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prancer

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Dd was cleared to dance full out by a sports medicine physician with dance knowledge. But her hamstring still hurts. The doctor basically acknowledged it will hurt, but he didn't think dancing would impair it more. Anyone been to this point with an injury? Just go ahead and train if you are willing to accept the discomfort?
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Becca

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Reply with quote  #2 
Is she seeing a good PT? Coming off an injury a good PT is absolutely a must, hopefully someone who understands dance but if not at least someone your daughter feels very comfortable with. Pain is different from sore and a PT should be able to talk to your dancer about different pain sensations (tearing, throbbing, stabbing) and let your DD know which ones mean to stop. Discomfort and soreness going back to dance after anytime off but especially an injury is to be expected but she needs to be taught what are the warning signs that she is doing too much. 
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JulieDB

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Agree with Becca. I'm a former dancer and my teacher had us dance through the pain. I can tell you from experience that this is a very bad thing to do. I have some permanent damage as an adult that I may not have had or may not have had as badly had I not ignored the pain. Pain is there for a reason.
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dave9988

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Dancers frequently push through pain, but as Becca and JulieDB have pointed out, they must know which pain is "OK" to push through vs what is not.  From what you are describing, I would not be comfortable letting my DD push through.  I'm no doctor, and I do not know your DD's diagnosis, but for my 2 cents hamstrings do not normally "hurt" unless something is wrong.  Soreness from use, sure, but ... not pain.

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tendumom

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Reply with quote  #5 
The post title alone made me cringe. I've seen some injuries get much worse when a dancer danced through the pain, such as stress fractures that became more serious fractures. Offhand, I can think of 2 dancers who did this. One eventually recovered, the other had a career ending issue. 

I suppose in your dd's situation, is the hamstring just tight and she has become sensitive to the status of her hamstrings. If that is the case, she needs someone who can teach her how to stretch and release them appropriately. A PT who deals with dancers is often a good choice. Anyone who does dance rehab would also be able to guide her better. 
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prancer

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Reply with quote  #6 
You are all making great points, and this is where I feel stuck. The sports medicine doctor cleared her. She has been through 3 sets of PT. He said no more PT needed.

She is very sensitive to physical concerns, but doesn't read them well, e.g. She still complains that her stomach hurts, I ask if she is hungry, and then she figures out that is why her stomach hurts. She really should know what hungry feels like at 13.

So, I don't really trust her to know the difference between bad pain and sore. I try to help her tell the difference and she says that when her hamstring hurts it always feels the same. It just hurts. She is anxious and frustrated, so this makes figuring out her situation difficult.

I will take her back for another round of PT, and ask them to help her identify the difference in the types of pains. It's worth a try.
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Noel

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Reply with quote  #7 
Speaking as both a dance mom and a PT myself this question really needs to be answered face to face with a lot of detail and intricacies and the benefit of eyes on and hands on back and forth. What I wanted to contribute was to ask if she has had good manual physical therapy; work that involved mobilizing all of the soft tissue and fascia, directly in the painful area and surrounding; has she had the actual joints in the surrounding area assessed to be sure that there are no capsular restrictions (particularly in the hip) as a result of the injury and necessary time off? Lastly, has she received a comprehensive functional screening for stability and timing to be sure that (while her MD cleared her) she is in fact return to sport ready? If not, all of those things, in my experience, are vitally important.
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prancer

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Reply with quote  #8 
Thanks Noel. I really do appreciate the feedback. Yes to manual PT and yes to free joints. The PT cleared her as did the doctor. Moves at the end of the range of motion are the moves that hurt. She is not as flexible as she once was on that side. I am going to go back to PT and recontact the MD. The MD did not do an MRI or ultrasound and perhaps we could follow up. She likes the hands on PT, so at least that feels good.

All her teachers have told her once you pull the hamstring it is never as good as it once was. Every single one of them has said so, so that is a little hard to hear.

My daughter is nearly done growing now, so at least that extra strain on the tendons from stretching because of growth is almost over. She may just have to get her mind around accepting some limitations for the time being, but that is hard with competition season ramping up.
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tappinmom

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Back when I was dancing (in the stone age) it was very common to "dance through it".  I can tell you with a real injury that is not a good idea.  I danced through it on many patellar dislocations.  I have had 14 knee surgeries including a knee reconstruction at 25 and am looking at knee replacements long before they are recommended.  Make sure that the pain she is describing is not "real pain" before she does permanent damage.
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Noel

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Reply with quote  #10 
Prancer please know that I am relatively very new to this site, so forgive me if I am repeating information that has already been widely discussed, but look up dynamic vs. static flexibility. I often find that how many studios approach flexibility vs. what recent science supports do not mesh. I wholeheartedly disagree that you are never the same. Your daughter's end range is not the same as anyone else and her pain at end range indicates a limitation. Perhaps this limitation cannot be addressed with manual therapy, perhaps it is best (and most safely) addressed through her own dynamic flexibility training. But... pain at end range would not get a seal of approval from me as the PT to return unlimited to sport. Stiffness, soreness, feeling resistance or feeling that it is not exactly as it once was yes, but pain at end range for a dancer who frequently works in the end range indicates that there is still healing yet to complete. I'd proceed with great caution.
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prancer

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Reply with quote  #11 
Thanks Noel. That sounds right to me about not having pain at end range for a dancer. I will push the issue some more and remind her to go easy. Her studio does dynamic flexibility and that is how she has been approaching rehab.

I think she feels stuck because comp, audition and performance season are coming.
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JulieDB

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Quote:
Originally Posted by tappinmom
Back when I was dancing (in the stone age) it was very common to "dance through it".  I can tell you with a real injury that is not a good idea.  I danced through it on many patellar dislocations.  I have had 14 knee surgeries including a knee reconstruction at 25 and am looking at knee replacements long before they are recommended.  Make sure that the pain she is describing is not "real pain" before she does permanent damage.


Oh boy, me too! Didn't discover until I was an adult what the real reason for the bad knee was. I have so much scar tissue now behind the knee cap, the Dr. said surgery probably wouldn't help because it would only create more scar tissue. Granted this was some years ago and the surgery now is likely different. I used to just get over the initial pain, wrap it then keep on going. 
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dave9988

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Quote:
Originally Posted by prancer
All her teachers have told her once you pull the hamstring it is never as good as it once was. Every single one of them has said so, so that is a little hard to hear.

My daughter is nearly done growing now, so at least that extra strain on the tendons from stretching because of growth is almost over. She may just have to get her mind around accepting some limitations for the time being, but that is hard with competition season ramping up.


My gut tells me she'll get some flexibility back now that she's not growing as much.  And if tightness contributed to her problems, that should help her moving forward.  Unfortunately, not overnight.
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DanceMomLaura

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Reply with quote  #14 
My daughter has been dancing through pain simply to finish out her season.  She has had hip pain for a couple years now ... started off mild, now its "career" ending.  In June, after recital, she will be done.    It doesn't necessarily hurt when she's dancing ... it's after.  Our first comp was this past weekend and she was very sore last night. 

She's only dancing through to finish out the year.  She was told that she could, although ideally the doctors would like her to cut back hours.  That just isn't possible right now.
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ballerinamom13

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Reply with quote  #15 
DD rolled her ankle in the second or third Nut this year. Not only did she do all 4 roles with a 3rd degree (severe) high sprain for 17 or 18 more shows, she never took time off and performed in 9 performances of Swan Lake, which has a brutal Corps.  She did have constant PT and was cleared to dance but she was in so much pain.  Although sometimes the PT was worse than the sprain.  Every kid is different, so I don't really have any advice other than to listen to your gut.  I think dd was crazy, but she was 21 (22 now) and I'm 1000 miles away. If I had been there, I would have tied her up and kept her at home.... IMG_6098.JPG  This photo shows the bruising after a PT scraping.  
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4boysmom

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Reply with quote  #16 
My DS recently strained ligaments in his lower back, and is receiving PT. He has been told that he can dance but to stop immediately, rest and heat if he feels pain. At this point almost everything hurts so he is mostly sitting and watching. His competition studio SO is urging him to dance, which I feel is unprofessional. We have competition in 3 weeks and if he is to compete then, he needs to rest now.
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tappinmom

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Reply with quote  #17 
Quote:
Originally Posted by JulieDB


Oh boy, me too! Didn't discover until I was an adult what the real reason for the bad knee was. I have so much scar tissue now behind the knee cap, the Dr. said surgery probably wouldn't help because it would only create more scar tissue. Granted this was some years ago and the surgery now is likely different. I used to just get over the initial pain, wrap it then keep on going. 


My issue was that I had 6 total dislocations from 8 through 16 and I never let any of them heal properly.  At 25 my tendons and ligaments were so stretched out that they couldn't support my knee.  They had to reconstruct the whole thing.  They also had to remove most of my cartilage since it was so damaged.  It was a brutal surgery but my knee has not given out since then.  The pain however never went away.  Now I have osteo and are essentially bone on bone in that knee.  Knee replacement coming soon.
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Rushhourmom

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Reply with quote  #18 
Quote:
Originally Posted by prancer
She is very sensitive to physical concerns, but doesn't read them well, e.g. She still complains that her stomach hurts, I ask if she is hungry, and then she figures out that is why her stomach hurts. She really should know what hungry feels like at 13.

So, I don't really trust her to know the difference between bad pain and sore. I try to help her tell the difference and she says that when her hamstring hurts it always feels the same. It just hurts. She is anxious and frustrated, so this makes figuring out her situation difficult.


Oh man I feel your pain (har har). My kiddo is the exact same way and I frequently wonder why she can't differentiate these sensations. Especially being involved in dance where she's really required to feel tiny corrections in form and technique. But she can't tell hunger from pain or injury from tightness? It's hard to parent that!

Our sports medicine doc has been great with teaching her what different pain sensations are being caused by and what is normal and what should be a red flag. We dealt with psoas pain that, as a mom, I was apprehensive about telling her to push past because I know that real injury to that area can create a lifetime of issues. He could immediately tell what was injury and needed resting and what was just tightness and needed the exact opposite. Giving ME permission to encourage her to stretch through the tightness (that she was calling pain) was so helpful to me as the parent. Without that guidance she would probably still be icing and resting an increasingly tight psoas. Instead she was able to release the area pretty quickly and is pain free.

All of that to say I really do empathize with your part in this as the parent of a not very physically in touch kid. And I don't think it's so easy as "all pain should be avoided. Never dance if you feel pain". There definitely are a few conditions where it simply will not make it worse to dance on it and if your dancer can tolerate it, there's no harm in doing so. And plenty more where dancing will help work through the issue. It really comes down to finding good doctors or PTs or chiropractors or whoever that know a dancer's body and can really work with both you and her to learn how to best confront the issue.
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Ktyyyyyyy

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Reply with quote  #19 
My dd pulled her hamstring a couple of years ago and she danced through it, but also modified her movement when necessary. She was very careful with anything that stretched the hamstring for a long time. There's a fine line between sore and painful. Dancing through the pain can definitely make the injury worse.

My dd does dance through pain on a regular basis though because she has juvenile rheumatoid arthritis that affects one of her knees. This is different than an injury though. While dancing is painful, the arthritis would be there regardless. The only reason dancing hurts more than just walking around is because the movements are more extreme. In this case, dd chooses to just dance through the pain. She sees a rheumatologist regularly and has been told that dancing won't make it worse.
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prancer

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Reply with quote  #20 
Thanks Rushhourmom.  We have another PT appointment, and part of my goal is to have the PT help her determine the difference between uncomfortable and pain.  

In the mean time Ktyyyyyy, she is dancing again with some modified movements.  Her Sports Medicine doctor said the issue was all soft tissue and that she wasn't going to make it worse at this point by dancing.  He told her it was pain tolerance  -  but I'm still a little cautious of that, so we are headed to more PT.  The sports medicine doctor could feel some scar tissue on the muscle, but he could also feel that everything is intact and strong.  I just suspect it will be a while before that scar tissue remodels in a way that is more suited to dance.  

and ballerinamom13 - I think she might be in for the scraper to help with that scar tissue.
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dave9988

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Reply with quote  #21 
Quote:
Originally Posted by 4boysmom
My DS recently strained ligaments in his lower back, and is receiving PT. He has been told that he can dance but to stop immediately, rest and heat if he feels pain. At this point almost everything hurts so he is mostly sitting and watching. His competition studio SO is urging him to dance, which I feel is unprofessional. We have competition in 3 weeks and if he is to compete then, he needs to rest now.


Ugh, sorry to hear that for so many reasons.  I imagine the pressure on a boy is even worse than for a girl.  The bench is usually thin, few (if any) boys from which to choose a replacement.
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4boysmom

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Reply with quote  #22 
Quote:
Originally Posted by tappinmom


My issue was that I had 6 total dislocations from 8 through 16 and I never let any of them heal properly.  At 25 my tendons and ligaments were so stretched out that they couldn't support my knee.  They had to reconstruct the whole thing.  They also had to remove most of my cartilage since it was so damaged.  It was a brutal surgery but my knee has not given out since then.  The pain however never went away.  Now I have osteo and are essentially bone on bone in that knee.  Knee replacement coming soon.

I have already had two knee replacements resulting from one injury. This is why I am so adamant about adequate healing from injury. Knee replacements are not fun, but teenagers don't look that far ahead when all they want to do is dance.
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Koopahla

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Reply with quote  #23 
Noel, can you come live with us!?!
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Noel

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Reply with quote  #24 
Koopahla I'm very passionate about sharing my knowledge and helping. If you ever need to bounce a physical therapy based issue off of me please feel free.
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