MANAGEMENT OF DANCE INJURIES
Developed by Will Arbogast, ATC, Sindecuse Sports Medicine Clinic and Associate Professor Jane Baas, Western Michigan University; additional information from Dance Kinesiology by Sally Fitt, Schirmer Books, New York, 1996

When you are injured, be "NICER" to yourself:

N--NSAIDS--Non-steroidal anti-inflammatory drugs
• Use caution in the first 24-48 hours if there is bruising at the injury site.
• Avoid taking anti-inflammatories without first seeing your doctor if you have a history of bleeding disorders, ulcers, or significant stomach upset with this type of medication. Do not use if you have a known allergy to this type of medication.

I--ICE initially (20 minutes at a time, the more frequent the better)
• A bag of frozen peas can work better than ice in surrounding the injured area.
• Freeze water in a paper cup, then peel away the top portion for ice massage.
• If you have a chronic injury and there is soreness with activity, definitely ICE after activity.
• You may use a heat/ice combination 72-96 hours after injury if swelling has subsided.

C--COMPRESSION
• Ace bandage wraps, taping and splinting can help decrease swelling and provide support for the injured area. DO NOT wrap so tightly that sensation is lost.

E--ELEVATION
• Raise the injured body part to prevent pooling of blood at the injury site. If possible, sleep with the injured area elevated.

R--RELATIVE REST
• Rest the injured part with gentle massage and/or gentle, non-weight bearing range of motion activity to help promote healing.

MEDICATIONS

ANTI-INFLAMMATORIES: These medications decrease or inhibit the body's inflammatory response. By reducing this response (swelling, etc.), pain is reduced because swollen soft tissue is not pressing so much on nerve tissue. These medications will NOT mask pain and are helpful in the healing process but are hard on the stomach and should only be taken with food. These medications are classified in the following manner:

STEROIDAL vs. NON-STEROIDAL (NSAIDS)
Steroidal by prescription only examples
Prednisone
Celestone
Prednisolone

Non-Steroidal by prescription only examples
Ansaid
Lodine
Anaprox
Naprosyn
Cataflam
Oruval
Daypro
Relafen
Toradol

Non-steroidal over the counter examples
Aspirin (Bayer, etc.)
Naproxen Sodium (Aleve)
Ibuprofen (Motrin, Advil, Nuprin)

ANALGESICS: The function of these medications is to decrease pain. The mechanism of how these medications decrease pain is different from the anti-inflammatory medications. Except for aspirin, which does have some anti-inflammatory properties, these medications CAN mask pain, thus causing greater injury. These medications are classified in the following manner:

NON-NARCOTIC vs. NARCOTIC
Non-Narcotic over the counter examples
Aspirin
Acetominophen (Tylenol, etc.)
Sports creams (ineffective)

Narcotic by prescription only examples
Darvocet
Darvon
Tylenol with codeine
Vicodin

MUSCLE RELAXANTS: These medications (i.e. Flexeril, Skelaxin, Valium) are prescription-only medications used infrequently for severe muscle spasming. They are quite effective, but can have significant side effects including drowsiness and lethargy.

SPECIFIC MEDICATION NOTES

• NON-ASPIRIN, NON-STEROIDAL ANTI-INFLAMMATORIES are primarily anti-inflammatories, but they have mild fever-reducing properties. You should not use them if your have stomach pain, ulcers, kidney problems, bleeding disorders, or a significant allergy to these medications or aspirin. Avoid if taking blood-thinning medications.

• ASPIRIN has some pain-relieving, fever-reducing, and anti-inflammatory properties. Like the other anti-inflammatory medications, it can cause stomach irritation. It can also have liver and kidney effects, so do not take high doses or take for prolonged periods. Avoid aspirin if you are taking blood-thinning medications such as Coumadin or Warfarin or have a history of bleeding disorders. Aspirin is not recommended for flu symptoms in children, teenagers and young adults because of possible complications associated with Reye's syndrome.

• ACETOMINOPHEN works primarily as a pain reliever and fever-reducing agent. It is NOT an anti-inflammatory agent. Prolonged use can cause liver and kidney damage.

COMMON DANCE INJURIES AND SYMPTOMS

FOOT, ANKLE AND LOWER LEG
• Long Flexor Tendinitis: Pain in the great toe when performing releve and point work.
• Sesamoiditis: Pain at the head of the first metatarsal in locomotion, jumping and releve. Caution is urged since these symptoms may also indicate stress fracture of the sesamoids.
• Plantar Fasciitis: Pain in the heel, particularly after periods of not bearing weight (sitting/sleeping).
• Shin Splints (Anterior Tibialis Tendinitis): Pain along border of shin, especially when jumping.
• Shin Splints (Posterior Tibialis Tendinitis): Pain along outside of the ankle and lower leg.
• Achilles Tendinitis: Pain in Achilles tendon on pointe, plie, releve, jumping, often accompanied by creaking and crunching in the area.

KNEE AND HIP AND LOW BACK
• Chondromalacia: Pain underneath the knee cap, often accompanied by creaking and crunching.
• Piriformis Syndrome: Pain in the middle of the buttocks caused by inadequate stretching of the outward rotators of the hip.
• Anterior Snapping Hip: Localized pain at the front of the hip on flexion, often accompanied by
• Lateral Snapping Hip: Loud clunking deep in the hip during such movements as grande rond de jambe and grand battement to second.
• Sciatica: radiating pain down the outside of the hip and leg, sometimes accompanied by numbness.
• Hamstring tears: pain and/or spasm in the back of the thigh.
• Spondylolisthesis: pain in low back at fifth lumbar/sacrum; frequently accompanied by painful muscle spasms in the low back.

Revised 4/11/03