Case studies in cervicothoracic spine function evaluation and treatment of two dancers with mechanical neck pain.

It has been reported that manual therapy directed at the thoracic spine followed by exercise may improve outcomes in patients with mechanical neck pain. At this point, there is little available data on dancers with neck pain, and it is unclear whether this type of treatment is appropriate for restoring the rigorous level of activity required of the dancer. The purpose of this study was to review the evaluation, clinical decision-making process, and treatment of two dancers-one with acute and the other with chronic neck pain-who fell into the classification of patients who might benefit from an intervention to the thoracic spine. The two participants were a musical theater dancer with an acute onset of neck pain and a retired dancer who was an active dance company director with an 11-year history of chronic neck pain. Both participants went through a standard examination and were treated with mobilizations to the upper thoracic spine followed by therapeutic exercises. In both cases, successful outcomes were achieved immediately after treatment and up to six months after discharge from physical therapy.

Functional criteria for assessing pointe-readiness.

The most popular criterion cited in the dance literature for advancement to pointe work is attainment of the chronological age of 12 years. However, dancers at this age vary greatly in terms of musculoskeletal maturity and motor skill development. The purpose of this study was to investigate whether objective, functional tests could be used in conjunction with dance teacher expertise to determine pointe-readiness. It was hypothesized that dynamic tests of motor control can better indicate pointe-readiness than chronological age alone or in combination with static musculoskeletal measurements. Thirty-seven pre-pointe students from two professional ballet schools were tested for muscular strength, ankle joint range of motion, single leg standing balance, dynamic alignment, and turning skill. In addition, the participating students' ballet teachers independently graded each student on her readiness to begin dancing en pointe. Performance on three functional tests (the Airplane test, Sauté test, and Topple test) was closely associated with teacher subjective rating for pointe-readiness. It is concluded that these tests may be more useful for gauging acquisition of the skills required for safe and successful performance than the traditionally accepted indicators of chronological age, years of dance training, and ankle joint range of motion.