Cynthia Laportilla, Physical Therapist with Miami Orthopedics and Sports Medicine Institute, says the average of physical therapy after a total knee and total hip replacement is about three months, and usually about more or less twenty-four sessions.
“Usually your therapist will have conversations with you; they might tell you you’re right on target, or this is maybe going a little slower, so it shouldn’t be a surprise to you if things are going slower,” she explains. Dance injuries can occur due to overuse or due to trauma, says Cynthia Laportilla, Physical Therapist with Miami Orthopedics & Sports Medicine Institute.
However, she explains the dance medicine research shows that most injuries are due to overuse rather than trauma.
Some of the risk factors that can cause dance injuries are: type of dance and frequency of classes, duration of training, equipment used, especially shoes, individual dancer’s body alignment, prior history of injury and nutritional deficiencies, she describes “Joseph Pilates and his wife Clara were very insistent that Pilates is a whole body and even a whole lifestyle approach,” says Cynthia Laportilla, Physical Therapist with Miami Orthopedics and Sports Medicine Institute.
She explains Pilates has three guiding principles: whole body health, whole body commitment, and breath, which is the first and the last thing that you do in your life. “Joseph Pilates used to talk about breath as being an internal shower, cleansing the inside of the body.” Cynthia Laportilla, Physical Therapist with Miami Orthopedics and Sports Medicine Institute, explains when a knee that has some degenerative changes in either some of their joints or all of their joints or has an osteoarthritis problem, it just has to do with the bones and cartilage, and other times it is an autoimmune or a rheumatic arthritis type of problem.
She points out the surfaces of the joint should be like smooth wet ice; when you have arthritis you have inflammation in the joint, and that inflammation causes wearing and breaking down of the cartilage, and that cartilage can wear down all the way down to the bone. “Bone is never really meant to come in contact with another bone, so by the time you get to bone on bone it can be a very painful condition.” Cynthia Laportilla, Physical Therapist with Miami Orthopedics and Sports Medicine Institute, says physical therapy is very important after surgery: “Any surgeon anywhere would say that without the therapy part of the equation, the surgery may even possibly be a failure. It’s a successful surgery to successful therapy that should hopefully bring you to the highest level of outcome that we can anticipate.”
She also says the whole point of having joint replacement surgery is for you to be better than you were before; it should work better than it did before you had the surgery, and then as you proceed in your rehabilitative process it should just continue to get better. Cynthia Laportilla, Physical Therapist with Miami Orthopedics & Sports Medicine Institute, says dancers suffer from hip, foot, ankle and knee injuries and stress fractures. However, foot and ankle injuries would be the most prevalent.
Male dancers suffer from hands and wrists injuries, because they have to do a lot of lifting and put stress on the hands and wrists.
The turnout position is when the ballerina stands with their legs in an externally rotated position: the knees, the feet and the toes point out towards the sides of the room. Manual therapy consists primarily of mobilization of the soft tissues of the body, like muscles connective tissue, fascia, ligaments, tendons and then, also, joint mobilization.
Cynthia Laportilla, Physical Therapist with Miami Orthopedics & Sports Medicine Institute, explains the specialist use manual therapy when there’s a movement dysfunction where either certain soft tissues may be a little bit too tight to allow the body to move normally.
Manipulating the spine can be a healthy part of treatment for different dance related injuries or even non dance related injuries, she affirms. In motion analysis, therapists apply certain sensor to the person’s body and then connect that to the computer and then have them go through a movement whether it be, such as walking or dance movements or any kind of movement of the patient.
Cynthia Laportilla, Physical Therapist with Miami Orthopedics & Sports Medicine Institute, also talks about electrical stimulation. It can be used to decrease pain, decrease inflammation, just promote a healthy tissue and can also use it to wake up nerves and muscles. Posture is especially important in dance because it can be part of the actual dance itself, especially of ballet dancers. They need to have a very kind of flat back and open chest, explains Cynthia Laportilla, Physical Therapist with Miami Orthopedics & Sports Medicine Institute.
She explains ballet dancers need to dance and move in an alignment that would not be what physicians conserved to be organic, what the body would naturally do on its own.
The specialist describes how good posture looks like. Ankle injuries are very common in dance and performing arts population, in the general population, affirms Cynthia Laportilla, Physical Therapist with Miami Orthopedics & Sports Medicine Institute.
When those injuries occur, physical therapists work on allowing the tissue to heal but letting the inflammation and the pain calm down. Once the tissue is ready, then they’ll start on a process of strengthening, she describes.
She affirms the muscles should be strong and protect the ankle joint in ballerinas, skaters or gymnastic people. Cynthia Laportilla, Physical Therapist with Miami Orthopedics and Sports Medicine Institute, says there are many similarities between Pilates and yoga. “Pilates is in part based on yoga, the control, the centering, the coordinated movement, and the breath, all of that you’ll find in both Pilates and yoga.”
She explains yoga in large part is entirely unassisted, you are usually just working with your body on a mat, sometimes that can be very challenging, and in Pilates, you have the benefit of using the different pieces of equipment that incorporates spring tension. Cynthia Laportilla, Physical Therapist with Miami Orthopedics and Sports Medicine Institute, explains what physicians recommend when you start to have pain and altered movement in a joint is starting with physical therapy, because it will work on regaining comfortable healthy joint motion, and it will work on strengthening the muscles around the joint.
“Then your next line of defense might be some injection therapy; there are anti-inflammatory injections, like cortisone that can be applied. There are joint lubrication injections, called viscosupplementation, that help to improve the lubrication mechanism of your joint, and then if your body still has a lot of pain, your surgeon may recommend a joint replacement surgery for you,” she says. In injuries caused by muscular imbalances, Pilates exercises promote an even musculature throughout the body by strengthening the core. It also stresses spinal and pelvic alignment, which is critical in getting us to move the way we are supposed to move to avoid injury.
Cynthia Laportilla, Physical Therapist with Miami Orthopedics and Sports Medicine Institute, says patients may not know about their body as a whole, so when they visit a physical therapist for a knee problem, they expect to work only on the knee. “In order for whatever other body part to be healthy, we have got to start from the core, from the inside working out, addressing those neuromuscular imbalances and the health of the entire body as we were at the knee.” Cynthia Laportilla, Physical Therapist with Miami Orthopedics & Sports Medicine Institute, says barre is a great core workout.
She explains there are eight benefits of barre: It’s the best core workout, it improves posture, it helps patient’s muscles work correctly, it increases body flexibility, it targets every muscle group, It’s low-impact, it has low injury risk and It’s fun.
The specialist affirms barre is the best stuff of dance. She describes she has plenty of patients who have transitioned from clinical therapy to barre classes.
