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Dance Medicine and Science at Dance UK’s ‘The Future: New Ideas, New Inspirations’ Conference

Posted By Sarah Beck, Monday, April 13, 2015

This past weekend, from April 9th to 12th, Dance UK hosted their first ever Industry Wide Conference titled The Future: New Ideas, New Inspirations. With the future of the dance sector at the heart of this conference, it seemed only right that dance medicine and science featured within discussions.

The program on Saturday 11th included 12 ‘healthier dancer’ sessions on a wide range of dance medicine and science topics including: ‘Protein for dancers’ from Professor Kevin Tipton, ‘The hypermobile student in dance class’ from Nicky Ellis, and ‘Psychology of injury: the impact of what we say and do’ from Dr Natalie Walker. Dance UK were also extremely honoured to be able to feature four presentations that were previously presented during the IADMS 24th Annual Meeting in Basel and extend thanks to IADMS for their partnership in this. IADMS also had a promotional stand at the conference, which delegates engaged with. Sessions were filled to capacity and attended by dancers, teachers, choreographers, and directors of schools and companies, as well as medical doctors, students, physiotherapists and dance scientists. This mixture led to interesting discussion on the application of principles discussed into practice, something I know we all strive for in this field. Many of the sessions were filmed and video clips will be available over the next few weeks.

The final day of the conference focused on education and training the dance artists of the future and although no specific dance medicine and science content was scheduled in this day, it certainly featured in discussion in a way that any dance medicine and science enthusiast would be proud of. One topic in particular kept resurfacing: periodization. It seems imaginations had been sparked by the presentation on the previous day from Professor Matthew Wyon and Joost Van Megan on the work in periodization currently underway at ArtEz in the Netherlands (also presented at the IADMS 24th Annual Meeting). I urge you all to follow the link and watch Dr Christopher Bannerman’s keynote speech, in particular from around 36 minutes 30 seconds in, to hear him enthusiastically discussing this presentation. 

This conference provided fabulous exposure of dance medicine and science into the wider dance sector in the UK, which we hope continues to inspire debate, collaboration, and practical implementation of and around ideas presented.


[The IADMS blog would like to feature further write ups of events and conferences so please do let us know about those happening in your local area so that they can be included.]

Tags:  conference  dancers  UK 

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The Spine: The impact of head position

Posted By Elsa Urmston on behalf of the IADMS Education Committee, Monday, April 6, 2015

This blog post from the IADMS Education Committee brings focus to the importance of spinal alignment and its role in aiding the efficient and effective mobilization of the body in dance.  Specifically this week, we will look at the cervical spine and the all too common problem of the forward head posture.


In recent weeks I’ve been aware of the images on social media about the impact of smartphone and tablet use on the alignment of the upper body in everyday life, bringing about the forward head posture which drops the shoulder girdle down and forwards, bringing with it the cervical spine and skull.  The middle back or thoracic spine area has a tendency to drift backwards and, to accommodate the upper back shift, the hips tip forwards, creating a domino effect of increased force on the central line of the body.  Herein lies muscular and skeletal imbalance as the center of gravity is pulled anteriorly and posteriorly off the midline – the result – pain, discomfort and inhibited movement range.  Here we see the resulting force placed on the spinal column, relative to degrees of anterior cervical spine flexion.

 



In my own classes I often see this forward head posture - whether it is a result of increased screen use is up for debate!  I’d like to think it is the students’ eagerness to learn but this forward head posture may come about because of students looking down, lack of confidence, concentration or any multitude of reasons.  But balancing the skull on the spine is critical in helping young dancers to find efficiency in their whole body movement, and tackling it early on in the training journey seems a prudent step in finding fluency of movement and avoiding injury risk. 


Ideal spinal alignment requires the skull to be balanced on the occiput, creating a central line through the spine which minimizes stress on the body.  And once the skull is balanced on the spine we can ensure that the natural curves of the spine are supported for maximum shock absorbancy in jumping and support for the dancing body in motion.  As soon as the head moves off this central line, forces impact on the joints of the body; of course sometimes we want that to happen as this initiates movement, or balances movement in other parts of the body.  But equally, we need to ensure the efficient balance of the skull on the spine to enable safe and effective practice.  Any distortion in the spine because of head position can impact balance and how we move – pirouetting with a forward head stance is nigh on impossible!  


The impact of the forward head posture on the spine is varied, but as I mentioned earlier there is always a domino effect on the spine and indeed the joints of the lower limbs.  This image below really illustrates this clearly – with the arrows indicating the stress points rippling down the body from poor head position.



So what can educators do to enable efficient head position amongst our youngsters and avoid the impacts on the spine we see above.  We have probably all experienced the image of the string coming from the top of the head, to ‘lighten’ the skull on the spine and allow length in the spinal column.  This can be helpful but I think can sometimes result in the chin being pulled inwards towards the throat, the head falling slightly back and in turn, creating the flat back posture, also often associated with young dancers as they try to find that length we all seek.  Those vital spinal curves disappear. 


Multidimensional images of the head-spine relationship seem to create a better balance amongst the students I work with.  For example, whilst standing we consider the string from the crown of the head, alongside marionette strings which cluster above the ears and draw upwards to help students understand the volume of the skull balanced on the spine.  Often I will have students working in trios, one partner clustering their fingertips firmly on the sides of the skull just above the ears.  They press gently on the flesh for 30 seconds or so, so that the dancer can feel the touch of their partner, the partner then draws the fingertips up to the crown of the head to unite and lengthen up into the space above, often drawing the hair with the fingers.  The other partner lightly cups one hand on the forehead and the other on the posterior curve of the skull and remains there whilst the marionette strings are drawn upwards.  Students’ reactions to this tactile task are always positive and they observe in their partners the lengthened spine and ideal head placement we seek but also the spinal curves remain intact.  They are able to recall the tactile memories of the hands-on work in their dancing as a reminder. 


For me, I have learnt a lot from Alexander Technique (AT).  The verbal directions, “to let the neck be free, to allow the head to go forward and up, so that the back can lengthen and widen”, alongside hands-on work in class as shown below, reiterate the balance of the head whilst dancing.  Examples of AT in practice are widely available on the web; these short films are a great visual introduction to the basic principles of AT, and their specific application in dance. 
Video 1
Video 2

I have also found these dance-specific AT podcasts helpful in developing my own understanding and taking these ideas into the classroom to help my students.  I strongly recommend a listen!
BodyLearningCast

IMAGE WILL RETURN SOON


At the DanceEast Centre for Advanced Training we spend a lot of time team-teaching in technique classes – a luxury I know.  I will work within ballet and contemporary classes, the class teacher leading the class in the normal way, whilst I circulate to work with students individually, reminding them quietly of teaching points covered in dance health classes, using tactile feedback from the examples above as well as many others, to try to support the transfer of learning of principles from our health classes to their application in technique and performance.  So in fact we are trying to overcome habitual movement patterns such as the forward head posture through re-education.  We find a sustained deepening of the students’ understanding when we work in this way, which enables an enquiring learning approach from the students in which they ask questions and interrogate their own practice.


There are numerous videos including stretches for forward head posture available on the web.  In my experience some people, sometimes find these useful, but the focus is on treating the pain caused by poor alignment rather than tackling the root cause.


For further resources, take a look at the following:


A great collection of Alexander’s writings:
Alexander, F. M.
The Alexander Technique: The Essential Writings of F. Matthias Alexander. Lyle Stuart. 1990.


Batson, G. Somatics Studies and Dance.  IADMS Resource Paper. 2009.


The Complete Guide to the Alexander Technique

  


Elsa Urmston MSc PGCAP AFHEA is the DanceEast Centre for Advanced Training Manager, Ipswich, UK and a member of the IADMS Education Committee.

Email: elsa.urmston@danceeast.co.uk

 

Tags:  dancers  ergonomics  neck  spine  teachers 

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What do ballet dancers, bar tenders and paramedics have in common?

Posted By Luke Hopper, PhD, Friday, April 3, 2015

Lifting is an important technique across dance styles. With diverse modern choreography, lifting is an increasingly common technique not only for males but for female dancers as well. The act of lifting is often described as giving the partner grace and the impression weightlessness as they float through the air. But what about the lifter below? What about their technique? And more importantly what about their health?

In industry, lifting is the focus of a wealth of attention in the interests of occupational safety and health. This is because so many workers injure themselves performing lifting tasks. And the injuries they experience are commonly to the lower back

Dancers experience lots of leg injuries, but backs, particularly lower back injuries are also way too common in dance. A serious back injury can be a disastrous career ending experience for a dancer. Therefore should lifting in dance be considered from an occupational safety and health perspective and how could it prevent injury? In the US, the National Institute for Occupational Safety and Health (NIOSH) have released a safe lifting equation which lists six key variables (in addition to the weight being lifted) that affect risk of injury to the back:

  1. Horizontal location of the object relative to the body
  2. Vertical location of the object relative to the floor/li>
  3. Distance the object is moved vertically
  4. Asymmetry angle or twisting requirement
  5. Frequency and duration of lifting activity
  6. Coupling or quality of the workers grip on the object

Swap the term ‘object’ in the list for ‘partner’ and I’m sure that you can think of a whole lot of examples where dance breaks most if not all of the rules. But should lifting be banned from all choreography? Certainly not. Should dancers question their partner’s weight? Definitely not. Should dancers be aware of the risks of lifting so they can perform safe dance practices? Absolutely.

Alderson et al. (2009) estimated the lumbar forces in male dancers performing two lifts:

  1. Arabesque or presage: where the female stands in arabesque and is lifted in the arabesque posture by the male above his head into straight arms
  2. Full press: where the female stands in front of the male, jumps into the lift and is lifted above the male’s head

Surprisingly, every male dancer, for every lift examined, experienced the largest forces in the back before his partner had even left the ground in the posture shown below (Figure 1). The forces are likely the highest at is point because the male is generating momentum into the lift which requires more force. Think of pushing a piano across the studio, it requires a more effort at the first push compared to after the piano is moving.


                Figure 1: The position of greatest force in the lift.

In addition, despite the female jumping into the lift and ‘helping’ the male, the maximum back forces in the full press lift (Figure 2) were larger than in the arabesque (Figure 3). The full press was likely to have higher forces because of the dynamic jumping like movements of the lift. The explosive movement at the start of the lift may make the lift feel easier but it is because of the increased forces at the start of the lift.

 
           Figure 2: Full press lift.                                 Figure 3: Arabesque Lift.

Dancers should be careful of their posture right at the start of the lift as the discs of the spine are particularly susceptible to injury during these kind of intense movements and flexed body positions. Maintaining good posture throughout the whole lift is really important but male dancers should be particularly aware of the posture they start the lift with considering the high forces they experience at that point.

The forces measured in Alderson et al. were above the NIOSH recommended safe limits. To add a bit of perspective, the forces measured were more than a paramedic lifting a stretchered patient, but less than a bar tender lifting a beer keg. Lifting remains an important component of modern day choreography, but so do the risks to the dancer. Technique is of course important, but approaching lifting in dance from an occupational safety and health perspective can only serve to make dancers more aware of their bodies, closely consider their lifting technique and the forces they put through their bodies.

Recommended reading and images sourced from:

Alderson J, Hopper L, Elliott B, Ackland T. Risk factors for lower back injury in male dancers performing ballet lifts. J Dance Med Sci. 2009;13(3):83-89.

Full text articles from the Journal of Dance Medicine and Science are available to IADMS members!

Luke Hopper, PhD, is a Postdoctoral Research Fellow at the Western Australian Academy of Performing Arts, Edith Cowan University.
Email: l.hopper@ecu.edu.au

Tags:  biomechanics  dancers  lifting 

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Core Control: “Not just abdominals”

Posted By Clara Fischer Gam on behalf of the IADMS Education Committee, Monday, March 16, 2015

 

In previous Education Committee posts we’ve spent time talking about turnout, and mentioned the importance of core control and neutral alignment in maximizing rotation of the legs.  Here, we spend a bit more time focusing on core control and what that might mean.

Everyone is talking about the importance of core control and the topic is becoming commonplace among dancers and teachers. We keep hearing that dancers got to have “core awareness,” “strong abdominals,” and “movement control.” Before we start “drawing our belly buttons in” we might well ask ourselves: 

What does core control actually mean?

The term core usually refers to the structures (including bones, muscles and ligaments) of the shoulder girdle, trunk, pelvis and hip. As the human spine is in essence an unstable structure, further stabilization is provided by the musculature.

There is still some debate within research about the muscles that constitute the core and their precise contribution to movement control, but here we will meet muscle groups that are often considered by researchers to be involved in the dynamics of core control:

Superficial muscles of the trunk: They produce trunk motion and act as prime movers during dynamic activities and provide multi-segmental stiffness over a wide range of motion (e.g.: rectus abdominis, external and internal obliques, iliocostalis thoracis).

Deep muscles of the trunk: These local muscles are better suited for segmental stability (e.g.: transversus abdominis, multifidus, interspinalis).


Transfer Muscles of the Shoulder Girdle and Pelvic Girdle: These muscle groups connect the upper or the lower limbs to the trunk thereby transferring the forces through the system during movement (e.g.: hip flexors, scapular stabilizers)


Above: Serratus anterior, example of transfer muscle of the shoulder girdle

 

Above: Psoas major and iliacus, examples of transfer muscles of the pelvic girdle

Pelvic Floor Muscles: These muscles are part of the compound structure that closes the bony pelvic outlet, offering support to the pelvic organs (e.g.: urogenital sphincter, levator ani)

As superficial muscles can be easily accessed, we tend to rely on them maybe more frequently than we should (e.g.: feeling only the “six pack” rectus abdominis activation without regard for the deep abdominals when “contracting” in Graham Technique class). Although deep muscles are not as easy to feel and recruit as superficial muscles, they’ve got an important function. Teachers can encourage students’ awareness for these deeper muscles (e.g.: they can be reminded of the action of transversus abdominis as well as of superficial muscles involved while reaching a penchée).

What then?

These diverse muscle groups act together to maintain control of positioning and movement of the trunk over the upper and lower extremities: and that’s especially relevant when it comes to dance. Core control seems to provide spine support and to back up pelvic alignment, which could be important factors to ensure movement control of legs and arms as well as to facilitate turnout in dancers.  You can find some ideas for core support training directed to turnout on this International Association for Dance Medicine & Science (IADMS) Resource Paper HERE.  Also check out our previous blog posts for bite-size information HERE.

Lack of core control seems to increase strain on the surrounding joints, bones and ligaments and has been related to injury risk on lower extremities and the lower back. As we know that dancers quite often acquire injuries on these parts of the body, bringing core control activities into studio practice could also play a key role on injury prevention and in turn enhance movement efficiency.

When cueing dance students to navigate through the core concept, it’s important to keep in mind that as postural adjustments and external loads entail constant changes to the body, core stability is considered a dynamic concept. That means that the contributions of each muscle on maintaining trunk stability may vary moment to moment throughout movement. For this reason, it’s hard to say that there is such a thing as a single core muscle we should always focus on while dancing. The core control muscles appear to work synchronously with one another.

Instead, it could be really useful (and fun) to explore the strategies used to achieve a desired movement you are working on and observe the muscle activation patterns it causes, whilst keeping in mind the anatomical references as well as research findings and discussions about core control. Why not help young dancers themselves to feel their core throughout movement and to identify their personal patterns during class? Kitty Daniels talks about strategies to help students to understand the role of core control in practice as well as to find a system of their own to work on individual challenges and artistic goals. Find out more about this teaching approach at this IADMS Bulletin for Teachers article HERE, click on Bulletin Volume 1, Number 1, pages 8-10.

As we’ve mentioned before providing images and online applications which allow dancers to locate these muscles really seems to aid understanding and importantly, the efficient execution of movement. Check out these short animated videos: they are great resources in locating those deep control muscles, which are often so difficult for dancers to feel.

Keep exploring:

Ambegaonkar JP, Rickman AM, Cortes N. Core stability: implications for dance injuries. Medical Problems of Performing Artists. 2012;17(3):143-148.

Cholewieki J & McGill SM. Mechanical stability of the in vivo lumbar spine: implications for injury and chronic low back pain. Clinical Biomechanics. 1996; ll(l):l-15.

Hodges PW & Richardson CA. Contraction of the abdominal muscles associated with movement of the lower limb. Physical Therapy.1997; 77(2):132-142.

Kline JB, Krauss JR, Maher SE, Quo X. Core strength training using a combination of home exercises and a dynamic sling system for the management of low back pain in pre-professional ballet dancers. A case series. Journal of Dance Medicine & Science. 2013; 17(1):24-33.

Panjabi M. The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. Journal of Spinal Disorders. 1992; 5(4):390-397.

Clara Fischer Gam, MS.
Dance Educator, Pilates Instructor
Rio de Janeiro, Brazil
Email: clara.figa@gmail.com

Tags:  anatomy  dancers  teachers  turnout 

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An intervention to improve turnout - Research Study

Posted By K. Michael Rowley, Tuesday, March 3, 2015

Many posts on the IADMS Blog from the Education Committee have been focused on the anatomy and control of turnout. But does awareness of where turnout comes from and exercise targeting hip external rotators actually make a difference in turnout a dancer can achieve? According to research from Florida State University published in the Journal of Dance Medicine and Science, the answer is yes.

Researchers developed a 45-minutes daily 10-day training intervention focused on turnout. This included education and awareness practices as well as exercises like the clam, a passé press will side-lying, side lunge, attitude on a rotating disc, stretches, and tennis ball massage. What made this study unique was that outcome measures were not only turnout ability, but also the rating of dancers performing an adagio by graduate students and faculty before and after the intervention.

Five of the six dancers tested increased their total turnout, measured by the angle of the feet on low-friction rotating discs (figure above), by 9° to 22°. A faculty rater with expertise in body sciences reported all post-intervention performance videos as showing greater turnout control than pre-intervention. The report states that, “Her comments included: ‘The pelvis looked more stable’; ‘the torso looked more lengthened’; ‘the chest was more open’; ‘I saw a greater level of confidence’; ‘much less hip hiking’; and ‘the initiation of the rotation is coming from the back of the legs.’”

Pata D, Welsh T, Bailey J, and Range V. (2014) Improving turnout in university dancers. Journal of Dance Medicine and Science, 18 (4), 169-177.

Full text articles from the Journal of Dance Medicine and Science are available to IADMS members!


 Photo Credit: Dan Dunlap, SarahKim Vennard

Tags:  dancers  research  teachers  turnout 

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5 Questions with Susanna Piculell

Posted By IADMS Student Committee, Tuesday, March 3, 2015

This month's featured member is Susanna Piculell of University College London. Susanna is a physiotherapist specialising in dance medicine. Her areas of interest include injury prevention, preseason functional screenings, periodization for dancers and performance psychology.

 

-How did you first get interested in dance science/medicine?


I’ve always been fascinated by dance, both as a spectator and a performer. Nevertheless, I felt pretty early that the performing artist profession was not for me, so I decided to approach the field from another angle by combining my dance, exercise and health interests. Thus, I decided to become a physiotherapist and specialize in dance medicine. 


-Are you currently participating in research? Can you give us your elevator pitch about your research area?

My MSc research proposal is on-going and due to be finished in September 2015. The aim of the study is to investigate whether there is a correlation between two preseason tests (knee to wall and single leg calf capacity) and subsequent injury to feet and ankle in professional ballet dancers. This is to gain a little further understanding of possible underlying factors behind these, far too common, ballet injuries and what kind of preseason tests are worthwhile to include. I see it as a small step that can lead on to future studies, new questions and new pointers.

 

 

-Which Annual Meeting has been your favourite so far and why?

I have only been to one, but the 21st Annual Meeting was wonderful. It was my first international gathering with other people like me, “dance nerds,” who also possess a fascination and enthusiasm to optimize dance performance.


-In which ways has IADMS helped you grow in your field of study?
Particularly after my BSc graduation in 2011, the JDMS has been very important to keep me updated on the progress of dance medicine. I also see IADMS as an essential source for networking, the world of dance medicine is still rather small and we need to collaborate and share our knowledge to keep on moving forward.


-What would you say to a student thinking of joining IADMS?

Do it! Especially now when you’re a student, not only because it is cheaper but also because now you might be needing it the most, in terms of career advice, access to literature and networking.

 

 

If you’re interested in the Student Committee and its initiatives, contact us at student@iadms.org.


Special thanks to the “5 Questions With...” Sub-committee, Andrea Alvarez and Siobhan Mitchell.

Tags:  5 Questions With  perspective  physiotherapy 

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To torque or not to torque: The summative contributions of the knee, tibia and foot in the use of turn out

Posted By Maggie Lorraine on behalf of the IADMS Education Committee, Monday, February 23, 2015

In a previous post we examined the structure of the pelvis and hip joint and observed how the anatomical variations of the structure can impact on an individual’s ability to externally rotate their legs in the hip socket (turnout). We know that in most cases, dancers do not possess perfect turnout or complete external rotation from the hip. Often turnout is viewed as the placement of the prescriptive positions of the feet on the floor, however it is important to remember that turnout is an aligned movement of the whole leg from the hip joint culminating in the centering of weight over the foot on the floor whilst dancing. Ergo turnout is an action not a static position.

Dr. William Hardaker and Dr. Lars Erick, in a paper delivered with Martha Myers to the 1984 Olympic Scientific Congress, estimated that the 180° turnout is achieved by 60°-70° rotation of the leg from the hip and the remaining 40°-30° is picked up by the knee, tibia and foot. At the tibia, torsion is defined as an axial twist of the tibia or shinbone. Dancers in their growth years may develop external tibial torsion as a result of turning out their feet beyond the range of the hip joint. The torsion has been measured as widely varied as 16° to 60° and also with differing amounts of tibial torsion in each leg.

The small bones in the foot allow a gliding action to occur at the arch and it is not uncommon to see dancers force the lower limbs beyond the normal limits of the hip’s range of motion, creating a compensating action called pronation or “rolling in” of the feet to achieve the perception of greater or perfect turnout. The injury rate for the foot and ankle complex is the highest of all joint systems and the illustration below clearly indicates the risk potential. Note the change to the alignment of the Achilles tendon and the weight distribution on the inside of the foot as a result of the pronation of the foot.

IMAGE WILL RETURN SOON

Many factors contribute to the safe and efficient control of turnout whilst dancing. Rather like a team, body alignment, core control and the recruitment of muscle groups, which activate and control turnout, all play their integral part. Should one part fail there is a chain reaction that effects the efficiency of the others.

Many years ago I learnt what was for me is the golden rule of alignment and turn out. The weight of the body should fall like gravity, through the centre of the bones and the weight of the body is evenly distributed over the feet on the floor. This ideology creates stability, strength and control in a way that would be difficult to achieve through the action of torsion of the knee, tibia and pronated foot. The bonus of the aligned mode of working, is that turnout can be improved by the efficient recruitment and strengthening of the turnout muscles and the intrinsic foot muscles supporting the body weight on the floor.

Follow these links for more information:

Information for this article has been drawn from the IADMS Resource Paper

The following IADMS link provides an excellent training program for dancers:

Further reading:

Grossman G, Krasnow D and Welsh TM. Effective use of turnout: biomechanical, neuromuscular, and behavioral considerations. Journal of Dance Education 2005;5(1):15-27.

Maggie Lorraine is the Leading Teacher in Ballet at the Victorian College of the Arts Secondary School and is a member of the IADMS Education Committee.

Tags:  anatomy  dancers  teachers  turnout 

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5 Questions with Claire Low

Posted By IADMS Student Committee, Monday, February 9, 2015

The Student Committee would like to introduce “5 Questions With…” a column designed to give students an opportunity to share something about themselves, their research, and their involvement with the International Association for Dance Medicine & Science (IADMS). Our first featured member is Claire Low, recipient of the Student Research Award in 2014 at the 24th Annual Meeting in Basel, Switzerland. She graduated from Glasgow Caledonian University and is currently a physiotherapist at Singapore General Hospital. Her areas of interest include dance injury, injury prevention, and Pilates for dancers.

 

-How did you first get interested in dance science/medicine?

My love for dance started early; I was in baby ballet by the time I was 3 years old. Over the years of training, I realized that I was restricted and had difficulty executing a number movements such as turn out. My dream to continue classical ballet was dashed when an examiner told my dance teacher that I was not a suitable candidate during one of the vocational examinations. Heartbroken, I went to the local library to do research on why my body was "different." It was then I stumbled upon Karen Clippinger's book "Dance Anatomy & Physiology." I learned that my physical limitations were structural and not because I did not work hard enough. Where I trained, anatomy is usually not taught or explained during dance class. There also are not any screening protocols to assist teachers and students in assessing their functional capabilities before pursuing dance. It was then at 14 years old that I decided to pursue a career in physiotherapy, which would allow me to work with dancers to promote understanding about their own bodies and prevent dance injuries through education. 

 

-Are you currently participating in research? Can you give us your elevator pitch about your research area?

I am currently working on writing up a publication of my research "Effects of supplemental training on fitness parameters in dancers: A Critical Review and Meta-analysis," which was presented at the Annual Meeting. The review aims to update dancers and practitioners about what current studies recommend on the type and duration of supplemental exercise, versus normal dance training, in improving fitness parameters like muscle strength and endurance capacity in ballet, contemporary, and modern dancers.

 

-What is the best thing about being a student member of IADMS?

Having access to the Journal of Dance Medicine & Science at a reduced rate! It helped me a lot with my dissertation, as most of the articles I used were published in JDMS and my university did not subscribe to it.

 

-What has been your favorite IADMS experience?

Meeting the authors of my critical review in person at the Annual Meeting.

 

-What would you say to a student thinking of joining IADMS?

Don't hesitate to join! Use the resources, especially JDMS, to broaden your knowledge. You also get to attend the Annual Meetings at discounted rates, which allows you meet other like-minded students as well as network with lecturers in the dance community. 

 

If you’re interested in the Student Committee and it’s initiatives, contact us at student@iadms.org. Special thanks to the “5 Questions With” sub-committee, Andrea Alvarez and Siobhan Mitchell. 

Tags:  5 Questions With  perspective  physiotherapy  students 

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Physiotherapy with the heart of a dancer – a personal history

Posted By Dinah Hampson, Monday, February 9, 2015

When I was five, I saw my first full-length ballet and fell in love.  I begged for lessons and studied dance for the next ten years.  Despite passion, talent and training I didn’t have the physical facility for a career on the stage and I chose a different path.  Ballet is defined as an artistic dance form performed to music using precise and highly formalized set steps and gestures.  I assumed my years of studio time were forgotten when university led me to a career in physiotherapy.  Physiotherapy is defined as the art and science underlying movement and function, whereby physiotherapists make clinical judgments and apply their skills to develop a patient’s functional abilities.  So in reality, the years of studio time were not forgotten, but rather formed a strong foundation on which I built my physiotherapy skills.

On reflection, I think that sharing this relationship is important for people interested in dance science for two reasons: 1) Physiotherapists with a dance background benefit their patients by truly understanding movement.  This is important for recognizing subtle alterations in normal movement, changes in motor patterns and compensatory muscle activity.  If left unaddressed, these subtle changes in movement are risk factors for delayed recovery and future injury.  I understand now that the years of practicing precise technique created an eye for alignment, symmetry, cadence and balance.  Without internalizing the rhythm and movement of ballet, my understanding of human movement and function would be less. 2) Secondly, I think it is important for dancers passionate about movement to understand that their skill set is valuable and transferable outside the studio.  Of the thousands of children who study dance, few will ultimately end up in a professional dance career and of those who do, few of those careers will last.  The average duration of a professional dance career is 15 years with many dancers stopping for health related issues.  Given age is not usually the limiting factor in ending a dance career I think it is important for dancers to understand that Physiotherapy is definitely a viable career option for which dance training is an asset.

IADMS forms a perfect environment for all people interested in dance, movement and science to network and share experience.  I would encourage any dancer interested to contact me or any other physiotherapist to explore the profession and recognize the value that ballet training brings to the art of science.

References:

1. Google search for ‘Ballet’. Available here.

2. The heart of the physiotherapy profession. Canadian Physiotherapy Association, 2012. Available here.

3. Transitioning from a professional dance career. Centre for arts and cultural policy studies, Princeton University. Available here.

Dinah Hampson BA, BScPT, FCAMT
Diploma of Manual and Manipulative Physiotherapy
Diploma of Sport Physiotherapy
Owner Pivot Sport Medicine and Orthopaedics, Toronto ON Canada
Email: dinah@pivotsmo.com

Tags:  perspective  physiotherapy  practitioner 

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Approaching turnout with young dancers: Muscles that rotate the leg

Posted By Elsa Urmston on behalf of the IADMS Education Committee, Monday, February 2, 2015

 

All too often we see our young dancers forcing their turnout in an attempt to achieve the illusive 180 degree line of the feet whilst often compromising the neutral line of the spine and pelvis and putting the knees, ankles and feet at high risk of injury.

The last blog post by the IADMS Education Committee focussed on the anatomy of the hip joint; this time we take a look at the muscles which govern turn out and the lateral rotation of the hip. Knowing which muscles do what can help young dancers especially work more efficiently; talking about the location and function of those muscles and showing images of them can really inspire children and young people to maximise the rotation of the hip whilst working safely and effectively. And reminding them that there are no turnout muscles in the feet is a light-hearted reminder of how turnout should work! There are some great applications available which can help our dancers to clearly understand the anatomy and musculature of turnout, and are well worth bringing into the classroom, such as 3D for Medical Muscle System and VisibleBody. 

Whilst the most obvious muscles of the hips are located in the buttocks, the muscles that are vital for turnout are the six deep lateral rotators, buried under the gluteal muscles and deep within the pelvic girdle. Identifying and recruiting these muscles can be tough and we often see an over-recruitment of the gluteus maximus in an effort to rotate the legs, both when standing and gesturing the leg in a non-weight-bearing position. The deep lateral rotators aid the efficient rotation of the leg, running laterally across the back of the hip joint capsule. They all attach on or adjacent to the greater trochanter of the femur and achieve rotation by pulling the greater trochanter backwards, towards the back of the pelvis. As well as the diagrams below, take a look at this great animation which demonstrates the location and function of these muscles in hip rotation.

Other muscles contribute to the rotation of the leg too. The sartorius is thought to help turn out the leg when the hip is flexed or abducted such as in retiré or attitude devant. And the inside thigh muscles (adductors) may also contribute to the rotation of the legs when they are extended and already turned out by the deep lateral rotators. In class I tend to talk about the adductor muscles lengthening to aid the rotation of the leg, especially when the leg is extended to second; this tends to bring about less tension and ensures that the deep lateral rotators remain the primary rotators of the legs, both when weightbearing and gesturing the leg.

 

It is important to remember that external hip rotation and turnout are not really the same thing. Anatomically, 60% of turnout is achieved by the outward rotation of the hip. The rest tends to come from the ankle, followed by the knee joint and tibia itself. 

The problem here of course is when those deep rotators are not recruited first. This, coupled with anatomical factors which hinder the rotation of the leg, can mean that the dancer screws the leg from the foot upwards in a bid to achieve that 180 degree line of the feet I mentioned earlier. This places huge torsion on the big toe joint, ankles and knees – a recipe for greater likelihood of injury. The knock on effect of this screwing action also often means that the alignment of the pelvis and spine are compromised. So, the use of core support and an awareness of pelvic alignment are also crucial if turnout is to be fully functional in dynamic dancing. The recruitment of the deep rotators and the stability of controlled foot placement on the floor are the key elements for the safe recruitment of turnout whilst dancing.

There is a range of specific exercises for conditioning the turnout muscles, and for helping dancers to recruit the primary and supporting muscles involved in rotating the leg and maintaining efficient alignment of the spine and pelvis. Take a look at the IADMS Resource Papers for lots more information and ideas to take into class:

·         Turnout for Dancers: Hip Anatomy and Factors Affecting Turnout

·         Turnout for Dancers: Supplemental Training

 

Further Reading:

Grossman G, Krasnow D and Welsh TM. Effective use of turnout: biomechanical, neuromuscular, and behavioral considerations. Journal of Dance Education 2005;5(1):15-27.

 

 

Elsa Urmston, MSc, PGCAP, AFHEA, is the DanceEast Centre for Advanced Training Manager, Ipswich, UK and a member of the IADMS Education Committee.
Email: elsa.urmston@danceeast.co.uk

 

Tags:  anatomy  dancers  teachers  turnout 

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