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Wayne McGregor on John Travolta, technology and why everyone can dance

Posted By Maggie Lorraine, Monday, January 23, 2017

“Everyone has a personal physical signature”   Wayne McGregor

 

This interview with Wayne McGregor is not the usual dance medicine and science post, however McGregor makes some interesting comments which refer to science and which imply how strongly science relates to art. McGregor makes reference to neuroscience (3:05) and specifically how he works with neuroscientists (3:32). He uses sound to shape action in his choreography (5:54) There are other choreographers who also use their voices to create sounds to achieve a movement quality from their dancers and dance teachers sometimes use verbal sounds to trigger a particular movement dynamic when teaching.

 

He also makes observations on personal habits and neuroplasticity (23:05), suggesting that we challenge ourselves to break our own movement patterns.

 

This is an inspiring interview for dancers and creators of dance.

 

Tags:  choreography  dancers  neuroscience 

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Adding Fitness to your Dance Agenda: Where to start?

Posted By Clara Fischer Gam on behalf of the IADMS Promotion Committee, Wednesday, January 18, 2017
So you came to the understanding that it is not all about dancing: in order to nourish your body for greater freedom of artistic expression, other elements have to be added to the equation. You have already done the reading about reducing the risk of injuries and enhancing performance. Then you came across supplementary fitness training and its role in supporting your career goals and longevityFeeling more responsible for your body and empowered to take care of yourself, you are now craving for putting it into practice – what then?

 

Signing up at the local gym? Trying yoga? Going for a run? – Practically speaking, where do you start?

 

 

 

To be responsible for your body means not only to get informed and up to date but also to know when to look for professional support. Having a certified health and fitness professional to guide you through supplementary fitness training is imperative. As Dance Medicine and Science is an emerging field, many of these professionals, however may not be familiar with the needs and aims of dancers, neither with the demands of the art form. Whilst it is always best to look for specialists from the field, we know that is not often feasible. It might be the case that you cannot find one locally, however it is much more likely that there will be good certified professionals working in your neighbourhood. This is when “being responsible for your body” comes into play again: Work together with your health/fitness professional as a team for your health by sharing with him the information you now hold and including  dancers’ health resourcesSupport him to support you.

 

Where to start?

 

  • Learn about the demands of your dance career: Are you a ballet dancer? Or are you training in Breaking? Kathak? Contemporary? Dance styles have their particularities; therefore, physical demands may likely vary. Besides, career level may also result in different requirements to your body. All of that has to be taken into account when preparing to perform. There is a lot of discussion and interesting findings concerning dance physical demands and to what extent styles and levels would differ in terms of elements of fitness being stressed. Find a well-rounded summary and good resources to start here.
  • Identify your own needs: At the moment, what are you aiming for in your career? Where can you spot that there is room for improvement? Have you got any injuries currently? Getting a screening session is the starting point for building up a fitness programme that supports your dance goals truly from inside out.
  • Understand your dance calendar: What are you preparing for? When? Keep track of your dance routine, daily schedules and performance calendar. Have you got a packed day of classes in school? If you are dancing in a company, when are you touring? Or will you be performing mostly one-offs? We know that in the dance world it can be very hard to predict in advance your dance curriculum or performances, specially if you are a freelance dancer. Likewise, you might not be in control of your rehearsals and classes schedules to adapt them to a better fitHowever, by estimating your workload, your fitness professional will be able to design a more suitable programme for you.

Image: Clara Fischer Gam

 

By having access to information about your needs, routine and dance demands, a fitness professional can more readily apply their expertise of training principles and methodologies to support you in your career journey.

 

Clara Fischer Gam, MS

MSc Dance Science | BEd Dance Education

Rio de Janeiro – Brazil

Dance Science Brasil Group

Corpos Aptos, Gestos Livres Project

 

Tags:  cross-training  dancers  fitness 

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Book Review: Dancer Wellness Textbook

Posted By K. Michael Rowley on behalf of IADMS Promotion Committee, Wednesday, January 11, 2017

This phenomenal Dancer Wellness textbook is like a who’s who of the dance medicine and science world. A quick scan of the Table of Contents will toss up well-known names in the community like Luke Hopper of Australia, Emma Redding of the UK, Derrick Brown of the Netherlands, and Margaret Wilson of the US among many many more. This textbook embodies what I personally have wanted from IADMS for the entire time I’ve been aware of the organization – a reference textbook combining the best of the best in contributors, scientifically and clinically rigorous information, and accessibility to multiple audiences.

 

 

Editors M. Virginia Wilmerding and Donna H. Krasnow have done a superb job compiling everything a dancer, dance teacher, or dance practitioner needs to know about dancer health and wellness. These two have even included chapters on Psychological Wellness (authored by Lynda Mainwaring of Toronto, Canada, and Imogen Aujla of the UK) and Optimal Nutrition for Dancers (authored by Derrick Brown of the Netherlands and Jasmine Challis of the UK). These two topics are frequently cited as overlooked or under-acknowledged. Well, not for these two star editors who clearly made every effort to give readers this important information.

 

A highlight of the textbook design is the Application Activity found at the end of each chapter. This takes information from the chapter and helps readers incorporate the main points into their practice or their wellness plan. In addition, the supplemental resources found on Human Kinetics webpage would be quite useful for students and teachers. Here, readers can find sample syllabi, slides, tests and quizzes, as well as learning activities for inside and outside the classroom.

 

I’ll end this short review by highly recommending this textbook. Whether you’re already plugged in to IADMS and the dance medicine and science community or not, this textbook is a great up-to-date summary of where the field stands. It delivers only the best to students, teachers, and practitioners who take advantage of it. You can order the textbook at Human Kinetics, here.

 

Editors M. Virginia Wilmerding (left) and Donna H. Krasnow (right)

Tags:  dancers  review  teachers  wellness 

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Introducing the knee: Anatomy and biomechanics

Posted By Elsa Urmston and Jonathan George on behalf of the IADMS Education Committee, Monday, November 28, 2016

As dancers, educators and clinicians, we know that knees cope with a lot!  Over the last decade or so, the demands placed on the dancer’s body has increased exponentially and ever more complexly.  Acrobatic movement is becoming evident and the effect to the joints of the limbs can often mean greater incidence of injury.  As Liane Simmel points out “pirouettes on the knees, knee drops, and even a plié in fourth position require particular leg stability and optimal mobility in the knee.”1  In reviewing the literature, Russell2 identifies the lower extremity to repeatedly be the most commonly injured region of the body amongst dancers.

 

 

The knee joint is hugely complex and as Teitz (in Solomon et al, 2005)3 explain there is no bony stability in its structure.  A modified hinge joint, the knee comprises articulations between the femur and tibia, and the patella and femur, held together by a fibrous capsule and connected via a network of ligaments.  It’s this lack of potential stability which makes the knee prone to injury, often through misalignment and poor mechanics, although as well through sudden trauma or overuse.  Over the next couple of weeks we have a series of posts which focus on the knee; today we zone in on the structure, anatomy and mechanics of the knee itself.  Part 2 provides an overview of common knee injuries amongst dancing populations, and in Part 3 we focus on two case studies of young men who have experienced knee issues during their training and have been successfully rehabilitated to class and performance via a joined-up clinical and educative rehab programme.

 

 

The tibio-femoral joint is a hinge joint, capable of flexion (bending) and extension (straightening).  The screw-home mechanism allows the knee to slightly internally and externally rotate too.  During the last 30° of knee extension, the tibia (open-chain movement such as rond de jambe en l’air) or femur (closed-chain movements such as ascending from a demi-plié) must externally or internally rotate respectively by about 10°.  This determines the knee as a modified hinge joint.  You can see Rosalie O’Connor from American Ballet Theater demonstrating the screw-home mechanism in a rond de jambe action here!

 

The patellar-femoral joint serves to heighten stability in the joint.  The patella (knee cap) is a sesamoid bone which sits in the quadriceps muscle, and during flexion and extension undergoes complex gliding movements. The fairly unanimous consensus as to the function of the patella is to effectively increase the movement arm of the patella tendon about the tibio-femoral joint, thereby magnifying the movement and force of the quadriceps muscle group about the knee.4

 

 

The stability offered by the joint capsule is complemented by numerous, strong ligaments and more than any other joint in the body, these ligaments are vital in guiding the aligned movements of the bones as they come together to form the joint.  Yet, they are arranged in such a way that the stability is not always constant; some remain taut to ensure stability when the knee is extended and others slacken to ensure mobility when the knee is flexed5.

 

The medial and lateral collateral ligaments

The collateral ligaments are located on either side of the knee joint (collateral means side by side).  The medial collateral ligament – the one on the inside of the knee – is taut in knee extension and external rotation.  It controls the knee if the knee rotates inwards and in fact when the knee bends in a demi-plie, it controls approximately 80% of the medial stress on the knee (Besier et al, 2001)6.  The lateral collateral ligament – located on the outside of the knee – becomes taut with knee extension and provides lateral stability to the knee.  It controls approximately 70% of the lateral stress of the knee for example when the knees bow out on flexion and cause the feet to roll outwards (Besier et al).

 

The cruciate ligaments

The cruciate ligaments join the tibia and femur to one another within the internal structure of the knee.  The cruciate ligaments prevent any forward/ backward motion of the femur and tibia in relation to one another.  The anterior cruciate ligament also has another role in aiding rotation of the knee and controlling hyperextension in the joint.  It also plays a role when deceleration from jumping, floor work and quick changes of direction are required. It is now also widely accepted that the anterior cruciate ligament provides up to 40% of medial knee stability7.

 

The menisci

The medial and lateral meniscus are two cartilaginous discs which sit on the tibia and deepen the articular surface of the knee joint – they provide a kind of collar in which the bony ends of the femur sit, thereby improving the congruency and stability of the knee joint.  They assist with shock absorption and help to friction thus aiding smooth knee movement. The menisci are critical in the production of synovial fluid-‘the oil’- around the knee joint.

 

Bursae

The knee has the most extensive distribution of bursae in the body. More than 20 bursae are thought to be within the knee joint, with the primary role of reducing friction amongst the structures of the knee joint.  Many are located around the patella to aid its gliding function within the muscle and over the top of the joint itself.

 

Iliotibial Band

The iliotibial band is an adaptation of erect posture and provides key lateral support to the knee and hip; it runs down the side of the upper leg from the rim of the pelvis, to the outer edge of the femur and tibia.

 

This super video really provides a great introduction to the anatomy and ligament structure of the knee joint – take a look!

 

 

The musculature

As with the skeletal anatomy of the knee, the muscles which act on the knee are complex!  Because the muscles of the thigh also act on the hips, they often have a dual purpose –hip movement is included in brackets for ease of understanding here!  We have provided a simple table of the main muscles which act on the knee to produce movement.

 

Muscle

Action

Anterior/ front of the thigh

Rectus femoris

Knee extension (hip flexion)

Vastus medialis

Knee extension

Vastus intermedius

Knee extension

Vastus lateralis

Knee extension

Sartorius

Knee flexion (hip flexion, hip abduction and hip external rotation)

Posterior/ back of the thigh

Biceps femoris

Knee flexion and external rotation (hip extension and hip external rotation)

Semitendinosus

Knee flexion and internal rotation (hip extension and hip internal rotation)

Semimembranosus

Knee flexion and internal rotation (hip extension and hip internal rotation)

Popliteus

External rotation of femur when foot fixed; internal rotation of tibia when foot free

Medial surface of thigh

Gracilis

Knee flexion (hip adduction and hip flexion)

Posterior/ back of calf

Gastrocnemius

Knee flexion (ankle plantarflexion (pointing))

 

 

As you can see muscles often have more than one role in creating the movement of the limbs – we separate them out to learn about them, but of course they should be seen in their entirety to understand the complexity of the muscular system.  This video really helps us to see the wholeness of this system but understand each individual muscle’s location in relation to each other – take a look.

 

 

 

 

1.    Simmel, L.Alignment of the leg and its impact on the dancer's knee: Clips from the 2014 Annual Meeting
2.    Russell, J. Preventing dance injuries: Current perspectives, Journal of Sports Medicine, 4, 199-210.
3.    Solomon, R., Solomon, J. & Cerny Minton, S. Preventing Dance Injuries.  Champaign, IL: Human Kinetics, 2005.

4.      DeFrate LE, Nha KW, Papannagari R, Moses JM, Gill TJ, et al. The biomechanical function of the patellar tendon during in-vivo weight-bearing flexion. Journal of Biomechanics 40:1716–1722, 2007.

5.      Clippinger, K. Dance anatomy and kinesiology.  Champaign, IL: Human Kinetics, 2016.

6.      Besier, TF., Lloyd, DG.,  Cochrane, JL. and Ackland. TR. External loading of the knee joint during running and cutting maneuvers. Medicine and science in sports and exercise33, no. 7:1168-1175, 2001.

7.      Quatman CE, Kiapour AM, Demetropoulos CK, et al. Preferential loading of the ACL compared with the MCL during landing: a novel in sim approach yields the multiplanar mechanism of dynamic valgus during ACL injuries. American Journal of Sports Medicine, 42:177–186, 2014.

 

More information about the knee’s structure can be found in a variety of dance specific dance anatomy, kinesiology and safe practice books.

 

Elsa Urmston is the Centre for Advanced Training Manager at DanceEast, Ipswich, UK as well as Chair of the IADMS Education Committee and a member of the One Dance UK Expert Panel for Children and Young People.  Jonathan George is a Chartered Physiotherapist at the DanceEast Centre for Advanced Training.

Tags:  anatomy  biomechanics  dancers  knee  teachers 

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Snapping Hip Syndrome

Posted By Janine Bryant on behalf of the IADMS Education Committee, Wednesday, October 5, 2016

Do your dancers ever say, ‘My hip snaps or pops when I do grand battement or developpe´ devant or a´ la seconde’?

 

The snap sometimes presents with pain but sometimes not, and happens either on the up phase or down phase of the movement. Dancers might also notice decreased range of motion through multiple planes of movement. .

Snapping or clicking hip is common in dancers and athletes who regularly move through range of motion extremes, experience some degree of tendinitis, and repeat abduction of the legs above waist level.  With proper diagnosis and care, the condition can be addressed in a timely way so that the dancer does not lose too much rehearsal and class time.

 

Usually painless and harmless, a snapping hip can happen as a result of a tendon or muscle passing over a bony structure. It can occur frequently in dancers in three ways:

 

·         Lateral Snapping Hip (Iliotibial band syndrome), which is more common, involves movement of the iliotibial (IT) band moving over the greater trochanter (large bony structure on the head of the thigh bone) and is also referred to as external snapping hip syndrome. A clue to diagnosis of this condition may be the inability to adduct past anatomic neutral, an anatomical position where the two bones that form a joint are parallel to one another, - with the bones parallel and joint space uniform, this creates ‘anatomical neutral’. A more likely indicator, however, is the location of the pain along with palpable tenderness.  Pain to the lateral (outside) side of the knee as well as pain at the lateral hip can occur simultaneously and could be symptomatic of lateral snapping hip. Initially, there may be a sensation of stinging or needle-like pricks that are often ignored. This can gradually progress to pain every time the heel strikes the ground and finally can become disabling with pain when walking or when climbing up or down steps. (1,2,3)

 

 

      

 

 

·         Anterior Snapping Hip presents as a kind of clicking or snapping, as the iliopsoas tendon passes over the iliopectineal eminence on the front of the pelvis or pelvic brim. This can be caused by inflammation of the bursa that lies between the front of the hip joint and the iliopsoas muscle. A cartilage tear or bits of broken cartilage or bone in the joint space can cause snapping, or a loose piece of cartilage can cause the hip to ‘lock up’. (2)

 

 

·         Intra-Articular Snapping Hip (intra-articular meaning inside the joint) results from capsular instability caused by muscular imbalance, skeletal inconsistencies, such as a leg length discrepancy or bony deformity, or previous injury to the hip joint or from a labral tear. Dancers with this condition may experience decreased range of motion in the hip and a painful click directly inside the joint caused by bony instability resulting from hip dysplasia or excessive congruency resulting from Femoral Acetabular Impingement (FAI). (2)

 

Treatment:   Dancers could benefit from physical therapy to strengthen the surrounding musculature, improve flexibility, restore function, and prevent re-injury.  Movement reeducation and progressive resistance training might also prove effective. (6) Dancers may need to temporarily reduce rehearsal/class regimen as part of recovery/management of the syndrome.

 

Please refer to the examples below.

 

 

 

 

Resources for further reading:

1.       Keene S, Coxa saltans: iliopsoas snapping and tendinitis. Hip Arthroscopy and Hip Joint Preservation Surgery.2014; 64(1):1-16.

 

2.       Lewis CL. Extra articular snapping hip: A literature review. Sports Health.2010; 2(3):186-90.

 

3.       Grumet RC, Frank R, Slabaugh M, Verkus W, Bush-Joseph C, Nho S. Lateral hip pain in an athletic population: differential diagnosis and treatment options. Sports Health. 2010;2(3):191–196.

 

4.       Battaglia M, Guaraldi F, Monti C, Vanel D, Vaninni F. An unusual cause of external snapping hip. J Radiol Case Rep, 2011; 5(10)1–6.

 

5.       Reiman, M P, Thorborg K. Clinical examination and physical assessment of hip jointrelated pain in athletes. International J Sports Phys Ther.2014; 9(6): 737–755.

 

6.       Laible C, Swanson D, Garofolo G, Rose DJ. Iliopsoas syndrome in dancers. Ortho J Sports Med.2013; 1-3.

 

7.       Weber A E.The hyperflexible hip: Managing hip pain in the dancer and gymnast. Sports Health 2015:7(4); 346–358.

 

8.       Frank RM, Slaubaugh M, Grumet RC, Verkus W, Bush-Joseph C, Nho S. Posterior hip pain in an athletic population: Differential diagnosis and treatment options, Sports Health.2010; 2(3): 237–246.

 

9.       Lee S, Kim I, Lee SM, Lee J. “Ischiofemoral impingement syndrome.Ann Rehabil Med. 2013; 37(1): 143–146.

 

10.    Sobrino, F J, Crótida C,  Guillén P.Overuse injuries in professional ballet: Injury-based differences among ballet disciplines.Orthopaedic J Sports Med, 2015; 3(6).

 

11.    Smith PJ, Gerrie BJ, Varner KE, McCulloch PC, Linter DM, Harris JD. Incidence and prevalence of musculoskeletal injury in ballet: A systematic review.Orthop J Sports Medicine, 2015; 3(7).

 

12.    Domb BG, Shindle MK, McArthur B, Voos JE, Magennis EM, Kelly BT. Iliopsoas impingement: A newly identified cause of labral pathology in the hip. HSS J.2011; 7(2): 145–150.

 

13.    Pun  S, Kumar D, Lane NE. Femoroacetabular impingement,  Arthritis Rheumatol, 2015; 67(1): 17–27.

 

14.    Sajko S, Stuber K. Psoas major: A case report and review of its anatomy, biomechanics, and clinical implications. The J Canadian Chiro Assoc. 2009; 53(4): 311–318.

 

 

Janine Bryant, BFA, PhD (ABD) is Senior Lecturer at the School of Arts at The University of Wolverhampton in the UK.  She is also a Registered Safe in Dance International Certificate Provider and member of the IADMS Education Committee.

 

Tags:  dancers  hips  injury  pain  teachers 

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Stretching the Point: Part 2

Posted By Gabrielle Davidson and Maggie Lorraine on behalf of the IADMS Education Committee, Wednesday, August 24, 2016

In Part 1 of “Stretching the Pointe” we discussed some issues that may arise as a result of incorrect use of the foot and faulty foot alignment in training.

 

Anatomical information about the foot is available in previous blog posts here.

 

In discussing the foot and the dancer, there are a few specific injuries and conditions that need to be taken into account to further strengthen the argument for ensuring correct alignment and muscle activation when teaching young dancers how to pointe their feet.

    


One of the most common of these injuries is posterior impingement of the ankle. This is when tissues at the back of the ankle are inflamed and prevent full ankle range into plantarflexion (pointing, demi pointe or pointe). This can either be due to compression of the soft tissues between the posterior edge of the tibia, the talus bone and the superior calcaneus [1] or irritation of the tendon sheath of the FHL (flexor hallucis longus- the muscle that controls the big toe into plantar flexion- full pointe)[4]. Posterior impingement and FHL tenosynovitis can go hand in hand and are often caused by the repetitive nature of dancers rising to demi pointe and pointe, and also pointing their feet [5]. It is thought that poor coordination of the lower leg and intrinsic foot muscles can exacerbate this condition. The condition can also arise after a sprained ankle and forced plantar flexion injuries, and in some cases has also been attributed to the presence of an os trigonum, a small bone that sometimes develops behind the ankle bone (talus bone). The os trigonum is a normal part of the ankle anatomy but sometimes fails to fuse with the talus therefore creating a small ‘extra’ bone in the ankle, and this can sometimes increase the effect of posterior impingement [1,3].

 

FHL tenosynovitis is frequently seen in female ballet dancers. It has been called “dancer’s tendinitis” but research has found that the condition is rarely a pathology of the tendon itself but of the sheath surrounding the tendon [1,2,3]. As mentioned above it can be part of the posterior impingement syndrome. The flexor hallucis longus muscle originates from the back of the fibula (outer lower leg bone/ lateral lower leg bone), then travels down along the inside of the lower leg and ankle where it inserts into the base of the big toe via the tendon. Its primary role is to flex the big toe assisting to pointe the foot (into plantar flexion), stabilise the foot and ankle as the dancer rises to demi pointe, and assist the foot to rise to full pointe [4].

 

The repetitive change in foot position from full plantar flexion (on pointe position) to full dorsiflexion (plié position) can cause this FHL tendon sheath to become inflamed [5], especially if it is not being supported by the other ankle and intrinsic foot muscles.


  


The repetitive loading of bones, especially in the feet, in activities such as fouettés (repetitive plantar flexion action of one foot on and off pointe) or landing from a series of repetitive jumps may cause bony stress. This is when loading of the bone outweighs its ability to recover and remodel, therefore leading to weakening of the bone structure itself and the resulting stress reactions or fractures [6,9].

 

Dancers are susceptible to a unique fracture at the base of the second metatarsal called the “dancer’s fracture” that is rare in other athletes and possibly as a result of the demi pointe and pointe work they carry out whilst dancing [5,7]. Controlling the amount of load a dancer is undertaking and controlling the rate at which this is increased, as well as making sure they have sufficient muscle support in both their feet and ankles will always help to reduce the risk of these overuse injuries.

 

Injuries to the mid foot in dancers while rare, can be debilitating [5]. The mid foot comprises the navicular, cuboid and three cuneiform bones. It stabilises the arch and transfers the forces generated by the calf, to the front of the foot during the stance phase of gait, so in dance terms this is whenever the dancer moves through their feet either rising or jumping. Acute cuboid subluxation may occur with ankle sprains, overuse of the peroneal muscles during repetitive movements such as rising up and down from pointe and excessive pronation of the foot, although the precise mechanism has not been proven [8]. Stress fractures and fractures of the navicular bone can be a career ending injury for a dancer.

 

  


Lisfranc injuries are injuries that occur to any part of the articulations of the 5 long metatarsal bones with the tarsal bones. These bones are connected by thick plantar ligaments (found on the underside of the bones) and strengthened by the tendons of tibialis posterior, peroneal tendons as they wrap under the foot and tibialis anterior tendon over the top of the arch. The Lisfranc ligament is the only ligament that binds the first and second metatarsal bones [8]. The mechanism of injury to this area in dancers may result from trauma to the foot of the female dancer when performing advanced pas de deux choreography where the edge of the pointe shoe sticks against an irregular floor surface when being slid along the foot by her partner. It can also occur from missed jump landings, during pirouettes/spins or during take-off for a jump [5].

 

Of course there are many more injuries that can occur in the course of a young dancer’s life but these are just a few of the main ones seen in the feet and ankles, some of which can be reduced with particular technique training and attention given to the development of specific muscle activity in the calves and intrinsic muscles of the feet, as mentioned in the previous blog post from the Education Committee.

 

The biggest message for young dancers, is to not allow pain to continue for too long. Seek treatment earlier rather than later to prevent too much time out of the studio and take heed of exercises and advice given by health professionals as their aim will always be to get you back dancing as soon as possible and for as long as possible.

 

Gabrielle Davidson and Maggie Lorraine

B.PHTY(HONS)              Leading teacher at the Victorian College of the Arts Secondary School

 

 

 

 

References:

[1] Russell J.A., Kruse D.W., Koutedakis Y., McEwan I.M., Wyon M. Pathoanatomy of posterior ankle impingement in ballet dancers. Clin Anat. 2010;23:613–621.

 

[2] Hamilton WG, Geppert MJ, Thompson FM. Pain in the posterior aspect of the ankle in dancers. J Bone Joint Surg Am 1996; 78 (10): 1491-1500.

 

[3] Peace,KA., Hillier, JC., Hulme,A., Healy, JC. MRI features of Posterior Ankle Impingement Syndrome in Ballet Dancers: A Review of 25 Cases. Clinical Radiol 2004: 59:1024-1033

 

[4] Kirane,YM., Michelson,JD., Sharkey, NA. Contribution of the Flexor Hallucis Longus to Loading of the First Metatarsal and  First Metatarsaophalangeal joint. Foot Ankle Int 2008; 29(4):367-377

 

[5] Kadel,N MD. Foot and Ankle Problems in Dancers.Phys Med Rehabil Clin N Am 2014; 25: 829-844

 

[6] Davidson, G., Pizzari,T., & Mayes, S. The Influence of Second Toe and Metatarsal Length on Stress Fractures at the Base of the Second Metatarsal in Classical Dancers. Foot and Ankle International  2007;28: 1082-1086

 

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

 

[8] emdedicine.medscape.com. Lisfranc Fracture Dislocation

Trevino, SG., Early, JS., Wade, AM., Vallurupalli, S., Flood, DL

 

[9] Mayer, SW MD., Joyner, PW MD., Almekinders, LC MD., Parekh, SG MD MBA. Stress Fractures of the Foot and Ankle in Athletes. Sports Health 2015: 6(6), 481-557.  

 

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

 

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

 

An interesting videowhich highlights the horror for a dancer of a career threatening injury:

Portrait of a Dancer: Lauren Cuthbertson

 

 

Tags:  dancers  foot  injury  teachers 

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Stretching the Point

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

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


 

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

 

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

 

 

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

 

 

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


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

           

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

 

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

 

 

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

 

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

           

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

 

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

 

Maggie Lorraine

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

Member of the IADMS Education Committee

 

References

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

 

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

 

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

 

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

 

Further resources

Common Foot and Ankle Ballet Injuries

Dancing Child: Foot Development and Proper Technique

 

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

 

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

 

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

 

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

 

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

Tags:  dancers  foot  teachers  toes 

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Foot Injuries in Dancers. Are they preventable?

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

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

 

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

 

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



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


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


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

 


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

 

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

  

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

 

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

 

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

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

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

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

biomechanics of rising to demi pointe and pointe.

 

Maggie Lorraine

 

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

 

         Turnout for Dancers: Supplemental Training

         Feet: Skeletal and Muscular Structure

         Resource Paper: The challenge of the Adolescent Dancer

Follow these links for more information:

YouTube - 1

YouTube - 2

 

 

Further reading:


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

 

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

 

 

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

Tags:  dancers  feet  foot  injury  prevention  teachers 

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Caring for bony injury demystified!

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

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

 

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

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

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

 

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

 

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

 

What are the most common bony injuries in dancers?

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

 

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



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



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

 

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

 

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

 


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

 

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



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

 

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

 

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

 

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

 

 

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

 

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

 


Concluding thoughts:

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

 

References:

 

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

 

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

 

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

 

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

 

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

 

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

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

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

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

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

 

Further Reading:

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

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

 

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

Tags:  bone  dancers  injury  teachers 

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Maybe you should stop dancing… a little

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

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


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


 


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


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


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


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


 


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


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


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

  

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

Tags:  dancers  teachers 

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