Clinically, with lumbar osteochondrosis, there is a secondary pain syndrome in the lower lumbar region, muscle tension in the lumbar region in the form of rollers. Movement in the spinal column is somewhat difficult when tilting posteriorly, but may not be limited. Radiologically, you can see a narrowing of the intervertebral spaces, sclerosis of the subchondral plates, sometimes the phenomenon of dysplasia of the lumbar vertebrae. Bone growths along the articular edges of the vertebrae indicate the transition of osteochondrosis to deforming spondylosis. Lumbar osteochondrosis with signs of deforming spondylosis often occurs with neurological symptoms.
The patient complains of pain in the lower lumbar region with radiation to the sacral region, scrotum, gluteal region or along the back surface of one of the lower extremities. On examination, an analgesic posture (torso towards the pain syndrome), tension of the lumbar muscles in the form of ridges is noted. Neurological examination shows hyposthesia in the innervation zone of the root of the I sacral vertebra, a decrease in the Achilles reflex on one side or the other, and a positive symptom of muscle tension (Laseg symptom).
Treatment of lumbosacral osteochondrosis consists in unloading the spinal column using a weightlifter belt or a semi-rigid corset of the Leningrad type, stretching on the bed with a belt for the pelvic section with a load of up to 3 kg. You can apply vertical traction in the pool with a gradual increase in load up to 12 kg. Stretching is combined with the obligatory wearing of a corset. Massage is prescribed for the lumbar, physiotherapeutic procedures – electrophoresis with novocaine, diadynamic currents, paraffin-ozocerite applications for tense muscles, injections of B vitamins, vitreous or rumalon.
In acute pain, manual therapy is often used , consisting in the reduction of a restrained or precipitated intervertebral disc. A preliminary comprehensive examination of the patient is carried out. Without examination, manual therapy is contraindicated.
Traumatic shoulder dislocation
Damage to the upper limb is observed mainly in dancers and is not typical for dancers. The most possible injuries for dancers are dislocations and habitual dislocations of the shoulder, tearing of the tendon of the long head of the biceps of the shoulder.
Traumatic dislocation of the shoulder . Dislocations in ballet dancers are less common than other injuries due to the good development of the muscles and the ligament-ligament apparatus of the upper limb. Dislocations occur during a fall on the shoulder or outstretched arm, less often when lifting a partner. More often dislocations occur in the shoulder joint, less often in the elbow.
The diagnosis of dislocation of the head of the humerus is not difficult, since immediately after the injury there is pain and deformation of the shoulder joint visible on the eye, limiting movements in it. Despite this, an x-ray should be taken both to determine the type of dislocation and to exclude a concomitant fracture of the humerus. Attempts to correct a shoulder dislocation without a preliminary x-ray should not be allowed, as serious consequences can occur. Dislocations can be lower when the head of the shoulder descends into the armpit, front, when the head is dislocated anteriorly, rear when the head of the shoulder is behind the collarbone, it is extremely rare to have an upper dislocation.
The treatment of the primary traumatic dislocation of the shoulder consists in repositioning the dislocation under local anesthesia, and with well-developed muscles, under anesthesia. The reduction is carried out by gradually relaxing the muscles, traction of the limb along the length while rotating it outward. After reposition, a plaster cast is applied, a bandage with fixation from a healthy shoulder blade, a diseased limb and forearm for 3-4 weeks. After removing the bandage, a complex of rehabilitation treatment is carried out, aimed at strengthening the muscles of the shoulder girdle to prevent relapse.