Marika Molnar, Physical Therapist , Inc.

Dancers commonly suffer from low back pain. This is often associated with the extreme lumbar extension range of motion and prolonged lordotic postures required by some dance forms. There is ample literature documenting extension-related instabilities such as spondylolisthesis in dancers. The aim of this article is to review the changes in motor control that occur in patients with subtle clinical instability and recurrent low back pain. Recent studies have consistently demonstrated changes in neuromuscular function in patients with back pain, and spinal stability retraining has become a popular component of treatment. However, most research to date has focused on maintenance of neutral spinal postures during assessment and treatment, whereas dancers must be trained to move with control through full lumbar extension range of motion.

Minor leg length discrepancies may not pose much of a problem in the general population, but in the dance population they should not be overlooked as a predisposing factor in overuse syndromes commonly found among dancers. The popular treatment of prescribing lift therapy is often inappropriate in this population as the patient may not wear a shoe during dance or may refuse a lift in their shoe as it interferes with the 'feel' of the floor. The key to successful treatment in the dancer is a thorough biomechanical evaluation and analysis of compensatory mechanisms. In this article, clinical evaluation of leg length discrepancy, common compensatory mechanisms, and clinical management in the dancer are discussed. An illustrative case study is presented to highlight some of the points made.