Sports Medicine & Dance

Every dancer knows that injuries are very real. We strive to perfect our technique, we spend time warming our bodies up, and we use our plie in order to prevent injuries, but sometimes... they still happen. Injuries can occur due to overuse or a single incident. The more we know about body mechanics, the better prepared we are to approach our dancing and healing from injury.

Ballet Shoes & Bobby Pins sat down with Dr. Raymond Solano to ask some dance-related questions about sports medicine.

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Photo Source: Kristina Shapran at the Grand Prix of the Mikhailovsky Theatre 2010

Dr. Raymond Solano is a Board-Certified Doctor of Chiropractic (DC), with a specialty in Sports Medicine. He is licensed through the Virginia Board of Medicine to practice both Chiropractic and Physio-Therapy. Born in Washington DC and raised in Hyattsville, Maryland, he attended The American University before receiving his Chiropractic Medicine degree from Life University's College of Chiropractic in Marietta, Ga. In addition, Dr. Solano has a post-doctural degree as a Chiropractic Sports Physician (CCSP) and is certified through the American Chiropractic Board of Sports Physicians to work with athletes from all levels.

He has been featured in the Washington Post and voted by his peers to be recognized in Washingtonian Magazine as an expert on "Keeping You in the Game." An award-winning doctor, he is the 2012 recipient of the 1st Annual Falls Church News Press "Best Doctor" Award. Dr. Solano has reached millions through TV, Radio, and Web. His reliable, practical and straight-forward advice can be found Thursday's bi-weekly on the NBC 4 Washington Midday newscast, where he discusses the latest trends in physical health and sports medicine.

Now, let's talk dance!

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Photo: Dr. Ray Solano

How did you become interested in Sports Medicine?

As a competitive athlete growing up, there often times came injuries. Anytime time I got hurt, I was always fascinated by how the body healed and how I was able to return to activity. Now that my competitive sports days are behind me, I enjoy seeing the same results in my patients. My practice is varied but primarily consists of the active population. I can see an expecting Mom, young athlete, dancer, and a Professional football player all in one day. It's a challenge, but I truly enjoy coming to work every day.

How often do you work with dancers?

In my 10 years of private practice, I have seen dozens of dancers. Some come see me when they are home from college, while others see me throughout the year from the Washington Ballet.

What is the difference between a "strain" and a "sprain?" When should we be worried?

The difference between a strain vs. sprain is big.

A strain always involves a muscle, while a sprain will involve the ligaments that hold bones together to form a joint. It is possible to have both at one time.

A strain to a muscle generally heals faster than a sprain to a joint. Therefore, more concern is given to sprains. In addition, sprains are graded from 1-3, with 3 being the most severe and often times requiring surgery to repair. None the less, ice should be applied immediately following a strain or sprain to ensure inflammation reduction and proper healing. If a sprain has occurred, any joint laxity (looseness) should be promptly evaluated to rule out damage to the ligament in question.

How can tendonitis affect us as dancers? What should we do?

Tendons are the portion of the muscles that attaches to the bones. If a muscle is overloaded or overworked, then tendinitis can develop. If this is the case, resting the affected are for 3-5 days and applying ice 4-8 times a day for 15 min helps promote healing and allows the area to rest before you return to dancing. During this time, it's important to keep elasticity in the affected area, so stretching often during the 3-5 days of rest is necessary.

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Photo: The Carolina Ballet On Canvas - Intimate Voices by Nicole White Kennedy

Sometimes, when we lift our leg, our hip pops. What is going on? How can we stop this?

If you lift your leg and "popping" occurs, chances are your surrounding hip muscles need more flexibility. The "popping" is not generally the hip joint, rather tight muscles rolling and rubbing over bones creating a "snap" or "popping" sound. It rarely produces pain. Therefore, for dancers, its essential to have proper flexibility in the hip flexors, hip adductors, IT Band, Hamstrings, and quads. All of these muscles insert around the hip joint and are pivotal for proper dance biomechanics.

Why is it important that dancers have basic knowledge of Sports Medicine?

Dancers need to understand basic anatomy and Sports Medicine practices in case they become injured. Sports Medicine works best when the patient is connected with their body and how they feel. The body is used more efficiently when it's understood. Understand the basic muscles of the hips, back, and shoulders. These are the areas commonly injured and seen in my practice. Understanding your body is also important when communicating with your doctor to determine the best course of treatment in Sports Medicine.

In class, we often hear, "I think I twisted my ankle." What does this mean in Sports Medicine?

When I hear "twisted" ankle I immediately think of a ligament sprain. The first thing is to apply ice treatments and have the ankle evaluated for instability and/or the need for special taping, bracing, etc. Sprained ankles are common in dance, especially if there is a history of sprains to the ankle. Strengthening of the foot and ankle can prevent this, as well as proper dance form.

Do you still suggest RICE if we aren't quite sure what happened, but know that something feels weird?

You can't go wrong with R(est) I(ce) C(ompression) E(levation), before heading to your doctors office or hospital. Its a valuable acronym to remember.

According to Dance Teacher Magazine, the top 10 injuries for dancers include:

Neck strain, Rotator Cuff Tendonitis and Impingement, Lower-Back Strain and Muscle Spasms, Snapping Hip Syndrome, Patellofemoral Pain Syndrome, Meniscus Knee Tear, Posterior Tibial Tendonitis, Achilles Tendonitis, Lateral Ankle Sprain, and Posterior Ankle Impingement Syndrome.

Is there anything we can do to prevent these, generally, from happening? Anything we should know?

With dancers, I will have to say the most common injuries seen in my practice are hip and low back strains. Because of the load that is placed into these areas, they often times are vulnerable to injury. In addition, improper warm-ups and lack of bio-mechanics to the hips/back can trigger injury to these areas. A sports medicine practitioner trained in rehab/exercise can properly evaluate a dancer for bio-mechanical deficiencies and establish a treatment plan to treat and prevent these injuries.

You work with people who crave movement and their daily lives includes high-level activity. What advice do you have for people healing from an injury that takes that activity away from them?

I almost never ask an active patient to cease activity. There are many other ways to stay active, yet still allow for that certain area of the body to heal. For example, a competitive dancer recovering from achilles tendonitis will be asked to swim in order to keep their heart rate up, maintain flexibility and strength, yet minimize any exacerbation to their original injury. It can be tricky at times, but keeping the active patients "active" is important not just physically, but mentally in order to promote healing.

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Photo: Escuela Nacional Cubana de Ballet In Havana, Cuba by Bryan Jones

Fun Questions

Favorite part of your job: Teaching patients about their body and how to fix it. The term "doctor" stands for teacher. I have fun taking it to another level and enjoying the rewards that come from it. I also enjoy using my expertise and sharing it with large audiences, like I do with NBC 4 Washington. I have a health segment bi-weekly on Thursdays dedicated to covering the latest trends in physical health and sports medicine. You can watch prior segments on www.DrRaySolano.com.

Sports Medicine is important because...: It’s a specialized branch of healing. Any one that enjoys activity in their life should establish a relationship with a sports medicine doctor. If the sports medicine doctor can't help you, he/she will put you in the right direction. That's the philosophy I use in my practice with all of my patients.

What you hope to see in the future for your field: In the future, I hope to see more athletes receiving treatments from experts trained in sports medicine. This will alleviate the busy family doctor practices and hospital waiting rooms. I also hope to see more athletes aware that sports medicine practitioners are out there more than ever before ready to assist in the healing process.There are many websites now in place that make finding a sports medicine practitioner easier than ever before. In addition, Sports medicine practitioners are also waiting to connect via social media, including myself, (@DrRaySolano) for discussion on a variety of your sports medicine needs.

I want dancers to remember that their body repairs itself faster when you are connected to it. This happens when you understand how it works. Once the connection is made, it will separate you from other dancers and put you closer to achieving peak performance as a dancer.

Complete the sentence... "Sports medicine and dance...:” should dance together more often. It's a winning combination and trust me from experience, we learn just as much from dancers as dancers learn from their doctor!

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