9 August
2004 12:00:00 EST
Redefining
Orthopedics: Recognizing the Importance of a Mechanical Ideal for
Injury Prevention and Performance
Stephen M.
Apatow, Director of Research and Development,
Sports Medicine & Science Institute
Classical ballet is recognized as the most advanced technical movement
mechanics training in the world, providing a foundation for the
development of joint strength, postural alignment and precision control
of the human frame in space. As one refers to the mechanical ideal of
this development program, we are provided a reference point for the
most balanced, non stressed articular relationship(s) that provides a
diagnostic and therapeutic tool to assist the analysis of joint stress
and mechanism of injury.
The Sports Medicine and Science Institute is pursuing research and
development associated with the classical ballet based mechanical
ideal, with emphasis on direct applications of this science for the
medical community, allied health profession and fitness industry.
Sports
Medicine, Exercise Physiology and the Science of Classical Ballet
Training
During the early eighties, my career path with sports medicine
encompassed a focus on non-drug/surgically related therapeutic
approaches to the prevention and treatment of joint injuries. It
was not until my sabbatical in 1984, to pursue international
competition in two sports, that the importance of postural alignment
and classical ballet training proved to be a foundational reference
point.
During my study of classical ballet, [1] as a student and scholar, my
emphasis on myology, anthrology, osteology, neurology, exercise
physiology and biomechanics provided a unique perspective for analysis
of the first through eighth year syllabus of the Vagonova training
method. This research, accomplished through a scholarship from
the Nutmeg Conservatory for the Arts, provided the foundation for:
- the
analysis of a joint complex (spine and extremity) by comparison to the
classical ballet mechanical ideal;
- tools
to assist with the differentiation of normal vs. abnormal tension
relations associated with postural deviations and articular
malposition, as well as the proprioceptive repercussions.
- the
development of corrective procedures to address both hypertonicity and
hypersensitivity of affected structures on the muscle-tendon level;
- pathways
to increase joint range of motion and flexibility to enable the
execution of correct classical ballet alignment.
In 1990, this work contributed to the development of a specialized
program for elite dancer, Cheryl Madeux, during a preparation period
for the Lausanne International Ballet Competition. [2] This case
presented the following findings:
- Soft
tissue level restrictions, not addressed in early developmental stages
of training, resulted in articular stabilization and compensatory
changes that limited the capacity of this dancer to reach her technical
potential. When a dancer is not a
product of a selection process, as observed in Eastern Bloc development
programs, specific attention must be made to address functional
limitations. [3]
- Articular
soft tissue level restrictions provided a door of opportunity to
increase overall flexibility (especially in the hip and shoulder
complexes), even after a decade of training, yielding an immediate
increase in functional range of motion.
- Integration
of this range of motion into classical ballet based retraining yielded
a rapid progression to the next technical level, an accomplishment not
considered attainable through the classical ballet program alone.
Nutmeg
Alumni: Cheryl Madeux (1990) became the only American finalist at
the Prix de Lausanne and later became "Presidential Scholar" of Arts
Recognition & Talent Search. Miss Madeux later joined the Joffrey
Ballet and has been principal ballerina for the Hartford Ballet. She
now dances with American Ballet Theatre. [4]
The Madeux case served as a starting point for the integration of this
work into all levels of the international program at Nutmeg
Ballet. In the early 90's, this work was expanded into
applications for athletes in Olympic and sports development programs,
and at the request of the medical community, orthopedic applications
that included entrapment neuropathies, asthma, [5] fibromyalgia, [6]
Friedreich Ataxia, [7] multiple sclerosis, [8] rheumatoid arthritis,
[9] scoliosis, [10] and veterinary cases (canine, equine). [11]
The Sports
Medicine & Science Institute offers a continuing education course
entitled “Optimization of
Classical
Ballet and Sports Development Programs”
and is in the process of developing a Biomechanics Specialist
Certification. This program would encompass certification
levels ranging from a Level I program for physical therapists, exercise
physiologists and fitness professionals to Level II program for medical
professionals (Physicians: D.C., D.O., M.D.). A Level II
certification course would also be developed for veterinary medicine.
[12]
References:
1. Performance Optimization: Progressing to the Next Level in Classical
Ballet and Olympic Development Program, Apatow, Stephen M., Sports
Medicine & Science Institute. http://www.esportsmedicine.org/optimization.html
2. Regimen Changes Body, Register Citizen, Torrington, Connecticut.
http://www.esportsmedicine.org/rcb.html
3. Why Eastern Bloc Countries Dominated the Gymnastics Field in Sydney
International Society of Biomechanics in Sports, Stephen M. Apatow,
Biomechanics Specialist & Technical Consultant. http://www.coachesinfo.com/article/?id=64
4. Nutmeg Ballet Graduates, http://www.nutmegballet.org/graduats.html
5. Asthma, Apatow, Stephen M., Sports Medicine & Science Institute.
http://www.esportsmedicine.org/asthma.html
6. Fibromyalgia, Apatow, Stephen M., Sports Medicine &
Science Institute. http://www.esportsmedicine.org/fibromyalgia.html
7. Friedreich Ataxia, Apatow, Stephen M., Sports Medicine & Science
Institute. http://www.esportsmedicine.org/ataxia.html
8. Multiple Sclerosis, Apatow, Stephen M., Sports Medicine &
Science Institute. http://www.esportsmedicine.org/ms.html
9. Rheumatoid Arthritis, Apatow, Stephen M., Sports Medicine &
Science Institute. http://www.esportsmedicine.org/rheumatoid.html
10. Scoliosis, Apatow, Stephen M., Sports Medicine & Science
Institute. http://www.esportsmedicine.org/scoliosis.html
11. Expanding Human to Veterinary Biomechanics Applications, Apatow
Stephen M., Sports Medicine & Science Institute. http://www.esportsmedicine.org/equestrian/veterinary/biovet.html
12. Optimization
of
Classical
Ballet and Sports Development Programs, Sports
Medicine & Science Institute. http://www.esportsmedicine.org/healthpromotion.html
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