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Stretching the Point

Posted By Maggie Lorraine on behalf of the IADMS Education Committee, Monday, August 15, 2016

Learning how to bend the knees and point the feet may be the first movements that dance students learn. It is sobering to consider that both of these movements are potentially harmful if not executed correctly and practiced in perfect alignment.  Experienced teachers of children and young people often notice that by encouraging students to “stretch” their feet rather than “point”, they are less likely to crunch their toes. Crunching results in a “shortened” line of the foot. On the other hand, “stretching” encourages the students to lengthen the leg through to the ankle and arch of the foot.  Anatomically speaking we are talking here about plantarflexion of the ankle of course, although this actual term is seldom used in a teaching context.


 

The pointed or stretched foot is the image that we so closely identify with classical ballet and arguably the control of the stretched foot whilst dancing is one of the skills that may take the longest to master.  It requires repetition throughout the dancers’ training to ensure sound alignment.  When teaching young children to dance it is important to consider the bone development of the body, which is called ossification. The completion of growth in a tubular (long) bone is indicated by the fusion or closure of the epiphyses (growth plates), located at each end of the long bone.  The long bones of the feet are the metatarsals – full anatomical information about the foot is available in previous blog posts hereThe final epiphysis to close does so at an average age of 16 years in boys and 14 years in girls (1). Of course, dancing can place added stress on growing bones and negligent dance training may also affect the development of the bony structures - repetitive trauma in training and increased impact due to poor biomechanical alignment can cause the epiphyseal plate to widen, rather than close (2).

 

It is acknowledged that foot and ankle injuries are the most prevalent injuries in classical ballet in both the student and professional population (3). The extreme position of the foot and ankle when dancing on demi pointe, (see illustration b) where the ankle is in full plantarflexion, the body weight is distributed on the ball of the foot, or en pointe, where the dancer is on the tips of her toes (see illustration c), the weight of the body is carried through the ankle joint, and the longitudinal axis of the foot may put the dancer at risk of injury.  Poor training, alignment, and faulty technique are all contributing factors to injury. Dancers, like athletes, are prone to common overuse injuries but they are also vulnerable to unique injuries, due to the extreme demands of ballet.

 

 

Teaching students how to align their feet and ankles, avoiding the urge to sickle (invert) or fish or wing (evert) when stretching their feet, and also ensuring that they do not crunch their toes (in an attempt to achieve the illusion of a high arch) will hopefully assist the student in avoiding serious foot problems. These issues will be exacerbated when the dancer rises on demi or full pointe. The control of the ankle when rising in an aligned position is a strengthening action.  However, when the ankle and foot is not aligned the action of weight bearing is potentially injurious.

 

 

Frequently students crunch their toes in an attempt to point their feet harder and consequently this action contracts the muscles of the foot causing the joints of the foot and ankle to compress.  Unfortunately, due to the students wearing shoes, the teacher does not always notice this problem, and the repetitive action possibly results in weakness in the intrinsic foot muscles and overuse of the extrinsic foot muscles, though this reasoning needs to be investigated scientifically. The issue sets up a pattern in the use of the foot that results in the toes crunching both when rising on demi pointe.  Strengthening the intrinsic foot muscles could potentially enable the middle joint of the toes to remain lengthened while stretching the foot. Research groups around the world are currently investigating just such possibilities and continually present their progress at annual IADMS conferences.


As teachers, we know that the habits that are developed in early training always affect the student in later years when greater complexity of training is introduced. Setting up the pattern amongst our students that they should strive to hold their feet evenly on the floor and keep their toes stretched out along the surface of the floor will help. While the feet are bearing the body’s weight they should be holding the ground at three points - one behind the back of the heel, and two in front of the heads of the first and fifth metatarsals. This triangle forms a base from which the muscles and soles of the feet can work to support the arch and align the feet. Potentially this will assist in the recruitment of the intrinsic foot muscles.

           

The intrinsic muscles are like the “core” muscles of the foot.  Because they are deep and don’t cross over too many joints, they can work well in stabilizing and protecting the arch and structures within the foot.  If the foot intrinsic muscles are weak, the foot structures are more prone to increased stress and injury.  Strengthening the intrinsic muscles of the foot is good for people with foot injuries and for those looking to prevent injury”(4).

 

Supporting the arches whilst standing all helps in ensuring strong, adaptable feet for dancing.

 

 

The extreme positions created when dancing on pointe are particularly hazardous if the body and foot are not physically ready to deal with the weight of the body on pointe. IADMS has produced a really useful guide to point readiness available here.

 

In conclusion movement habits practiced in early training can have a profound effect on the young dancer’s development and their potential for injury.  By laying the foundation of sound alignment the teacher will empower the student to achieve their goals with reduced potential for injury.  Celia Sparger describes it well: 

           

"It cannot be too strongly stressed that pointe work is the end result of slow and gradual training of the whole body, back, hips, thighs, legs, feet, co-ordination of movement and the 'placing' of the body, so that the weight is lifted upwards off the feet, with straight knees, perfect balance, with a perfect demi-pointe, and without any tendency on the part of the feet to sickle either in or out or the toes to curl or crunch. “

 

The IADMS Education Committee will post a follow up article describing possible foot and ankle conditions and injuries that may impact on the dancer written by Gabrielle Davidson who is the Physiotherapist of the Dance Department at the Victorian College of the Arts Secondary School.

 

Maggie Lorraine

Leading Teacher in Ballet at the Victorian College of the Arts Secondary School. Australia.

Member of the IADMS Education Committee

 

References

(1) Weiss, D., Rist, R. and Grossman, G. Guidelines for initiating pointe training.  IADMS Resource Paper, 2009.  Available here.

 

(2) Laor T, Wall EJ, Vu LP. Physeal widening in the knee due to stress injury in child athletes. AJR Am J Roentgenol. 2006; 186(5): 1260–1264.

 

(3) Foot and Ankle Injuries in Dance.  Physical Medicine and Rehabilitation Clinics of North America December 2006.  

 

(4) Amy McDowell, P.T From ARC Physical Therapy Blog

 

Further resources

Common Foot and Ankle Ballet Injuries

Dancing Child: Foot Development and Proper Technique

 

Micheli, L. J., Sohn, R. S., & Solomon, R. (1985). Stress fractures of the second metatarsal involving Lisfranc's joint in ballet dancers. A new overuse injury of the foot. J Bone Joint Surg Am, 67(9), 1372-1375.

 

O'Malley, M. J., Hamilton, W. G., Munyak, J., & DeFranco, M. J. (1996). Stress fractures at the base of the second metatarsal in ballet dancers. Foot & ankle international, 17(2), 89-94.

 

Wiesler, E. R., Hunter, D. M., Martin, D. F., Curl, W. W., & Hoen, H. (1996). Ankle flexibility and injury patterns in dancers. The American journal of sports medicine, 24(6), 754-757.

 

Kadel, N. J. (2006). Foot and ankle injuries in dance. Physical medicine and rehabilitation clinics of North America, 17(4), 813-826.

 

O'Malley, M. J., Hamilton, W. G., Munyak, J., & DeFranco, M. J. (1996). Stress fractures at the base of the second metatarsal in ballet dancers. Foot & ankle international, 17(2), 89-94.

Tags:  dancers  foot  teachers  toes 

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Putting on a Conference: An Interview with IADMS Day for Teachers organizer Brenton Surgenor

Posted By IADMS Program Committee, Monday, August 8, 2016

A Day for Teachers is an important part of the annual IADMS programme. This popular event evolves year by year depending on where it is and who is organizing it. To find out exactly how the programme is developed I sat down with this year’s organizer, Brenton Surgenor, to find out what makes A Day for Teacher Hong Kong unique.


  


(1) How do you go about producing a Special Interest Day that is both educational and appealing?

 

Well that’s easy. I’ve been to going to IADMS conferences since 2010 and always attend A Day for Teachers (ADFT).  This experience has given me a good idea of who attends and what sort of content dance educators are looking for.  Firstly, I thought it was important to incorporate some practical session - which in Hong Kong will be Franklin Method for Dancers presented by Morten Dithmer. Then I felt it important to include a “hot topic” which this year is Nutrition for Dancerspresented by Frankie Siu from the Hong Kong Sports institute (which just happens to coincide with the IADMS Education Committees new resource paper on nutrition).  Finally, I wanted to include a panel discussion so dance educators could ask their burning dance science questions and get advice and support from our panel of experts.

 

(2) Who is involved in putting together A Day for Teachers?

 

Like so many advocates for the wonderful work of IADMS, I’m a bit of a Dance Science one-man band here in Hong Kong.  So the first thing I did was consult with local dance teachers to see what they thought was important to include.  Once I had an outline and some initial ideas I then sort the guidance and advice from my international colleagues (Edel Quin, Erin Sanchez and Margaret Wilson) who were instrumental in finalizing the programme and presenters. So I would say this has definitely been a team effort.

 

(3) Every Special Interest Day is different so what do you think is different or special about this year’s?

 

A Day for Teachers Hong Kong is unique because this year it’s nested within the main IADMS conference.  In the morning ADFT delegates have specially designed programme and then in the afternoon ADFT delegates are invited to attend any of the presentations or movement session offered as part of the main IADMS conference.  This is exciting as it means that our ADFT delegates will have the opportunity to be a part of the main IADMS conference and to meet and share ideas with delegates from across the world.  In this way it fully reflects IADMS commitment to inclusivity and introduces new delegates to the wonderful world of Dance Medicine and Science.

 

(4) What do you think you are most looking forward to about A Day for Teachers or conference as a whole? 

 

For me it’s all about learning.  And by this I mean knowing what is current in the field of dance medicine and science.  Dance medicine and science is evolving very quickly and there is always something new being discovered. By utilizing the knowledge I learn by attending an IADMS conference, it ensures that my students at the Hong Kong Academy for Performing Arts have the best opportunity to be happy, healthy and performing at their very best.



 

Tags:  conference 

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Putting on a Conference: An Interview with the IADMS Program Committee Chair Alexander McKinven

Posted By IADMS Program Committee, Monday, August 1, 2016
Alexander McKinven is the IADMS Program Committee Chair and works year-round to prepare for the IADMS Conference. Here are his answers to a few questions we had about what goes into planning a conference.

 

1)       How do you go about producing a conference that is both educational and appealing?

 

As a multi-profession organisation, it is so important that the conference is relevant to all members. We are relatively guided by the abstracts submitted each year but do balance this with clinical symposia choices.

The program committee has continued to develop our selection process to ensure the highest quality of presenters are selected for conference and want to ensure that the association is at the forefront of dance medicine and dance science development.

As this is our second time in Asia, we have tried to harness the expertise from Australasia and the Indian subcontinent.

 

2)       Who is involved in putting together the conference program?

 

It truly is a combined effort from SO many people. The program committee are responsible for the scientific content of the program but behind the scenes we have the blinded reviewers for the abstract selection, the IADMS IT personnel, the local host committee and the education committee of IADMS who specifically help develop the special interest group day. This year, the work of IADMS member Brenton Surgenor and Hong Kong Doctor Jason Brockwell have been instrumental in these SIG days.

 

3)       What timeline do you have to work to leading up to the conference?

 

The conference work is ongoing throughout the year.

After each conference we review the delegates’ feedback and see how we can implement the members’ views to improve the next conference.

At the start of the year we ensure that all the systems are in place for when the call for abstracts goes out. Once all the abstracts are submitted the program committee work exceptionally hard to review and select the very best for conference. I am excited for our members to see the Hong Kong schedule once it is released and am so proud and thankful to the team that I have lead this year.

 

4)       Every annual meeting is different so what do you think is different or special about this year’s?

 

The IADMS conference is three and half days long this year, with the special interest group days called A day for Teachers and A day for Medics, running concurrently within the main program. This decision was taken in line with IADMS mission statement, to raise the standard of the SIG days and to work with the local community where the conference is taking place. China is such a vibrant country and the opportunity to learn and work with the local community of Hong Kong is exciting. I am very much looking forward to seeing some of the performances that have been lined up and exploring the wonderful culture of the East.

 

5)       What do you think you are most looking forward to about the conference?

 

There are some fantastic presentations this year. What I look forward to most is attending a talk or movement session on a topic I know relatively little about. I really believe that this cross collaboration is what makes the IADMS conferences unique and would urge delegates to expand their knowledge and challenge their benefits by trying something beyond their professional norms.

Tags:  Conference 

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Getting ready for the conference: Students and Young Professionals

Posted By the IADMS Student Committee, Thursday, July 14, 2016

The annual conference is fast approaching and it’s time to start making plans. This year the exciting city of Wanchai, Hong Kong will be on the map as the second Asian location for the meeting to be held. Here are a few things we’ve been thinking about in preparation for heading to the tropical paradise in a cosmopolitan city, which happens to have the highest density of 7-Eleven shops in the world AND the world’s largest collection of skyscrapers…

 

Accommodation

If you’re looking to meet up with other student members AND cut some costs why not find a roommate on our student forum. Don’t forget that you need a current membership to access the forums! This can be a great way to get to know other members and will mean you have company finding your way to/from the conference. If you’re in the UK and are looking for a roommate, you might also want to join the Dance Science Study UK Facebook group and share a post there, we’ve met loads of great new people this way!

 

Travel

Getting between the airport and the city…

You might want to start thinking about your travel plans for when you arrive in Hong Kong. This way, instead of feeling flustered when you arrive you can take in the sights and sounds of Hong Kong!

The airport express is the fastest way to get between the airport and the city, reaching Hong Kong Island in around 24 minutes. Airport Express allows free in-town check-in services for major airlines; passengers are also able to take a free shuttle bus from Kowloon and Hong Kong stations to major hotels. More information on the free shuttle bus here.

 

Getting to the conference venue…

Planning your route between where you’re staying and the conference venue ahead of time will also help you to make the most of your time in Hong Kong. If you’re presenting or hoping to make it to the conference for a particular session or workshop, you don’t want to be worrying about how to get there.

The quickest and most efficient way to get around Hong Kong is traveling via the Mass Transit Railway (MTR) system. It covers major districts in Hong Kong, which includes stops at the boundary with Mainland China (Lok Ma Chau Station and Lo Wu Station). 

The Academy is located roughly mid-way between the Admiralty and Wanchai MTR stations, although it is slightly closer to Admiralty (take exit D signposted to the Hong Kong Academy for Performing Arts).

Another option is to use the bus. Buses in Hong Kong are comfortable, plentiful and mostly air-conditioned. They are popular for watching the great views from the top deck of the double-deckers.

Bus route guide for the conference venue:

A) A12, 18, 18P, 18X, 40M, 590, 720, 720A, 722, 780, 788

B) 2, A12, 18, 18P, 18X, 70, 104, 260, 307, 309, 590, 720, 720A, 720P, 722, 780, 788, 930A, 930X, 967X, 969X


Connecting with other students

The IADMS annual conference offers a unique opportunity to connect with peers and professionals who specialise in dance medicine and science. Here’s our top tips on how to make the most of this opportunity…

Top tips

·         Attend the student social – this is a great way to meet other students before the conference even begins!

·         Attend a roundtable – this can be a great way to meet other students and professionals in your area. There is also the student roundtable, an opportunity to discuss key issues with students in dance medicine and science

·         Check out the student networking session – this session brings together professionals from a wide range of dance medicine and science disciplines and gives you an opportunity to meet peers in your research area and to get to know the professionals in your area too.

·         Networking – put yourself out there and try to talk to as many new faces as possible. The IADMS conference is a great place to make new connections and to talk to professionals who are as passionate about dance science as you are!

·         Introduce yourself to the Student Committee - we’re really friendly and love getting to know other young people who share our passions J

 

Getting the most out of the conference

In addition to connecting with other students and professionals you want to make sure that you get the most out of what’s on offer at the conference and in the city of Hong Kong.

Top tips

·         Attend a variety of sessions not just your main area and try to sit down with the conference schedule before you go and plan out the sessions you want to check out

·         Be brave – ask questions during the sessions and get involved!

·         If you don’t fancy asking questions during the formal sessions, attend a roundtable. The roundtable is a great opportunity to engage in discussion with a smaller group of people on a more specific topic.

·         Make the most of your breaks – use this time to try to get to know new faces at the conference and to talk to new people.

·         Make the most of any free time to explore the city – this is one of the perks of being a part of an international association!

 

Student Events

Getting involved with student events can really help you to make the most out of your time at the conference and the events we have on offer mean that you can get to know some new faces before the conference even begins!

Student social

Our student social is a great way to meet other students before the meeting begins and to network with Dance Medicine and Science students from across the globe! This years’ student social will take place the Wednesday before the conference begins to give you a chance to meet up in person before attending the conference.

 

Other student events and sessions include our student and young professionals networking event, the student roundtable and presentations on The future of dance medicine & science: An IADMS student survey and Building your career: how to establish and foster a mentor-mentee partnership in your interest area

 

Little things…

Something as small as having the right travel charger can be the key to making your trip a success.

Travel chargers – The electric power is 220 Volt, 50 Hertz. A power converter is necessary to avoid damage to computers designed specifically for 120 V. Hong Kong uses a Type G electrical plug that has three rectangular blades in a triangular pattern and has an incorporated fuse (usually a 3 amps fuse for smaller appliances such as a computer and a 13 amps one for heavy duty appliances such as heaters). Check out this website for info on what type of adapter you will need.

 

Watch this space! More details to come on our student events in our upcoming blog posts :)

Tags:  Annual Meeting  Conference  students 

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Foot Injuries in Dancers. Are they preventable?

Posted By Maggie Lorraine on behalf of the IADMS Education Committee, Wednesday, July 6, 2016

Perfecting the art of dance requires long hours of intensive training over many years with constant repetitions of exercises to refine and perfect the execution of sequences and movements. Dance places high demands on the body and for this reason professional dance training institutions often include physique testing, conducted by the resident physiotherapist as part of the audition process. Subsequently even the physiques that are deemed “ideal” for training at a pre professional level are at risk of injury as a result of faulty alignment and technique.  In recent years the quest for greater virtuosity in performance has added an extra layer of risk to the aspiring young dancer who is hoping to achieve a career in dance. Issues such as more intrusive stretching techniques to achieve higher extensions of the leg, bigger and higher jumps with added complexity, more virtuosic turns and particularly greater engagement of the spine in movement. These trends have all added to the necessity for dance teachers to have a comprehensive knowledge of human anatomy, physiology and kinesiology. This knowledge will give teachers the information to guide their students to reach their full potential and to avoid sustaining injuries.

 

No dancer is immune to the possibility of injury, however the young dancer who is experiencing a growth spurt is at the greatest risk. Whilst growing, a child’s bones are more susceptible to issues, since as the bones lengthen the growth places stress on the muscle tendon unit and consequently the young dancer at a higher risk for stress fractures and fractures.

 

Building from our previous posts on the foot’s skeletal and muscular structure, this article focuses on the foot and issues that arise from faulty biomechanics, technique and resulting from over pronation of the feet.



Incorrect turn out of the legs and feet often results in over pronation or “rolling “of the foot and ankle. To make up for inadequate mobility at the hip, dancers often rely on the rotation of the knee, and ankle to achieve the desired 180-degree turn out of the feet. This problematic mode of movement compromises the control of the rotation of the leg in the hip socket and the efficient recruitment of the deep rotator (turn out) muscles which assist in the stabilizing muscles of the legs and pelvis.  Maintaining alignment, stability, strength and control is difficult to achieve whilst dancing with torsion of the knee, and pronated foot. When the foot is pronated the weight of the body falls through the unaligned joints of the knee and ankle creating an increased torque of the medial (inner) arch and ankle and poor intrinsic foot muscle control  (see photograph above).


When there is poor intrinsic muscle strength in the arch of the foot, foot pain may occur. The intrinsic foot muscles are the tiny muscles, which contribute to control a ballet dancer's arch. If the muscles are not working effectively, larger muscles known as the extrinsic foot muscles, which originate on the leg and cross over the ankle joint, become overused.


Over-pronation of the feet can lead to a number of problematic conditions, which contribute to foot pain and may cause conditions such as bunions, hallux rigidus, plantar fasciitis, and sesamoiditis.

 


Unfortunately bunions can be common in dancers. They begin to develop in young dancers who do not have the muscle recruitment in place to support the growing bones. Both male and female dancers are at risk from the increased stress on the medial column of the foot as a dancer attempts to achieve greater turnout from the knee and ankle. Some bunions (or hallux valgus) are hereditary, however dancers may develop them as a result of forcing turn out with little to no intrinsic muscle control. Tight fitting shoes and pointe shoes may also contribute to bunions as the shoes narrow to the pointe and the foot is broadest across the metatarsals. Squeezing the toes into narrow pointe shoes put pressure onto the big toe joint which is exacerbated by carrying the weight of the body on the tiny surface of the shoe en pointe.

 

Repeated strain on the big toe joint may result in hallux rigidus or stiffness of the big toe. Dancers with bunions are more prone to hallux limitus. The shock and forces from dancing can lead to inflammation of the big toe joint, and over time cause stiffness and a lack of range of motion. Because of the pain and stiffness, dancers will shift their weight to the outside of the foot during demi-pointe. 

  

Metatarsalgia is an overuse injury and the term describes pain in the ball of the foot, which usually develops over months. High impact activities such as jumping without sound foot control and abnormal weight distribution on the foot can result in this injury. Although this injury is not solely a result of hyperpronation, the reduced foot control resulting from poor intrinsic strength will be a contributing factor.

 

Sesamoiditis is another condition where pain is often felt in the ball of the foot and is a result of excessive pressure on the forefoot. The sesamiod bones are two tiny bones within the flexor hallucis longus (FHL) that run to the big toe and when a person has sesamoiditis the tendon become inflamed. Dancers, who alternate between extreme plantar flexion and dorsiflexion rely on the flexor hallucis longus (FHL) for dynamic stability of the foot during these movements and they may be particularly susceptible to this condition. Other causes can be an increase in activity, having a foot with a high arch or a bony foot (with insufficient fat to protect the tiny bones) and also stress fractures. Most frequently dancers with sesamoiditis have an imbalance of FHL vs. gastrocnemius/soleus {calf muscles} and FHL vs. intrinsics.

 

The plantar fascia is a dense band of fibrous tissue that originates at the heel and connects to the base of the toes. It stretches each time the foot is used, and is prone to overloading especially if the arch is not supported by proper footwear. Dancers experience pain and swelling at the inside base of the heel and arch area and it is known as plantar fascilitis.

This article has focused on foot injuries, which may result from faulty biomechanics of the foot in dancers.

Forcing turn out from the foot and ankle instead of at the top of the leg at the hip joint results in faulty alignment and poor muscle recruitment. Dancers require strong intrinsic muscles of the feet, which are imperative for aligned foot control against the ground in repetitive movements of the foot, pointe work and jumping.  Without this control of the foot the dancer is at risk of injury.

The next article in this series will examine issues resulting from incorrect stretching of the foot and faulty

biomechanics of rising to demi pointe and pointe.

 

Maggie Lorraine

 

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

 

         Turnout for Dancers: Supplemental Training

         Feet: Skeletal and Muscular Structure

         Resource Paper: The challenge of the Adolescent Dancer

Follow these links for more information:

YouTube - 1

YouTube - 2

 

 

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.

 

Jeffrey A. Russell, PhD, ATC. Breaking pointe: Foot and ankle injuries in dance.

 

 

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:  dancers  feet  foot  injury  prevention  teachers 

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Caring for bony injury demystified!

Posted By Meredith Butulis, DPT, ACSM HFS, Monday, June 27, 2016

Welcome to Part Three of our three part series on muscle, ligament, and bone injuries. We will explore some common myths and how you can use current evidence to efficiently return to optimal performance. This month we will explore bony injuries.

 

“It’s just a stress fracture; I can keep going.”

 “I only take the boot/orthopedic shoe off to dance, other than that I wear it all the time. Is that OK?”

“I can prevent shin splints by stretching my calves more.”

 

As dancers, teachers, or allied health professionals, we’ve likely experienced situations like these.

 

What are some essential pearls that dancers, teachers, and allied health providers need to know when it comes to preventing and caring for bony injuries?

 

What are the most common bony injuries in dancers?

At this time, research does not clearly differentiate dancers versus other athletes with regard to bony injury; however, common bony injury sites for athletic youth and adults including dancers will be discussed here.

 

Common sites for bony injury, particularly stress fractures, include metatarsals, tibia, fibula, navicular, talus, calcaneus, and pars interarticularis.1,2,3,4 Teens and youth are also susceptible to injuries involving epiphyseal (growth) plates. See Fig 1. for an illustration of these common locations.



Clinically, I also find that many dancers think that they have a chronic muscle strain as opposed to a bony injury, especially when fractures are located in the back, pelvis, hip, shins, or feet (Fig 2). For example, dancers often enter the clinic with a self-diagnosis of “hamstring strain,” “hip flexor strain,” “back strain,” “plantar fasciitis,” or “ shin splints.” Once medically evaluated, many of these are found to be fractures. 



Now that we’ve taken a look at common sites of bony injury, let’s get into some common myths and alternative views surrounding these bony injuries! We will delve into management tips, and foundations for designing your own injury prevention programs.

 

Myth # 1: It is OK to dance on a stress fracture.

 

Fact: Dancing on any fracture is not recommended. A stress fracture indicates excessive loading to the involved bone, typically over a period of time; this is different than an acute fracture, which occurs in a single episode.3 Continuing to dance on any fracture can lead to a non-union where the bone terminates its healing process; this is an undesirable outcome as it can lead to needing to permanently modify activity choices. High-risk locations are much more susceptible to delayed or non-union injuries.3,5,6

 


Myth #2: All ankle and foot injuries should be treated with PRICE (protect, rest, ice, compress, elevate) for 2-3 days followed by gradual return to activity as long as they don’t show excessive swelling and bruising at first.

 

Fact: Many bony ankle injuries actually do not swell and bruise extensively immediately. Many can also take more than two weeks to show on an X-ray image.3,7 There are a few indicators that should lead a dancer to see a medical provider initially, as opposed to trying self-treatment for a few days. These indicators are known as the Ottawa ankle rules, and further medical evaluation should be performed. If there is bony tenderness to the distal 6 cm of the medial or lateral malleolus, posterior edge or tip of either malleolus, talar neck, navicular, or base of the 5th metatarsal, medical evaluation is indicated (Fig 4).8 Additionally, if there is inability to weight bear to walk at least four steps either at the time of injury or subsequent time, medical evaluation is indicated. 8  



Myth #3: Once a fracture has healed, the dancer can return to his/her previous level of dance immediately.

 

Fact: Return to activity is guided by the high versus low risk classification of the fracture, the extent of the injury, and the typical training or competitive schedule for the individual.9 Generally, stress fractures take 6-8 weeks to heal with proper rest and rehabilitation; 7 the high risk sites can take quite a bit longer to heal.2,3 Low back fractures typically have a minimal healing time of 3 months.6

 

Proper management of a stress fracture goes beyond bone healing. Ligamentous laxity, leg length differences, areas of joint hyper or hypomobility, and neuromuscular imbalances can all play a role in minimizing improper loading forces through the body.3 Rehabilitation professionals also often use functional test batteries to determine the neuromuscular control of the involved body part prior to returning a dancer to activity.

 

Additionally, comprehensive management of a stress fracture is not limited to physical rehabilitation. Training schedules, adequate recovery strategies, fatigue management, nutrition, medications, menstrual cycle patterns, and footwear should also be evaluated.3

 

 

Myth #4: Stretching the calves regularly will prevent shin, ankle, and foot bony injury.

 

Fact: Injury prevention requires a comprehensive approach in managing multiple risk factors. Risk factors are commonly divided into intrinsic (a property of the individual human body), and extrinsic (the environment surrounding the individual).  Intrinsic risk factors include bone density, skeletal alignment, flexibility, muscular endurance, bone turnover rate, hormonal balance, and nutrition.10  Extrinsic factors include dance surfaces, footwear, training schedules, and load.10 All of these factors need to be considered with regard to the individual performer (Fig 5). 

 


Concluding thoughts:

Now that we’ve explored bony injury myths, and samples of current recommendations in prevention & treatment, how will you utilize this information in your practice?  

 

References:

 

1. Brunker PD, et al. Stress fractures: a review of 180 cases. Clin J Sports Med. 1996; 6(2): 85-9.

 

2. Bennell KL, Brunker PD. Epidemiology and site specificity of stress fractures. Clin Sports Med. 1997. 16(2): 179-96.

 

3. Mayer SW, Joyner PW, Almekinders LC, Parekh SG. Stress Fractures of the Foot and Ankle in Athletes. Sports Health. 2014;6(6):481-491.

 

4. Smith PJ, Gerrie BJ, Varner KE, McCulloch PC, Lintner DM, Harris JD. Incidence and Prevalence of Musculoskeletal Injury in Ballet: A Systematic Review. Orthopaedic Journal of Sports Medicine. 2015;3(7)

 

5. Behrens SB, Deren ME, Matson A, Fadale PD, Monchik KO. Stress Fractures of the Pelvis and Legs in Athletes: A Review. Sports Health. 2013;5(2):165-174.

 

6. Standaert CJ, Herring SA (2007). Expert Opinion and Controversies in Sports and Musculoskeletal Medicine: The Diagnosis and Treatment of Spondylolysis in Adolescent Athletes. Archives of Physical Medicine and Rehabilitation. 88(4): 537-40.

7. Verma RB, Sherman O. Athletic stress fractures: part I. History, epidemiology, physiology, risk factors, radiography, diagnosis, and treatment. Am J Orthop. 2001; 30(11): 798-806.

8. Bachmann LM, Kolb E, Koller MT, Steurer J, ter Riet G. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ. 2003;326(7386):417.

9. Deihl JJ, Best TM, Kaeding CC. Classification and return-to-play considerations for stress fractures. Clin Sports Med. 2006 Jan;25(1):17-28, vii.

10. Bennell K, et al. Risk factors for stress fractures. Sports Med. 1999 Aug;28(2):91-122.

 

Further Reading:

1. Robson B, Chertoff A. Bone health and female dancers: Physical and Nutritional Guidelines

Resource Paper. International Association of Dance Medicine and Science. 2010. Available at: http://c.ymcdn.com/sites/www.iadms.org/resource/resmgr/resource_papers/bone_health_female_dancers.pdf

 

About the Author: Meredith Butulis, DPT, MSPT, OCS, CIMT, ACSM HFS, NASM CPT, CES, PES, BB Pilates is a dance-specialized Physical Therapist, Personal Trainer, Pilates Instructor, and dance performer. With over 15 years of experience, she is based in Minneapolis, MN at Twin Cities Orthopedics and the Minnesota Dance Medicine Foundation.

Tags:  bone  dancers  injury  teachers 

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Maybe you should stop dancing… a little

Posted By Luke Hopper and Peta Blevins, Wednesday, June 15, 2016

We all know how super hard dancers work. Dance is a passion, a lifestyle and an identity for millions of people around the world. And you only get to the top with hard work and grit right? But can you have too much of a good thing?


Most dancers know the stories of dance legends like Nureyev and Cunxin dancing through adversity night and day, spending more time in the studio than any other dancer on their way to greatness. And we have all heard stories of dancers pushing their bodies through performance because the show must go on. These are inspirational stories of motivation and determination, but the fact is while dancers are super humans they certainly aren’t superhuman, and injury caused by over working in dance is a worldwide problem. A dancer who has not experienced some form of injury that has forced them to stop or modify their training is a rarity. This is really no surprise because dancers love what they do. They want to be the best they can be and put a huge number of hours into the studio pursuing their dreams. But all this training can come at a cost. No-one can work as hard as dancers do without running the risk of experiencing injury or illness that is going to stop them dancing in some way. So, could dancers actually train less, reducing the risk of injury or illness, and still progress in their training, perhaps even faster?


 


The majority of dance injuries are referred to as overuse injuries. The term overuse means just what it says - injury occurring as a result of the body being overused. The tissues in the body become fatigued and susceptible to injury when a dancer is overusing them. This is the risk dancers take in dedicating so much time training. Nobody wants to get injured and one of the hardest parts about injury for a dancer is having to take the time out of dance to recover and rehab the injury. But let’s step back and look at the injury from a different perspective. Maybe the injury is a way in which your body is showing that you are working too hard and the injury has actually just forced you into a period of recovery time? Think all of the days or weeks in the past years that you may have spent not dancing as a result of injury or illness. This is time that your body has spent recovering from training. Wouldn’t it be a better option to dedicate time for recovery as part of your regular practice so that you don’t become too injured or ill to dance in the first place?


Colleagues who work in sports are often amazed when they hear how much time dancers actually train. It is way above the training time of elite or professional athletes. This is partly because of two fundamental principles of physical training used in sport, progressive overload and recovery. Progressive overload refers to the concept that training should stress, fatigue and challenge the body beyond a comfortable limit. As a result, after the training, the body responds by adapting with strength or fitness gains, or whatever physical capacity the training challenged. But it is only after training that the body adapts; it is only when the body is recovering that we improve. Making sure you get enough sleep is just as important as working really hard in the studio. We do some of our best work at night when we are asleep in bed.


These principles go beyond the physical and apply just as strongly to psychological factors. There is a huge amount of psychological pressure that goes hand in hand with being a dancer. Dancers may feel pressure to look a certain way, they may be worried about gaining employment, and more and more there is increasing demand for dancers to have versatility in their performance skills. It’s not always possible to leave our worries at the studio door and often we find they creep into the studio behind us and start affecting our performance. Often the first reaction we have when we notice performance dropping off is to increase our training efforts, but maybe training smarter is a better option than just training harder.


A first step in becoming a smarter dancer is looking at yourself as a whole person, not just a dancing body but also a dancing mind. It’s important to acknowledge that pressures from within and outside the dance world, as well as a combination of physical and psychological factors, can have an impact on your performance. Finding a balance between pushing hard and backing off training when you need to recover is a bit like walking a tightrope; it’s very easy to lose your balance and only you can feel where your center of gravity is. There can be a bit of a stigma attached to taking it easy; no one wants to be seen a quitter or a ‘lazy dancer’. But it’s so important to be aware of your own recovery needs and to know when you can push your training and when you need to spend more time focusing on recovering from the hard work you’ve put in.


 


So let’s think about recovery in the context of injury or illness again. You push a little hard through training, ignoring the niggle in your foot or tickle in your throat and all too soon you are too sick to get out of bed or you’re watching class from the side waiting for your foot to recover. Can you frame this series of events as your body forcing you to recover after you have been forcing your body to train? If you can accept that recovery in dance is inevitable (and indeed, essential), then you have the choice of taking the recovery pill the easy way or the hard way. There is nothing like coming home from a hard day’s training, feeling you have accomplished something and are on your way to being a brilliant dancer. So reward yourself, take some downtime, even half a day coupled with an easy afternoon’s training. You are much better spending the day recovering and doing some light training than pushing your body with another hard session risking injury or a week in bed.


So how much training is enough and how much rest is too much? Ultimately, this is your choice, nobody knows your body’s limits better than you. A good place to start is to plan your training over the next few months. In sports this is called periodization and IADMS President Prof Matt Wyon’s articles are a great guide to get you on the way here. By scheduling rest periods it means that you may be able to train differently on your work days and Glenna Batson’s article on distributed practice in dance can help you through that. You will also need to think about your existing schedule, when do you have high intensity classes, days or weeks and how can you schedule your recovery time around these periods.


Finally, recovery does not mean being a couch potato. Elite athletes don’t spend nearly as much time in physical training as dancers but they certainly train full time. This means that when athletes aren’t training in the gym or on the field they will often be reviewing games, looking at game strategy or doing mental skills training. This is referred to as active recovery. So why not schedule half a day a week or so to study dance history or even better catch up on your journal of dance medicine and science articles or IADMS blogs! There are heaps of activities you can do that aren’t dancing that will let your mind and body rest and recover and make you a better dancer.

  

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Luke Hopper (Post-doctoral Research Fellow) and Peta Blevins (PhD Candidate) are based at the Western Australian Academy of Performing Arts. Peta Blevins’ PhD advisory team include Luke Hopper, Associate Professor Gene Moyle (Queensland University of Technology) and Dr Shona Erskine (Western Australian Academy of Performing Arts). Peta will present her research investigating recovery in dance at the IADMS conference this year at the Hong Kong Academy for Performing Arts.

Tags:  dancers  teachers 

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TaMed Dance Medicine Conference Report

Posted By Richard Gilmore, Wednesday, June 1, 2016

How to begin to capture my impressions of the weekend? The essence of the 13th Congress for Dance Medicine held by the Dance Medicine Organization in Dresden on this past Mother’s Day weekend requires a mental review of the subjects, ideas and movement classes. The fact that so many people were sufficiently captivated to stay indoors while the sun gave Germany a first preview of summer speaks for the event and for the inventiveness of our presenters and organizers. There are always new approaches and new aspects of dance medicine worth lending our ears, but also our bodies and souls.



 

We got started not with our ears but with our stomachs, as three lectures addressed various aspects of nutrition for dancers. Among other things, we learned that classical dancers have more eating issues than Latin-American formation dancers, that depression can be one of the major predictors of eating disorders, and that we should have more than just a cappuccino for breakfast. While digesting these lectures we also heard that there are different methods of coping with injuries depending upon obsessive versus harmonious passion for dancing and we were introduced to a tool for fascia work to complete the first segment of the Congress.


Since dancers are not known for being especially awake at early hours, it was advantageous to begin the Saturday morning with Andrew Greenwood, who gave us information packed together with a movement “cappuccino”. He transmitted inspiration to get us all involved in a block of lectures mostly on dance with older or disabled people, but also touching on occupational diseases and skin problems. The wide variety of workshops on all three days allowed for individual selections which could give every participant the chance to find desired information on yoga or emotions, on eurythmy or holistic physiotherapy, fascia work or ballet for seniors, just to mention a few possibilities. The only frustration was from not being able to experience all of them.



Fascial therapy seems to have become established as a standard approach for therapy of dancer’s chronic problems. A lecture on its application to the foot, which followed an examination of factors leading to hallux valgus, the pathological bunion joint, addressed the need and possibilities for prevention.

 

The final segment of the congress began with holistic methods for treating dancers’ injuries, including a method called Wingwave®, which can root out the potentially emotional causes of barriers to performance. The final two lectures headed in a critical direction. While dance medicine attempts to find methods to relieve the pains and to avoid wear and tear from dancing, the world seems to just keep pushing dancers in a direction that is ever more demanding. It could not be determined from where these pressures originate, but the feeling seems to be that dancers are less appreciated as artists and have become more interchangeable, thus can be discarded when broken. While this was not a happy ending, it was cause for all to do some serious thinking.



Tags:  regional conference  TaMed 

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Caring for ligament sprains demystified!

Posted By Meredith Butulis, DPT, ACSM HFS, Wednesday, May 25, 2016

Welcome to Part Two of our three part series on muscle, ligament, and bone injuries. We will explore some common myths and how you can use current evidence to efficiently return to optimal performance. This month we will explore ligamentous injuries.

 

“It’s just an ankle sprain; can I perform this weekend?”

 “My hip flexors are always tight, so my friend taught me the frog stretch; is this a good stretch?”

 

As dancers, teachers, or allied health professionals, we’ve likely experienced questions like these.

 

What are some essential pearls that dancers, teachers, and allied health providers need to know when it comes to preventing and caring for ligamentous injuries?

 

What is a ligament and what does it do?

A ligament is a connective tissue in the body that connects a bone to another bone.  Ligaments serve to create stability in the joint structure. Injury to a ligament is called a sprain, which is different than a muscle or tendon injury.

 

Myth # 1: After resting a new sprain for a few days, the dancer will be ready to return to the stage.

 

Fact: Ligament healing depends on the grade of the sprain, location, and overall health of the dancer.


 


However, the most common sprain, that involving the ATFL (anterior talofibular ligament) in the ankle, notably takes 6 weeks to 3 months to achieve mechanical stability4, with 30% of these sprains continuing into a state of chronic instability.5

 


Dancers may wonder if they should see a medical provider if they suspect a sprain. A correct diagnosis will help lead to the most efficient route of correct treatment. There are a few indicators that should lead a dancer to see a medical provider initially, as opposed to trying self-treatment for a few days. These indicators are known as the Ottawa and/or clinical prediction rules, and further medical evaluation should be performed. Since these findings indicate possible fracture, we will discuss them in next month’s blog post on bony injury.

 

Myth #2: New ligament injuries should be treated with PRICE (protect, rest, ice, compress, elevate) for 2-3 days followed by gradual return to activity.

 

Fact: Rehabilitation strategies depend on the type of injury and its phase of healing. Current evidence supports matching rehabilitation strategies to healing phases.

 


Within this decade, sports medicine has also revealed that ligament sprains are more than a localized injury; they affect the entire kinetic chain and sensorimotor system of the body. 7, 8 Therefore, rehabilitation needs to include these elements. Details on proprioceptive training can be found in the International Association of Dance Medicine & Science’s resource paper, Proprioception.9 Details on progressions of functional training can be found in General Considerations for Guiding Dance Injury Rehabilitation in The Journal of Dance Medicine and Science. 10

 

Myth #3: Stretching is the best strategy to prevent sprains.

 

Fact: Stretching can be part of an injury prevention program, as it can help to improve joint alignment and neuromuscular efficiency; however, stretching by itself has not been proven to prevent injury. 11 Currently, there is not a consensus on best prevention, as injury prevention involves addressing the individual within the context of his/her abilities, movement tasks, and environment. 7, 8, 10

 


Generally, stretches should be reserved for muscles, not ligaments. One should not attempt to stretch his or her ligaments, as they may excessively elongate and fail to stabilize the joints that they protect. 12

 

Here is an example of a popular dance “frog” stretch targeted at the ligaments and capsule in the front of the hip. Since the stretch targets ligaments and the joint capsule, it is not recommended.

 


Instead, alternatives like stretching the hip adductors or hip flexors would provide safer and more muscularly targeted stretches. 

 


Clinically, I have found that when dancers are instructed in how to stretch muscles instead of ligaments and joint capsules, their pain often decreases; their functional pain free range of motion often improves within a couple of weeks.

 

Concluding thoughts:

Now that we’ve explored ligament sprains, myths, and samples of current recommendations in prevention & treatment, how will you utilize this information in your practice?  

 

 

 

References:

1. Manske RC. Postsurgical Orthopedic Sports Rehabilitation: Knee & Shoulder. Philadelphia, PA: Mosby. 2006.

 

2. Axe MJ, Snyder-Mackler L. In: Current Concepts of Orthopedic Physical Therapy, Independent study course 21.2.11, 3rd Ed.  Manal TJ, Hoffman SA, Sturgill L. American Physical Therapy Association. 2005.

 

3. Haddad SL. Sprained ankle. OrthoInfo. American Academy of Orthopedic Surgeons. 2016. Available here.

 

4. Hubbard TJ, Hicks-Little CA. Ankle ligament healing after an acute ankle sprain: an evidence-based approach. J Athl Train. 2008; 43(5): 523-529.

 

5. Wilkstrom EA, Hubbard-Turner T, McKeon PO. Understanding and treating lateral ankle sprains and their consequences: a constraints-based approach. Sports Med. 2013; 43(6): 385-93.

 

6.  Phuc L. Human Anatomy System: Skeletal System (Free App for iPhone)

 

7. Petersen W, Rembitzki IV, Koppenburg AG, et al. Treatment of acute ankle ligament injuries: a systematic review. Archives of Orthopaedic and Trauma Surgery. 2013;133(8):1129-1141.

 

8. Fulton J, Wright K, Kelly M, et al. Injury risk is altered by previous injury: a systematic review of the literature and presentation of causative neuromuscular factors. International Journal of Sports Physical Therapy. 2014;9(5):583-595.

 

9. Batson G. Proprioception. International Association of Dance Medicine and Science. Resource paper. 2008. Available here.

 

10. Liederbach MJ. General considerations for guiding dance injury rehabilitation. JDMS. 2000; 4(2): 54-64.

 

11. Clark MA, Lucett SC, Sutton BG, Eds. NASM Essentials of Personal Fitness Training, 4th Ed. Baltimore, MD: Wolters Kluwer; 2012

 

12. Norkin CC, Levangie PK. Joint Structure & Function, 2nd Ed. Philadelphia, PA: FA Davis; 1992.

 

Further Reading:

1. Critchfield B. Stretching for dancers. Resource Paper. International Association of Dance Medicine and Science. 2011. Available here.

 

2. Sefcovic N. First aid for dancers. Resource paper. International Association of Dance Medicine and Science. 2010. Available here.

 

 

About the Author: Meredith Butulis, DPT, MSPT, CIMT, ACSM HFS, NASM CPT, CES, PES, BB Pilates is a dance-specialized Physical Therapist, Personal Trainer, Pilates Instructor, and dance performer. With over 15 years of experience, she is based in Minneapolis, MN at Twin Cities Orthopedics and the Minnesota Dance Medicine Foundation.


Tags:  dancers  injury  ligament  sprain  teachers 

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Bridging Dance and Health in Brazil V – Towards a Brazilian framework for dancers’ health and wellbeing

Posted By Clara Fischer Gam, Tuesday, May 17, 2016

Welcome to the last installation of the series about the opportunities and challenges of Dance and Health in Brazil! Since January, we have been delving into the Brazilian dance sector through the eyes of our local IADMS members. Along this post series, we have been exploring information accessibility issues and public policies impasses, meeting inspiring initiatives, and familiarizing with the dance career pathways in the country. Today, as we get to the end of a journey, another one begins: this time towards a Brazilian framework for dancers’ health and wellbeing.


 

 

“Dance sector’s problems are still of a very elementary level”, states IADMS member Dr. Adriano Bittar. As we investigated in the 4th installation, Brazilian dancers’ every-day challenges concern employability, low remuneration rates, and lack of recognition in the field. Besides regulations for professional careers, educational development and retirement planning in dance are still proceeding towards approval, mentioned in a previous post. “There are so many unmet needs that inquiry on dancers’ health was left out”, says Dr. Bittar.

 

 Over the years, we have been observing that there are changes taking place, however there is still a long way to go. “In Brazil, dancers are overexposed to health risks during their careers. There is a considerable disparity between the knowledge produced internationally in dancers’ health and the present scenario”, points out rheumatologist Dr. Izabela Gavioli, another IADMS member. Whilst discussions about dance and health are in an early stage, raising awareness of such topics could be in itself a strategy to empower the community, promote the sector, speed up the development of public policies and achieve professional recognition. At the moment, both the dance sector and the broader community are still in the process of understanding the potentials of the dance profession, questioning the nature of the occupation and the further application of dance.

 

Embedded in this context, there is an emerging movement for putting dance medicine and science into practice. Across the country, there are people taking action to bridge that gap. As we have previously explored in depth, there is a growing number of initiatives for dance and health in Brazil. Being part of this community of dancers, researchers and educators that are fostering an emerging field, my peers and I have all been individually working to understand: What does Dance Medicine and Science looks like from a Brazilian perspective? How does it apply to the Brazilian context? 

 

 

 

Since I founded “Dance Science Brasil”, a group on Facebook to connect IADMS members in Brazil, firstly located through IADMS members directory, and other professionals interested in this area of knowledge, a lively space has been opened up for change-makers and leaders of the field to communicate and take this shared inquiry forward.

 

In a few months, the opportunities for sharing and integration to occur will be expanded due to another initiative, proposed by IADMS members Dr. Adriano Bittar from Brazil and Dr. Matthew Wyon from the UK. The project will establish a collaboration network for dance medicine and science between Brazil and the UK, representing a giant leap for the field in my country. As this innovative partnership unfolds, members of IADMS from both nations are getting together in two research workshops to strengthen the bonds and facilitate exchange.  

 

Having arrived back in Brazil less than a year ago, it is very exciting to be in the source of an emerging field in this country. Specially, to have the opportunity to share it with you through this post series! It was a pleasure to bring to you an overview of the challenges and opportunities for dance and health down the Tropics, and with your help I really hope we can keep nourishing this field together!

 

The Brazilian members of IADMS are:

 

- Adriano J. Bittar Sr

- Aline N. Haas

- Bárbara P. Marques

- Clara Fischer Gam

- Claudia Daronch

- Daisy M. Machado

- Flora M. Pitta

- Izabela L. Gavioli

- Kaanda N. Gontijo

- Marcia Leite

- Mariana G. Bahlis

 

Join us on the Facebook group “Dance Science Brasil”!

 

Clara Fischer Gam, MS

“Dance Science Brasil” Group Admin

MSc Dance Science | BEd Dance Education | Pilates Instructor

Rio de Janeiro – Brazil

clara.figa@gmail.com

www.clarafischergam.com

www.gestoslivres.com

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Integrando Dança e Saúde no Brasil, Parte V:  por uma perspectiva brasileira para a saúde e bem-estar do bailarino

 

Bem-vindo à última postagem da série sobre as oportunidades e desafios de Dança e saúde no Brasil! Desde Janeiro de 2016, estamos investigando o setor da Dança no país, através da perspectiva dos nossos membros locais da IADMS. Ao longo desta série de postagens, viemos explorando questões relativas à acessibilidade de informação e políticas públicas, conhecendo iniciativas inspiradoras, e nos aproximando dos desafios da carreira de bailarino no Brasil. Hoje, ao passo que alcançamos o fim dessa jornada, uma outra se inicia: dessa vez em busca de uma perspectiva brasileira para a saúde e bem-estar do bailarino.

 

"As dificuldades do setor da Dança ainda são de um nível bastante elementar...", afirma o membro da IADMS Dr. Adriano Bittar. Como nós investigamos na  quarta postagem dessa série, os desafios diários dos bailarinos brasileiros incluem empregabilidade, baixa remuneração e falta de reconhecimento no campo. A regulamentação da carreira profissional, além de outras questões quanto ao desenvolvimento educacional e o planejamento da aposentadoria na Dança, ainda estão sendo discutidas ou em processo de aprovação legal, como mencionado em uma postagem anterior. "Há tantas necessidades não atendidas que a discussão sobre a saúde dos bailarinos foi deixado de fora.", diz o Dr. Bittar.    

 

Ao passar dos anos, têm ocorrido mudanças nesse sentido. No entanto, existe um longo caminho pela frente: "No Brasil, bailarinos estão sendo super expostos a riscos de saúde durante suas carreiras. Existe uma disparidade considerável entre o conhecimento produzido internacionalmente em saúde na Dança e o cenário atual no país.", destaca a Reumatologista Dra. Izabela Gavioli, outro membro da IADMS. Enquanto as discussões sobre Dança e saúde encontram-se em um estágio inicial, a conscientização de tais temas poderia ser em si mesma uma estratégia para empoderar a comunidade, promover o setor, acelerar o desenvolvimento de políticas públicas e alcançar o reconhecimento profissional. No momento, tanto no setor da Dança, como em outras camadas da sociedade brasileira, parece haver um interesse nas potencialidades da Dança, no sentido de explorar a natureza da profissão e sua possível aplicabilidade em outras áreas do conhecimento.  

 

Neste contexto, há um movimento crescente para levar a Medicina e Ciência da Dança para a prática. Em diferentes regiões do país, algumas pessoas têm trabalhado para dar conta dessa lacuna. Como já descrito em profundidade  em um texto anterior, um número crescente de iniciativas tem sido criada pela Dança e saúde no Brasil. Como parte dessa comunidade de bailarinos, pesquisadores e educadores que estão promovendo um campo emergente, eu e meus colegas temos trabalhado individualmente para entender: quais são as particularidades da Medicina e Ciência da Dança na perspectiva brasileira? como este campo de estudo aplica-se ao contexto deste país?

 

Desde que fundei o "Dance Science Brasil", um grupo no Facebook criado para conectar os membros brasileiros da IADMS  (localizados através do diretório dessa associação), além de outros profissionais interessados ​​e atuantes nessa área de conhecimento no país, surgiu um espaço dedicado à comunicação e partilha para facilitar que agentes e líderes do campo pudessem levar esses questionamentos compartilhados adiante.  

 

Muito em breve, as oportunidades para a integração do campo serão ampliadas devido a uma outra iniciativa, proposta por dois membros da IADMS: Dr. Adriano Bittar, do Brasil, e Dr. Matthew Wyon, do Reino Unido. O projeto pensado por eles vai estabelecer uma rede de colaboração para a Medicina e Ciência da Dança entre Brasil e Reino Unido, representando um salto gigante para esse campo de conhecimento no país. Ao passo que essa parceria inovadora desenvolve-se, membros da IADMS de ambas as nações irão reunir-e inicialmente  em dois workshops de pesquisa para fortalecer os vínculos e facilitar o intercâmbio.  

 

Tendo retornado ao Brasil menos de um ano atrás, posso afirmar que tem sido fascinante participar do desenvolvimento de um campo em ascenção neste país. E ainda mais especial foi ter tido a oportunidade de compartilhar algumas impressões com você através desta série de postagens! Foi realmente um prazer ter podido apresentar uma visão geral dos desafios e oportunidades de Dança e saúde nos trópicos, e com a sua ajuda eu espero que possamos continuar nutrindo este campo juntos!

 

- Junte-se a nós no Grupo “Dance Science Brasil”!

 

- São membros brasileiros da IADMS:

 

Adriano J. Bittar            

Aline N. Haas            

Bárbara P. Marques            

Clara Fischer Gam  

Cláudia Daronch         

Daisy M. Machado            

Flora M. Pitta            

Izabela L. Gavioli            

Kaanda N. Gontijo            

Marcia Leite            

Mariana G. Bahlis    

 

Clara Fischer Gam, Mestre Ciência da Dança

Licenciada em Dança

Administradora do grupo Dance Science Brasil

Co-fundadora do Corpos Aptos, Gestos Livres

Rio de Janeiro – Brazil

clara.figa@gmail.com

www.clarafischergam.com

 


Tags:  Brazil  translation 

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