Saturday, August 15, 2009

Rheumatology Appointment

Although there hadn’t been an “official” medical need for me to see a rheumatologist, for reasons linked to my JHS research, HB very kindly offered to see me in a dual capacity.

The assessment was very thorough because H needed to know my medical history, including information about other family members because of the genetic component to the condition, and he was able to confirm I have JHS. We concluded that I had probably inherited the “shallow” hip and shoulder sockets from my maternal family, and the ligamentous laxity from my paternal family. Although H thought it was a general 50/50 split between the two aspects of hypermobility, we thought conclusively that the bony component might be slightly dominant.

H’s assessment of my joints was very interesting. He didn’t do the standard Beighton Score, but looked at a far greater range of joints than is assessed in the Beighton Score (see entry 16 October, 2008). For example, H looked at my shoulders, hips and ankles and determined that my hips and shoulders are hypermobile and demonstrate greater mobility than other Caucasian women of my age, meaning it was not acquired hypermobility through dance.

H had been particularly interested in my reporting a significant difference in leg length (see entry 12 November, 2008) and on examination of my spine suspected that I have what he calls an “S-Shaped twist” on one side of my spine. He also noticed that my shoulders were uneven, and that (as I knew) I hinged in a particular area of my lumbar spine. All this might explain my injury pattern and the compensations that are being made biomechanically in my legs, to account for this structural imbalance. In order to determine diagnosis H needs me to have a lumbar spine and pelvic x-ray. Following that he will be able to make further recommendations to K and the pilates team about how this might be corrected. It will include working predominately to the one side (presumably the weaker side).

H actually thought that my proprioception was quite good in terms of my shoulders and that by virtue of my dance training I had become very good at disguising this possible S-Shape twist. He felt that the pain I had started to experience from the age of 18 was certainly significant on whatever was going on in my spine at the time.

Anyway, upon results of x-ray, which will presumably take a while to organise, there will be a course of more exercises to correct this. I had noticed in certain movements my spine is twisted, and sometimes I cannot get straight in arabesque. Still, as my mother pointed out (who knows everything!) Lots of us have structural imbalances and unequal leg length, which is all true and is all good and well if it doesn’t cause you pain or problems, but mine has caused me significant pain over the years. It looks like K is stuck with me for some time to come yet, and the poor pilates team!

In terms of ballet, it might explain some movements – e.g. twisting arabeque, and particularly grand battement, where the latest video of me still shows significant torsion.

H was incredibly helpful, patient and kind. We would have assessed my warm-up, but I said I hardly did any, and then proceeded to shoulder my leg, then and there! I had just got a DVD of me dancing, so I could send him that, but he can also see me dancing if he sees me again to oversee my pilates schedule.

Finally, he said that doing ballet was going to be much better for my actual spine than contemporary dance would be, based on what he saw today. Good job I only do ballet then…!


Unknown said...

Hey Isobel, came across your blog while I was doing a research on forward back bend. I was impressed by the way you are keeping track of each and every progress that you are making in your dancing. Keep it up and it is an inspiration too..

Isobel said...

Thank you so much for your feedback :)