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Core Control: “Not just abdominals”

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

 

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

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

What does core control actually mean?

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

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

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

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


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


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

 

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

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

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

What then?

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

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

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

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

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

Keep exploring:

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

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

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

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

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

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

Tags:  anatomy  dancers  teachers  turnout 

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An intervention to improve turnout - Research Study

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

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

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

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

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

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


 Photo Credit: Dan Dunlap, SarahKim Vennard

Tags:  dancers  research  teachers  turnout 

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

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

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

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

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

IMAGE WILL RETURN SOON

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

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

Follow these links for more information:

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

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

Further reading:

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

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

Tags:  anatomy  dancers  teachers  turnout 

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Approaching turnout with young dancers: Muscles that rotate the leg

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

 

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

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

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

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

 

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

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

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

·         Turnout for Dancers: Hip Anatomy and Factors Affecting Turnout

·         Turnout for Dancers: Supplemental Training

 

Further Reading:

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

 

 

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

 

Tags:  anatomy  dancers  teachers  turnout 

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What has the “Anatomy of the Hip Joint” got to do with Louis XIV?

Posted By Maggie Lorraine on behalf of the IADMS Education Committee, Tuesday, January 13, 2015

Classical Ballet is a dynamic art form. The art of ballet has undergone change since its birth in the mid-17th to early 18th Century. It is interesting to review the description of the organization of the body, codified by Pierre Beauchamp (1631-1705). The five positions of the feet are described as turned out from the hip to an angle of 45 degrees. It was emphasized that the feet should never be turned out more than 45 degrees.

Over time, there has developed an expectation for Ballet dancers to turnout each foot to 90 degrees creating a 180 degree shape with the feet.  By studying human anatomy it appears that Beauchamp was more anatomically sound in his recommendation of the 45 degree turn out “from the hip” than the current 180 degree placement “of the feet” that we now often see.  There are many anatomical factors contributing to the effective use of turn out.

The Bone Anatomy of the Pelvis

The pelvis is formed from the fusion of three bones: ilium, pubis, and ischium. Each of the three bones contributes to the hip socket or acetabulum.


The Ball and Socket

The hip joint includes two main parts, the ball and socket. The ball of the hip joint consists of the round head of the femur or thigh bone and the femur articulates with the hip joint to enable the leg to rotate outwards.

There are three factors that affect turnout from the bony structure of the hip joint and most researchers agree that these conditions cannot be altered with training:

1.      Angle of femoral anteversion

On average, the neck of the femur is angled 15 degrees forward relative to the shaft of the femur (see Figure 3A). An increase in this anterior angulation, called anteversion, often will cause someone to toe in when they walk, (see Figure 3B). People who are born with more anteversion, the orientation of the femoral shaft in the hip socket makes the knees face towards each other when standing or walking. In ballet class, when they turn out their legs from the hip, the knees face the front, leaving little additional hip rotation to create the expected angle of outward rotation visible at the feet.

However, a decrease in this angulation, called retroversion, will allow one to have greater turnout (see Figure 3C). People born with retroversion have a much easier time with turnout. Just standing in neutral, the knees and feet tend to face outward. By adding external rotation at the hip, they can achieve a larger angle of outward rotation visible at the feet than the average person.


2.      Orientation of the acetabulum

The socket of the hip faces out to the side and somewhat forward.  The socket that tends to face more directly to the side with a less forward facing will allow a greater amount of turnout to come from the hip therefore greater movement range.

3.      Shape of the femoral neck

The neck of the femur is subject to some variability. A longer and more concave neck allows a greater range of motion at the hip and is therefore considered to be advantageous.  A shorter and less concave neck will have the opposite effect and limit turnout resulting in less movement range.

Bearing these anatomical differences in mind, it is more important to encourage dancers to use the turnout they have, rather than working against their anatomical make-up to achieve an unrealistic position.  Louis XIV was happy with 45 degrees, we can safely move beyond that if we apply a good understanding of anatomical structure and function.

Further Resources:

Wilmerding V, Krasnow D.  Turnout for Dancers - Hip Anatomy and Factors Affecting Turnout, IADMS Resource Paper. 2011.
Available HERE

Krasnow D, Wilmerding V. Turnout for Dancers – Supplemental Training. IADMS Resource Paper. 2011.
Available HERE

A useful tutorial on the hip joint, range of motion and function:
Sechrest R. Hip Anatomy Animated Tutorial, 2012.
Watch it HERE

A great tutorial on hip function in squats with additional images on bone structure, which may govern why people may need to approach movement in different ways:

De Bell R. The Best Kept Secret: Why People Have to Squat Differently, 2015.
Watch it HERE

Tags:  anatomy  dancers  hips  teachers  turnout 

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