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Injury Prevention Research: Investigating patellar tendon development in adolescent dancers

Posted By Aliza Rudavsky on behalf of the IADMS Education Committee, Thursday, July 30, 2015

Our final injury prevention installment comes from Aliza, reporting early findings of a piece of research which has investigated patellar tendon development amongst adolescent dancers. 

Jumper's knee is a condition where there is pain just below the knee cap associated with jumping.  The medical term for this condition is "patellar tendinopathy" and it is a fairly common condition in elite dancers, especially those who are strong jumpers and tend to jump a lot.  Jumper's knee is an overuse condition.  The main risk factor for developing symptoms is having pathology within the patellar tendon (pictured below).  It is not clearly understood when pathology can develop in the tendon or when the tendon matures.  

 

A group of researchers from Melbourne are investigating how this tendon changes during adolescence in young ballet students.  The goal of this study is to identify normal and abnormal tendon development.  In order to observe changes in the tendon, this study involves using a 3-D ultrasound device called a UTC (Ultrasound Tissue Characterization) to image the patellar tendons of young ballet students at the Australian Ballet School and the Victorian College of Arts Secondary School throughout puberty.   

This research group will be following the same cohort of students over a two year period to monitor subtle changes in their tendons as they grow and progress through skeletal maturity.  Dancing and other exercise volume is also being closely monitored as well as participation in classes and any injuries.  

The evidence so far has demonstrated that people with pathology in their tendons are at a much higher risk of developing jumper’s knee symptoms.  Researchers have discovered already that after approximately 17 years old, tendons are mature and do not generally turn over new tissue; therefore, if people have pathology within their tendons by this age, it will likely remain within their tendons for life.  This doesn’t mean they will definitely get jumper’s knee symptoms, however they are at a much higher risk than someone with completely healthy tendons.  In younger dancers and athletes (pre-pubertal), the incidence of pathology on their patellar tendons is much more rare and it is thought that perhaps during these pubertal years where adolescents are surpassing their peak height velocity (peak height growth spurt) pathology can develop.  Once we have a better understanding of how tendons mature normally during this time period, we may be able to gain some insight into abnormal tendon maturity.  Throughout this study and in future studies, we hope to gain further understanding of the impact of loading this tendon before it has fully developed and clarify how much jumping is ideal for optimal tendon formation in order to reduce jumper’s knee in dancers and other jumping athletes.  

 

Aliza Rudavsky

Doctorate of Physical Therapy

PhD Student, University of Copenhagen 

 

Tags:  dancers  injury  teachers  tendon 

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Dancing Longer: Safe and effective dance practice to optimize performance, and minimize injury risk

Posted By Edel Quin on behalf of the IADMS Education Committee, Monday, July 27, 2015

This is the third installment on the topic of dance injury on the IADMS blog. Elsa began by introducing us to injuries and injury management in dance, highlighting some great examples of specialized and tailored injury care for dancers in the UK (National Institute of Dance Medicine and Science) and the USA (Harkness Center for Dance Injury). This was followed up by Stephanie’s post on multi-disciplinary screening programmes as a means of highlighting “any concerns with regards to health, injury risk or mental and physical capabilities” and also the potential role of screening as an educational tool in contributing towards injury prevention. As the next contributor in this series, I focus on minimizing injury risk from the perspective of safe and effective dance principles as applied to dance teaching and dance making.


 

Photographer: Chris Nash, 2015.
Trinity Laban Conservatoire of Music and Dance
Dance Science Testing with Wayne McGregor | Random Dance
Dancer: Jessica Wright

Firstly, it is important to dispel the impression that safe dance practice is about ‘wrapping dancers in cotton wool’ to the point that there is no risk, no creativity, no progression. I do not dare to think what dance - a wonderful, expressive, art form - would become if this were the way we engaged with dance teaching and dance making! No – safe dance practice is the complete opposite, it is a means by which dance can continue to challenge physical (and mental) capabilities, through the application of knowledge and understanding of research-informed practice. It is often noted that choreographic practices of today are increasingly demanding of dancers physicality, and at times reach extremes of athleticism. This can be what makes dance exciting! But, how can we continue to push these artistic boundaries, without increasing an already high injury rate1… enter safe and effective practice.

The principles

Safe practice does not solely aim to reduce injury risk, optimizing dancer potential is just as, if not more, important! The combination of these two aims results in the ultimate intention of prolonging participation in dance through healthful practice. The principles are borne out of dance science research, and engage with key overlapping areas of physical, psychological and environmental knowledge (see figure 1 below). Once understood these principles can be applied and adapted to any dance style, any age group, and any dance setting. 


Ask yourself…

As dance leaders (i.e. teacher, choreographer, artistic director, etc.) some of the key safe practice questions we should ask ourselves are:

1. Do I understand and apply physiological principles of warming-up and cooling down to my dance classes/rehearsals? [look out for the upcoming IADMS Resource Paper on Warm-up and Cool-down!]

2. Am I aware of different ways to stretch and when is it best to the different types? [see here]   

3. Do I understand basic anatomical principles and have an awareness of the possible implications of any alignment variations, such as hypermobility or a forward pelvic tilt, within my dancers?  [check out ‘Teaching the Hypermobile Dancer’ by Moira McCormack or ‘Improving Pelvic Alignment’ by Jennifer Deckert]

4. Do I consider the physiological training needs of my dancers (not just the technical or artistic needs)? [see IADMS Resource Paper]  

5. Do I appropriately balance amounts of activity with rest within in dance class/rehearsal3?

6. Do I understand and encourage effective fuelling (nutrition and hydration) in my dancers? [see IADMS Education Committee Resource Paper]

7. Do I know how to manage an injury, if one occurs during my dance session, or how to engage an injured in the dance class? [check out First Aid for Dancers or Technique Class Participation Options for Injured Dancers]

8. Am I aware of how I could create a positive and healthful learning climate in the dance studio?  [check out ‘Standing on the Shoulders of a Young Giant How Dance Teachers Can Benefit From Learning About Positive Psychology’ by Sanna Nordin and Ashley McGill]

9. Do I know how to adapt my safe practice knowledge to my specific dancers and dance style? [see chapter 10 in Quin, Rafferty & Tomlinson (2015)]

If the answer to any of the above is ‘No’ or ‘I’m not sure’, then let today be the day that you take the first step to exploring that specific area of your practice a little more. Dance has evolved, our understanding of the dancing body and mind has evolved, our teaching practices should also continue to evolve.  Keeping up to date with the developments in dance medicine and science research are certainly integral to my own safe and effective dance practice, and that of the dancers that I teach.

While not every dancer or dance teacher has access to the wonderful work of organizations such as the Harkness Center for Dance Injuries in New York or the National Institute of Dance Medicine and Science in the UK, fortunately every dancer, dance teacher, dance leader has access to the growing number of widely available resources, a mere sample of which have been included in this post!  IADMS obviously provides a wide range of easy-to-read research-informed educational resources such as the Resource Papers, the Bulletin for Dancers and Teachers, as well as Posters to adorn dance studio walls. There is also an expanding number of dance-specific texts that are applying the research into practice. There is even an organization dedicated to supporting, developing, encouraging and endorsing safe and healthy dance practice world-wide; Safe in Dance International (SiDI), go here for more.

So, as we strive to advance our art form, let’s do so with the aim of minimizing injury risk, optimizing potential and prolonging participation, by educating ourselves on dance science informed principles. As dance medicine and science research continues to develop, so should our knowledge and application of safe and effective dance practice. Just imagine the possibilities….!

  

Photographer: Kyle Stevenson, 2010.
Trinity Laban Conservatoire of Music and Dance
MSc Dance Science Students Investigating the Dance-specific High Intensity Fitness Test
Dancers: Helen Reeve and Casey McEldowney


For further reading, have a look at these resources:

1. Shah, S., Weiss, D.S., & Burchette, R.J. (2012). Injuries in professional modern dancers: Incidence, risk factors, and management. Journal of Dance Medicine and Science, 16(1), 17-25.

2. Quin, E., Rafferty, S., & Tomlinson, C. (2015). Safe Dance Practice. An applied dance science perspective. Champaign, Ill, USA: Human Kinetics.

3. Batson, G,. & Schwartz, R.A. (2007). Revisiting the Value of Somatic Education in Dance Training Through an Inquiry into Practice Schedules. Journal of Dance Education. 7(2):47-56

 

 

Edel Quin MSc FHEA

Dance Educator and Researcher, Programme Leader MSc Dance Science at Trinity Laban Conservatoire of Music and Dance

Tags:  dancers  injury  teachers 

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Injury Prevention: Screening as a tool for education

Posted By Posted by Stephanie De’Ath on behalf of the IADMS Education Committee, Tuesday, July 7, 2015

What is screening?

Screening is often used for pre-entry to a school or company to highlight any concerns with regards to health, injury risk or mental and physical capabilities. Although research suggests that protocols should, where possible, be carried out by a physiotherapist or dance science professional there are some protocols that can be adopted by schools or companies with limited resources to at least complete some of the tests for educative purposes.  Although not widely used as an educative tool, screening provides a great opportunity for dancers to learn more about their bodies, optimise performance and identify injury risk1. By addressing the weaknesses or concerns which arise as a result of the screen, a programme of activity can be developed to compliment training and reduce the likelihood of injury. As a member of Trinity Laban's screening team for the past four years, in this post I will explore how screening can contribute to injury prevention from an educational perspective.

 

What is involved in screening?

As highlighted by Liederbach et al2, screening often involves collating information on many components including medical history, skeletal structure, alignment, range of motion, strength, cardio-respiratory response, motor skills, stability and mobility, self esteem, motivation and nutrition amongst others.  From personal experience, the benefits for using screening as an educative tool, rather than pre-entry or for research, is that the methods can be adaptive to reflect the student needs, the current staff's knowledge/experience and developments in research. This can however make it somewhat difficult to use the data for research, which is why changes in protocols should be considered carefully

 

In the UK National Institute of Dance Medicine and Science (NIDMS) screening program, we explore a number of different areas which include: health and injury history, current training exposure, anthropometrics, hypermobility/flexibility, strength, a functional musculoskeletal screen and an aerobic fitness test. Once the assessments have been completed, individuals are invited for feedback to go through each test result: looking at comparable means and discussing how their results can impact their training.

 

How can screening contribute to injury reduction?

There are many benefits and outcomes of screening, however the following are the five testing protocols that I typically find to be most helpful in educating dancers on injury reduction. These protocols can easily be adopted by individuals, especially those with limited resources.

 

1.  Health and injury history

As we already know, results from injury history, menstrual status and nutritional status can be combined to “red flag” symptoms of Female Athlete Triad3. A red flag for each area would be:

- Frequent bone related injuries (more than 2) in the last 12 months e.g. Fractures, bone bruising, etc and/or already diagnosed osteoporosis and/or a known low bone mineral density.

              - Amenorrhea, or no menstrual cycle, for more than three months.

              - And disclosure of, or indicators of, an eating disorder or disordered eating.

There are of course many other areas which may arise as a concern from completing the health and injury questionnaire. For example a low BMI or sleep disturbances, however what is important in this instance is that any red flags for Female Athlete Triad or any other issues are dealt with appropriately. Therefore, if you do not have the provision in your school/ company to provide nutritional advice, have a reliable contact who you can refer your dancers to.

2.  Single jump height

Single jump height measures how high an individual can jump. This result is important information for dancers, however what I find more interesting as an observer of the test is the biomechanics of an individual's jump technique. By looking out for the following we can use the screen itself to optimise the performance of the jump and reduce injury:

             - Are they rolling in or out of the ankles during take-off/landing?

             - Turning in/out of the feet, looking to see if one is more turned out than the other.

             - Are they able to maintain the 90 degree angle at the knees during take-off and
             landing, as specified in the test protocol.

             - If/when fatigued, are they able to maintain technique e.g. feet pointed during
             jump, land in parallel, maintain height, maintain speed, etc

By breaking the jump down and giving this feedback to the dancers I find this to be more helpful than informing them how high/powerful their jump is (of course they will still be interested in this!) as you may point something out to them that hasn’t been identified before.


3. Turnout/turn in

There are a number of different ways to test turnout/ turn in, however I find active standing turnout to be one of the most useful for educative screening, as it is most representational of the dancer in the studio. The dancer will stand on two rotational discs (therefore removing the friction from the floor) and starting in parallel they will turnout or in. The distance of each measurement will be recorded in degrees and repeated three times for accuracy, as they can be rather wobbly if you haven't used them before! In literature it is suggested that dancers should be achieving 70 degrees of turnout4, which may be true for ballet dancers, however for other dance genres this requirement may not be as necessary. What I find that we are actually looking for here is bilateral balance between the right and left side, with no more than 10 degrees difference between the right and left score. An inability to achieve bilateral balance may be an indicator of muscle weakness or tightness in the internal or external rotators or simply a lack of proprioception. I particularly like this test because the dancers are unable to "cheat" due to there being no resistance from the floor - but make sure their knees stay over the toes to ensure no cheating!

                      USEFUL VIDEO HERE.

4. Plank

Like all of the other tests, the plank is more than just achieving a number, it can be indicative of a number of different physical aspects. However from past experiences we usually see dancers achieving roughly around the 2-3min mark.

Whilst the dancer is completing the plank (feet hip width apart and resting on forearm) you can also look out for the following:

              - Feet: are they rolling in/ out or can they maintain a true parallel?

              - Hips: are they even? Or does one side dip more than the other?

              - Alignment: can they ensure that the head, hips and feet sit in one straight line.

              - Shoulder blades: do they "wing" off the back?

5. Dance Aerobic Fitness Test (DAFT)

Over the past 10 years schools and companies have been able to use Dance Specific Fitness Tests (DSFT)5,6,7. One of the most frequently used DSFT by schools and companies is the contemporary Dance Aerobic Fitness Test (DAFT). This fitness test has a number of advantages beyond the data produced i.e. heart rate and rate of perceived exertion (RPE). Observers can also make notes on the individual’s technique over the five stages, each of which is four minutes and progressively increases in intensity. An observer might look out for: arm placement, landing from the jumps, extension of movements, focus, musicality, coordination, etc. The DAFT stage three is representative of the effort levels required for a technique class and stage five is representative of performance intensity. Therefore, the individual can track the changes in their heart rate and RPE over a time period, to see if their training is providing any positive adaptation in their aerobic fitness levels and resistance to fatigue, which allow them to perform set movement at a lower relative intensity. There is currently no published data available on the norms or averages for each stage of the DAFT, however Redding et al will be presenting this information for the first time at the 25th Annual meeting in Pittsburgh…so watch this space!

 

So…what do we do with all this information?

Well, as you can see from the above information, the outcomes are primarily indicators of an area of weakness. To allow this information to contribute to injury reduction we need to ensure that we apply these findings back into training. Therefore, I would recommend that your feedback time is highlighted as one of the most important features of your educative screening session. These indicators cannot be actioned if dancers do not understand the importance and relevance of the results, and furthermore, how to implement this into their training. Ensure you are confident with the official protocols for each test and most importantly, develop a network of dance specialist professionals who you trust for onward referral.

 

References/ recommended resources

1.       Wilson, M., & Deckert, J. L. (2009). A screening program for dancers administered by dancers. Journal of Dance Medicine & Science, 13(3), 67-72.

2.       Liederbach, M., Hagins, M., Gamboa, J. M., & Welsh, T. M. (2012). Assessing and reporting dancer capacities, risk factors, and injuries: recommendations from the IADMS standard measures consensus initiative. Journal of Dance Medicine & Science, 16(4).

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

4.       Howse, J., & McCormack, M. (2009). Anatomy, Dance Technique and Injury Prevention. A&C Black.

5.       Wyon, M., Redding, E., Abt, G., Head, A., & Sharp, N. C. C. (2003). Development, reliability, and validity of a multistage dance specific aerobic fitness test (DAFT). Journal of Dance Medicine & Science, 7(3), 80-84.

6.       Redding, E., Weller, P., Ehrenberg, S., Irvine, S., Quin, E., Rafferty, S., Wyon, M. & Cox, C. (2009). The development of a high intensity dance performance fitness test. Journal of Dance Medicine & Science, 13(1), 3-9.

7.       Twitchett, E., Nevill, A., Angioi, M., Koutedakis, Y., & Wyon, M. (2011). Development, validity, and reliability of a ballet-specific aerobic fitness test. Journal of Dance Medicine & Science, 15(3), 123-127.

 

Stephanie De’Ath, MSc, SRMT, is a Lecturer in Dance Science at UK Higher Education Institutions and is a Sports and Remedial Massage Therapist at London Contemporary Dance School and Central School of Ballet.

Email: stephaniedeath1@gmail.com

 

Tags:  dancers  injury  screening  teachers 

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Alignment of the leg and its impact on the dancer's knee: Clips from the 2014 Annual Meeting

Posted By Liane Simmel, Tuesday, June 9, 2015

IADMS Simmel from Steven Karageanes on Vimeo.

This presentation gives an insight into the functional anatomy of the dancer’s knee, its biomechanical prerequisites and its economic use as base for a high resilience to dance injuries.

 

Over the last decade as more and more acrobatic movements invaded the various dance styles, the strain on the dancer’s knees has largely increased. Training on hard, inappropriate floors or dancing choreographies in high heels can add even more problems. Pirouettes on the knees, knee drops, and even a plié in fourth position require particular leg stability and optimal mobility in the knee. But dancers often pay little attention to their knees. They are seldom specifically warmed up, directly trained or used consciously in everyday life. Nonetheless, their functionality is a top priority if dancers’ knees are to be kept fit and healthy.

Being the largest joint of the body, the knee works as an important coordination centre to the leg. Located between the hip joint above and the foot below, it reacts to all movements and positions of these, its two functional partners. With its high number of daily repetitions, even seemingly small dance technical pitfalls like rolling onto the inner side of the foot in the turned out position or losing the alignment of the leg in demi plié  can lead to overuse problems and even acute injuries in the knee area.

As dancers are accustomed to work precisely on their coordination and alignment they do have a big supply of tools for improving leg alignment, be it in the dance class or in everyday life. They just have to be made aware of this potential...

When analyzing leg alignment and knee load in a dancer, there is more to consider than just screening the bony and functional anatomy of the lower extremity itself. When it comes to assessing the stress and load on the dancer’s knee, the form and mobility of the foot, the bony and muscular situation of the hip joint, the position and mobility of the pelvis as well as the torsion of the tibia play an important role. Thus, to get an impression about the dancer’s anatomical prerequisites, screening should start by analysing the anatomy of the whole functional chain: the foot, the torsion of the tibia, the antetorsion angle in the hip joint and the position and mobility of the pelvic girdle. To detect the keystones by which the dancer can influence, change and improve his or her individual biomechanics the next step in line is to assess the flexibility, function and muscular strength of all functional partners – foot, hip joint, pelvis and last but not least the knee itself.  

Being the most common challenges in many of the different dance styles, turnout, plié and hyperextended legs have been chosen to explain the approach of biomechanical awareness training in dance. Dancers spend a great deal of their days in the studio, but there is still a life outside the ballet room, and movements and biomechanics outside the studio seem to have potential for improvement in many dancers. Therefore the habits in the dancer’s everyday life movement should thoroughly be analysed and searched for negative influence on body functionality by imprinting unhealthy movement patterns in the dancer’s neurological motor program. If not detected and changed these often unconscious habits will be trained on a regular daily basis, imprinting into the dancers motion cortex. To break them up, specific exercises should be performed, with the focus on (1) mobilization (to allow new movement possibilities), (2) awareness (to make unhealthy movement patterns conscious and consider possible changes), (3) strengthening (to enable the muscles and the neurological system to perform unfamiliar movements) and (4) relaxation (to reduce unnecessary muscles tension and soft tissue restrictions). With “one second exercises” performed numerous times per day, the reset of the neurological motor program gets started.

Finally, what seems for the majority of the dancers the most challenging step, the new movement potential have to be transferred back from everyday life to the studio, to the individual dance technique. Easily understandable anatomical and biomechanical images and movement cues can support this tricky step. And last but not least: patience.

Liane Simmel, MD, DO, tamed, Tanzmedizin Deutschland e.V., Fit for Dance, Munich, Germany

Tags:  alignment  anatomy  presentation 

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An Introduction to Dance Injury

Posted By Elsa Urmston on behalf of the IADMS Education Committee, Thursday, June 4, 2015

 

Well, it’s the moment that all dancers and their teachers dread.  Sustaining an injury in dance can be at best, a ‘momentary’ interruption to dance training and performance, at worst a career-ending catastrophe.  Thankfully, dance medicine and science colleagues have produced a vast range of conditioning and injury prevention strategies to enable dancers to be stronger and ever more versatile, as well as take ownership over injury if, as and when it might occur.  Yet of course, by just looking at the repertoire of our modern dance and ballet companies, we can see that choreographers and audiences have increased their expectations of what the human body can achieve.  Injury remains a very real possibility. 

Improving awareness of dance injury, in terms of how and when it might occur, and ensuring dancers know about injury care, can play a large part in the successful rehabilitation and timely return to dancing.  This blog post is one in a series which introduces dance injury.  Subsequent posts will focus on how we might be able to prevent dance injury in the first place, through screening for dancer health and wellness, and by ensuring dance educators’ practice is safe and effective for all involved.

Research suggests that the most commonly perceived causes of injury were cited as ‘fatigue’ and ‘overwork’, along with repetitive movements amongst dancers and managers alike.  Organisations such as IADMS, Dance UK and Harkness Center for Dance Injury amongst many other dancer wellness initiatives, all advocate for optimising dancers’ training and performance through supporting dancer fitness and conditioning, ensuring sound biomechanical function in dancing and promoting an autonomy supportive environment for dancers to flourish.  New research from ArtEZ Institute for the Arts in Arnhem, Holland has sought to reconceptualise how the undergraduate dance curriculum is shaped to maximise performance through the principles of periodisation.  The programme year is designed as a series of macro- and micro-cycles in which the training intensity alternately increases and decreases, ensuring that the dancer develops and recovers without causing staleness or overtraining.  The approach has seen a significant reduction in injuries and less course dropout since the instigation of this system.  Take a look at this easy-read overview of the project at ArtEZ here.

 

So what actually happens when I sprain my ankle or strain a muscle?   

Essentially, if cells become damaged, the body releases a number of chemicals that create an inflammatory response, usually resulting in swelling, redness, heat, pain and loss of function.  Inflammation is the body’s natural response in promoting new cell growth, and is a necessary stage of the healing process.  The injury process can be conceptualised like this:


How can we help our dancers manage injury in the short-term?

Try and help your dancers remember the acronym PRICED – it’s an invaluable first aid guide to immediate treatment which can be self-administered, and when used in the first minutes and hours after injury can help in controlling pain and inflammation and assist in the safe return to dancing.

  • PROTECTION: Remove additional danger or risk from injured area.
  • REST: Stop dancing and stop moving the injured area.
  • ICE: Apply ice to the injured area for 20 minutes every two hours.
  • COMPRESSION: Apply an elastic compression bandage to the injured area.
  • ELEVATION: Raise the injured area above the heart.
  • DIAGNOSIS: Acute injuries should be evaluated by a health-care professional.

And in the first few days after injury, help them to avoid HARM too.

 

  • HEAT: Any kind of heat will speed up the circulation, resulting in more swelling and a longer recovery.
  • ALCOHOL: Alcohol can increase swelling, causing a longer recovery.
  • RUNNING OR OTHER EXCESSIVE EXERCISE: Exercising too early can cause further damage to the injured part. Exercise also increases the blood-flow, resulting in more swelling.
  • MASSAGE: Massage increases swelling and bleeding into the tissue, prolonging recovery time.

 

And what about managing injury more long-term?

Drawing on some of the most recent research findings about injury, such as the periodisation work at ArtEZ, the growing body of research-informed practice around screening dancers and the importance of safe dance practice, we should be seeking ways to embed these examples of best practice in our work to minimise the likelihood of injury first and foremost.  But in managing injury more long-term, we should aim to reduce swelling, restore proprioception (awareness of where the body is in space without relying on the visual system), maintain cardiovascular health and ensure a healthy, balanced and varied diet to facilitate healing.  IADMS have a very accessible resource paper full of practical ideas about First Aid for Dancers here.

 

Local provision

In the UK the establishment of the National Institute of Dance Medicine and Science means that through shared expertise and a network of multidisciplinary partners, better and more affordable, high quality, evidence-based, dance specific health care and dance science support services are being offered to dancers across the sector.  Please check out their website.

In the USA the Harkness Center for Dance Injury is dedicated to providing the dance community with the highest quality injury care and preventative resources. Harkness offers many subsidized and free services including orthopaedic and sports medicine clinics, physical therapy and athletic training services, and injury prevention lectures and workshops.  Please check out their website.

If there are other support services in your locality not listed here, please do add them in the comments box below.

 

For information about dance injury and treatment have a look at the following recommendations:

Laws, Helen. Fit to Dance 2-Report of the second national inquiry into dancers’ health and injury in the UK, 2005.

Solomon, Ruth L., John Solomon, and Sandra Cerny Minton, eds. Preventing dance injuries. Elsevier, 2005.

 

For more information about optimising dancers’ fitness have a look at these texts too:

Welsh, Tom. Conditioning for dancers. University Press of Florida, 2009.

Krasnow, Donna and Jordana Deveau.  Conditioning with imagery for dancers.  Thompson Educational Publishing, 2010.  Additionally there are some useful introductory videos on Krasnow and Deveau’s approach here.

 

Don’t forget to watch out for our forthcoming posts continuing this series about preventing dance injury.

 

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

Email: elsa.urmston@danceeast.co.uk

Tags:  dancers  injury 

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IADMS Education in Motion: A member reports on a Pre-Pointe Education Workshop in New Zealand

Posted By Esther Juon Veitch, Tuesday, May 19, 2015
 

IADMS is an international organization, and our reach is truly international.  In addition to annual conferences and regional workshops, our members are taking the information from dance medicine and science to the most important venues—private studios in small towns, where the application of the information can make a difference for the young dancers and their teachers.  This report from Esther Juon describes such an event.

 

I have recently come back from a five day trip to Aratapu a small place consisting of a hotel and a dance school and a few houses 10 km from Dargaville in provincial New Zealand.

To cover this full day workshop, followed by assessments and fittings, most of the 8 students attending the workshop held a fundraiser. By selling homemade cupcakes and raffle tickets in their town, they raised enough money to pay for the course and the assessments.


 

I had been invited to present a six hour Foot & Pointe Shoe Workshop, followed by fittings of pointe or demi-pointe shoes the next day.  These dancers are in three different classes, the equivalent of BBO (British Ballet Organisation) or RAD Grade 5, Intermediate Foundation and Intermediate.

After settling into the local hotel I met up with the ballet teacher that evening and took her through our PowerPoint presentation and the relevant articles from the IADMS Bulletin for Teachers and Dancers.

I was able to cover the new material and explain the importance of the approaches I was going to use in the workshop. 


We began the morning with an interactive PowerPoint presentation, covering the anatomy of the foot and how that relates to ballet. We also explored what the requirements are for a dancer to be ready for pointe and how the foot should be supported in a pointe shoe (resource here).

The second part of the workshop included working with the dancers on the personal commitment required to safely get ready for pointe work. This includes being technically, mentally, and physically ready to go on pointe. I took the dancers through a series of exercises & stretches that should to be done on a daily basis in order to prepare for pointe work.

Day two was spent working with the dancers individually (2 hours each) and preparing a 5-6 page report, with photos, for each of them to refer to once I was gone. The teacher filled in a pre-prepared form & took notes about each student, while I worked with them. I took photos of what the dancer does currently and noted any improvements she could make. This way the teacher could see why a dancer had certain problems with movements or steps and was involved in changing the way the dancer worked and moved. The report was edited later on, photos added & emailed to the teacher, dancer, and parent. They now have a document to work from until I see them again. At that stage new photos will be taken so we can document the progress each dancer has made.

The teacher has since decided to revisit everything learned and shared in the course and is addressing the personal corrections for each student so progress can happen quite quickly. I look forward to going back to visit them and fundraising for my next trip has already started.

Working with the resources from IADMS I am hoping to reach out to many more teachers to provide them with information to help them prepare their students for pointe work. It is imperative that each dancer goes through her adolescent growth spurt before starting pointe work. In my opinion this is the most important consideration to make for the well-being of the dancer.

 

Esther Juon Veitch:  BBO RTS Dip CID. Member of IADMS Education Board.


   IADMS series one posters are a perfect resource for this topic as they cover the Adolescent Growth Spurt, Pointe Readiness and Proprioception. To order this set, and other IADMS posters, click here


Tags:  education in motion  pointe  teachers 

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Beyond Ballet: Why and How? A Conference Report

Posted By Erin Sanchez on behalf of the IADMS Education Committee, Tuesday, May 19, 2015

  Image by Visuele Notulen | Michèle Giebing

On April 16-18th, ArtEZ School of Dance and Balettakademien Stockholm presented BEYOND ballet why and how, a conference "initiated by education, partnered by the dance profession" in Arnhem, the Netherlands. BEYOND's name alludes to the success of the event's predecessor in Stockholm in 2012; Ballet: Why and How?, which focused on ballet technique and its role in professional vocational training for dancers. This year's conference took on the future of dance with a wider view of dance education, training and professional life through five themes: Educational, Artistic, Urban, Preservation and Medicine and Science. Topics were progressively developed over three days through a series of linked lectures, workshops and practical classes, panel and research discussions, and time for open dialogue and debate.

Dance medicine and science were directly discussed in many areas of the conference, with sessions on empirically supported and clinically relevant medical care and the composition and uses of an interdisciplinary team in delivering support and health care for dancers. However, the most inspiring revelation was the continuing and growing appreciation from dancers, teachers, artistic directors and medical professionals of the value of dance medicine and science in every aspect of dance; from physical implications of collaboration between dance and circus, creative implications of research into synchronization in motor control, awareness of nutrition and body image among dancers and the lengthening of dance careers to radical improvement of traditional dance training through research on attentional focus, periodization and emotional intelligence.

Throughout the conference, methods of training, research, leadership and care of the dancer dominated the discourse. Delegates had time to discuss these themes and to hear rich debate and thought about the future of dance as an art form through the lens of these topics. Cross disciplinary dialogues between artists, educators and medical professionals provided safe place to debate change and growth. Further, students from both ArtEz and Balettakademien Stockholm provided a voice of the future by actively participating in every session, raising questions and providing insights. IADMS members Elsa Urmston, Sanna Nordin-Bates, Margot Rijven, Derrick Brown, Adrienne Stevens and Clare Guss-West all shared knowledge and research from their specialist fields.

 

If you are interested in learning more about the conference proceedings, sessions have been captured in video, articles and blog posts here.

 

Erin Sanchez, on behalf of the IADMS Education Committee

Healthier Dancer Programme Manager (part-time) Dance UK

Web Resources Administrator Rudolf Nureyev Foundation Medical Website

Dance UK, Unit A402A, The Biscuit Factory, 100 Clements Road, London, SE16 4DG

Tel: 020 7713 0730 | Mobile: 07838 956 423

www.danceuk.org

www.nureyev-medical.org

 

Watch videos of the UK's first-ever industry-wide dance conference,

The Future: New Ideas, New Inspirations, conceived and developed by Dance UK.

Tags:  regional conference 

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Maintaining Correct Alignment When Training Positions Retiré or Passé - (to withdraw or to pass)

Posted By Maggie Lorraine on behalf of the IADMS Education Committee, Wednesday, May 13, 2015

 

In the last post from the IADMS Education Committee “Dancing with the pelvis” the authors focused on pelvic alignment and its relevance to movement execution in the studio. When reading this post on the retiré position, it would be useful to refer back to information posted on previous IADMS posts, as each new post now reinforces the anatomical truths that guide us as teachers. To quote Clara Fischer and Elsa Urmston,“We have all learned from experience: proper alignment is one of the basic building blocks for achieving the aesthetic line and form required for dance technique.”

Dancers and teachers cannot underestimate the importance of achieving correct pelvic alignment when practising or performing the retiré position, as it is a key position for the successful performance of many dance movements. Pirouettes and developpé are clearly affected by the placement of this position and the retiré influences the execution of many steps of virtuosity.


Pictured: Rebecca Blenkinsop
Photo by: Maggie Lorraine 

In this photograph (above) Rebecca is demonstrating a well aligned retire position en pointe. Note that her head is centred over her foot en pointe.

Points to remember when practising retiré:

Commencing in 5th position

The Supporting Leg.

  • Full transference of weight over the center of the supporting foot as the gesture leg leaves the floor. The dancer should be ready to rise to demi pointe without further adjustment of weight by ensuring the foot is controlled against the floor. Check that there is no pronation of the supporting foot.
  • Lengthen through the supporting hip maintaining pelvic alignment and the control of turnout of the supporting leg.

The Gesture Leg

  • The foot and ankle of the gesture leg retain alignment, no sickling or winging of the foot.
  • The thighbone or femur inserts into the hip socket or acetabulum from the front of the pelvis and the rotation of the thigh should occur from the turnout in the acetabulum, which is initiated by the deep rotator muscles.
  • The continued control of the deep rotator muscles and core muscles as the gesture leg passes through petit retiré to full retiré.
  • Maintain control of the femur extending from the acetabulum and maintain the knee, ankle and foot alignment. The appearance of the position will vary from student to student depending on their personal pelvic structure, however students should be encouraged to work with their respective physiques rather than meeting a “prescribed” position.
  • Remember “turnout is a verb” and the turnout muscles should continue to be active throughout.

          Thus the retiré position should demonstrate pelvic, shoulder, and head alignment.

Points to consider:

  • On the point of transference of weight from two feet to one foot it must be emphasized not to sink into the supporting hip as this action will result in loss of rotation and control in the supporting side.
  • The hip of the gesture leg must not be raised by lifting the thigh higher than can be controlled by the dancer. This will result in the weight moving off the supporting leg and pelvic alignment will be lost. The deep rotators cannot recruit efficiently when pelvic alignment has been sacrificed
  • Placing the foot too high at the side of the supporting knee can be problematic for some, as not all dancers possess the range of movement in the hip to accommodate this position of the foot and retain pelvic alignment. Many will anteriorly tilt their pelvis, which will result in loss of turnout, and the gluteal muscles will overwork to accommodate the position of the thigh.

When viewing this photograph (below, left) of Rebecca practising retiré it would appear that her retiré is turned out. Observing the same retiré from the side (below, right) we can see that Rebecca is far from turned out, her thigh is in reality inwardly rotating. 

   

 

Please follow this link to see how perfect alignment can work in steps of virtuosity - enjoy!
In this video Isabela Rodriques has an unfortunate slip when performing the coda of the Diana & Acteon pas de deux but later goes on to repeat the whole coda.  You will see that in both of these dancers the gesture leg in retiré is placed in front of the bodyline.

 

 

Maggie Lorraine

IADMS Dance Education Network Subcommittee

Leading Teacher in Ballet

The Victorian College of the Arts Secondary School 

 

Tags:  alignment  dancers  passe  pelvis  retire  teachers 

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Tring Park and IADMS present: Building a Dancer

Posted By Sarah Beck, Wednesday, May 13, 2015

On Sunday 10th May 2015 Tring Park School for the Performing Arts, UK, hosted a one day Professional Development Conference for dance teachers, in association with IADMS, entitled: Building a Dancer. An enthusiastic group of dance teachers, ranging from those working with professional and vocational dancers to grass roots community dance schools, gathered together to learn and discuss.

At the start of the day I was able to present a brief overview of the IADMS mission and the work IADMS does to achieve this. Key resources relevant to this group, such as the resource papers and the Bulletin for Dancers and Teachers were highlighted and copies of ‘The Challenge of the Adolescent Dancer’ paper flew off the promotion stand during the following coffee break.


Pictured: Rachel Rist

Former IADMS President, Director of Dance at Tring Park and Conference Organiser, Rachel Rist, gave the first presentation of the day which provided a detailed guide through a complex list of safe dance practice topics for teachers to navigate with a particular emphasis on ‘building a thinking dancer’ rather than an ‘obeying’ dancer. Principles highlighted and examples given were then beautifully demonstrated in practice to delegates who had the opportunity to watch Rachel in action teaching her Year 7 (11-12 year olds) Girls ballet class later in the afternoon. During this class the young students were highly engaged with their learning and went through a process of identifying, problem solving, and reflecting on their own technical and postural corrections through Rachel’s questioning and guidance. A particularly nice idea was asking each dancer to vocalise their ‘big learning’ and ‘small learning’ at the end of the lesson. Personally I found this approach to dance teaching incredibly positive as well as refreshing and inspiring.

Julie Pedrick, Pilates and Rehabilitation specialist at Tring Park, delivered a practical demonstration of some key conditioning exercises with three willing student volunteers. Working through all areas of the body, from the feet up, delegates gained an understanding of the important teaching points in each exercise and how they may be beneficial for their students.


Pictured: Julie Pedrick

After lunch, parallel sessions were offered. I attended a session introducing the teachers to certifications available through Safe in Dance International (SiDI). In this session Maggie Morris and Sonia Rafferty introduced the ten core principles examined by the course, which are drawn from a multidisciplinary examination of dance studio practice. 


Pictured: Maggie Morris and Sonia Rafferty

Alexander McKinven, Physiotherapist and IADMS Development Committee Chair, and Terry Wright, Deputy Director of Dance at Tring Park, talked us through (and demonstrated) the role of the central nervous system and an application of neuroscience in building the technique of dancers, with a particular focus on strategies of motor learning. 


Pictured: Alexander McKinven

With the day finishing with class observations, overall the conference did a fabulous job of bridging theory and practice; transforming all concepts discussed into tangible applications in the dance studio.  I personally now look forward to October 8th for the special interest group day: ‘A Day for Teachers’ at the IADMS 25th Annual Meeting in Pittsburgh to continue these discussions!

Tags:  regional conference 

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5 Questions With Amanda Clark

Posted By IADMS Student Committee, Wednesday, May 6, 2015

Our next featured member in the “5 Questions With…” column is our Student Committee Chair, Amanda Clark. Her areas of interest include dancer wellness, health, and education. Amanda will be graduating from Case Western Reserve University with an MFA in Contemporary Dance this May.


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

I chose to read Sally Fitt’s Dance Kinesiology textbook for a free reading assignment in my sophomore English class and once I finished the book I went to my favorite Science teacher and said “I know what I want to do when I grow up. I want to be a Dance Medicine Specialist.” He looked at me and said “What does that mean?” and I responded “I’m not quite sure. I’m not quite sure how I’ll get there, where I should study or what I should study, but I’m going to make it happen; I’ll call you when I do.” I loved dancing and knew I couldn’t stop doing what I was passionate about, but also had a passion for science and said “Yes! This is it!” I’ve been enjoying every step of my professional journey since that day.

 

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

I presented the current iterations of my research that I have been participating in for the past two and a half years at the Annual Meeting in Basel, Switzerland. I hope to continue to finesse my study on attitudes and perceptions related to wellness screening and plan to publish in the future. My research is qualitative, and I am ever-curious about environmental & cultural effects on dancers’ attitudes and perceptions related to various health and wellness activities.

 

-Which annual meeting has been your favorite so far and why?

My favorite annual meeting was the 22nd Annual Meeting in Singapore. It will always hold a special place with me because it was my first experience as an IADMS member. I had heard about the organization through my undergraduate studies and always looked forward to the opportunity to join, attend the AM, and to hear what others in the field of Dance Medicine & Science are doing. It helped me realize how wide-spread yet close the community is. I was able to meet other student members, make new connections, and pick professionals’ brains. The innovations, findings, and studies that were presented helped me figure out what pathway I want to go down as a professional. 

 

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

Being able to connect with and network with such a range of intelligent and creative individuals is great. Having resources available like the Educational Opportunities Document, the forums on the IADMS website, and social media connections to other students and young professionals from around the world make me feel like if I have any questions, want to connect with another student for research, or anything else I might need, I can get answers, discussion, and connected.

 

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

You should definitely join IADMS. The benefits are wonderful, the people are kind, the presentations at the Annual Meetings are inspiring, and the student committee is ever-helpful.

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

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

Tags:  5 Questions With  students 

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