She Could Have Danced All Night

Victoria L. Magown, CMTPT, LMT and George S. Pellegrino, LMT, CMTPT

Ever since her high school days, Kathy had enjoyed the unofficial title of “The Dancing Queen”. As a child, her mom imagined she would some day be recognized for her talent on the dance floor. In fact, Kathy had won several awards but always danced to the beat of a different drummer.

All through college and into her adult life, the joy of moving to music provided numerous social and professional opportunities for Kathy. Whether it was ‘80’s Rock and Roll (her favorite) or Country Western, Kathy was always on the dance floor. However, a motor vehicle accident that occurred several years ago left her barely able to walk without pain. Even powerful pain medication couldn’t disguise her pain.

When Kathy came to MyoRehab, it wasn’t for the right hip pain or lateral leg pain and numbness. She had learned to just smile and live with it. She was referred to MyoRehab for chronic neck pain that developed since the motor vehicle accident.

After several myofascial therapy treatments, Kathy’s upper body and neck pain had significantly decreased. The following week however, Kathy came in with her right neck pain significantly exacerbated and increased pain in her right hip and thigh.

What could have caused such a flair up? There was more to this story than was immediately apparent. Kathy was feeling so much better that she couldn’t resist trying it out on the dance floor. On both Friday and Saturday nights, Kathy went dancing.

What became very clear to us was the influence her right hip and leg pain was having on her neck. It became obvious that we would need to resolve the lower body pain and dysfunction in order to fully resolve her neck pain. An in-depth evaluation of her lower body showed significant Myofascial Trigger Point activity in the gluteus minimus and piriformis muscles (Illustration A and B).

A Myofascial Trigger Point (TrP) is a hypersensitive spot in a muscle that when stimulated, usually produces pain referred in a predictable pattern away from the Trigger Point. As you can see in illustration A, the gluteus minimus can mimic the pain pattern of sciatica. It refers pain from the hip down the lateral thigh and leg all the way to the ankle. This was a big part of Kathy’s pain pattern.

The piriformis (illustration B) was also contributing pain to the hip and buttocks. This muscle can become so tight that it can compress the sciatic nerve causing a lack of sensation or numbness in the leg. On evaluation, the piriformis confirmed its contribution to the numbness Kathy was experiencing.

We also found another component of her hip pain and dysfunction; the tensor fascia latae muscle (illustration C) which refers pain directly into the hip. After treating these muscles we gave Kathy a Home Exercise Program to keep the muscles lengthened. We also suggested modifications to activities and postures that contributed to her pain and dysfunction referred to as Perpetuating Factors.

Modifying her computer workstation and chair gave her the support necessary to keep her body in correct ergonomic alignment while working, which prevented Kathy from reestablishing Myofascial Trigger Points in her neck muscles. Since Kathy told us she experienced hip pain while lying in bed sleeping on her side, we suggested modifications that enabled her to get a full night’s sleep without pain.

Now that her hip and leg pain was resolved, Kathy’s neck pain significantly decreased with each treatment. Kathy was surprised to learn how the pain and dysfunction in her lower body had contributed to her neck pain.

What she really wanted to know was how soon she could start dancing again. When we gave her the OK, she was ecstatic. We continued with treatments, scheduling them further apart, until Kathy’s pain was completely resolved. Now, Kathy can “dance the night away”.

Has the music stopped for you? Does it seem like your dancing days are over?
Give us a call at MyoRehab.