Itamar Stern PT

This isn’t one of my “usual posts” of a young ballet dancer or a professional dancer working to correct, prevent or rehab an injury. This is a 50 yo ballet teacher, ex professional ballerina, who had her hip replaced 6 weeks ago after years of struggling due to hip pain and Labral repair procedures. She had a “SuperPATH” procedure that does not have mobility limitations after surgery. The patient has been fully weight bearing for a few weeks and has been working hard on ROM and strength. Today we initiated ballet specific activities with 3 movements that we will progress over time until she returns to work; Side laying forward leg lift in a turned out position, supine knee bent leg lift to the side, standing turnout on rotation disks. The first 2 are supported by me against gravity. The patient had soreness in her opposite hip (needs replaced as well) after the turnout exercise so we progressed to a single leg turnout on the disk supported by a barre. Many retired professional dancers go on to have hip replacements which is something we all should be aware of when we work on them in the early years and professional years observing over stretching in all directions and ignoring potential “red flags”. It is our hope that with good knowledge of the dancers body, dance mechanics and requirements, current and future PT’s will be able to reduce the frequency of hip replacements in these dancers. Thanks for reading this if you made it all the way here :). Surgery was performed by @joshsilvermd_ortho #dancerhipreplacement #physicaltherapy #sportsmedicine #dancemedicine #dancespecialist #dancespecifictraining #balletdancer #balletteacher #balletspecialist #hipreplacement #superpatharthroplasty #earlymobilization #hiprehabilitation #dancership #dancersareathletes #turnout #dancerstrong

One year ago today, @serafin_castro_dancer underwent reconstruction of his ACL. People describe Serafin as “superhuman”, as his physical capabilities seem to be endless. An ACL reconstruction can take down the mightiest of the mighty, the strongest of the strong. It’s a serious procedure that takes nearly a year to fully recover from. And it’s not an injury that professional ballet dancers typically deal with. There are numerous ACLR rehab “protocols” that provide therapists with a step-by-step, week-by-week guide on how to progress. Unfortunately, this doesn’t exist for ballet dancers, or really, dancers of any kind. This process took a deep understanding of ballet mechanics and technique, as well as patience, humility, and persistence for everyone involved—Serafin, his therapists, his family. There were many times that Serafin struggled to stay positive throughout his recovery, and was often questioning if he would ever be able to dance at a professional level again. Some of our sessions focused more on getting his head straight than his knee straight. But he came out of it, happy, healthy, and well on his way to dancing stronger than before. Dancers, your body is your everything. Trust it with people who know, people who listen, people who get it. #builtforballet #dancerehab #balletrehab #physicaltherapyfordancers #aclrecovery #aclreconstruction #persistence #dancestronger #kneerehab #ballet #balletaz #proud

A month ago, I had a great opportunity to speak and present a breakout session at the @orthoarizona sports medicine conference. The topic of the presentation was “Managing the unstable ankle in the hyper mobile athlete” with a focus on ballet dancers. I was fortunate to have @builtforballet join me for the breakout session and demonstrate some of her treatment techniques and @azankledoc who invited us to speak and demonstrated some ankle instability tests. Thank you to @le_endler for taking the time to be our model. I strongly feel that it is our obligation, as dance medicine specialists, to educate our peers and the interested public about the differences and the intricacies in care to these athletes, we welcome any opportunity to do that. #balletphysicaltherapy #physicaltherapy #dancemedicine #balletdancer #balletinjuries #danceinjuries #ankleinstabilitytreatment #dancersankle #anklesprain #proprioception #danceeducation #pointe #dancespecifictraining #dancespecialist #dancersareathletes #balletstrong #injurypreventions #publicspeaker #continuededucation #sportsmedicine #jointinstability

Working on regaining full control of hip and ankle movement after a prolonged period of rest due to a metatarsal stress fracture. This non weight bearing exercise combines ballet turnout with resisted ankle motion in all directions. #ballet #ballerina #turnout #hipstrength #anklestrength #proprioception #pointeshoes #balletphysicaltherapy #dancerehab #dancespecifictraining #dancespecialist #balletspecific #dancersareathletes #anklestability #manualtherapytechniques #manualresistance #physicaltherapy #rehabonpointe #balletspecialist

Following a lower extremity injury that required modified weight bearing dancers tend to “lose the connection”between the lower extremity muscles, extremely important in dance for optimal performance and injury prevention. This is a series of rhythmic stabilization exercises for dancers, emphasizing co-contraction of ankle and hip muscles in a non weight bearing position. It involves ankle stabilizers and hip rotators while in dorsiflexion, ankle stabilizers and hip abductors/adductors while in a pointed position and ankle stabilizers only with the isolated ankle exercise. All variations require a strong Quad contraction maintaining the knee in full extension. The dancer is instructed to maintain a stable position, preventing hip, knee and ankle movement against my rhythmic resistance. The speed in which the resistance is applied changes which requires fast adaptation by the dancer, preparing her for progression into weight bearing stabilization. #balletdancer #physicaltherapy #physiotherapy #dancetherapy #dancerehabilitation #dancespecialist #balletinjuries #danceinjuryprevention #rhythmicstabilization #pointeshoes #dancespecifictraining #balletspecific #dancersareathletes #injuryprevention #proprioception #cocontraction #balletspecialist #anklesprainrehab #ankleinstabilityrehabilitation #anklestrength #dancepainfree #jordan1

ACL injuries are uncommon in Ballet but happen even to some of the strongest dancers. @serafin_castro_dancer tore his ACL landing a jump and began rehab 2 days after surgery. There are special considerations to rehabilitating a dancer’s ACL: Hyper-mobility, symmetry and turnout being the main ones. At 6 weeks (now 11 weeks), Serafin is displaying full range and a good Quad contraction. In this exercise he is shifting weight on a flat foot and on releve while performing his, insta famous, grand battement. Being able to incorporate dance specific movement to a dancers ACL program is important physically and mentally. I love listening to the dancers and including some of their ideas into their programs. Serafin and @point.your.feet are very involved in this specific program design, @shuttlesystems for making so much possible for our dancers. #balletdancer #maleballetdancer #aclrecovery #aclrehabilitation #dancerACL #danceinjuries #dancespecifictraining #dancespecialist #balletspecific #closedkineticchain #openkineticchain #performingarts #physicaltherapy #dancephysicaltherapy #balletphysio #grandbattement #dancersareathletes #injuryrehab #sportsmedicine #dancemedicine #sportsrehab #balletstrong

This young and very talented dancer suffered a patellar subluxation 4 weeks ago. This is a common problem with dancers who “bite more than they can chew” turnout wise. They place their foot in an exaggerated turned out position, much greater than what their hip allows, and their knee, in plie or in landing a jump, falls inward of their foot causing the patella to be forced laterally, and in some cases dislocate. In this reel we are teaching knee control. The foot is placed on a half foam roller to monitor arch collapse and pronation, and a band is pulling the dancers knee in, forcing her to use her “turnout muscles” and maintain turn out as she performs a plie. The goal is to have the knee fall in a plumb line to the second toe (more work needed). This is performed at the dancers true, non-compensated turnout, measured during the evaluation. More to come with progression of these exercises. We are protecting the knee with tape during these exercises. #balletdancer #plie #turnout #hipmuscles #patellainstabiliity #danceinjury #danceinjuryprevention #balletinjury #physicaltherapy #dancerehabilitation #dancemedicine #dancespecialist #dancespecifictraining #balletphysicaltherapy #balletspecialist #injurypreventionfordancers #dancersareathletes #performingartsmedicine #footpronation #halffoamroller #theraband #dynamictape

A dancer with limitations into pointe position can benefit from a physical therapist supervised range of motion and strengthening program done in a safe manner, taking the dancers general and specific foot and ankle mobility into consideration. Increase in “pointe angle” can occur in a few joints in the foot and ankle and knowledge of “how much is too much” is imperative. This is an accomplished young dancer who wants to maximize her pointe range of motion. She has achieved a 5-10 degree improvement in a month of work. Strengthening of the “new ROM” is important and exercises are performed daily to maintain gains. Thank you @isabellaguinevere for letting me use your foot for this demonstration. #physicaltherapy #ballet #balletdancer #dancersareathletes #pointe #pointeshoes #pointeposition #pointeangle #mobilization #footmobilization #mobilizationintopointe #dancerrehab #dancespecifictraining #dancespecialist #balletspecialist #ankleimpingement #injuryprevention #footmobility #anklemobility #balletspecific

Ankle ligament injuries in dancers present with many rehabilitation and surgical repair challenges. Preserving ballet specific mobility while protecting against instability is a critical component. This is an early exercise we use when returning to pointe position after an ankle sprain. The goal is for the dancer to maintain pointe position through external perturbations in the direction most common for an ankle sprain. This is followed by numerous proprioceptive exercises specific to ballet positions. Special thanks to @azankledoc for his care and availability. #anklesprain #balletdancer #balletinjury #danceinjury #dancemedicine #dancerehabilitation #balletspecific #dancespecialist #proprioception #balanceboard #pointe #pointeshoes #injuryprevention #dancersareathletes #anklestability #ankleinjury #sportsmedicine #physicaltherapy #physiofordancers #danceiswhatwedo

In our practice, we treat quiet a few ballet dancers with posterior ankle impingement. Most are younger females due to the demands of a pointe position early in their physical and professional development. Lack of necessary range of motion at the ankle or mid-foot, weakness, poor technique and selection of pointe shoes can be some of the causes. The dancers that have good passive barefoot pointe motion but lack full weight bearing pointe position in a pointe shoe might be weak at the mid foot (loading posterior structures), have not “figured out” how to recruit their mid foot muscles to help or have significant equipment resistance (shoe, shank). Our model CC @little.bun.head is working on increasing mid foot ROM and strength, unloading the posterior aspect of her foot and ankle. #ballet #balletdancer #pointe #pointeshoe #pointemechanics #dancersareathletes #posteriorimpingement #danceinjury #dancemedicine #balletinjury #anklepain #physicaltherapy #dancerehabilitation #dancespecialist #dancepainfree #pointestrengthening #injuryprevention #performingarts #footandanklespecialist #footandankle

Most young dancers have a major difference between passive mobility into ballet positions versus active, muscle controlled, movement into the same position. This is due to weakness of specific muscles into ranges that are considered hyper-mobile. In this video we are working on increasing active movement into Grand Battement to the side in 4 stages: 1. Assisted motion through available range. 2. Assisted motion with muscle recruitment at end range- hold. 3. Active motion without assistance. 4. Stabilized motion (hands on table) which anchors the dancer and allows her to use the full motion at the end of the drill and makes her realize how much motion she can control. This could be done in standing, straddle sit on treatment table (demonstrated) or in a modified center split position as an advanced position. Another stage I didn’t demonstrate is eccentric lowering of the leg from the high position after the hold. Thank you @izzy_lovesdance for demonstrating and good luck at @eliteclassicalcoaching #balletdancer #ballet #balletspecialist #dancesport #dancespecifictraining #dancespecialist #sportsmedicine #dancemedicine #dancetherapist #dancersareathletes #hypermobility #grandbattement #dancerehabilitation #hipimpingement #hipmobility #stabilitybeforemobility #balletfeet #performingarts #strongdancers

Low back (Lumbar) stress injuries are as common in Ballet as they are in gymnastics. Hypermobile dancers/athletes relay on their mobility to achieve impressive dance positions, neglecting stability, resulting in lumbar extension injuries such as Spindylolysis (pars fracture). We teach abdominal control allowing the dancer to “lower themselves” into positions such as Cambre back relaying on strong abdominals past the range of motion we are used to working our abdominals in. Advanced abdominal exercises such as this Pilates teaser variation performed by @dancer_in_the_desert allow a dancer to maintain control of her spine in a position that would be impossible to hold as well as an irritant to a Lumbar extension injury if her abdominals were weak. #physicaltherapy #corestability #pilatesteaser #ballet #ballerina #balletdancer #sportsmedicine #dancemedicine #abdominalworkout #dancerrehab #dancespecifictraining #balletinjury #danceinjuries #dancersareathletes #dancespecialist #balletspecific #hardworkpaysoff #performingarts #pointe #spondylolysis #parsdefect #lowbackpain #corestrength