (2020). Turnout insight for dancers, dance teachers, and dance parents. Canada's National Ballet School. Accessed July 7 2020. A.: https://www.nbsenb.ca/resources/dancers-physio-tips/turnout-tips, E.T.07.07.2020.
5. Fitt, S.S. (1996). Dance Kinesiology. New York: Schirmer Books.
6. Grieg, V. (1994). Inside Ballet Technique. Hightstown, NJ: Princeton Book Company, 1994.
7. Hofmann, S., Kramer, J., Vakil-Adli, A., Aigner, N., Breitenseher, M. (2004). Painful bone marrow edema of the knee: differential diagnosis and therapeutic concepts. Orthopedic Clinics North, 35: 321-33. doi: https://doi.org/10.1016/j.ocl.2004.04.005.
8. Kabakcı, A.G., Ahmet Hilmi Yücel, A.H., Ayvazoğlu, S. (2017). Physical characteristics of students to receive ballet training. Cukurova Medical Journal, 42(1):55-60. doi:10.17826/cutf.280093.

9. Kadel, N.J. (2006). Foot and Ankle Injuries in Dance. Physical Medicine and Rehabilitation Clinics of North America, 17(4):813-26. doi: https://doi.org/10.1016/j.pmr.2006.06.006.
10. Khan, K., Brown, J., Way, S., Vass, N., Crichton, K., Alexander, R., Baxter, A., Butler, M., John, W. (1995). Overuse injuries in classical ballet. Sports Medicine, 19(5): 341–57.
11. Kwon, Y.H., Wilson, M., Ryu, J.H. (2007). Analysis of the Hip Joint Moments in Grand Rond de Jambe en l'Air. Journal of Dance Medicine & Science, 11(3):93-9.
12. Martin, S., Felix, M., Ordonio, M., Allen, D.D. (1998). Measuring functional range of motion in ballet dancers hips. Journal of Dance Medicine & Science, 2(2): 56–62.
13. Kelly, R.M. (1994). Injury in ballet: a review of relevant topics for the physical therapist. Clinical Commentary JOSPT, 19(2): 121-9. doi: 10.2519/jospt.1994.19.2.121.
14. Mistiaen, W., Roussel N.A., Vissers, D., Daenen, L., Truijen, S., Nijs, J. (2012). Effects of aerobic endurances, muscle strength and motor control exercise on physical fitness and musculosketal ınjury rate in professional dancers: an uncontrolled trial. Journal of Manipulative and Physiological Therapeutics, 35(5):381-8. doi: 10.1016/j.jmpt.2012.04.014.
15. Negus, V., Hopper, D., Briffa, N.K. (2005). Associations between turnout and lower extremity injuries in classical ballet dancers. Journal of Orthopaedic & Sports Physical Therapy, 35(5): 307-18. doi: 10.2519/jospt.2005.35.5.307.
16. Trentacosta, N., Sugimoto, D., Micheli, L.J. (2017).Hip and Groin Injuries in Dancers: A Systematic Review Hip problems in dancers. Sports Health, 9(5):422-27. doi: 10.1177/1941738117724159.
17. Tondi, C. (2015). Rond de Jambe En L'Air. Ballet with Chiara. E.: http://balletwithchiara.weebly.com/blog/rond-de-jambe-en-lair, E.T.17.07.2020.
18. Uygur, A.G., Polat, S., Ayvazoğlu, S., Yücel, A.H. (2019). The physical features suitable for classical ballet trainin. Journal of Back and Musculoskeletal Rehabilitation, 32:569-78. doi: 10.3233/BMR-181173.
19. Warden, S.J., Burr, D.B., Brukner, P.D. (2006). Stress Fractures: pathophysiology, epidemiology and risk factors. Current osteoporosis reports, 4:103-9. doi: 10.1007/s11914-996-0029-y.
20. Wilson, M. (2008). The Science and Art of Grand Rond de Jambe en l’air: Applications to Teaching and Performance. Journal of Dance Education, 8(4):117-25. doi: 10.1080/15290824.2008.10387372.
21. Wilson, M. (2009). Applying biomechanic research in the dance studio. International Association for Dance Medicine & Science, 1(2):11-3.
22. Wilson, M., Lim, B.O., Kwon, Y.H. (2004). A three-dimensional kinematic analysis of grand rond de jambe en l’air skilled versus novice ballet dancers. Journal of Dance Medicine & Science, 8(4):108-15.
23. Wilson, M., Ryu, J.H., Kwon, Y.H. (2007). Contribution of the pelvis to gesture leg range of motion in a complex ballet movement grand rond de jambe en l'air en dehors. Journal of dance medicine & science, 11(4):118-23.
24. Yi, S.R., Lee, Y.H., Kim, H.M. 2015. Bilateral bone marrow edema syndrome of the femoral head with a unique onset a case report. Hip Pelvis, 27(4):273-7. doi: 10.5371/hp.2015.27.4.273.