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A Young Dancer's Guide: What every young dancer needs to know about injury prevention and rehabilitation: Video from the 2014 Annual Meeting

Posted By Bobby Bernstein, Tuesday, September 29, 2015

IADMS Bernstein from Steven Karageanes on Vimeo.

Dance today is an athletically strenuous art form and many young dancers suffer from injuries. My co-author, Nancy Kadel, MD, and I have many insights into why these injuries commonly occur and how they can be prevented. The focus of this blog is on cross training for young dancers, one of the most important topics we discuss in “A Young Dancer's Guide: What every young dancer needs to know about injury prevention and rehabilitation”.

 

There are approximately 32,000 dance schools in the United States alone [1], and countless young dancers are under-informed about dance injury, prevention, and rehabilitation. This lack of awareness can result in young dancers sustaining potentially preventable physical injuries. Knowledge in these areas may be improved if parents seek out qualified cross-training instructors. Great cross-training options for young dancers include Yoga, Pilates, GYROTONIC®, and Yamuna Body Rolling™.

 

Working as a GYROTONIC® instructor for more than eight years, I have experienced that cross-training greatly improves the overall sense of how young dancers use their bodies. In the beginning, they are usually good at showing the movements and at mimicking what is demonstrated. However, they soon learn to feel the movements in their own bodies, to discover the range, tempo, and quality of the movements, and they gain a deeper understanding of how the body works. The following is an example of this learning process.

 

One of the most important skills for young dancers to learn is how to correctly turn out (externally rotate) their legs from their hips. Not all bodies are built to be able to achieve the level of external leg rotation, that is often demonstrated by professional ballet dancers. Young dancers being told that they do not have enough turn out in dance classes can cause mental distress and often results in far too many young dancers forcing their turn out from their hips, knees, ankles, and/or feet. This can cause preventable injuries in those areas as well as in their backs. My favorite way to teach young dancers how access and/or improve their true turn out is by using the GYROTONIC® Full Circles exercise.

 

Please note: In this exercise the student is lying in a supine position on the bench with the upper straps of the GYROTONIC® pulley tower attached to their feet and ankles. The straps are counter weighted cables used to teach control and for muscle conditioning. The movement starts with the legs together, straight, in parallel, and slightly higher than the torso. The legs are then brought up to a 90 degree angle with the torso. Next, the legs are externally rotated, opened to the sides and brought down and around until they meet again at the starting position.

 

To begin, I ask my young dance students to execute the Full Circles without instruction other than to use their abdominal muscles to protect their backs and to stabilize the movement. In most cases, young dancers will overuse their muscular strength, try to open the legs as far to the sides as they can in as close to 180 degrees of external rotation as possible, and to complete the whole circle at a relatively quick tempo. The movement usually lacks control and generally young dancers do not naturally use the correct muscles throughout the whole movement. Specifically, they do not use the correct deep rotator muscles to achieve their full external rotation before opening the legs to the sides. In many cases (depending on how deeply the head of the femur naturally sits in the hip socket), if the femur bones are not properly rotated before opening the legs to the sides then the heads of the femurs can be “blocked" by the sides of the hip sockets. In addition to not being able to access their full external rotation, this also causes gripping of the muscles, discomfort, and tension in the body. I will then ask the young dancer how the movement felt and they will often report some level of pain in the hip while doing the exercise and a snapping in the hip might also be heard. With further conversation it usually comes out that they also feel some hip pain, and many additionally hear this same snapping sound, when lifting their legs in high positions in their dance classes. (The sound most often indicates that the young dancer is also suffering from Snapping Hip Syndrome or Dancer's Hip, which is where the snapping sound is usually caused by the movement of a tendon over a bony structure in the hip.)

 

The next step is that I teach my students to feel the difference between forced external leg rotation and correct external leg rotation. To accomplish this I move their legs one at a time into an assisted, relaxed, fully externally rotated position and then back into parallel multiple times. I then teach them how to use their deep lateral rotator hip muscles to achieve their full external rotation. I continue to cue (hands on teaching techniques) their movements and to gradually increase their range of motion while maintaining the correct muscle activation as they open their leg to the side. Usually, the first several times they try to do this by themselves they continue to grip in the front of their hip and to tighten their quadriceps and gluteal muscles. However, by continued use of hands on cueing they soon un-learn these incorrect movement habits. The end result is that they are able to turn on the correct external rotation muscles without assistance and to correctly execute the complete Full Circles (which also includes the use of the inner thigh muscles, hamstrings, and abdominals) without any hip pain and without the snapping sound if it was also previously present.

 

Learning to move in this new way requires a decrease in tempo. As young dancers become more proficient in correctly executing external leg rotation an increase in tempo becomes possible. Their quality of movement changes naturally as a result of their new body awareness. Full Circles that started out with a forced, slamming quality as the legs opened to the side, gain a soft, easy quality of movement. Once correct rotation of the leg in the hip socket is achieved, and young dancers have learned to access their true turn out without forcing and gripping, they can then use this information in numerous practical levels in their dance training.

 

For example, this is how using correct turn out activation is then transferred into doing a correct tendu from first position (First position is when the heels are together and the toes are pointing away from each other with the goal of achieving 180 degrees of external rotation). I ask the young dancer to start with the feet in parallel facing the barre and then to simply open and close their feet from parallel to first position and back again several times. As they do this, I cue them to feel the correct external rotation muscle activation the same as was achieved in the Full Circles exercise. Then we work on maintaining the un-gripped turn out on both the standing leg and working leg as the young dancer does slow tendus through the entire range of the movement (A tendu is when the working leg is extended away from the standing leg to the front, side, or back, until the foot is fully pointed while maintaining contact with the floor and then the motion is reversed). Improved self-knowledge of this kind can then be further applied to correctly doing all barre exercises and more complicated center work. Improved execution of advanced dance combinations and choreography is only achieved when young dancers increase their over-all body knowledge, but for many aspects of dance this foundation of true external leg rotation with correct muscle activation is key.

 

In addition to the cross-training modalities initially mentioned, there are many helpful exercises that can be easily done in the studio before dancing. For example, young dancers can greatly benefit from doing warm-up/strengthening exercises with a resistance band every day. Nancy Kadel, MD also recommends the following:

 

“Doing slow pliés and relevés in parallel with a tennis ball between your heels is my favorite recommendation for dancers to warm up the little muscles in their feet and ankles in correct alignment.”

 

It is incredible to see young dancers being able to dance pain-free through greater self-knowledge. Supporting this increase in understanding can help the young dancers of today reach their goals healthily and become the great artists of tomorrow!


 

 

Bobby Bernstein

Professional Dancer

Certified GYROTONIC® Instructor

Dance Teacher

IADMS Member

 

e-mail: thehealthyyoungdancerproject@gmail.com

 

 

[1] “Education Statistics-National Dance Education Organization”, Ndeo.org, 2015


Tags:  cross-training  dancers  teachers 

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What Dancers and Dance Teachers Need to Know about Motor Development, Motor Control, and Motor Learning: Part III

Posted By Donna Krasnow, PhD, and Virginia Wilmerding, PhD, Monday, September 14, 2015

This is the third of three posts looking at the field of motor behavior and its impact on dance training. This post will deal with motor learning, which looks at the changes in motor skills caused by experience and practice, rather than development as described in a previous post. These changes can only be observed by changes in performance and are relatively permanent. This area of motor behavior is probably the most useful for dancers and teachers.


How dancers learn is strongly affected by instructional strategies and learning styles. The three main categories of instructional strategies are demonstration, verbal instructions/cueing, and feedback. Demonstration is very important to dancers, especially beginners, because we are so visual in our learning. What learners perceive when they watch the teacher or another dancer demonstrating is related directly to the coordination pattern of the skill. With verbal instructions, the important message is that dancers should not be overloaded with information when they are learning a new skill or combination. Instructions should be also be age-appropriate. Imagery can be highly useful in keeping instructions concise, stimulating, and suitable for the age group. Finally, feedback that expresses how the movement was done (knowledge of performance), rather than simply giving information about what occurred (knowledge of results), is far more useful.


The importance of motivation in dance training cannot be over-emphasized. Dancers need feedback that tells them what they need to improve, but the tone and message should always remain positive. Criticism does not imply negativity, and can be balanced with praise and support. It is important to set clear and reasonable goals for dancers, which sustains a motivational climate.


All dancers and teachers know that learning demands considerable practice. The issue is how to keep this interesting and progressive. Variability in practice is a key factor. While repetition is essential, variations can help with both developing the larger general motor plans as well as assisting in motivation. A movement or skill should only be repeated in the same way over and over when that particular form of the movement is going to be needed in choreography. Two other factors to consider are using random practice, that is, practicing a variety of skills alternately, and rest. Rest is crucial for muscle recovery as well as consolidating memory.


Dancers and teachers use several strategies to make learning easier. Segmentation means to practice sections of a phrase, before putting them altogether. Simplification involves doing a less complex version of a skill, such as a passé balance, before doing the complex version, such as a double pirouette in passé. Fractionization is for multi-limbed movements, and means practicing just the arms or just the legs before doing all the limbs at once.


Two other tools that dancers can use to assist in learning are mental practice and improvisation. Mental practice combined with physical practice can enhance learning, and even by itself, such as during times of injury, can help maintain skills. Improvisation allows dancers to explore movement concepts and focus their attention on fundamental ideas without worrying about choreographic detail.


With a firm understanding of motor development, motor control, and motor learning, dancers and teachers can make the most of the dance training environment.


Donna Krasnow, PhD, and Virginia Wilmerding, PhD, are IADMS members and co-authors of the newly released Human Kinetics text Motor Learning and Control for Dance: Principles and Practices for Performers and Teachers.

Tags:  dancers  motor control  motor learning  teachers 

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What Dancers and Dance Teachers Need to Know about Motor Development, Motor Control, and Motor Learning: Part II

Posted By Donna Krasnow, PhD, and Virginia Wilmerding, PhD, Monday, September 14, 2015

This is the second of three posts looking at the field of motor behavior and its impact on dance training. This post will deal with motor control. Motor control is the study of the nervous system, that is, the brain and all of the nerve cells communicating with the body, and how this system organizes and guides the muscles to create coordinate movement. It also explains how the senses such as vision and hearing, as well as information from the environment, are used to accomplish movement. The study of motor control can yield valuable tools for the dancer and the teacher.


Sometimes teachers suggest that dancers try to contract individual muscles consciously to create dance movement. However, once teachers and dancers understand how the brain functions to create movement patterns with multiple muscles, and the nonconscious processes that are ongoing, they will realize that what they are attempting to do is inefficient. They will be more effective using language that describes whole tasks.


One important aspect of motor control is attention, which simply put is concentrated mental activity. Today people think that it is possible to multi-task, but in truth, when two or more tasks demand the same type of attention, the brain must switch back and forth.  It cannot do the two activities at the same time.  This is why we can drive and listen to music, but we cannot drive and text safely at the same time, because both demand visual attention. If dancers are distracted in their attention in class or rehearsal, they will not be able to dance their best. Finally, levels of sleep and anxiety can greatly affect attention.


Motor control is a balance between movement that is primarily centrally controlled, and movement that is primarily responding to environmental factors. The simplest example of this balance is to consider an outdoors walk.  Walking is determined by what is called a central pattern generator (CPG).  CPGs are groups of nerve cells that can create rhythmic patterns, like walking, which can continue without sensory feedback once initiated. However, if the environment changes, such as approaching a stairway, the brain can respond to this feedback and alter the movement pattern. It may be possible that CPGs can be developed through dance training, such as continuous jumps in first position.


Another type of centrally controlled movement patterns is called a generalized motor program (GMP). By practicing variations of a given task, dancers can develop GMPs for movement categories. For example, dancers usually learn sissonne en avant first, and then learn versions to the back and to the side. They also learn finishing both open and closed, and many arm variations. This variety helps the dancer develop a GMP for sissonne, so that any new variation can be learned easily.


Dancers can also change movement while in progress if the movement is sufficiently slow. Otherwise dancers must wait for the next attempt to use environmental feedback, such as a correction from the teacher. Teachers and dancers also need to understand that as speed increases, accuracy diminishes. When teaching fast movements, it is best to work for accuracy first. However, the movement must not be slowed down so much that it becomes a different GMP. Walking is not simply a slow version of running!


Donna Krasnow, PhD, and Virginia Wilmerding, PhD, are IADMS members and co-authors of the newly released Human Kinetics text Motor Learning and Control for Dance: Principles and Practices for Performers and Teachers.

Tags:  dancers  motor control  motor learning  teachers 

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What Dancers and Dance Teachers Need to Know about Motor Development, Motor Control, and Motor Learning: Part I

Posted By Donna Krasnow, PhD, and Virginia Wilmerding, PhD, Monday, September 14, 2015

Dance training is at the heart of the art form of dance. All dancers can recall the teachers who had tremendous influence on their growth as young dancers and artists. The science known as motor behavior is having a stronger voice in helping teachers and dancers develop to the top level of their skills and artistry. Motor behavior is an umbrella term that represents three areas: motor development, motor control, and motor learning.  This is the first of three posts that will describe these areas of motor behavior, and explain how teachers and dancers can benefit from this knowledge. This post will cover motor development.


Motor development is the study of ongoing changes to movement abilities that are common to all people, and it looks at these changes through all the stages of life. These changes are both progressive, meaning that one skill builds on the next, and irreversible in a healthy population, so that once a stage of development is reached, it does not disappear.


It is important for teachers to understand the age-appropriate material for various groups of dancers, and establish their expectations accordingly. For example, balance has three components – the visual system, the vestibular system in the inner ear, and proprioception. These systems are all present in the young child of 3 or 4 years old, but they are not integrated until after age 7, and not fully developed until the late teens. This is why children can take the head off vertical, and they can turn while traveling across the floor, but they cannot do both at the same time until they reach a certain age, regardless of years of dancing. Postural control and balance are the foundations for success in almost all movement in dance, and it is essential to focus on these aspects of training in the early years.


Locomotor skills follow a particular developmental pattern: walking, running, jumping, galloping, hopping, and skipping. These skills must be presented in order, and at the right age. These are the general age milestones at which locomotor skills can be seen:

·         Walking at 10-15 months

·         Running with high level coordination at 2 years

·         Various forms of jumping at 2-3 years

·         Galloping between ages 2-3 years old, after having been able to run for 6 months

·         Hopping starting at about 3-1/2 years old, and continuing to develop past age 5

·         Skipping is the last to develop and occurs between ages 4-7 years old


It is also important to realize that the full coordination of use of arms, particularly in dance-specific patterns, can take even longer to develop. And as all teachers know, refinements such as straight legs and pointed feet in jumps can take years of practice. Finally, ballistic skills are some of the most difficult to develop, and include grand battement and leaps, which demand a sophisticated motor pattern, not just the strength to do those actions. Teachers’ effectiveness and dancers’ skills can be enhanced through a sound knowledge of motor development.


 

Donna Krasnow, PhD, and Virginia Wilmerding, PhD, are IADMS members and co-authors of the newly released Human Kinetics text Motor Learning and Control for Dance: Principles and Practices for Performers and Teachers.

Tags:  dancers  motor control  motor learning  teachers 

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Creating the Annual “picture”

Posted By IADMS Program Committee, Thursday, September 10, 2015

The Annual Meeting is the highlight of the IADMS calendar. The Program Committee (PC) has the complex task of piecing together the various jigsaw puzzle pieces in order to produce a scientific conference that is both educational and enticing. The committee is made up of four long standing IADMS members: Ginny Wilmerding, Marika Molnar, David Weiss and Alexander McKinven. The mix of professions, nationalities, backgrounds and personal interests means that each of us has a unique perspective on how the Annual Meeting should evolve.  Every Annual Meeting has its own character, with many variables, but the PC strives to develop each one and make it even better than the last.

When the PC gets involved, the location for the Annual Meeting has already been chosen and the Annual Meeting Producer is already working with the local host team. They have an understanding of the size/space available and times slots needed to be filled. Think of this like the template on a canvas with the Program Committee ‘artists’ waiting to know the colours of paints, (the abstracts), they will be given.

After the abstract submission deadline, the committee works on a strict timeline to ensure the integrity, standard, and relevance of the conference by:

·         Making sure the submitted abstracts follow appropriate international ethics standards and any commercial interests are disclosed,

·         Working with the Continuing Education Committee to ensure CME credits are available for healthcare professionals,

·         Distributing the abstracts to a group of independent reviewers who, blinded to the abstracts authors, will perform the task of grading the submitted abstracts,

·         Categorizing the abstracts into relevant topics/subjects to ensure flow, and

·         through their networks, inviting learned colleagues to fill the ever popular and always well attended Clinical Symposia.

As the number of submitted abstracts increases each year - 123 of them in 2006, and growing to an all-time high of 228 of them in 2015 - the task of selecting the best presentations gets harder and harder. Throughout the selection and planning process, there can be unforeseen changes to the program due to presenter’s work commitments, medical problems, flight cancelations, and electronic meltdowns; the Program Committee team are in regular contact with the selected presenters. (The sooner we know about these issues, the better!)

When October comes, hearing the buzz, seeing the presentations live, and being involved in the discussions makes all the hard work worthwhile. To know that we are helping the international dance scientists, clinicians, and researchers have a platform to showcase their work and to see the  satisfaction from the ‘painting’ you helped develop, grow, and stand on its in own is a very satisfying process for the four of us!

Tags:  Annual Meeting 

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Dancers - More Power To You!: Video from the 2014 Annual Meeting

Posted By Jatin P. Ambegaonkar PhD, ATC, Monday, August 31, 2015

IADMS Ambegaonkar from Steven Karageanes on Vimeo.

Watching a dancer perform can be breathtaking and fun. Being a dancer is hard! This is because dancer’s movements often involve jumping and landing. To safely perform these explosive movements, dancers need good power in their lower body (Lower Body Power - LBP). Understandably, 70% of all dance-related injuries are to the lower body. Dancers are also supposed to have better balance than non-dancers. In athletics, sprinters with better strength and power and balance have better performance. In modern dance, aesthetic performance and jump ability are positively correlated to each other. However, research investigating potential interrelationships between LB power and balance among dancers is lacking.

We examined (a) the relationships between LBP measures and balance in dancers, and (b) the relative contributions of LBP to predict balance in 61 female collegiate dancers (18.3 + 0.7 years, 164.7 + 7.3 cm, 61.7 + 9.5 kg and with 11.3 + 4.8 years of dance experience). The dancers performed three vertical jumps on the Just Jump Mat (Probiotics, Huntsville, Alabama USA) and we calculated Peak and Average Power. Dancers also performed the Single leg hop for distance, which examines horizontal LBP. We measured balance using the Star Excursion Balance Test, a commonly used valid and reliable test of balance, which has been found to predict the risk of injury.

Our primary findings were that all balance and LBP measures were positively correlated to each other. We found that the more powerful dancers also had generally better balance.  Our findings thus challenge the often-pervasive myth among that being more powerful equates to being more muscular, which then can worsen dance performance. In fact, our evidence supports the opposite view that for dancers, being more ‘powerful’ also translates as being more ‘balanced’ - a MUCH desirable quality!

We are excited with this finding as, to our knowledge, our results are among the first times in the dance medicine and science that we can say to dance teachers and healthcare professionals that dancers balance and power are positively related to each other. In fact, our data suggest that the three LBP measures collectively combined to predict almost 50% of the change in balance scores. Overall, for dancers being powerful is really a good thing!  Furthermore, prior researchers have noted that training can improve power, strength, and dancer performance. Combining these prior reports with our findings, we can recommend that dance medicine and science professionals need to encourage dancers to incorporate strength and power training outside of dance practice in their training regimens to improve balance and overall dance performance.

 

Reference:
Ambegaonkar, J. P., Caswell, S. V., & Cortes, N. (2014). Relationships among lower body power measures and balance in female collegiate dancers. Paper presented at the 24th Annual Meeting of the International Association for Dance Medicine & Science, Basel, Switzerland.

Tags:  biomechanics  dancers  presentation 

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The female athlete triad in college dance students: Video from the 2014 Annual Meeting

Posted By Amy Avery, BFA, MS, and Jane Baas, MA, MFA, Monday, August 24, 2015

IADMS Avery Baas from Steven Karageanes on Vimeo.

Diet and exercise is an important factor in addressing the health related problems of the estimated sixty seven percent of American adults who are overweight or obese.However, diet and exercise can also become a potential problem when mixed with a strong desire to become or maintain a very thin physique.  Eating disorders can result from these desires, where harmful behaviors are used to lose weight or maintain a thin appearance.2 When taken to the extreme, the practice of excessive calorie restriction and expenditure can have severe health implications.3

            The Female Athlete Triad (Triad) can result from disordered eating patterns and can have severe health consequences.4 The Triad is an interrelated problem and includes three syndromes: 

     1.      abnormal dieting behaviors include restrictive eating, fasting, using diet pills,
                   diuretics, enemas, overeating, binging and purging,5 
     2.      amenorrhea, is characterized as the loss of menstruation, and 6
     3.      osteopenia or osteoporosis, is known as a decrease of bone mineral density. 

The Triad can affect the entire body and mind in ways such as:

·         a reduction in speed, endurance and strength.7
·         fluid and electrolyte imbalances, with depleted muscle glycogen stores and blood
               glucose which can increase risk of injury.
8
·         a higher incidence of  infection, anemia, and electrolyte disturbances; impaired healing,
               cardiovascular differences, osteoporosis and endocrine conditions. 8 Without the
               production of estrogen, bone health can be compromised leading to increased
               occurrence of injuries and osteoporosis. 

Without the proper intervention, the consequences of the Triad can be as simple as the loss of participation in physical activity or as severe as emaciation or death. 2,3 What may begin as a simple diet can lead to a psychological disorder, with eating disorders having the highest mortality rate of all mental illnesses.9

            The occurrence of the Triad is a growing concern among populations, such as athletics, who focus on body image and body weight . 4 This population includes dancers.  Research has indicated the figure to be as high as 60% or greater for athletes in particular sporting events. 10 Historically, having a thin physique has been essential for consideration in the dance world.  Unfortunately, this can encourage eating disorders that are associated with the Triad. 11  The prevalence is unknown in college dancers. However, it is known to be higher in the dancer population due to collective pressures to maintain a thin body. 12 It is a common occurrence for dancers to limit their food intake to meet the demands of professional expectations of body image.  Weight control is influenced by aesthetic considerations and body image.8 Much has been written concerning eating disorders in dancers. 5,8,12-15 However, few studies have been conducted regarding the Female Athlete Triad and the premature occurrence of osteoporosis.16,17

            The purpose of this pilot study was to discover the prevalence of the Female Athlete Triad in college dance majors and minors. An anonymous survey was used to collect data from the current female dancers at an American university to determine if a relationship existed between injuries and eating disorders. Sixty female dancers participated in the survey that included a combination of questions extracted from the Eating Attitudes Test-26 (EAT-26) and the Pre-Participation Evaluation from the Female Athlete Triad Coalition. Findings indicated that 25% of participants could be classified as being in the symptomatic range for disordered eating patterns and behaviors; 48% stated the absence of a monthly menstrual cycle; and 16.67% had sustained stress fractures. 

  

 


            Dancers with a higher eating disorder attitude tended to have more injuries. Further, the sample population had disordered eating patterns and that a relationship existed among the Female Athlete Triad symptoms. In addition, more educational resources should be implemented in dance courses, along with an increase in seminars, town meetings, and counseling services addressing the consequences of eating disorders.

 

A Need for Education

In 1998, the American College of Sports Medicine advised detailed approaches be established to identify, prevent and treat this syndrome. These strategies included education about the Triad for a wide range of individuals including teachers, choreographers, directors, coaches, trainers, administrators, health care providers, parents and the dancers/athletes themselves.  Identifying individuals who may be at risk is especially difficult in the dance population.  In a field where a preoccupation with weight and disordered eating is considered "normal," how can we determine when “normal” becomes excessive? Becoming familiar with the signs and symptoms may help increase the prevention of a full blown eating disorder. It is recommended by the NCAA that those who work with dancers and the students themselves need to be aware of the risk factors and symptoms. Being aware of the situation is the first step in changing behavior. A teacher or a coach can be influential in providing students and staff with the education they need to decrease the risk of Disordered Eating and the Triad. Instructors must promote intelligent knowledge to their students and be healthy role models for their students.

Promoting healthy choices is crucial to the wellness of their dancers. Robson and Chertoff 18 make the following recommendations:

• Encourage positive attitudes and healthy bodies;

• Provide information regarding calorie consumption and energy expenditure;

• Raise awareness regarding adequate nutrition and bone health;

• Be mindful of early signs of the female athlete triad;

• Advise vulnerable dancers to seek proper assistance;

• Insist on regular medical check-ups;

• Create strategies to develop ideal health and wellness resources for dancers.

Current research indicates a need for additional resources, education and information for dancers of all ages. This was especially true for dancers in a serious training facility.

 

References

1.  Center for Disease Control/National Center for Health Statistics. (2009). Fast stats:      Overweight prevalence. Retrieved from http://www.cdc.gov/nchs/fastats/overwt.htm.

2.  American College of Sports Medicine. (1998). Position stand, the female athlete triad. Journal of Dance Medicine & Science, 2(1).

3.  Hobart, A. & Smucker, D. (2000). The female athlete triad. American Family Physician. Retrieved from http://www.aafp.org/afp/2000/0601/p3357.html

4.  Reinking, M., & Alexander, L. (2005). Prevalence of disordered-eating behaviors in     undergraduate female collegiate athletes and nonathletes.  Journal of Athletic Training,      40(1), 47-51. Retrieved from    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1088345/.

5. Sonnenberg, J. (1998). Etiology, diagnosis, and early intervention for eating disorders. Journal of Dance Medicine & Science, 2(1).

6. Sherman, R. & Thompson, R. (n.d.) Managing the female athlete triad. NCAA Coaches Handbook. Retrieved from htttp://www.princeton.edu/uhs/pdfs/NCAA%20     Managing%20the%20Female%20Athlete%20Triad.pdf

7. Williams, N. (1998). Reproductive function and low energy availability in exercising     females, a review of clinical and hormonal effects. Journal of Dance Medicine &             Science, 2(1).

8.  Culnane, C., & Deutsch, D. (1998). Dancer disordered eating: Comparison of disordered eating behavior and nutritional status among female dancers. Journal of Dance Medicine & Science, 2(3), 95-100.

9.  Sullivan, P.F. (1995). Mortality of anorexia nervosa. American Journal of Psychiatry. 152(7), 1073-1074.

10.  Kenney, W., Wilmore, J., Costill, D. (2012). Physiology of Sport and Exercise. Champaign, IL. Human Kinetics, (5th ed). 

11.  The challenge of the adolescent dancer. (2000) International Association for Dance Medicine & Science. http://www.iadms.org/?1

12.  Vincent, L. (1998). Disordered eating, confronting the dance aesthetic. Journal of Dance Medicine & Science, 2(1), 4-5.

13.  Glace, B. (2004). Recognizing eating disorders. Journal of Dance Medicine & Science, 8(1), 19-25.

14.  Ringham, R., Klump, K., Kaye, W., Libman, S., Stowe, S. & Marcus, M. (2006). Eating disorder symptomatology among ballet dancers. International Journal of Eating       Disorders, 39(6), 503-8. DOI: 10.1002/eat20299.

15.  Robson, B. (2002). Disordered eating in high school dance students: Some practical   considerations. Journal of Dance Medicine & Science, 6(1).

16.  Torstveit, M., & Sundgot-Borgen, J. (2005). The female athlete triad:  Are elite athletes at increased risk? Medicine & Science in Sports & Exercise. 37(2), 184-193.

17.  Myszkewcyz, L. & Koutekakis, Y. (1998). Injuries, amenorrhea and osteoporosis in active females. Journal Dance Medicine & Science, 2(3) 88-94.

18. Bone health and female dancers; physical and nutritional guidelines. (2008) International Association for Dance Medicine & Science.  http://www.iadms.org/?212

Tags:  nutrition  presentation 

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A Welcome Message from the 2015 Annual Meeting Host Committee: Top 10 things to do on your trip to Pittsburgh

Posted By Andrea Kozai on behalf of the Host Committee, Monday, August 24, 2015
The Host Committee for the 25th Annual Meeting is incredibly excited to welcome you to Pittsburgh, Pennsylvania! Pittsburgh is a beautiful metropolis in the heart of Steel Country, and has transformed itself from an industrial powerhouse of yesteryear to a vibrant economy based in technology, medicine, and academics. There is lots to do and see, so we thought it would be helpful to share a list of our favorite parts of this city. Without further ado:

10. Visit the historic Strip District. Whether you're looking for local shopping or local food (breakfast at Pamela's is a must), the Strip is the place to be. Pittsburgh is a town proud of its sports teams, so pick up some black and gold gear while you're there!

9. Tour local movie sets. Did you know Pittsburgh is known as "Hollywood of the East"? Movies such as The Dark Knight Rises, The Perks of Being a Wallflower, Dogma, Jack Reacher, Night of the Living Dead, and Flashdance were all filmed here (and a few, including The Perks of Being a Wallflower and Flashdance, were set here too!) Create your own tour using suggestions from this excellent article.

8. Visit Fallingwater. A bit farther afield, Fallingwater is a home Frank Lloyd Wright designed for the Kauffman family of Pittsburgh. It is built over a waterfall and appears to not even stand on solid ground. It is a National Historic Landmark and is open for public tours. Click here for more information.

7. Take a walk from the Marriott City Center to Point State Park, located at the confluence of Pittsburgh's three rivers. See where the Allegheny and Monongahela rivers come together to form the Ohio river and take in the glorious views.

6. Visit one of Pittsburgh's many museums. The Carnegie Museums of Pittsburgh boast a number of options for art (including the Warhol Museum), natural history, and science. Or, check out the Toonseum or the Heinz History Center.

5. Get lunch at Primanti Bros. With several locations including one walking distance from the Annual Meeting, opportunities abound to experience this classic Pittsburgh eatery. Don't be surprised when your fries come on top of your sandwich instead of next to it!

4. Take a trip up one of the inclines for the best views of Downtown Pittsburgh (or, as the locals call it, the Golden Triangle.) See how many bridges you can count (Pittsburgh has the most of any city in the world, including Venice!)

3. See the artists of Pittsburgh Ballet Theater up close. On Thursday, Oct 8th the delegates of IADMS have a special opportunity to see a studio showing put on by Pittsburgh Ballet Theater. Afterwards, enjoy drinks and light bites with the artists. Sign up when you register for the conference.

2. Attend the Opening Reception and participate in the Silver Anniversary Auction. In honor of the 25th Anniversary of IADMS, a silent auction will run through the conference to raise funds for IADMS-IT. Donate something, bid on something, and be a part of the next 25 years of IADMS!

1. Learn, network, and participate in everything the 25th Annual Meeting has to offer! A fabulous program awaits you, so don't miss a minute of it.


For more ideas and assistance planning your trip to Pittsburgh, check out www.visitpittsburgh.com. See you in October!

- Andrea Kozai, Host Committee Chair

Tags:  Annual Meeting 

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Do Dance Professionals think about their health? : Video from the 2014 Annual Meeting

Posted By Derrick D Brown, Tuesday, August 4, 2015
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Nutrition Research should drive advice and practice: which nutrients should the dancer be updated on and why: Video from the 2014 Annual Meeting

Posted By Jasmine Challis, BSc, RD, Monday, August 3, 2015

This blog looks at the information I presented at the 2013 IADMS conference in Seattle. It looks at an area where there is a lot of controversy and tries to steer a research based path to advise the dancer on current best practice considering the current evidence.

Introduction

Dancers interested in making sure their food and fluid intake optimises their performance are faced with a huge amount of nutrition information in magazines, newspapers, the internet, blogs(!), TV and radio programmes, Twitter and other social media, plus that from  teachers/colleagues/ peers/family and friends. It can take determination not to be drawn into believing the latest trend as to what is best. It is probably useful to remember that nutrition research changes knowledge slowly in almost every case, so if a claim sounds dramatic, it has probably been exaggerated or the actual information twisted to try and make a story.

When we think about nutrition we tend to think about energy, measured in either kcals (USA) or kjoules (Europe and Australia), which can come from carbohydrates and fats (and alcohol- though not relevant for training/performance), - and technically from protein. Although protein can be used as an energy source, it can’t then be used for its main roles in growth and repair so it’s not a viable option for most dancers. It is also the most expensive component of most meal plans so most dancers will have more of a challenge to take in enough protein to meet their needs than to have surplus to burn as a source of energy.

Moving on from energy we then need to consider the vast range of vitamins and minerals that humans, including and particularly dancers, need. There is ongoing research identifying new roles for established nutrients, such as Vitamin D having a role for a healthy immune system, as well as clarifying the roles of nutrients such as Vitamin E which we still don’t fully understand.

The tables below show the vitamins and minerals that are perhaps of most relevance to the dancer, and the body systems that are most important in dance and whether the nutrient may or may not be involved. Nutrition research is very challenging for a number of reasons. It is difficult to persuade people to keep to a fixed diet so that an experiment can be done to change just one food or nutrient; people do not all react the same; it may take a long time to see a difference, and all of this makes research very expensive and time consuming. Also, when trying to change a nutrient, unless it can be added to an existing part of your diet, for example adding folate to bread, then introducing more of one nutrient, means another typically must be reduced and this can impact your total energy intake which may in itself affect the results. Another problem is that large amounts of any nutrient is likely to do harm, and at extremely high intakes the body may process these nutrients differently compared to when taken in moderate amounts. 

  

There is also a problem that anyone can call themselves a nutritionist – though the title ‘Dietitian’ or ‘Dietician’ is legally protected – so there are many ‘experts’ who are taking some evidence (at best), and advising people without having the depth of knowledge to give the best advice. Always remember that if it sounds too good to be true, it probably is. And that nutrition is almost never black and white, because of the simple reason that if you make a change you are most likely taking something out of your meal plan to put something else in. If you take out sweets and put in fruit, your energy level as well as your intake of vitamins and minerals may well be better overall, but if you were eating a lot of sweets you will need to put in a large amount of fruit which may upset your digestive system at least initially (you may adjust in time) and also be acidic for your teeth and result in some damage over time. So what sounds like a very good change may bring a less welcome effect.

Small gradual changes you can sustain are best – avoid making huge changes that take a lot of time and effort unless your starting meal plan really needs a complete overhaul and is causing you problems at the moment.

So, think about your food plan, be honest with yourself; if changes would be helpful introduce them gradually and make sure you can keep up the new plan, along with the benefits it will bring, before making further changes. If you can find foods that you enjoy and that help you achieve your nutrition goals that is going to make keeping to a meal plan easier!

Jasmine Challis, BSc, RD

Tags:  dancers  nutrition  presentation  teachers 

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