Applying Current Concepts in Pain-Related Brain Science to Dance Rehabilitation

Abstract

Dance involves exemplary sensory-motor control, which is subserved by sophisticated neural processing at the spinal cord and brain level. Such neural processing is altered in the presence of nociception and pain, and the adaptations within the central nervous system that are known to occur with persistent nociception or pain have clear implications for movement and, indeed, risk of further injury. Recent rapid advances in our understanding of the brain's representation of the body and the role of cortical representations, or "neurotags," in bodily protection and regulation have given rise to new strategies that are gaining traction in sports medicine. Those strategies are built on the principles that govern the operation of neurotags and focus on minimizing the impact of pain, injury, and immobilization on movement control and optimal performance. Here we apply empirical evidence from the chronic pain clinical neurosciences to introduce new opportunities for rehabilitation after dance injury.

Elite athletes’ experiences of musculoskeletal pain management using neuroanatomical dry needling: A qualitative study in Swedish track and field

“…To facilitate their goal of uninterrupted training the athletes sought medical consultation for minor pains or fractional reductions in physical capacity. This low threshold for seeking MSKP treatment is concordant with previous reports 20,21 and may be driven by the athletes learning that MSKP hinders physical performance, 21 performance related anxiety, 22 a desire to 'tune-up' their bodies 20 and an apparent understanding of pain as a localised manifestation resulting from biomechanical issues, e.g. painful trigger points.…”

“…26 Insecurities about the causes of pain have previously been reported as sources of psychological strain amongst elite track and field athletes. 22 Therefore, providing an explanation for pain, for example via an unambiguous biomedical diagnosis, may reduce the threat level associated with MSKP and increase an athlete's sense of control. 27 However, providing certainty in MSKP diagnosis is challenging as current evidence states pain levels and tissue state are not closely correlated and gold-standards for MSKP diagnosis are lacking.…”

Cognitive, emotional, and somatosensory behavior in professional dancers with acute and chronic pain

“…Pain could affect dance movements both from a proprioceptive perspective and in planning and movement execution terms at the central nervous system level. 31 In addition, chronic pain may have a direct influence on cortical body representation. Cortical representation integrates information in somatosensory areas about the body and the stimuli it receives.…”

Peer Review #1 of "Implicit motor imagery performance is impaired in people with chronic, but not acute, neck pain (v0.2)"

“…It is important to consider the wider body of evidence when interpreting the current results because different problems might underpin impairment of accuracy as distinct from response time. Full review is beyond the scope of this paper, but deficits in accuracy are more consistent with disrupted proprioceptive representation and deficits in RT are more consistent with unequal weighting between representations of either hand, or movement (see (Moseley, Butler et al 2012, Wallwork, Bellan et al 2016, Wallwork, Bellan et al 2017 for extensive reviews, although see Pelletier, Bourbonnais et al (2018) for other possible contributors to performance).…”