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MagnoliaDanceMom

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Reply with quote  #1 
Hi everyone!!!

I am here looking for advice. A little bit of background: My daughter's physical activity has increased quite a bit. Since Jan 2017, her weekly dance hours increased to ~12 hours a week, from ~8 hours a week. Also, starting in August, we added some extra tumbling (2 1/2 hours instead one 1 hour). Lastly, she started middle school in August and joined the athletic program. This requires 10 mins of running a day (1 mile) among other activities (it's like an introduction to all the sports). Another important fact for this story is that she is 11 years old and has grown about 8 inches in the last year (now 5'8"). Long story short...2 weeks ago she came home from school saying her knee hurt. I figured it was growing pains. However, that night she called me from the dance studio to pick her up. It was visibly swollen. We now know that she has a dislocated knee cap (actually both are dislocated...just one is swollen...her landing leg). We immediately suspended tumbling, athletics and dance. She has been seeing a chiropractor that specializes in treating athletes. She told me it was a lot of activity on joints were trying to keep up with all the growth. She is miserable not being able to dance (not to mention she is concerned about this dance season). Here is my question: Has anyone experienced something similar and do you have any advice to share? I know it's better to rest more now than to create a more permanent injury. I just need to hear from others that are looking at a similar situation in their rearview mirror. I am also curious if this was too much for an 11 year old. She never complained and always wanted more. 

Ps. Glad we never started Pointe!! (I would be wondering if doing Pointe without enough training caused it)

Thank you in advance. I truly appreciate your honest feedback.
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Kfish1987

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Reply with quote  #2 
My 11 year old daughter snapped her knee cap out of alignment but it immediately snapped back into place. She did the while trying to put a high top shoe on without loosening the laces.

She wore a brace for 2 weeks and now is fine.

She takes 10 classes a week. 2 ballet, 1 technique, 2 tap, 1 jazz, 1 modern, 1 contemporary, 1 lyrical and hip hop. She has 1/2 hour privates for solo and duos.

She also has 2 hours of cheer practice through the middle school and weekly aerial lessons.

She also does 2 mile runs once a week along with other PE activities.
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tappinmom

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I am a former dancer.  The first time I dislocated my knee I was 8.  After that I had 6 more dislocations between 12 and 18.  Each time I didn't listen to the Dr., didn't get the proper treatment and kept dancing.  When I was 25 I had to have a complete rebuild on that knee because the tendons and ligaments were so damaged it was dislocating just walking down the street.  My advice is to see an orthopedist that specializes in dancers and follow whatever they say to the letter.  Good luck.
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dancemom0987

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Reply with quote  #4 
My DD has had a lot of knee/ankle problems, and we've discovered that physical therapy works the best for her. Last year, we found a wonderful physical therapist who specializes in dancers and DD actually had a lot of fun during her PT appointments there!
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Phx115

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Outside of NY, LA, and other dance centers where do you find a physical therapist that specializes in dance? I've found a few that specialize in sports medicine, but not specifically dance.
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dancemom0987

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Reply with quote  #6 
I really have no idea how to find one that specializes in dance. DD's previous physical therapist only specialized in sports medicine, but she was pretty fat from out house. I ended up searching for physical therapists in our area and the first one I looked at happened to specialize in dancers!
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MagnoliaDanceMom

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Thank you all for your comments. My daughter's pain is now only when she put weight on that knee (before it hurt most of the day). Now we are just trying to figure out the best time to begin dance again. Slowly. Torn between starting this week with a little bit each day (no leaps/tumbling) or just give it a third week of no activity. Any experience with that? What worked? What didn't? I know every case is different.

Kfish1987 - You have given me hope. Was she off all activity during the two weeks? How did she start back up?

tappinmom - Thank you for sharing. I read that without the proper healing the nerves can be damaged so pain stops which people incorrectly take as an indication that it healed. 

dancemom0987 - How long did she do PT? How before she was back at dance? Does she have any preventive treatments or just when it hurts?

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Kfish1987

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She was completely off all activity. I even left work to drive her to and from school. (I work 15 minutes from my house). She did her leg strengthening exercises and stretches the doctor recommended

The first week back, she wore the brace for running. She put on th brace when she did sideline cheer at Middle School Night at the high school. But felt that she did not need her brace for dance.

She carries her brace around with her but has not needed it for the last 2 weeks. She keeps doing the knee exercises every night.
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tappinmom

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Quote:
Originally Posted by MagnoliaDanceMom
Thank you all for your comments. My daughter's pain is now only when she put weight on that knee (before it hurt most of the day). Now we are just trying to figure out the best time to begin dance again. Slowly. Torn between starting this week with a little bit each day (no leaps/tumbling) or just give it a third week of no activity. Any experience with that? What worked? What didn't? I know every case is different.

Kfish1987 - You have given me hope. Was she off all activity during the two weeks? How did she start back up?

tappinmom - Thank you for sharing. I read that without the proper healing the nerves can be damaged so pain stops which people incorrectly take as an indication that it healed. 

dancemom0987 - How long did she do PT? How before she was back at dance? Does she have any preventive treatments or just when it hurts?



The biggest problem, according to my orthopedist who specializes in knee replacement and reconstruction, is that the tendons and ligaments are elastic and everytime they are stretched out of place they lose some elasticity.  The first time they are weakened and when you don't allow them to heal fully they stay weakened which causes a second injury which stretches those tendons and ligaments even more.  In my case it happened so many times that the tendons and ligaments never snapped back and so I had no stability in the patella femoral joint.  Depending on where the knee cap is pressing and where the stretched tendons and ligaments are lying within the knee that can cause some nerve compression as well.
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Sprmom2679

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PLEASE READ:  Let me tell you my daughters story this year and hopefully this provides you with the hindsight view you are looking for.  My daughter dislocated her patella in January.  We did go to the orthopaedist and had an MRI.  She was placed in a straight leg brace 6 weeks.  Those ligaments and tendons that stretched out during the dislocation need to recover and heal.  This is the only way to lessen the possibility of future dislocations. After 6 weeks the brace came off and we did PT for another 6 weeks.  During these 6 weeks, she was only allowed to do some minimal stuff, no dancing, both feet on the ground at all times.  After those 6 weeks, she went back to dance slowly and she continued to have issues, pain, and periodic swelling, we could even feel what we thought were fluid pockets floating around.  We went back to the ortho 4 weeks later and they did another MRI which just showed some swelling and fluid in the knee.  The ortho was going to cut off activity for another 6 weeks, however, he decided to take an x-ray to watch it every other week while it healed.  This x-ray revealed a cartilage/bone sliver that was 2" long broken off and floating around.  This sliver was NOT seen on TWO MRI's (it was literally a sliver) and was the culprit of the continued damage inside of her knee.  She ended up having to have surgery in May to remove the fragment and while they were in there they saw all of the damage this sliver had caused and they had to remove more cartilage that had not healed properly and drill small holes into her femur to prompt new cartilage growth.  

After surgery, she was non-weight bearing for 6 weeks (no walking at all), then was in another brace for another 6 weeks, then no brace for another 6 weeks, and finally just returned to dance.  Not only did she have the knee injury, but she subsequently had major muscle atrophy, decreased stamina, and loss of strength overall.  She has had 60 PT visits this year already and does Pilates to help get her strength back.

The moral of this story is please don't mess around with your daughter's knee, it could turn into a major issue if you don't take care of it now.  She will survive if she misses a season.  She needs her knee for life, not just childhood.  Take her to the orthopedic and insist they do an MRI and an x-ray.  They will most likely tell you, no dance for 3 months.  After she is released or starts PT, find a PT that specializes in sports medicine.  A Pilates instructor who specializes in dancers would be great, but many of them used to dance and those are good too.  She will need to strengthen the muscles around her knee to help keep it tracking properly and in place and reduce the risk of future dislocations.

Not trying to sound dooms dayish but it really is very important that you seek proper medical care and take care of her knee with longevity in mind.  
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Sprmom2679

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Reply with quote  #11 
And to add to the long previous post, if it helps.  We started with just ballet in August and have slowly added back in more classes.  She has done choreo for comps but we did ask for no leaps or knee drops in her dances unless they were added later.  She just tried a leaps/turns class last week as the first one since her surgery in May.  
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5678StarMom

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Reply with quote  #12 
What a long ordeal Sprmom. Glad to hear that she's finally recovering. That's a long time dealing with it!

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tappinmom

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Reply with quote  #13 
Adding on to Sprmom2679's post.  I had my reconstruction at 25.  It was major surgery with a foot long scar down the front of my leg.  I was in hospital for over a week, hip to ankle cast and no weight bearing for 6 weeks and then months of physio.  Here I am 22 years later and that knee is arthritic and causes issues for me every day.  I will eventually need a total replacement and all because I didn't follow Dr's orders on my 1st or 2nd or 3rd dislocation.
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MagnoliaDanceMom

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Reply with quote  #14 
Thank you Sprmom2679 for sharing your daughter's story. Glad to hear she is gradually getting back to dance. We have been off dance for 3 weeks now. We saw an orthopedic surgeon last week and he diagnosed a rupture of the patella tendon. We have an MRI scheduled for this week to confirm and determine severity. He thinks it's minor. We also begin physical therapy tomorrow four times a week for an initial six weeks. My daughter is hopeful she will be back at full swing this dance competition season (Jan), but I am not as hopeful. My heart aches for her...but I don't think she will be ready. I also don't think they will let her start that quickly. We will know more in the upcoming days.




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PasDeChatMom

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Reply with quote  #15 
Quote:
Originally Posted by Phx115
Outside of NY, LA, and other dance centers where do you find a physical therapist that specializes in dance? I've found a few that specialize in sports medicine, but not specifically dance.


Call the closest professional ballet company and ask who they recommend to their dancers and students if there is a school attached.
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AusDM

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Reply with quote  #16 
My then 12yr daughter suffered from Osgood-Schlatter in her knees because of a growth spurt and was off dancing for nearly 2 months.  Thankfully some of it fell over the Easter school holidays but it was still a tough time with initial rest and then a lot of physiotherapy to rebuild the strength.  She eventually made it back to class but doing the exercises in pain wasn't fun to watch, but a necessity all the same.

She's now 14 and has recently recovered from a dislocated shoulder, and another 2.5 months off dance, so we're definitely getting used to lessons in patience.
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MagnoliaDanceMom

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Reply with quote  #17 
AusDm,

I am now just seeing your post. Thank you for sharing your story. I am convinced this is what my daughter has as she has grown over a foot in the last couple years. Her Orthopedic surgeon just calls it Patellar Tendonitis. He did say the rapid growth was the root cause. My daughter stopped dancing on October 25th and has not been able to resume dance or any other activity (PE, tumbling) at this point. We are hoping to be able to go back to dance in January but the inflation and pain still remain (even after almost 6 weeks of rest). We started physical therapy on November 13th and made great progress over the thanksgiving break (pain was almost gone). Unfortunately as soon as school started back up the pain and inflammation got worse. They removed the lockers this year and kids carry their backpacks from class to class. Her's must weigh about 40 lbs. I am meeting with the school Monday to see what accommodation they can do. See if that helps some. She also got a lot more ice during the holidays (its hard to get a much when she is at school all day). The nurse offered to start giving her ice and elevate her legs during the PE class. I am hoping that will also help.


What worked for your daughter? How long had she been pain free when she started dance? How gradual did you start? Did she have any episodes after? I would love to hear all the details from you. 


I hear you on patience. He competition season starts in January and she will have A LOT of catching up to do. I am sure she will have to start gradually but don't know how gradually. 


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prancer

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Reply with quote  #18 
I would ask your doc, but if it is osgood schlaters (you would likely see an inflamed bump under the knee cap) the bands athletes wear just below their knees helped both my kids reduce pain.
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Momof3

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Reply with quote  #19 
Quote:
Originally Posted by prancer
I would ask your doc, but if it is osgood schlaters (you would likely see an inflamed bump under the knee cap) the bands athletes wear just below their knees helped both my kids reduce pain.


DD13 suffers from mild Osgood Schlatters, and she also finds some relief from the patella bands.
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