Non-extension of the vertebral arch is also a congenital anomaly of the development of the vertebrae, consisting in various forms of its non-closure. Most often, ballet dancers have non-closure of the V lumbar and I sacral vertebrae.
Clinically, this form proceeds as a secondary lumbosacral pain syndrome. The pains appear after supports, a long rehearsal or a large load in the performance and are localized in the region V or I of the sacral vertebrae, and a frequent relapse of these pains is characteristic. X-ray examination clarifies the location and size of the non-closure of the vertebra.
Congenital malformations of the spinal column are a manifestation of dysplastic syndrome of the development of the body. As a result of functional and anatomical insufficiency of the vertebrae under the influence of heavy everyday physical exertion, chronic overstrain of tissues, chronic microtraumas, painful phenomena develop in one or another section of the spinal column. In the future, degenerative changes in the intervertebral discs develop, causing secondary radicular pain. They bring the ballet dancer to the doctor. After a thorough examination and a collected history, one or another type of anomaly of the development of the spinal column is established.
Despite the large number and difference of abnormalities, the treatment is mainly symptomatic, aimed at unloading the spinal column and relieving pain. The complex of rehabilitation treatment includes unloading the spinal column by wearing a weightlifter belt, a semi-rigid corset of the Leningrad type, or a fixing belt of corset-rubber fabric. After examination by a neurologist, treatment is prescribed taking into account the existing neurological disorders: B vitamins in injections, injections of the vitreous body or rumalon, massage of the muscles of the lumbar, a set of therapeutic exercises to strengthen the muscles of the back and abdomen, warm baths – sea, coniferous, sulfide or radioactive.
The complex of rehabilitation treatment includes physiotherapeutic procedures – electrophoresis with novocaine, diadynamic currents, phonophoresis with corticosteroid drugs. The entire complex is repeated 2 times a year, and in summer they recommend spa treatment at balneological and mud resorts.
With similar dysplastic manifestations in the spinal column, ballet dancers noted weakness of the muscles of the back and abdomen. Therefore, they recommend a constant set of exercises to strengthen the muscles of the abdomen and back.
In the prevention of pain in the lumbar spine due to dysplastic syndrome, an important role should be given to strict medical selection of children in the choreographic school, as experience has shown that signs of dysplasia of the spinal column and its deformation (scoliosis, kyphosis) are absolute contraindications to admission.
Osteochondrosis and deforming spondylosis
Osteochondrosis is a degenerative disease of the spinal column, leading to a violation of the function and structure of the vertebral bodies and intervertebral discs. Pathological changes are a violation of the fibrous ring of the intervertebral disc. It changes the metabolism, the elasticity of the disc is lost. Factors contributing to the development of osteochondrosis in ballet dancers are early professional exertion, when the body has not yet completed growth and formation, early support in boys, chronic overload and microtrauma of the spinal column, dysplastic changes (congenital anomalies).
Clinically, osteochondrosis in ballet dancers manifests itself much earlier than in people of other professions – at the age of 25 years and older. But in recent years, osteochondrosis of the spinal column began to be observed at an even earlier age — 10-15 years. This is facilitated by congenital dysplastic changes in the intervertebral discs.
Cervical osteochondrosis often occurs with increased load on this spine. The dancers are dominated by high jumps, support, rotation in the air, and the ballerinas have a large amount of movement and postures associated with turning and tilting the head.
Cervical osteochondrosis is accompanied by pain in the cervical spine, which extends to the occipital region, shoulder girdle, shoulder blade, numbness of the fingers often occurs. In the initial stage, cervical osteochondrosis occurs without neurological symptoms. In advanced cases, paresthesia in the upper extremities, tension of the occipital muscles, pain in the supraclavicular region due to damage to the roots of the cervical nerve plexus, hyposthesia on the outer surface of the shoulder joint and hand are noted. When moving the head in the cervical spine, a pronounced crunch may be noted. X-ray narrowing of the intervertebral spaces, sclerosis of the subchondral zones and in some places bone growths of the edges of the vertebrae in the form of spikes.
Treatment of cervical osteochondrosis begins after a patient is examined by a neurologist who identifies the degree of neurological disorders. An unloading head holder made of foamed polyethylene for severe neurological disorders, massage of the collar zone and neck, therapeutic exercises, stretching on a chair with Glissoia loop, injections of B vitamins, vitreous or rumaloia, physiotherapeutic procedures, and later spa treatment are prescribed.