Each year dancetrain asks the leading group of performing arts healthcare professionals across Australia to talk about their expertise and experiences plus any new technological developments in the management & treatment of injuries.
This years Bodywise articles are a must read for any dancers who want a psychological and physical edge when the pressure is on.
The importance of seeing a healthcare professional that has experience and an understands the psychology of a performing artist, the pressure to keep performing and pushing yourself, even with injury, has a unique set of parameters that must be navigated and understood.
Bullying our Boys by
Dr. Kate Fennessy
drbywater.com.au |
bernadette@drbywater.com.au |
02 9713 9265 |
0448 641 892
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“Over 96% of boys face some sort of verbal or physical abuse when they choose to dance.”
Doug Risner, Professor of Dance at Wayne State University.
Let that sink in for a moment, almost every single boy or man who pursues dance receives abuse for making that choice. In recent documentary DANSEUR, which looks at the experience of male dancers, an overwhelming history of name-calling, physical intimidation, cyberbullying, ostracism, and sometimes even death threats throughout dancers training and careers emerges. Worryingly, the bullying is so rampant that it appears to have been accepted as a growing pain of becoming a male dancer.
Why is this still happening?
In Australia, dance is seen as an unusual hobby and less of a profession. Even while we strive for gender equality, a narrow view of gender roles persists when it comes to some professions. A choice such as a boy in ballet class can spark ignorance and fear, expressed as homophobia, stereotyping, harassment or ostracism. Matthew Lawrence, the Royal Academy of Dance’s Australian ambassador, has been quoted saying that his early life was, “not so much about bullying as isolation. The silent treatment.” No one wanted to sit near a ballet dancer. This can make for an unnecessarily difficult and even traumatic path for those boys who are brave enough to follow it.
If this is happening to you, remember:
1. This is the bullies’ problem, and never yours. People will pick on others because they act or appear different, to feel more important, popular, or in control. They are intimidated by what they don’t understand. They can misinterpret what sets someone apart as a weakness, when actually it is a strength.
“A lot of the kids who bully want some kind of essential quality that you have. They want the freedom that you already have to do what you love.” Dancer and choreographer Chris Bell, in DANSEUR.
2. Remember why you are dancing. Exploring your talent is an amazing thing. It would be the worst shame to stop doing what you love to do because of some random persons opinion. Find supportive friends and stick to them instead. Following your preferences can be hard to do, but it is also really important for a happy and fulfilled life.
3. The best way to defuse a confrontation is not to engage, not to take the bait and give the bully the response they want. You cannot control the perceptions of others but you can choose not to give them power by paying attention to them. Also, success is the best revenge.
4. If the bullying gets bad you need to tell someone before it gets worse. There is no need to cop it just because you are a boy. You can ask for help and you deserve to receive it. Sometimes this can be talking about it with someone you know and trust.
5. If it’s possible, be around other boys who dance, see professionals dancing, and see the audience responding to them. You could also watch movies and youtube to feel inspired and connected to your wider dance community.
How can parents and teachers help?
Doug Risner advocates educating yourself and others about ballet, particularly if you are a father. It takes a lot of power, strength, determination and artistry for men to be successful dancers. When others see this as weak or feminine that can be devastating, especially when the person is a parent or role model.
If your child is being bullied, listen to their experiences and work together on solutions. Teaching young people how to cope with hurt feelings, how to redirect frustration, and how to avoid being diminished by the behaviour of others is central to their growth and finding their identity. This comes to the fore in any sport, and is especially vital when trying to forge a path when you are in the minority.
Schools can help be introducing dance early just like any other sport. That way, people find it easier to learn about what dance can be, how it can be masculine, and what a cool choice it is. Dance after all, should be for everyone.
If you are 25 and younger and being bullied, or if you are a parent or teacher in Australia seeking guidance about bullying, access support through Kids Helpline 1800 551 800 or visit Parentline.com.au.
Dr. Kate Fennessy is a clinical psychologist who works with adults and young people in a private practice in Sydney.
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COMPETITIONS How to survive by
Jocelyn Penna Sports Psychologist
performancepsychology.com.au |
02 8011 4435 |
NewClient@performancepsychology.com.au |
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In this time period more than any other, it seems dancers are competing for the solo, to win the competition and to get the highest exam mark. This competitive nature continues into the professional world, with dancers vying for coveted companies and roles. Whether we like it or not, we live in a competitive world and competition is inevitable.
Competition involves striving for external rewards, and although it’s possible to compete against one’s own achievements, competition usually encompasses achieving superiority over others. Many activities in society are based on competition: academic performance, job promotions, sporting endeavours, innovations and medical breakthroughs. As science, technology and analytical thought extend human limitations, society becomes more competitive. In dance, as we push the boundaries of what we thought was humanly possible and use sport medicine, sport psychology and sport science to assist in getting more out of ourselves, the standards continue to rise. A healthy competitive nature can encourage excellence, persistence and resilience.
Whether or not humans are innately competitive, it seems that many are driven to compete, and people enjoy watching competition. The positive feelings and affirmations that come from success drive the desire for further competition. An accolade leads to feelings of competency and desire for future accolades. Therefore, competition can be motivating if achievement is frequent.
Unhealthy competition, however, can be demotivating and demoralising. Performance evaluation always have element of subjectivity and we can never know how well another dancer will perform on competition day. Competition success can’t be guaranteed, so if achievement is the primary or sole focus, disappointment will eventually prevail. An unhealthy competitive nature focusses on what the outcome may be and what other people might think, rather than on what can be done. It can have potentially devastating effects by decreasing motivation, triggering anxiety, distracting from corrections and choreography and numbing artistic performance.
Frequent competition will heighten feelings of pressure, which can have physical and emotional consequences over time. Ongoing pressure may eventually lead to burnout or withdrawal from any activity. Some dancers become reluctant to participate in a competition if they don’t believe they will place. Moreover, young children do not understand competition and not meeting expectations, or comparing their performance to other dancers’, can affect their overall self-esteem.
The competitive nature of training flows into the professional world with dancers carry that competitive psyche with them. Dancers need to compete for selection into companies and performances. Although these are wonderful achievements, it appears that for many dancers, within a few years there is a renewed desire to climb the professional ladder and strive for solo positions and coveted roles.
Given that we can’t remove competition from society, it is wise to explore how to thrive in competitive environments.
There are several aspects to a healthy competitive nature. Firstly, most time and effort should be focussed on oneself. Staying focussed on self-progression and not engaging in comparison with others or with the past is the most adaptive and valuable approach to consistent improvement. Working relentlessly and wisely towards predetermined achievable mastery goals will increase focus on the task at hand and thereby enhance performance. Striving for excellence, rather than the unobtainable perfection produces an environment that is less inhibited by stress, enabling more consistent skill execution. When focussed on themselves, dancers can achieve a more engaging performance. Making self-reflection and self-improvement the primary focus will facilitate a productive environment for excelling.
When it is necessary to explore what other people are doing and achieving in order to become competitive for a position or role, consider the following:
o All dancers have different strengths and suit different companies and roles, so discover your strengths and showcase them.
o Don’t compare with others, for the sake of knowing who might be “better”. When exploring your competition, stay focussed on how it will assist you.
o Use the information you discover intelligently by setting realistic goals, working on identified needs and only focussing on things that are controllable and achievable.
Unhealthy comparison has a negative tune and often results in a negative mood. Although usually intended to motivate, it more often triggers a pattern of thought that decreases perceived ability, affects self-worth and may eventually lead to self-sabotage. One with an unhealthy competitive nature might say “I / you need to become as strong as James”.
Healthy competition is encouraging and associated with a positive mood. Personality and experiences will affect how people react to competitive environments. By monitoring mood, a dancer or teacher can determine if the environment or feedback is constructive for the dancer. A dancer or teacher with a healthy competitive nature might say “It seems the director is looking for strength. I will make it my focus to increase my leg strength this month”.
Competition is ingrained in society, and whilst a heathy competitive nature can be productive, an unhealthy competitive nature can be quite harmful. If you are struggling with competitive nature, contact a psychologist familiar with the demands of dance.
Jocelyn Penna from Focus Performance has 18 years experience working with professional and developing performing artists. She enjoyed a background in dance and now studies the psychological challenges and rewards of being involved in the field. Working from clinics at Turramurra and Homebush. Skype and phone consultations are also available.
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Dance Rehabilitation, A Dancers Journey by
Madison Cronin & Georgina Barr
Dancers require a greater range in their joints than the average human. While this is a primary contributing factor to the beauty of dance, it can also significantly impact post-injury healing and rehabilitation.
The healing time period for an injured hyper-mobile joint can take considerably longer to stabilise. These joints require greater strength so as to support the greater ranges of motion. The dancer must be rehabbed back to activities of daily living and then to activities of specific dance technique.
The following story is an exploration of this issue.
Madison Cronin began dance at three years of age in New Zealand, she then moved to Tanya Pearson Academy in Australia for full-time training at 15 and then at 17 The Royal Conservatoire of The Hague, The Netherlands for her final 2 years of pre-professional ballet training. After 18 months in Holland she sustained a significant injury that changed her course. This is her story.
“In January 2018, I found myself in the back of an ambulance en route to the hospital after an accident in the middle of morning ballet class.
I was at the barre performing an arabesque en fondu. During this movement, which is performed in turnout, the knee must track directly over the midline of the foot (second toe). Unfortunately, the upper leg tracked outwards and forced what was later diagnosed to be a lateral subluxation with dislocation of the patella. As I fell to the ground, I heard a pop, and could not get up. When I looked to the source of the pain, which was wracking through my whole body, I found that my kneecap was in quite the wrong place.
About 45 minutes later, with morphine administered I was disoriented, and in hospital where only x-rays were taken. Patella subluxation with dislocation was diagnosed; I was poked and prodded, fitted with a full leg brace and given crutches, and told that after four to six weeks in the brace I could resume dance training. I had to book in a couple of check-ups with the Orthopaedic Surgeon a few weeks down the track but that was it.
Relief washed over me when physicians told me that knee dislocations happen all the time and are easy to heal. This was just a small bump in the road and I’d be right soon. Little did I know that recovering from this was going to be the toughest thing I’d done yet.
I had one week on crutches, two more weeks in a full leg brace and three weeks in a half leg brace before wearing a knee compression sock. During this time, I was physically and emotionally left to my own devices. I suffered through watching class, desperately wanting to join in. No one advised danced-based core and upper body strength and conditioning because of the positions my knee would be on to do these. I began work with my physiotherapist after about three weeks. At this point the brace had to be on at all times aside from in those sessions or when I was asleep.
Along with the lack of rehab in the first three weeks, the next issue was when the brace eventually did come off I essentially had to teach myself to walk again. My physio was great; she’d worked with dancers at my school for a long time. She structured my rehabilitation going off the exact notes she’d received from the hospital. But I only had 6 sessions with her because now the brace was off she passed me onto her colleague (a ballet teacher at my school and recently trained physio).
It was a tedious process as it took a lot of effort to work through the pain and trust my knee to do the simplest of ballet steps. After a month of private lessons twice a week and also working on my own, I was ready to re-join my class. I was incredibly excited and nervous. I stood in the corner, so I could modify the exercises that were set each day to simpler versions if I needed, or as instructed by my rehab teacher, without causing a distraction. I began by doing the first 10 minutes of class and then every few days tried to add on one more exercise, and so on. When I was able to complete a full barre that was an achievement. I then moved onto centre, which I was eventually able to complete as well – aside from grand allegro. From there I moved onto pointe work, very slowly and alone, because all normal pointe classes on the schedule had become rehearsals for up-coming shows.
What was clear to me now was my recovery was not as anticipated. Ever since the deadline the doctors gave me had passed, I had an ever growing niggle deep down that something still wasn’t quite right. During the next 5 months, the greater that feeling took hold, the more I ignored it. I was getting stronger and my knee was becoming increasingly more capable by the day, yet I was still getting frequent pain at inconsistent times. Something else I’d also noticed was that my right knee constantly felt very different from my left, and simply put, I just didn’t trust it. I told myself to stop being weak, to harden up, it was just fear, I’d done everything the health professionals had told me and more, so I’m obviously just convincing myself that something is wrong due to a lack of confidence.
All I longed for was what eluded me – the freedom and utter joy that flying around the studio gives.
The reason for this elusion I now know. My injury was consuming absolutely everything. I was never able to fully let go and truly dance because I was thinking about my knee all the time. And the explanation for this, I found out later, was that there was still something physically wrong. My body knew it, but my mind refused to see it. I kept thinking how much I missed the stage and rehearsing for hours on end, and those simple moments of tough inner workings that allow us to produce the most beautiful form of art, every single day. During the drawn out months of rehab I craved those times immensely, so I ignored the warning signs. I went against my instincts, and due to my constant state of denial and refusing to listen to my body, it wasn’t until I was home in New Zealand for the European summer that I finally asked for a check-up and got a second opinion, only because my parents managed to convince me. That was in August 2018.
When my physio here in New Zealand was able to give me a diagnosis five minutes into my appointment, I didn’t quite know what to think; so many different feelings and thoughts were going through my head. Initially, it was relief that there was actually something wrong, followed quickly by regret that I hadn’t seen someone sooner. And finally, pure devastation because I was pretty sure I knew what this meant.
The intensity of my dislocation was far worse than diagnosed. Having such hyper-mobile knees meant that the doctors who treated me initially did not pick up its severity. Also, they were not doctors who knew dancers bodies and the extremities to which we push our bodies. They had only done x-rays, no ultrasound scans or MRI. The hospitals x-rays had come back clear but if I had a scan it would have shown the ligament damage and my deeply torn Vastus Medialis Oblique muscle on the inner upper part of the knee.
My physio was impressed with what I had achieved considering my rehab had been so specific, focussing on the knee itself and immediately surrounding area, but nothing broader. All those greater muscles on the inside and outside of the leg had done their best to heal themselves. The difference in the level of strength between my ‘good’ and ‘bad’ leg was quite a shock.
My new physio discussed with me my options, possible realities and we made a plan. I made it clear how determined I was to set things straight, so intense rehab was the way to go. At this point, what would happen next just had to be a wait-and-see scenario. After a while I eventually managed to get my knee to a point where it didn’t affect me in everyday life anymore, which to many may seem small, but from where I’d come from it felt like a massive victory. It gave me something to hold on to!
I am becoming more content as the days go by. To put it metaphorically,
I know now that just because the door I was sure I’d go through suddenly caught fire, it doesn’t mean I can’t climb out the window and land in the garden.
I had to make the decision in October 2018 to say goodbye to my beautiful life in Holland and move back home to New Zealand, one of the most difficult things I’ve ever done. But it was the right choice. Coming to the realisation that your injury might prevent you from dancing professionally is a lot to figure through.”
Madi’s journey is unfortunately not uncommon, where lack of understanding of the demands of dance, not a lack of medical skill, is a causative factor in rehabilitative success. The opportunity for a second opinion is always valid and dancers know their bodies and must be encouraged to trust their instincts.
“For anyone who has gone through it or is dealing with an injury – the mental challenge is just as hard, if not more difficult to overcome than the physical. It destroys your identity. You will often feel entirely overwhelmed and for a while might not have any idea where you are going but you will find yourself again. It may be a different path, but it is in no way less. Try to remember that.”
Madi Cronin
Madi is currently completing her Bachelor of Dance at the University of Auckland, which she started whilst she was in Holland. Madi hopes to then either teach, choreograph or study dance medicine research, just as long as she is heavily involved in the dance industry!
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Flexibility by
Michael Bellantonio Physiotherapist, Titled APA Sports Physiotherapist
southsidephysio.com.au |
02 6282 5010 |
wip@sspg.com.au |
Level 1, Canberra Healthpoint Building, 16 Wilbow Street, Woden ACT
To tweak a line from William Shakespeare – some are born flexible, some achieve flexibility and some have flexibility thrust upon them (don’t do this! Flexibility should never be forced).
Flexibility is the capacity of the soft tissues structures (muscles, tendons, ligaments, connective tissue) around a body part to lengthen smoothly through that body part’s available range of movement. There are two types of flexibility – dynamic and static. Dynamic flexibility is the ability to move a body part through a range of movement using your muscles (for example, how high you can lift your leg in a grande battement). Static flexibility is how much stretch of a body part is achieved passively, without the use of your muscles (for example, how high you can lift your leg if you use your arms to pull it up). Both are important in injury prevention and technique. As a general rule, females are more flexible than males, and this is no different in the dancing population.
Let’s talk about the first group mentioned in the misquoted Shakespeare line – those that are born flexible. Why is this? This can be due the skeletal makeup of their joints allowing for greater freedom of movement. They can also have a different genetic makeup of their connective tissues – the tissue that surrounds muscles and its fibres. Two important components of our connective tissues are fibres called collagen and elastin. In basic terms, collagen protects our joints and muscles from injury. Normal collagen can only elongate around 10 per cent. In contrast, elastin, as its name suggests, has elastic properties and can elongate up to 200 per cent and still return to its normal resting length. Due to hereditary variations in the collagen structure or an overall relative increase in percentage of elastin content in connective tissues, some dancers have the ability to move their body in ways other dancers cannot. We term this genetic hypermobility (rather than acquired hypermobility, which we’ll touch on later). Hypermobile athletes are naturally drawn to ballet and gymnastics, because it is easy for them to achieve desirable joint ranges.
I feel it is important for dancers that have to work hard to maintain their flexibility to not try and compare themselves to dancers that are naturally hypermobile. Your tissue makeup is different. Pushing yourself to be like the super bendy dancers in your class only increases your risk of injury.
For those dancers that are naturally hypermobile, you already have an increased risk of injury, because the type of collagen in your tissues does not provide as much protection. I would argue that these dancers don’t even need to do stretching regimes, and most certainly do not need push into over-stretch. Just because you can achieve over splits, doesn’t mean that you necessarily should. I would advocate that this population of dancers should be focusing on strength programmes through range to provide protection to their joints, ligaments, muscles and tendons, and decrease their injury risk. It’s important to mention that there are some rare genetic collagen disorders, such as Elher-Danlos Syndrome, which should be investigated further should the naturally hypermobile dancer have continued joint pain, recurrent joint subluxations or dislocations, and/or if they have excessively stretchy skin.
To our next group of dancers – those that achieve flexibility or develop acquired hypermobility. This takes sheer hard training and time. Static stretching, which involves elongating a muscle to its comfortable tolerance and then holding for a period of thirty seconds (repeating the stretch 3-4 times, as it takes a minimum ninety seconds to obtain tissue elongation), has been shown to have the greatest effect at producing long term changes in flexibility; it just takes a long period of time to achieve this. Static stretching needs to be regular and maintained over time to achieve the desired outcome of increased tissue extensibility. Stretching should be performed at the end of class, when the soft tissue is warmed up and more able to elongate. Stretching should not be used as a warm up, as this can actually increase risk of injury and decrease performance.
In those that have to work to achieve flexibility, the fascia and associated muscles develop an increased tolerance to stretch. Since we are naturally more flexible when young, stretch tolerance may be easier to achieve in the younger dancer, than say, a dancer that takes up ballet in their teenage years. Additionally, if ballet is started young, as the skeleton is still maturing, it is also possible to develop adaptations within bones which allow for greater movement at joints, in particular enhancing turnout from the hip. I would strongly recommend that all gains in flexibility be met by appropriate strengthening through this newly obtained range.
So, yes some are born flexible and need not push their stretching, and should focus instead on strengthening. Others can achieve flexibility through stretching and training but should also complement this with appropriate strengthening. In fact, supervised dance-specific strengthening focused on areas of weakness is also an effective way to increase flexibility, and I would argue, is more protective to the joints and soft tissues than stretching alone.
Michael is a Senior Physiotherapist at Southside Physio, Woden in Canberra. A Titled APA Sports Physiotherapist with over fifteen years of experience, he has worked with elite level male and female rugby players and lectured on APA Sports Physiotherapy courses. Over the years he has developed a passion for treating dancers, undertaking multiple courses and workshops from some of the best minds in Dance Medicine to ensure his knowledge and skills for managing dance related injuries are of the highest quality possible.
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The Dancer’s Hip: Preventing injury
by
Katie Godwin Senior Physiotherapist , APA Titled Sports Physiotherapist, Physiotherapist for Dancers and Performers
kineticaphysiotherapy.com.au |
enquiries@kineticaphysio.com.au |
02 9948 6188 |
410 Sydney Rd, Balgowlah and
87 Chandos St, St Leonards I
While every dancer’s hip is different, there are some injury prevention principles that are applicable to almost all dancers. We encourage you to give the below exercises a try, preferably under the guidance of your physio initially so that you can be assured that you are doing them properly. Remember none of the below exercises should cause pain. If you do experience pain, please stop and make a time to talk to your physiotherapist. Enjoy!
To get the best out of your hips and prevent injury:
1) Avoid excessive stretching – especially of front of the hip joint capsule, and over-splits.
Dancers love to stretch. The reality is however that too much stretching of the front of the hips, or pushing the hip into over-splits is likely to do more harm than good. Many hip injuries are due in part to dancers having insufficient stability at the front of the hip joint. Stretches such as froggy stretch (fig 1) contribute to this loosening of the front of the hip joint, and are best avoided.
2) Strengthen: By far our best strategy in creating hips that are injury resistant is to strengthen them. The following muscles are important both in creating stability and optimising control at the hip joint during dance.
i) Psoas strengthening: Starting with the hip flexed so that the knee is higher than the hip will assist in targeting our psoas (or hip flexor) muscle. One way to do this is to lie on your back with your foot supported by an upright structure and theraband looped around your knee (fig 2). Gently draw your knee toward your chest and lift your heel off as you push against the theraband. You should feel a tendon tightening at the front of your hip joint as you do so. If not, try turning your hip out slightly. Avoid tilting your pelvis forward or back as you lift your knee. Start by holding for 10 seconds, and repeat 5 times, building to 10 repetitions as you get stronger.
ii) Deep external rotator strengthening: These are our turnout muscles and are located at the lower part of our buttocks, midway between our sitting bone and the outside of our hip. Strengthen these muscles by starting in 4 point kneeling with a light theraband looped around the inside of your ankle and attached to an upright structure (fig 3). Without moving your pelvis, gently slide your foot along the ground toward the other foot increasing the tension on the theraband as you do so. Hold for 10 seconds and repeat 5 – 10 times.
iii) Adductor magnus strengthening: Lie on your side with your bottom leg stretched long and your top leg bent and resting on a pillow in front of your hip. Keeping the knee straight, and your leg hip in neutral rotation (not turned out or in) lift your bottom leg off the ground, hold for 3 seconds, and slowly lower almost to the ground before lifting again (fig 4). Repeat 20 reps. If this is easy, you can add a light weight (0.5 – 2kg) to your knee or ankle.
3) Release: overactivity in certain muscles can contribute to hip tightening and restricted movement. Releasing these muscles helps to restore balance to the hip joint.
i) TFL: Lie on your side with a spikey ball positioned 5cm below and behind the bony point at the front of your hip. Initially you may need to do this on a soft surface or with a towel between the ball and your hip (fig 5). Relax over the ball for 30-60 seconds depending on what you can tolerate. If you don’t have a spikey ball, a roller or tennis ball work well too!
ii) Piriformis/superior gluteal muscles: Cross one leg over the other and sit on a foam roller, leaning to the side you are releasing. Roll forward and back on the roller to release tension in these muscle fibres (fig 6)
Remember, there are lots of variations to these exercises and what works best for one dancer may not work at all for another. If you’re not sure, always ask your physiotherapist. Taking care of your hips is an excellent investment in injury free dancing.
Good luck!
Katie is an experienced physiotherapist, having spent more than 10 years working with clients from a variety of backgrounds, including The Australian Ballet Company. Katie lectures regularly to school students and full-time dance students on safe dance practices.
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Dance Massage
by
Marina Bull
marinasremedial.com.au |
marinabull@outlook.com.au |
0477 938 170 |
An addition to your training schedule that will enhance your performance beyond imagining
Marina joins our health care team this year to talk to you about the benefits of massage. It must be said that not all massages are equal and that dancers should always seek out an experienced massage therapist, like Marina, who have a history of treating dancers.
Marina trained at an elite level with Tanya Pearson Academy and Elmhurst Ballet School and went on to have a successful career performing with Birmingham Royal Ballet, The Paris Opera Ballet, The Croatian National Ballet, Ballet Manila, Moravian Theater of Olomouc (Czech Republic), The National Ballet of Romania and The State Ballet of Stara Zagora (Bulgaria).
Massage played an integral part in her ability to dance through the many demands placed on her, which included a broken pelvis for the entirety of her career! Inspired by the noticeable therapeutic effects of massage and a desire to assist dancers, Marina now runs a successful clinic in Sydney.
For a dancer, I do not think it gets any better than having a dancer tend to their bodies in this way. Marina’s experienced hands understand how the dancer moves and therefore which muscles gain the most benefit from her attention. She is inspired by connections, the one she has with her clients and the one her clients have with their bodies.
Some dancers find their passion and dedication to become a professional dancer later in their teenage years. What advice do you offer these dancers in terms of how they work their bodies?
For dancers who find their passion in their late teens, they often feel an intense need to push quickly and catch up on what they feel they’ve missed. Dancers really need to find teachers and also therapists who specialise in this. Be patient and take the time to find balance between taking care of your body and still making daily progress. A weekly massage will aid in your recovery and help you to manage any niggles as they present in your body which will be key in minimising serious injury. This type of therapy will make you more productive in class and enable you to work harder and smarter. It has been proven that a relaxed mind plays a significant role in the bodies ability to perform at its best
Be very mindful pushing yourself too hard, too quickly in pursuit of flexibility and strength because the body can only take so much. Building the necessary strength and flexibility takes time.
What are the benefits of a weekly massage?
Regular (weekly or fortnightly) massage is an amazing investment in preventing injury and hastening rehab. However even more importantly it can be used to enhance physical ability.
Quite often dancers can be at odds with their bodies, frustrated with the fact their bodies will not move in the way they desire. Massage positively reconnects the dancer with their body. Restoring your mind and your body will improve your body’s condition, just as feeling at one with your strong and flexible body will inevitably improve your mental state.
Massage can help with so many aspects of your training and life – mood, sleep, focus, digestion, pain, headaches, period pain, flexibility, energy levels and strength.
Massage is also a wonderful tool to support the dancer through injury recovery as it prevents compensatory muscles strains, and improves circulation to nourish the healing areas. Appropriately directed massage eases pain, relaxes mind and muscles, improves circulation and the range of motion that can be achieved both actively and passively.
A muscle that can fully extend and relax will also be able to generate more power because it then can create a larger contraction with more forceful engagement. This means higher legs, greater back bends, higher jumps, and more strength in all movements and positions.
Pointe and demi pointe range is improved when the muscles of the feet and legs have been treated, depending on if your restriction is caused in the toes, mid foot, ankle, knees, or hips.
Port de bras become more expansive, with an open back and chest. This works both for female dancers and enhances men’s strength to lift women.
When there is no muscular restriction the muscles and tendons can function with optimum technique. This applies to all joints and all aspects of movement, and translates from class to stage and everyday life.
In addition to Marina’s dance training…
Association of Massage Therapists Senior Member. Senior First Aid (latest update 2018). Certificate in Dry Needling, Precise Points (2018). Certified International Kinesiotape practitioner (2015), Kinesiotape International. Diploma in Remedial Massage (2015) Australian College of Massage. Certificate IV in Massage Therapy (2013) Australian College of Massage. Certificate IIV in Fitness Instruction- Australian Fitness Institute,(2011)
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JUMPS, KICKS & WEIGHTS TOGETHER Why they do not help!
by
Joanne Maskrey B.Phty from InSync Physiotherapy and Pilates
insyncphysiopilates.com.au |
insync@live.com.au |
03 9813 2188 |
Picture the perfect grand jeté. You’re dancing across the room and you take flight, soaring through the air as if you were removed from the grasp of gravity. And then lightly, like a feather, you float back to earth before taking the next leap into the air. Weightless. Effortless. Graceful.
Or imagine a grand battement devant. Your hips and pelvis, square. Your body, tall. Your leg effortlessly swings up to a limitless height. Light. Free. Controlled.
The reality is, to achieve such jetés and kicks requires immense strength and control throughout the entire body. It is only natural that dancers are all too willing to invent new ways build up the strength they need to increase their extension.
A method that is by no means new, is adding cuff weights to limbs, particularly around the ankles. The theory is, adding ankle weights during leg lifts and jumps increases the load applied to muscles and as a result they strengthen to meet the demand. By contrast, once the weights are removed, the muscles will have more strength to move lighter loads. The result being effortless movement and a sense of lightness in the limbs Although this sounds good in theory, the reality is the regular addition of weights to such exercises may cause more harm than good.
How high a person can jump depends on how much force they are able to exert on the ground. The dancer lowers into a demi-plié, creating elastic energy in the muscles through the bending of the hip, knee and ankle joints. This energy is then rapidly released as the dancer straightens the knees and point the feet to push off the ground and accelerate into the air. Landing from the jump again requires a well-controlled demi-plié to absorb the impact as the dancer returns to the ground.
Placing weights on the ankles does indeed increase the effort required to jump off the ground. However, the weight placed on the ankle as the body propels up from the ground, creates traction forces through the joints in the leg, leaving them vulnerable to injury.
The same can be said for attaching ankle weights while practicing grand battemants. Elevation of the legs beyond 90° requires recruitment of specific deep core muscles to stabilise the trunk, enormous amounts of gluteal strength to properly transfer the weight off the body onto the supporting leg and tremendous strength through the deep hip flexor muscles, psoas and iliacus, to lift the gesture leg. Too often, student dancers struggle to find their deep hip flexors to lift their legs above 90°. Instead, they recruit the superficial hip flexor muscles, TFL and rectus femoris. Have you ever felt like your thigh is bunching up as you attempt to lift your leg higher? Chances are, you, like many other dancers, could be using those superficial hip flexors instead of your deep hip flexor muscles.
In order to lift the leg up en l’air, activation of the deep hip flexor muscles is required; the deep core muscles need to be engaged to stabilise the spine and pelvis. This enables the deep hip flexors that attach onto the spine and pelvis a stable base to work upon and effectively lifting the leg up into the air. Without stability in the pelvis, the deep hip flexors cannot move the hip joint optimally, and the superficial muscles will be called upon. These muscles are not an efficient means of leg elevation and repeated use of them can cause irritation through the front of the hip joint. Further increasing the weight of the leg with the use of ankle weights only increases the likelihood of the superficial muscles being recruited, leaving the hip more vulnerable to injury, without any added strengthening of the correct muscles.
To build strength in the deep hip flexor muscles requires specific exercises performed in positions where the spine and pelvis can be well supported so to mimic the actions of the deep core muscles’ role in stabilizing the spine. This then allows for the deep hip flexors to activate to move the hip. Frequent practise of deep hip flexor activation will help to train a new pattern of muscle recruitment for lifting the leg en l’air.
Consider practising a simple folding movements at the hip joint while lying on your back with your leg supported. Can you fold your hip past 90° without flattening your lower back to the floor while at the same time keeping all your muscles soft within your hip crease? If you have mastered the hip folds while lying down, try lifting your knee past 90° in a seated position. Can you lift your thigh bone up off the seat, keeping your back straight and without rolling off the tips of your sitting bones? If you’re uncertain whether you are recruiting the correct muscles, it can be useful to seek help from a physiotherapist specialising in dance, a dance teacher or a dance coach.
As for training to fly through the air in allegro, make sure you are strengthening your calves, quadriceps and gluteal muscle groups individually. Also, consider breaking down your jumps into their various components. Try jumping up onto a box or a step to improve the height of your jumps. Try jumping down from a height to practise your landing control. Practise jumping while travelling in different directions. Attempt these jumps on two legs first and then progress to single leg as you are able. Practise in parallel positions as well as in turnout. Be sure to keep your trunk stable throughout your jumps and keep you knees over your toes to maintain good leg alignment control. Once you have mastered each component of jumping, it will be far easier to bring it all together in a grand jeté!
Every step in dance, from the most basic of tendus to coupe jetés en tournants, rely on the strongest of techniques, which stems from good muscle strength and activation patterns, as well as sound body alignment control. The use of weights and resistance, which does indeed have its place in strengthening muscles, should be left for slower movements only, with the body placed in supported positions. Ultimately the key to success in any movement, especially ballistic, is to consistently work on the correct activation and strength of individual muscle groups and to coordinate the associated efficient muscle activation sequence. Happy Dancing!
Joanne Maskrey B.Phty from InSync Physiotherapy and Pilates Joanne trained in the Royal Academy of Dance syllabus up until Advanced. She studied Pilates at the Australian Physiotherapy and Pilates Institute in London and Physiotherapy at the University of Melbourne. To this day she still attends ballet class.
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Decisions, Decisions
by
Dr. Kate Fennessy
drbywater.com.au |
bernadette@drbywater.com.au |
02 9713 9265 |
0448 641 892
It’s Audition Season! How to make decisions when the heat is on…
Choosing a dance school can be a challenging experience. The first of many difficult decisions for dancers is figuring out which opportunities are the right ones to pursue. Parents, teachers and peers will all weigh in, and the process can be more than a little overwhelming. Asking the right questions as you prepare to audition can help to steer you in the right direction.
What do I want in the long term? The opportunity must relate to your personal career aspirations. The clearer you are with yourself, the better able you will be to research and make choices about which direction you wish to go in. If you know why you are at a particular audition, it will be easier to remain focused, even if you are just there for the experience.
What are the most important things to me? Knowing your values and what is important to you is key. Values are chosen life directions; the things that give life meaning, so knowing what you value can steer the choices you make and the goals you set. To discover what is truly important to you, look back on your life and think about times you were really confident that you were making good choices. Thinking about times when you were happiest, the most proud of yourself, and the most fulfilled, and why those experiences contributed to how you felt. This can help you to determine what you most value, and what you truly can’t do without.
Below are some questions to ask about the prospective course, and to help you think of what else you might need to know to make a good decision.
What is the philosophy, culture and reputation of the company, school or organisation?
What is the size and structure of classes or rehearsals?
What is their performance repertoire and types of medium?
Who is their audience?
What do others have to say about their experiences here?
Will I get the training I need to do the work I ultimately want to do?
Am I being realistic about my technical level/ time/ financial resources?
Is travel involved and to what extent?
Will this work with my other important commitments?
Each of these answers can be weighed up against your values to help to clarify your options. For example, some school are competition schools where performing and competing are the major emphasis, while others may offer non-competitive performance opportunities a few times per year. While both offer valid dance education, the philosophy and emphasis of the school might make a big difference to your experience. Do you value competition? Is it something which makes you tick and motivates you? Or is it something you could do without?
What not to base your choices on:
Impulse: the best decisions are based on logical rational thought as well as emotion.
Whatever is easier: making a choice based on values doesn’t necessarily feel good or easy.
What your friends are doing: what is right for others might not be right for you.
The opinion of one person: evaluate different points of view before deciding for yourself
When you consider your values in decision making, you can be sure you will approach decisions with more clarity, and know that the choice you are making is best for your current and future happiness and satisfaction. Although choosing a dance school may seem overwhelming, it need not be. It will take some time and research, but in the long run, making the choice for a healthy and positive learning experience will be well worth it.
Dr. Kate Fennessy is a clinical psychologist who works with adults and young people in a private practice in Sydney. For more information, visit drbywater.com.au or telephone 0448 641 892.
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danceScience
by
Dr. Luke Hopper WAAPA Lecturer
waapa.ecu.edu.au |
enquiries@ecu.edu.au |
134 ECU (134 328)
What is ASPAH? How will teachers and students benefit from their work?
ASPAH, the Australian Society for Performing Arts Healthcare, was formed just over 10 years ago primarily by clinicians and researchers who predominantly worked with performing artists. They recognised that performers needs were different from the general population and sports people, and created a communication hub for a network of clinicians to swap information on performing arts heath. This has helped to improve awareness and the quality of care for performing artists.
Its great because teachers and students have access to a number of performing arts health care resources as well as an extensive network of practicing health care professionals all of whom have a background in performing artist health and wellbeing.
They understand the demands and needs of performing artists – what dancers do, how they use their bodies. Just think about the way dancers use their feet for pointe work, the pressures and loads on the foot, it’s very different to anything else in other physical disciplines. Also, the motivations that dancers have to train, the pressures behind them for improving and getting back into class, for good or bad.
Understanding where a dancer is coming from and where they want to go is really important.
Tell us about your work with Harlequin?
I first connected with Harlequin at the start of my PhD. I sent them an email to say I’m interested in doing some research around dance floors – what are the standards, what are the needs, how are the floors produced and created for dance-specific purposes? A testament as to why they’ve been great to work with is that they immediately got back to me; it was actually Guy Dagger, Managing Director of British Harlequin (his father Bob Dagger started Harlequin many decades ago).
They are dedicated to dancer health and wellbeing but by the same token have respect for the research process.
They were really supportive of and interested in seeing what the research outcomes could provide whilst seeing a separation between the commercial drivers and demands, and the research requirements to maintain that standard and rigour through the research. It’s that openness to new ideas and that recognition of the relationship between a commercial entity and a research institution that works really well.
How has dance medicine and science research impacted on today’s dancers?
There’s less of a stigma around illness and injury in dance although there’s still a long way to go. Dance will continue to change quite a lot over the coming years. But certainly the engagement of dancers with supplemental training and looking at other ways in which they can keep their bodies in shape, and being smarter about the way they used and trained their bodies has improved. They’re more open and understand that dance is difficult.
You have to push your body to an extent but you also have to be clever about managing your body.
Dancers are more proactive in their approach to their training and engage with the available information more readily.
If there is a problem dancers are starting to see the problem rather than hide it or push through it.
They’re really trying to be sensible about the way that they approach training and use the health professional community. Maximising and being smart about what training dancers are doing when they’re in good health is important too. Then if they become ill or injured, to be sensible about the rehabilitation and seek advice from professionals that understand dance and can help the dancer get back into the studio.
What’s next for dance science?
Over the past two decades, dance medicine and science has really established the frequency of injury, the severity of injury and the impact of injury on dance in the community. This has probably had the most impact on the community as it has built awareness and opened up the conversation around injuries.
Now, its great to see all this proactivity occurring in the field looking at injury screening, best practices in rehabilitation, and also loads monitoring and the amount of activity that dancers are doing.
To look further ahead I think the biggest areas yet to come forth are: the workloads of dancers, managing the amount of effort dancers are putting into their training, and ways of developing efficiencies through that training so they’re more proactive about preventing overuse injuries.
There are of course psychological and physical aspects to that.
Both a dancer’s psychological and physical well-being needs to be maintained, so they’re really getting the most value from their training but not pushing themselves so far that they’re get these overuse, over-training and burn-out type symptoms.
Advice for aspiring performers?
I would really encourage the readers to
engage with the different publications and websites such as ASPAH and IADMS, and to use the available resources.
The more demand for these resources, the more that the dance medicine and science community will produce.
ASPAH is running a symposium in November. For more information aspah.org.au
Dr Hopper completed a PhD specialising in the biomechanics of dance and injury prevention at the University of Western Australia's School of Sports Science, Exercise and Health in 2011. Dr Hopper coordinated the biomechanics module in the pioneering Master's of Dance Science at the Trinity Laban Conservatoire of Music and Dance in 2010 before commencing as a lecturer in bio mechanics at the University of Notre Dane Australia. Dr Hopper's work in dance science and performing arts health has involved several collaborations with international ballet companies such as Birmingham Royal Ballet and with industry partners Harlequin Floors. Dr Hopper continues to work with the International Association of Dance Medicine & Science and the Australian Society for Performing Arts Healthcare in the development and dissemination of health evidence in preventing injury and illness in performing artists. In his position at ECU, Dr Hopper is developing a health education and research program for biomechanics 3D motion capture facilities and in collaboration with WAAPA staff and students
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Dancing is good for kids
by
Dr. Kate Fennessy
0448 641 892
Children are natural dancers, moving for fun and to express themselves with their bodies before and during speech development, all the way into adulthood. Research has found that dance supports several key aspects of development for children and young people in several domains.
Physical Development
Dance places positive stress on growing bones causing them to grow into stronger, healthier bones! Girls lay down an incredible 25% of their total lifetime bone mass over the 2-3 years of their peak growth spurt (usually between the ages of 11 and 13). Weight bearing exercise will maximise the amount of bone that is laid down at this time, which can help to prevent bone diseases such as osteoporosis later in life.
Many adolescents find it difficult to maintain good sitting and standing posture, and develop bad postural habits during these years. Poor posture can lead to back and neck pain, and even headaches in some cases. Dance helps to strengthen postural muscles, including core muscles that surround and support the spine, helping to keep spines healthy and improve physical posture.
Studies show that children today are becoming less coordinated than previous generations (1), probably because they aren’t exposed to the same amount of physical exercise. Dance helps to develop a strong sense of coordination, timing and balance.
Katie Godwin
Kinetica Physiotherapy
Cognitive Benefits
Children learn best through the experience of “doing”, and dance helps to support this kinaesthetic learning through providing novel and diverse sensory and physical experiences. In addition to this enhanced sensory and physical awareness, improvements in coordination and mimicry can promote pattern learning and left-right neural differentiation. Dance can also support children’s literacy as acquisition of language primarily involves the translation of movement expression into words, and there is some evidence that a lifetime of dance is protective against certain forms of dementia, and aids memory and concentration in later life.
Emotional Development
Dance for all ages boosts serotonin levels, and can be a source of fun, excitement and joy.
Children and young people who dance can better understand and express their emotions through their bodies, and can have a greater awareness of the self and others through creative movement. While performance can be challenging, it also offers an opportunity to share experiences and achievements with family and friends, and can be a source of pride. While dance provides a physical release, which can help with stress, anxiety, low mood and anger, it also provides opportunities for the development of emotional maturity and self-expression, a shortcut to clearing the mind, feeling positive, and letting go of strong or painful emotions. It can become a space in which young people can break from other pressures and changes and focus on the moment, which can be meditative, and a way to affirm their own inner life and realities.
Social Development
A large part of communication is nonverbal, and can occur outside of our conscious awareness. Helping children become more aware of how they hold and move their bodies helps to develop their social awareness and communication skills. Dance, like other activities, can also provide an opportunity to meet others, mixing with people from other schools and making new friends. Dance fosters social encounters, interactions, and cooperation, and provides young people with a sense of community. Moving together can be a very unifying feeling and through learning to work within a group dynamic, and the challenges that come with cooperation and responding to instruction, children learn to better understand themselves in relation to others. This can be particularly helpful as children develop their sense of individuality as they approach their tween and into their early teen years, and serves as a foundation to the development of more advanced social skill.
Dr. Kate Fennessy
Dr. Bywater and Associates
1.Hardy, LL; King, L; Espinel, P; Cosgrove, C; Bauman, A 2010, NSW Schools Physical Activity and Nutrition Survey (SPANS), NSW Ministry of Health, Sydney.
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Motivation
by
Katie Godwin
kineticaphysiotherapy.com.au |
enquiries@kineticaphysio.com.au |
02 9948 6188
Understanding how you work and what motivates you can get you to your goals faster. What you currently do with ease provides clues to what motivates you. The things that make you upset or angry can also point the way to what you care about. Asking yourself what it is that gets you going about a particular activity can help you to reach your goals, by setting up valued rewards for when the road gets tougher. Good luck!
There are two sources of motivation: extrinsic and intrinsic factors. Extrinsic factors are those that arise from outside of us and often involve rewards such as trophies, money, social recognition or praise. Intrinsic factors are those that arise from within, such as doing a complex crossword purely for the personal gratification of solving a problem.
Both extrinsic and intrinsic factors can also be aligned with our personal values, such as being reliable, or having physical beauty. The person who values physical appearance may have no problem scheduling in regular, expensive hair appointments and will be motivated to attend them for as long as is needed, which would be difficult for an individual who does not value this as highly. [/one_half]
One person may be more intrinsically motivated in their passion, while others may be more extrinsically motivated, and will persist for a reward they value. Dancers may value and be motivated by different things, for example, the intrinsic motivators of self-expression, the feeling of dancing, the satisfaction of being consistent, or the extrinsic motivators of winning praise or triumphing over the competition. Why we do things may sometimes quite complex, and one person can value a combination of all of these factors or be motivated for quite another set of reasons altogether!
Katie Godwin is an experienced physiotherapist, having spent more than 10 years working with clients from a variety of backgrounds, including The Australian Ballet Company. Katie is the current Chairperson for the NSW Dance Network, and lectures regularly to school students and full-time dance students on safe dance practices.
kineticaphysiotherapy.com.au | enquiries@kineticaphysio.com.au | 02 9948 6188 | 410 Sydney Rd, Balgowlah & 87 Chandos St, St Leonards
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How much is too much?
by
Katie Godwin
kineticaphysiotherapy.com.au |
enquiries@kineticaphysio.com.au |
02 9948 6188
There has often been discussion in the media regarding how much is too much when considering the level of exercise that young people engage in. Extreme examples of overtraining tend to make headlines, and can unnecessarily worry parents and teachers. No one wants to put any child or adolescent at risk of injury; that’s a given.
It is important, however, to put the idea of overtraining into perspective. Australia’s physical activity and Sedentary Behaviours Guidelines recommend that children aged 5 – 17 years should engage in at least 60 mins of moderate to vigorous physical activity daily. Furthermore: ‘To achieve additional health benefits, children should engage in more activity – several hours per day’. And: ‘on at least 3 days per week, children should engage in activities that strengthen muscle and bone’1. So this is to say that at least 7 hours of physical activity per week is recommended as a minimum.
For most young people, the dangers of inactivity have far more serious long term health implications than the perceived dangers of dancing at a high workload.
The other extreme: how much is too much?
In some instances however overtraining does exist, to the detriment of the dancer. This is where parents in particular find it difficult to know when they need to step in and advise ‘enough is enough’. No parent wants to stand in the way of their child’s dreams by setting arbitrary limits, but no parent wants to allow their child to burn out either.
While every case is different, there are generally a couple of things all young dancers should be aware of when considering appropriate dance load.
1.
The adolescent growth spurt:
Right about the time when dancers are often being encouraged to dance harder and longer, they will often commence their adolescent growth spurt. For girls this is usually between the ages of 11 and 13, and for boys 13-15. During this spurt bones grow quickly, muscles tighten, and coordination suffers. Building hours or dance intensity during this time may lead to frustration as the dancer’s body isn’t able to respond as well as normal. Because of the rapid bone growth during this time, bones are also more susceptible to injury. Repetitive overload of rapidly growing bones can cause bone stress or fracture which needs to be taken seriously to ensure the long term health of the dancer. Recognising times of rapid growth and communicating these with the dance teacher, should result in an easing off on dance workload rather than pushing forward. Such easing of load will not cause a dancer to fall behind as is feared, instead they are likely to perform better as their muscles and bones are given the space they need to develop optimally.
2.
The adolescent body needs sleep:
More so than adults, adolescents need sleep. And in large quantities. Studies recommend ≥9 hours per night for adolescents; a hard ask in the current climate of homework, smart phones and extra-curricular activities. If dancing is taking place of sleep, this should be a consideration when asking yourself whether the load is too high.
3.
The female menstrual cycle
While this is often irregular (or absent) in the healthiest of young females, it can be an early warning sign of overtraining. A dancer’s body needs to have lots of energy available for high levels of dancing. It also requires energy for optimal hormonal function and menstruation. When energy availability is low (either through low caloric intake or high levels of exercise) there may not be enough energy left over to maintain normal menstruation2. A dancer may experience delayed menarche, irregular menstrual cycles, or cessation of menstruation as a result. The hormone oestrogen which is produced during menstruation is also essential to build and protect healthy bones. Therefore low levels of oestrogen can cause bones to become more brittle, and that can be a problem. In all likelihood, your abnormal period may be completely ok for you. But it doesn’t hurt to discuss any change in menstrual status with your GP to ensure that it is not an early sign of overtraining.
4.
Tendons, bones, and muscles need time to adapt to increasing load
More so than total dance load, large fluctuations in load lead to injuries. Any increase in dancing hours or intensity needs to be introduced gradually so that a dancer’s body has time to adapt. It is recommended, for example, that a dancer needs at least 4 years of dance training after the age of 8 to develop enough strength and control to start pointe work (along with other considerations)3. Jumping suddenly from 5 hours to 10 hours of dancing in a week is likely to put a dancer at high injury risk. If however the same dancer had increased that load gradually over a term, their risk of injury is much lower.
So where can parents find that magic number of hours that is appropriate for a dancer’s age?
The formula that is required to make a successful adult dancer is not easily pinned down. Certainly competitive dancing requires a combination of physical fitness and artistry that cannot be achieved without much hard work, hours at the barre, and no small degree of natural talent. But it also requires maturity. Towards the end of high school, many dancers who go on to dance professionally are participating in pre-professional training and full time loads without apparent detriment to their long term health. The potential benefits and risks of allowing 12 or 13 year old dancers (who are still growing rapidly) to do full-time loads are more uncertain. While there are exceptions in every case, there is the risk that high loads during these years may allow dancers to shine in the short term at the later cost of burnout or injury.
Signs of overtraining may include:
– Ongoing fatigue that is not easily improved with a night’s rest
– Deterioration in dance performance
– Lowered concentration
– Loss of menstrual cycle
– Multiple injuries over a relatively short time period
If you are concerned that you are not dancing at your best and you are considering whether you are doing too much, talk to your GP or Dance Physiotherapist. Having a good support team around you is a great way to ensure that you are achieving a balance that is right for you.
Keep dancing safely.
Katie Godwin and the team at Kinetica Physiotherapy
1. Australia’s physical activity and Sedentary Behaviours Guidelines. www.health.gov.au
2. IADMS Resource paper: Bone Health and Female Dancers: Physical and Nutritional Guidelines. J Dance Med Sci
3. IADMS Resource paper: When can I start pointe work? Guidelines for initiating pointe training. J Dance Med Sci
Katie Godwin is an experienced physiotherapist, having spent more than 10 years working with clients from a variety of backgrounds, including The Australian Ballet Company. Katie is the current Chairperson for the NSW Dance Network, and lectures regularly to school students and full-time dance students on safe dance practices.
kineticaphysiotherapy.com.au | enquiries@kineticaphysio.com.au | 02 9948 6188 | 410 Sydney Rd, Balgowlah & 87 Chandos St, St Leonards
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The Port De Bras
by
Gabrielle Davidson and Bradley Smith
insyncphysiopilates.com.au |
insync@live.com.au |
03 9813 2188
Understanding how your body is put together can help you understand and access the right muscles, joints and bones to allow you to perform with greater strength and artistry.
Whilst watching dance it is the legs and feet that appear to carry out the majority of athleticism and it is the port de bras that displays artistry and intention with fine, controlled movements paramount to helping an artist tell a story.
The whole upper body inclusive of the head, upper back, chest, shoulders, arms, fingers and even the eyes contribute to the creation of a beautiful port de bras. Shoulder and upper limb stability and strength are imperative for both line creation and the execution of dynamic movement and pas de deux.
The spine has 3 healthy curves, the neck, thoracic and lower back. The thoracic spine, also known as the mid-back is where the the ribs, shoulder girdle and arms attach. A healthy thoracic spine allows you to arch, curve and bend from side to side.
The upper limbs attach to the central skeleton in just two places, one for each side, at the base of the neck, by a joint known as the sternoclavicular joint, made up of the collar bone and breast bone. The arm and shoulder blade both connect to the clavicle to allow force from the arm to be transferred and distributed by the axial skeleton. An example of this would be when you are holding your partners hand for support. As the shoulder blade has no direct attachment to the central skeleton, it essentially rests on the back of the ribcage with all the support and control coming from the muscles attached to it.
The shoulder blade is an important part of shoulder and upper arm movements. The shoulder blade can rise with the upper trapezius muscle, lower using gravity and the pecs, move away and in from the midline using the serratus anterior muscle and middle traps and rhomboids respectively, rotate upwards using upper traps and serratus anterior and rotate downwards using the latissimus dorsi. A weakness in the serratus anterior muscle can often lead to winging scapula (chicken wings). A sense of width through the front and back of the chest can help to activate the serratus and prevent this. Mastering and controlling these movements are the key to strengthening your port de bras and preventing shoulder injury and instability.
Attaching to the shoulder blade is the humerus (upper arm), with the ball and socket joint known as the gleno-humeral joint (shoulder joint) allowing multiple movements in many different planes. These movements include lifting arms to a fifth, reaching arms behind the back, lifting arms to second, returning arms from second to bra bras, rotation of the shoulder so that palms face the front, rotation of the shoulder so palms face the back and combination movement. The stability of this joint is provided by the rotator cuff complex. The rotator cuff is referred to as a dynamic stabiliser due to its muscular nature, made up of the muscles and a tough sheath of tendons and ligaments that support the arm at the shoulder joint. The rotator cuff muscles play an important stabilising role in all shoulder movements by holding the humerus into the socket of the shoulder blade to prevent dislocation. The supraspinatus, infraspinatus and subscapularis muscles also contribute directly to the movements of shoulder abduction, external rotation and internal rotation respectively. The deltoid and latissimus dorsi play the prime role in flexion, extension, abduction, adduction.
The shoulder blade must be free to complete all movements to help position the shoulder girdle perfectly to allow the rotator cuff to work well and dissipate the arm forces through the clavicle to the central skeleton. The rotator cuff muscles must be strong enough to support the gleno-humeral joint as well as contribute to the smooth execution of movements. The strength required of the deltoid, latissimus dorsi and rotator cuff muscles increases tremendously in dancers who are partnering as the arms are usually the point of contact between the two dancers.
So now you get an idea of how all of these joints, muscles and bones need to work so you can tell a beautiful story with your arms or be supported in a lift or execute a dynamic dance routine.
Dancers can benefit by incorporating thoracic mobility, rotator cuff exercises as well as shoulder strengthening into their regular strength and conditioning program to help get the most out of their ballet training, improve the artistry of performance and protect shoulders from unnecessary injury. Your local physiotherapist can help to determine the best exercises to target these muscles.
“When the arms accompany each movement of the body with exactitude, they may be compared to the frame that sets off a picture. But if the frame is so constructed as not to suit the painting, however well executed the latter may be, its whole effect is unquestionably destroyed. So it is with the dancer; for his steps, unless his arms be lithesome and in strict harmony with his legs, his dance can have no spirit or liveliness, and he presents the same insipid appearance as a painting out of its frame or in one not at all adapted to it.” Carlo Blasis (1797-1878 Italian dance, choreographer and dance theoretician, trainer of Enrico Cecchetti’s teachers.
Gabrielle Davidson and Bradley Smith are Dance physiotherapists at InSync. Their team is at the forefront of a new wave of practitioners applying modern sports medicine principles in a dance specific environment. Their elite, pre-professional and professional dance backgrounds, give them first-hand knowledge and understanding of the stresses dancers place on their bodies. They understand “the show must go on”, liaising with dance teachers and other health professionals so the client may continue to dance through the rehabilitation period by applying the correct treatments and training practices.
insyncphysiopilates.com.au | insync@live.com.au | 03 9813 2188 | Level 1, 505 Riversdale Rd, Camberwell VIC 3124
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Over Stretching
by
Susan Bond
evolutionpilates.com.au |
info@evolutionpilates.com.au |
02 9518 5009
Over stretching is where you stretch the muscle or hold a position for over 30 seconds at end of joint range limit.
Recently physiotherapists from The Australian Ballet medical team, have said they favour strengthening exercises rather than prolonged stretching on muscles. This has led to some confusion, as dancers cannot imagine going into class or performance without some sort of flexibility warm-up or back ground stretch training.
Dancers may have experienced the negative effects of going straight into high kick movements without warm-up, sustaining a muscle strain/tear as a result. However some dancers have felt the effect too much prolonged stretching has had on their allegro ability during class. They feel wobbly and lack coordination needed for ballistic jumping motion.
Your warm-up needs to be active movement to increase body temperature, increase blood supply to muscles, warm-up joints and other connective tissue. It is preferable to do dynamic range of movement exercises rather than sitting into stretches for a long time (eg. over 30 seconds) A 10 second stretch is adequate to give your body an idea of the movements and range you are about to embark on. A light walk then jog around the studio and leg swings with bent, then straight leg will help achieve this benefit.
Sustained stretches can ‘switch off’ protective nerve reflexes and the natural tightening of muscles that occurs around joints, leaving joints and tendons vulnerable to injury.
An example of stretching, that can be detrimental in the long term, is sitting on the floor with the legs out wide in 2nd position and holding this position while doing homework. It is especially detrimental to roll the pelvis forward and back over the hip joints in this extreme position. Many dance physios feel this could damage the hip labral cartilage and over stretch ligaments and joint capsule. The normal joint structures are designed to keep the joint stable and limit an unnatural compression, sheering and slip forces between bones. It is unlikely muscles are the main structure being stretched in this position. Bone/cartilage on bone pressure is potentially detrimental to the joint in the long term, as the majority of people’s hip joints are not anatomically designed for this position.
Stretching for Rehabilitation and Body Balance Exercise
I give dancers stretches to do for therapeutic purposes. There are times when muscles and connective tissues get tight because they are spasming in protection over injured areas, or following over exercising with poor postural or limb alignment. Some muscles need to relax a bit to allow a healed area to move more easily. I never give prolonged sustained stretches to dancers that require the spine or limbs to hang unprotected in ‘end of range’ positions.
The key is to do some detective work, to ask why an area of the body is getting tight and sore. I have clients who get relief from pain and tightness by doing specific stretches carefully. The tightness will return however in many cases, an underlying issue is the cause. That is when we need to do some detective work. For example if a dancer presents with regular feelings of tight calf muscles, I ask.. what is their pelvic dynamic muscle stability like? How is the dancer using all the muscles in their feet/ leg? Are each of the muscles sharing the load ? How many hours and what style of dance is the dancer doing a lot of? What type of floor surface are they dancing on? What specific strengthening exercises are needed to correct muscle ‘imbalance’? And the list goes on in our detective work.
The Facts…
• Dynamic stretches involving whole body movement are preferable in warm-up times
• Ballistic uncontrolled stretches into end joint ranges are not advised
• Careful 15-30 second static stretches are OK once the body is warm
• Combining controlled range of movement and strengthening exercises is a beneficial way of increasing dancer flexibility and functional control
• Sustained or prolonged static stretches are thought to be detrimental for dancers, especially just before class or performance requiring strength, agility and balance (eg. Allegro)
• Over stretching repeatedly, can cause long term joint instability issues
Balancing flexibility with strength is key. Before you attempt stretches seen on Social Media you need to consider more facts than the ones you can see. How old is the dancer? What is their Flexibilty:Strength ratio? And the most important one, are they performing the stretch/move safely to achieve the desired goal? A professional dancer has the necessary strength and flexibility ratio to extend themselves far more than a student who is still learning to understand and develop this balance.
If you are very flexible you will need to ensure the muscles around your joints have the necessary strength to support your movement. You do not want your joints to pay the price in years to come. If you are not so flexible but very strong then increasing flexibility is achievable as long a you are always considering joint health, not putting too much pressure on your joints. Visiting with a dance specialist physio will help you achieve either of these goals.
Susan is the Director of Evolution Pilates and MG Pilates, she is a Dance Physiotherapist, Pilates Instructor and has been dancing since she was 5. Susie has run lectures to dance schools and Dance degree courses in Australia and UK. She is a founding member of the special Dance Network, in the Sports Australia group of the Australian Physiotherapy Association and a member of the Australian Pilates Method Association and the International Assoc. for Dance Medicine and Science.
evolutionpilates.com.au | info@evolutionpilates.com.au | 02 9518 5009 | 3/63 Johnston Street, Annandale NSW 2038
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The Benefits of Cross-Training for Dancers
by
Natalie Orola
thebalanceddancer.com |
info@thebalanceddancer.com |
0415 715 080
Traditionally, a dancer’s training has been restricted to building their technique and performance levels during a dance class. Whilst we can all appreciate the demanding impact that dance has on our bodies, the dance industry has been relatively slow on the uptake of exploring cross-training pursuits for dancers. For many, it is the fear of injury or the appearance of looking ‘too bulky’.
As we progress into the 21st century there has recently been a significant shift in the training undertaken by dancers across the globe. With the rise of innovative and holistic solutions for dancers, there has never been a better time for dancers to access a wide range of services to take their dancing to the next level.
I am a firm believer that there is never too much variety in a dancer’s training. Whether this is through vigorous cardio-exercise, weight-training, yoga, swimming or acrobatics, a dancer is spoilt for choice when it comes to exploring innovative ways to enhance their dancing outside the scope of the dance studio.
What Types of Cross-Training Assists Dancers?
One of the most effective cross-training practices for dancers is yoga. Many of us can relate to the evident relaxing and calming qualities of yoga: the stillness of the positions, the meditative style of practice, the calm surrounding you while you fluidly move through the practice. What many dancers might not appreciate is the versatility which yoga can add to their skill set. In addition to the mental focus and joint stability which yoga can provide, it also improves posture, increases strength and flexibility. These are all benefits which can be incorporated into a variety of dance genres and progress a dancer’s skill set almost immediately.
Another example of a beneficial cross-training field for dancers is acrobatics. Whilst acrobatics is an especially challenging style for dancers to master as training in both dance and acrobatic elements is required, it can improve a dancer’s skill across a number of areas including balance, particularly in core control, flexibility and overall body strength. What’s more, a dancer with acrobatic skill holds a significant ‘triple threat’ competitive advantage at audition and eisteddfod time as they can incorporate more variety in their dance pieces and showcase more unique movement in their work than their counterparts.
How Does Cross-Training Assist Dancers?
On a physical level, with adequate training, supervision and moderation, a dancer in the current industry will significantly benefit from cross-training across their whole discipline. Expectations from dancers across the world are continuously rising and are at an all time high. Simply review the progression of traditional classical ballet poses, such as Penché’s and Grand Jeté’s, over a 40 year period, and you will appreciate the greater lengths that dancers need to go in order to keep ‘up to date’ with their skill set, especially if they have their hearts set on dancing professionally.
I have witnessed this for myself during private coaching sessions with my clients. One of my private dance clients who regularly participates in swimming lessons with a personalised coach possesses an enviable level of stamina and agility during our intensive 1 to 2 hour dance coaching sessions. A level which we have not consistently witnessed across our entire client base. Another one of my clients regularly participates and competes in gymnastics. His core strength is so highly developed, it allows him to execute explosive elevation work including dynamic Grand Jeté’s and larger barrel turns, with such poise and confidence that many of his peers cannot achieve.
On a mental level, cross-training provides even more advantages to a dancer. It adds balance to the day-to-day schedule and promotes positive health and wellbeing. Cross-training also helps those dancers rehabilitating from an injury maintain strength and stamina. Speak to your doctor or rehabilitation physician to understand the wide range of benefits. Cross-training assists in maintaining levels of motivation with an additional set of goals to strive towards within their cross-training program. This enhances a positive state of mind when they approach goal-setting in the dance context.
The benefits of cross-training are endless. My take-home message is that as long as dancers strike a balance between maintaining safe dance technique, practice cross-training in moderation, and ensure they are adequately fuelled for the mission (through nutrition), cross-training should be incorporated in every serious dancer’s timetable.
Natalie is the Founder of The Balanced Dancer, a holistic dance coaching and mentoring platform for dancers around Australia. Natalie is an Associate of the Australasian Dance Association (ADA) (formerly the Federal Association of Teachers of Dancing), an Affiliate Member with The Commonwealth Society of Teachers of Dancing (CSTD) and trained in the Royal Academy of Dance (ballet) syllabus, holding over 15 years of dance teaching experience at various dance schools throughout Sydney, Gold Coast and Brisbane, Australia. A true advocate of balance - Natalie offers her dance coaching and mentoring services to dancers while practising as a full-time lawyer and hopes to inspire young dancers all around the world to reach their potential through balance.
thebalanceddancer.com | info@thebalanceddancer.com | 0415 715 080
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Living with a Dream with Uncertain Job Prospects
by
Jocelyn Penna
performancepsychology.com.au |
info@performancepsychology.com.au |
02 8011 4435
Most people feel more secure when they know what is around the bend, but unfortunately life is full of uncertainties. Dancers in pre-performance years usually have an idea of their desired career path, however each company, school and director have their own criteria and preferences. Performance is subjective so even if a dancer met the required criteria their selection is still uncertain. They must also deal with uncontrollable factors including health, puberty and injury.
Developing a resilient sense of confidence, planning and providing coping strategies is the most effective way to help pre-professional dancers prepare for an uncertain future. It is possible to feel secure when the future is unclear if one knows they will be okay regardless of the outcome.
Are there tell-tale signs of when this type of uncertainty is getting ‘too much’?
Uncertainty may become difficult to handle when
• it is present for extended periods.
• several things are indefinite at the same time.
• there are several unknowns one after the other.
• personality traits and life experiences have triggered a desire for feeling in control.
For many people uncertainty causes a little stress. If insecurity is perceived as threat however, the body will attempt to protect itself with an anxiety type physiological response including heightened alertness, and increased breath and heart rate. Whilst harmless in the short term, if prolonged this response can result in physical and mental exhaustion. Insecurity can also lead to changes in mood with more sadness, frustration, anger and worry. People who feel insecure might appear inflexible as they attempt to create as much structure and control in as many life domains as possible to compensate for whatever is making them feel “out of control”. They might also experience self-doubt or self-sabotage to help dreaded outcomes seem more bearable.
Dancers often describe themselves as perfectionistic. Sometimes people strive for perfection assuming they have ultimate control. Whilst the trait can help dancers refine technique, perfection is unobtainable, and the future is unpredictable, so if unmonitored it’s relentlessness can lead to burnout.
Does everyone feel this stress?
Whilst uncertainty is part of life, insecurity does not need to be. People with a resilient sense of self confidence know they will be okay regardless of the outcome of their circumstances.
• They see possibilities and opportunities instead of necessities.
• Their self-worth and perceived value to family, friends and society is not related to decisions, desires or career path.
• Subjective judgements of performance don’t influence their self-worth.
• All feedback is transformed into constructive criticism and used for development.
• They realise that some opportunities will be desirable, and others will be stepping stones.
Are their tips for discovering your own coping mechanisms?
If you feel like uncertainty is becoming too much,
1. Acknowledge your dream goals, even if they seem unobtainable! Pretending they don’t exist will increase your uncertainty.
2. List your limitations and strengths, so you can realistically consider your dream goals.
3. Revisit your dream goals and see how you can adjust them to be obtainable. Come up with as many variations as possible, to increase the certainty that you will achieve one of them.
4. View them as opportunities and possibilities, as uncertainty can be motivating if any of the consequences are welcome.
5. Maximise your chances of achieving your goals and decrease uncertainty by setting out a step by step action plan. Make sure these steps are controllable, for example to “stretch nightly for 20 minutes”, rather than “place first in the eisteddfod”.
6. Know your physiological and cognitive responses to uncertainty and deal with them proactively. Explore unhelpful thoughts, manage anxious feelings with abdominal breathing and grounding, talk to a trusted friend or family member and ask for help to cope with stress.
7. Forge security in other areas of life by maintaining family and friend relationships, making a secure home base and keeping other interests.
8. Seek support if you think an unobtained dream goal may change how you feel about yourself.
Look into meeting with a qualified performance psychologist, familiar with the world of dance if
• you would like specific strategies to manage physiological and cognitive responses to uncertainty,
• you are becoming inflexible or uncertainty is leading you to feel “out of control”
• you are not sure that you will be secure in uncertainty.
Remember that life is highly unpredictable, so numerous pathways to a dream goal are essential and there are many ways to experience the joys that performance brings.
Jocelyn Penna from Focus Performance has 18 years experience working with professional and developing performing artists. She enjoyed a background in dance and now studies the psychological challenges and rewards of being involved in the field. Working from clinics at Turramurra and Homebush. Skype and phone consultations are also available.
performancepsychology.com.au | info@performancepsychology.com.au | 02 8011 4435
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OVERLOAD
Understanding the Triggers
by
Charissa Fermelis
charissafermelis.com |
0438 020 167 |
info@charissafermelis.com
Understanding when you are at risk of injury will help you better take care of yourself. Charissa offers some great advice on how to better understand you and gain a greater understanding of when you might be overloading.
‘Load’ refers to the overall physical force being placed on the body. Managing load appropriately is vital in dance conditioning as it reduces the risk of injury and guides rehabilitation. When the amount of load outweighs the body’s ability to cope, an overload injury can occur. The difference in the younger population is that throughout growth spurts and physical changes during puberty, the body is undergoing constant change in size, shape, weight and hormones.
Finding the balance between participating in enough class work to continue progressing a dancer’s skill, without overtraining, can be quite the juggling act.
Sports physiotherapists and dance medicine experts look at the influence of external and internal load, and ratio between the cumulative training load over a 4 week average and the load in the current week.
External Load is the number of hours of physical activity. For example, a typical client of mine is a 13 year-old aspiring ballerina, whose weekly timetable involves 15 hours of dance, 3 hours of netball, and 2 hours of school sport – 20 hours per week on a regular basis; over the course of a school term, her body adapts and is now capable of managing this workload. During the holidays she participates in a ballet intensive, involving an additional 6 hours of dance per day over 5 days (extra 30 hours); her body has not prepared for this sudden spike in volume, so is now more susceptible to injury.
Internal load can be measured as the rate of perceived exertion (RPE) on a numerical scale from 1 to 10; 1 being minimal and 10 being maximal exertion. Both the dancer and the teacher can report RPE and note any discrepancies. For example, a teacher may report that a student had a fairly light class and rated the RPE as 4, yet the dancer rates her RPE significantly higher at 9. This discrepancy could be a warning sign that the dancer perceives a higher intensity of class, which could lead to an overuse injury. Professional sporting teams connect to an online database where players upload specific data, which is analyzed to calculate optimal loads for individual athletes. Recreational dancers can monitor their internal load/RPE on a daily basis in their diary, calendar or on smart phone apps.
As well as the dancer keeping track of their RPE, other signs for dance teachers and parents to watch out for are:
• Reduced tolerance of current activity schedule – they are just not able to keep up in class
• Sudden deterioration of performance – both physical and mental function, at dance or school
• Washed out feeling, fatigue, lack of energy – they used to voluntarily practise their class work at home but have ceased
• Body aches and pains which do not subside with rest
• Reduced immunity – they are experiencing frequent colds or sore throats
• Headaches
• Altered sleep patterns – the National Sleep Foundation recommends a teenager aim for between 8 and 11 hours of sleep per night, as during sleep, the brain triggers a release in hormones that instigates tissue growth and repair
• Withdrawal from friends and activities which usually bring joy
The World Health Organization suggests that kids aged between 5 and 17 should accumulate 60 minutes of vigorous physical activity daily. Many dancers will be doing in excess of this and their bodies are able to cope just fine…to a point. Any number or combination of factors can contribute to the development of an overload injury, such as:
• a rapid growth spurt – more than 1cm per month over a few months is considered significant
• a sudden spike in physical activity volume – might not even be dance-related, such as cross country running at school
• a sudden change in type of current class work – unexpected extra attention on allegro
• a recent injury to another body part which has lead to a technique modification or biomechanical substitution
• an unsustainable/unreasonable chronic load
• a recent illness
• emotional stress caused by school work, friends, family concerns
Nobody knows a dancer’s body better than the dancer themself, and most understand that mild muscle soreness is inevitable when learning a new technique, after a holiday/break or after a particularly demanding class. The challenge with young people is that thankfully most have never experienced adverse pain; the challenge is helping them to differentiate between an acceptable post-exercise soreness, a ‘warning pain’ and a ‘must stop pain’.
Charissa is a physiotherapist and Pilates practitioner with particular expertise in dance medicine. Charissa has a passion for dance injury rehabilitation and technique optimisation in the adolescent dancer, intertwining scientific-based clinical medicine with a grounded and wholistic approach to wellbeing. Charissa has worked alongside renowned physiotherapists from the Victorian Institute of Sport, the Victorian College of the Arts and the Australian Ballet Company, and managed a team of dance physios at one of Melbourne’s leading studios. Charissa currently consults on-site at dance schools across Melbourne and regional Victoria.
charissafermelis.com | 0438 020 167 | info@charissafermelis.com
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Body Talk- Pain Train Your Brain
by
Louise Drysdale
pondera.com.au |
07 3846 1488 |
admin@pondera.com.au
As dancers, our bodies are the most important tools we have. We need them to be in peak physical condition. When an injury occurs, we panic. Firstly, we start to wonder what is wrong, then pour back over the past few days, hours or seconds to find the point in time when it started hurting. Why is this new pain here? Will it go away and be better tomorrow? Will it come back? Will it ever get better? Will I still be able to dance?
Pain science is a huge area of scientific research. It is such a difficult thing to study because no two individuals experience pain in exactly the same manner. Here are some nifty things that pain science has taught us.
1. Pain is really useful. It’s a survival tactic. Listen to your pain and have conversations with it, your body is trying to tell you something.
2. Being stressed, anxious, fatigued or nervous can make pain feel worse. The difficult part about this is deciding how much of the pain is a mental manifestation and how much is physical. It will always be a bit of both.
3.Sometimes we find things on scans like MRIs and X-Rays and they don’t hurt.
4.Sometimes we can scan a painful body part expecting to find something to make sense of the pain, but we don’t find anything.
5.Pain is an experience shaped on past experiences with similar pain in similar situations. For example, if you rolled your ankle at an eisteddfod last year, you will likely associate competing in this years eisteddfod in the same theatre with having a sprained ankle. It doesn’t mean it will happen again, but your body will prepare itself in case it does.
6.People can lose limbs and still feel pain coming from them. This is a fascinating phenomenon that suggests perhaps there is a small area of the brain that represents each body part. The good news is that this will change over time. This phenomenon is called “neuroplasticity”. By the same token, bone, ligament, muscle and other body tissues re grow and heal. This is called “bioplasticity”. You are your own best way to heal.
Signs you might need to seek some help in better managing your pain:
1. You can’t work out how to change your pain, for example, you aren’t sure what makes it better or worse and you are having trouble modifying your dancing around it. Does your pain feel weird (not normal) or is it stopping you from dancing?
2. Your pain has lasted longer than three months. This is termed chronic pain or longstanding pain. This sort of pain requires a different treatment approach. If you have been seeing a health professional already for this length of time and you haven’t seen a change, it might be time to ask for a change (you can do this, we don’t mind) or try seeing a different health professional. We don’t always get it right and sometimes it takes a few health professionals working together to get it right.
3. You are relying on medication to get you through your dancing.
4. If your pain comes with swelling, redness, pins and needles, clicking, locking, numbness or weakness.
5. Someone has told you you won’t be able to dance anymore because of your injury or pain.
A dance physiotherapist is a good place to start, because we treat pain all the time and we understand where you’re coming from and what you’re trying to return to. Physiotherapists also recognise situations where a general practitioner, pain specialist or psychologist might also be useful in helping you to manage pain.
Where else to get help and find information?
- Explain Pain- book by Lorimer and Mosley
- TED Talk Lorimer Mosley https://youtu.be/gwd-wLdIHjs “Why things hurt”
- http://www.painaustralia.org.au/about-pain
Where I got my information
- Moseley, L., Baranoff, J., Rio, E., Stewart, M., Derman, W., Hainline, B. (2018). Nonpharmacological Management of Persistent Pain in Elite Athletes: Rationale and Recommendations, Clinical Journal of Sports Medicine, July (published ahead of print)
- Mayes, S., Ferris, A.R., Smith, P., Garnham, A., Cook, J. (2016). Professional ballet dancers have a similar prevalence of articular cartilage defects compared to age- and sex-matched non-dancing athletes, Clinical Rheumatology
- Hainline, B (et al.) (2017). International Olympic Committee consensus statement on pain management in elite athletes, British Journal of Sports Medicine, September.
Louise Drysdale (B.Phty, Grad Cert Msk Phty) is a physiotherapist at Pondera Physiotherapy and Pilates in Brisbane. She has a keen interest in dance injury management and prevention - from budding students to seasoned professionals. She is currently Assistant Physiotherapist to Queensland Ballet and Queensland Ballet Academy.
pondera.com.au | 07 3846 1488 | admin@pondera.com.au | Level 1, 162 Boundary Street, West End, Brisbane Qld
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Reduce injury and Promote Performance
by
Melanie Fuller
pondera.com.au |
07 3846 1488 |
admin@pondera.com.au
Dance classes work on neuromuscular coordination, this relates to your technique and balance1. Training in other areas can have a positive impact on our performance and overall health, and may reduce injuries. But how can we use our time most efficiently to achieve these results?
Research shows us that injury prevention exercise programs can reduce injuries, and enhance athletes abilities
2. It has also shown us that strength training can reduce injuries by almost half
3. While strength training can reduce injury, stretching has not been shown to be effective to prevent injury
3.
An injury prevention training program may be affected by how often you can incorporate this training into your weekly schedule. A short program may be performed two to three times per week2. Developing muscle endurance can be a useful place to start, training certain muscle groups such as your calves, with higher repetitions, and low loads1.
Aerobic training that can be achieved by swimming, running, or cycling may also complement your dance classes. Other sports that increase your heart rate and maintains it at that level for 20-40 minutes on a regular basis could also be used1.
It’s also important to remember to schedule recovery activities, which might include getting enough sleep. Diet and hydration are also other important aspects to consider to ensure your body is adapting appropriately to the demands of your training.
The message is to start early in your dance career, train your strength and aerobic fitness appropriately with a consistent exercise program, and consider utilising recovery strategies to help your body adapt well to the demands of your training.
References:
1. Irvine, S., Redding, E., & Rafferty, S. (2011). Dance fitness. Retrieved from https://www.iadms.org/page/303.
2. Ardern, C., Ekås, G., Grindem, H., Moksnes, H., Anderson, A., Chotel, F., Cohen, M., et al. (2018). 2018 International Olympic Committee consensus statement on prevention, diagnosis and management of paediatric anterior cruciate ligament (ACL) injuries. British Journal of Sports Medicine, 52(7), 422-438.
3. Lauersen, J., Bertelsen, D., & Andersen, L. (2014). The effectiveness of exercise interventions to prevent sports injuries: A systematic review and meta-analysis of randomised controlled trials. British Journal of Sports Medicine, 48(11), 871-877.
Melanie Fuller - APA Titled Sports & Musculoskeletal Physiotherapist, M Sp & Msk Phty, M Phty, B Ex Sci, Adv Dip PA (Dance)
Melanie is Physiotherapy consultant to QUT Dance. She has provided physiotherapy to Queensland Ballet, Expressions Dance Company, The Australian Ballet, Sydney Dance Company, Bangarra Dance Theatre, Royal New Zealand Ballet and Paris Opera Ballet. As well as musicals: Legally Blonde, Mary Poppins, Grease and other touring shows for their Brisbane seasons.
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Garuda
by
Anna Tetlow
annatetlowpilates.com.au |
0438 595 792 |
enquiries@annatetlowpilates.com.au
When we think of techniques that work specifically well alongside dance and in particular classical ballet, we think of Joesph Pilates and The GYROTONIC® methods. I have a new technique to add to your repertoire and it is called Garuda. Creator of The Garuda Pilates Method, The Garuda Apparatus and founder of The Garuda Studio, James D’Silva was born and raised in Goa, India, before moving to England to become a professional dancer. I have worked with James for over 17 years and am the master trainer of Garuda in Australia. I am very excited to be be able to teach this wonderful method and to make it available ad a part of a dancers training as well being responsible for training Garuda teachers in Australia in the future.
Garuda is a perfect accompaniment to a preprofessional and professionals repertoire, it can assist and support dance teachers teach correct anatomy, is a remarkable method with proven results in injury rehabilitation and is a natural side step for professional dancers
wanting to retrain in a field that has a close synergy with dance.
Garuda combines the spirituality, pranayama and asana practice of yoga, the core strength and focus of pilates and the balletic grace of dance increasing strength, flexibility and body tone. It has all the benefits of a robust cardiovascular workout, while stretching the mind as well as the body. Garuda is a test of mental strength as well as physical, demanding total concentration during the exercises.
Using the specially designed Garuda apparatus, mat or other complementary equipment you’ll learn to control your body through precise stretches and actions, placing an emphasis on smooth, seamless movements without any stress on the joints. Through routines carefully choreographed you will work every area of your body.
Because of the choreographic, fluid nature of the technique dancers greatly enjoy and benefit from classes wether it be for strength, stretch, rehab or overall fitness. Garuda makes for a perfect cross training activity to complement your dance practice.
Developing Garuda training alongside dance training helps to strengthen and safeguard against injury. Programs can be developed for the touring dancer to support their schedule. Sessions are tailored to the individual need of the dancer, focusing on turn-out, pelvic stability, optimum hip extension, foot strength, alignment, correct thoracic placement for ports de bras, pointe work strength and muscle efficiency. Anna has developed a technique that is transferrable to the ballet class, and works to ensure dancers are firstly aware of any imbalances, and then able to take responsibility for the advancement of their own technique. This technique and anatomical knowledge of their own personal architecture empowers dancers to understand their own bodies, its strengths and frailties.
Anna Tetlow trained at the Royal Ballet School and went on to perform internationally with numerous prestigious ballet companies, culminating in over 30 years of experience in the elite ballet industry. As a Pilates teacher with 20 years of experience working with remedial professionals in rehabilitation she also continues to work closely with James D'Silva giving and as his master trainer for Garuda Australia she is responsible for all teachers trainings in Australia. A ballet examiner and educator of young dance students in injury management and correct muscle use to achieve optimum classical technique, she continues to work alongside ballet teachers, ballet companies and medical professionals to achieve the best results for dancers refining technique and rehabilitation from injury. Anna is passionate about mentoring dancers during both their major transitions, student to professional and life after stage.
annatetlowpilates.com.au | 0438 595 792 | enquiries@annatetlowpilates.com.au | 165 Miller Street, North Fitzroy, Melbourne Victoria
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It Takes Two
by
Michael Bellantonio
southsidephysio.com.au |
02 6282 5010 |
wip@sspg.com.au
In the immortal words of Tina Turner and Rod Stewart: two can really ease the pain, like a perfect remedy.
As a male physiotherapist with a special interest in treating dancers, developing a good rapport with them is paramount. Most of my dance clients are young females, so they need to feel comfortable with me treating them. The importance of a good professional relationship and communication cannot be underestimated. It is as important as the interventions I provide to the dancer.
Over my fifteen years of clinical experience, I have come to appreciate that injuries to dancers can leave them devastated. Frequently I hear “will I dance again?”, ”when can I dance again?”, “I have an eisteddfod this weekend, will I be fit to dance?” And when you look at dance specific blogs, this type of thinking and questioning is a common theme.
You can’t blame dancers for being upset at the thought of possibly not being able to do something they love and have worked so hard at. I would be no different. This is where providing clear education to the dancer can affect both their attitudes and behaviour. I work together with the dancer to set realistic goals and functional targets as part of their rehabilitation, being mindful that rushing back to dance too soon could potentially see an aggravation of their current issue, or the development of another.
The dancer should feel like they have control over their injury and take ownership of their recovery. This can be extremely empowering for them in a time when they feel somewhat hopeless. You can feel their mood lift and the tears stop, replaced by a sense of optimism and excitement about the challenges ahead and returning safely to dance, not only with a lower risk of injury, but with improved aesthetics. I get a real buzz hearing my dance clients tell me that since they started doing the exercises I have given them, they receive fewer corrections in class and they feel stronger and have more control.
It is only through a good rapport that I get to appreciate the different personalities and eccentricities of my dancers. Personality makes a huge difference in the language I will use with them. Some are prone to catastrophising and irrational fears about their injury and they require a higher level of empathy, especially when there is a hard to diagnose problem or a diagnosis that potentially carries with it a long term recovery. Others will shrug their shoulders and get straight into the rehab – these dancers I can be more direct with. One of the best pieces of information I received at a dance therapy course was from Paula Baird-Colt about being mindful of the language you use to dancers, as it can have a negative impact on their psyche. As such, I have changed the words I use in describing deficiencies that I would like to change. “You’re weak!” or “you’re doing that wrongly!” all carry a negative tone. It is much nicer for the dancer to hear “you use this strategy, which is fine, but I’m going to show you a different strategy to try and we’ll see if that helps things.” Research shows that using language that makes a client feel incompetent leads to poor exercise adherence. Using language that gives them some autonomy and control over change greatly improves exercise adherence.
I have also come to appreciate the dancer’s perspective in the therapist-client relationship. They need to have clear communication from me. They need to have confidence that as their therapist, I possess the knowledge to help them, and will be humble enough to re-evaluate any diagnostic hypothesis should things not be progressing as anticipated. They need me to understand and appreciate the demands – both physical and psychological – of their craft. Finally, I should listen to and enquire about their goals of the treatment, and have enthusiasm for the treatment.
I now have a lovely list of dance clients, some of whom I have treated for almost ten years, and they are happy to confide in me any small niggle they have without fear I’ll simply pull them from dance for two weeks. This has only been made possible by developing a strong professional relationship with the dancer, their parents and their dance school, all of whom are assured that I will do my utmost to manage any injuries to the best of my ability. I reciprocate by having trust in the dancer that they will adhere to the treatment plan we have developed together, to ensure optimal recovery, safe return to dance and future prevention.
It takes two.
Michael is a Senior Physiotherapist at Southside Physio, Woden in Canberra. A Titled APA Sports Physiotherapist with over fifteen years of experience, he has worked with elite level male and female rugby players and lectured on APA Sports Physiotherapy courses. Over the years he has developed a passion for treating dancers, undertaking multiple courses and workshops from some of the best minds in Dance Medicine to ensure his knowledge and skills for managing dance related injuries are of the highest quality possible.
southsidephysio.com.au | 02 6282 5010 | wip@sspg.com.au | Level 1, Canberra Healthpoint Building, 16 Wilbow Street, Woden ACT 2606
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The Benefits of Private Coaching by
Natalie Orola thebalanceddancer.com |
info@thebalanceddancer.com |
0415 715 080 The importance of a regular dance class builds socialisation skills, develops ‘team spirit’, allows for easier pathways to group performances and concerts, and provides students with clear, real-time benchmarks at their level within the class environment. So, where does private coaching fit in?
At The Balanced Dancer, private coaching provides a wide range of supplemental benefits or “enhancers” to regular dance class, which do not trump, but allow dancers to excel and make the most of their regular dance class. The benefits of private coaching are wide-ranging and no two private coaching students will have the same experience.
Unlike the generally standardised method of teaching in a regular dance class, private coaching provides customised learning – strengths and weaknesses can be identified in the very early stages of the relationship and tailored coaching plans can be developed to harness a dancer’s strengths and rectify and overcome any limitations. Private coaching also offers a personalised experience – the relationship between coach and student is unique, fluid and really “one of a kind”. Private coaches are not just teachers who instruct a particular method – they often take the role of “mentor” or “big sister” and allow students to walk away from each coaching session with a deeper understanding about not only their syllabus, but the student’s broader aspirations and visions. A good way to think about the relationship between private coaching and regular dance classes is to compare it to the relationship between personal fitness training and group fitness classes.
Whilst regular dance classes are an effective way for dancers to learn method and routine, the most effective way for a dancer to harness their strengths, appreciate their abilities and develop their dance goals in a holistic way in a personal dedicated setting is through private coaching. A healthy mix between formal dance school training and private coaching is vital for any dancer who wants to not only excel in dance but also personally gain and grow from all that dance has to offer.
“tailored coaching plans can be developed to harness a dancer’s strengths and rectify and overcome any limitations.”
Natalie Orola is the Founder of The Balanced Dancer. Natalie is an Associate of the Australasian Dance Association (ADA) (formerly the Federal Association of Teachers of Dancing), an Affiliate Member with The Commonwealth Society of Teachers of Dancing (CSTD) and trained in the Royal Academy of Dance (ballet) syllabus, holding over 10 years of dance teaching experience at various dance schools throughout Sydney, Gold Coast and Brisbane, Australia.
thebalanceddancer.com | info@thebalanceddancer.com | 0415 715 080
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Dance screening & injuries on the rise
by
Holly McPaul
baimed.com.au |
02 4227 1990 |
admin@baimedphysio.com.au
What is a Dance Screen?
A dance screen is comparable to the appointments you make with your dentist or optometrist, except for the dancers body. We look at movement patterns, technique and dance movement control. Sometimes it is a simple thing that throws off the rest of the body or movement pattern and is easily corrected with exercises (that we call correctives). Your dance screen will be part of your dancer profile, allowing us to compare previous screens, and we can track changes to make sure that students continue to perform at their very best.
The screen is also very beneficial for the students parents and teachers and supports the teaching of safe and correct technique ensuring the activities done in youth do not hurt the adults body later in life.
How often should you be screened?
Ideally 3 times per year. We must consider that the body is always growing and changing and physical work load and demand are usually increasing as well.
Why have a dance screen?
The screen helps to determine any areas of a dancers’ body that could be prone to injury and highlights any areas, like their strength or flexibility, that can be improved on, from an aesthetic or performance perspective. Exercises are often simple but highly effective. Seeing a dance physiotherapist like myself, once every three to six months, decreases the likelihood of load related injuries. Every dancer is a changing athlete that needs reassessing and managing to assure that their physical capacity and their physical demand remain equal.
We are able to direct dancers to the the BaiMed Performance Centre to work under our highly skilled sports science team. Here they receive further objective testing and strength programming specific to the needs of the dancer identified in the screen.
The biggest goal is to keep people injury free so that they’re in the studio doing what they love doing. That’s my number one goal.
Are you seeing an increase in any types of dance injuries?
I am seeing more load related injuries, such as stress fractures and tendonopathies (chronic inflammation of tendons). These occur for a number of different reasons. Sometimes it is when training or performing volume increases rapidly and there’s not enough recovery time between classes or performances. Sometimes they occur when difficult skills or movements are performed incorrectly. A lot of the time they can occur because of a strength or range of motion deficit that’s causing a particular body part to become overloaded beyond its physical capacity.
There is a lot of focus in the world of elite sports around capacity versus load and the idea is that to minimise injury, we have to ensure that workload doesn’t exceed physical capacity. It’s the same with dancers who are essentially training as elite athletes. When load (the amount and types of dancing you are doing) and capacity (how strong and flexible you are) are out of balance we see load related injury starting to occur.
With the aid of Social Media there is a lot of pressure on young girls and boys to be able to do skills that are perhaps above and beyond their skill level. Some students are also not being taught by professional or skilled or experienced dance teachers. Seeing a dance specialist physiotherapist will help those parents without an extensive knowledge of dance understand how incorrect technique can cause injury.
Holly McPaul from BaiMed is a Physiotherapist and Exercise Physiologist with a Bachelor of Exercise Science and Rehabilitation UOW, Master of Physiotherapy USYD. Holly has danced since she was 3 as well as taught dance for many years. Holly is an advocate for specific programs for dancers – including a Dance Specific Screen, designed to highlight strengths and weaknesses in order to structure programs to suit the individual.
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HSC Dance – how does it support a dance career?
by
Katelyn Boshell
thedancetank.com.au |
0415 839 030
Maintaining a dancing body at peak performance level can be a struggle for dance students rehearsing for an eisteddfod, exams or even for their final NSW Higher School Certificate (H.S.C) practical examinations.
“Students often hear that they need to prepare their bodies both mentally and physically, but what does this really mean?”
Students undertaking the NSW 2 Unit H.S.C Dance Course through their secondary school/college or externally study the essential components required for body maintenance. The course teaches the core principals of the Safe Dance Practice pedagogy to ensure bodies are prepared for examination at peak fitness level, as well as safeguard against injury.
Students develop their physical dance technique through a series of contemporary dance exercises that concentrate on correct alignment to dance efficiently without the threat of injury.
Exercises begin on the floor focusing on Graham Technique through static stretching and spinal alignment curves and extensions. Moving to the barre, exercises such as tondues and balances assist the student to find their core stability. Centre-work follows, such as adage/shape exercises allowing a better understanding of engaging the required muscles to ensure correct quality of line. Lastly, a range of travelling/locomotor sequences explore kinaesthetic awareness as well as improve stamina and endurance for performance examination pieces.
Mental preparation for these final examinations is as crucial as training the physical body. The H.S.C Dance Course provides students with the knowledge of beneficial body maintenance tools consisting of healthy nutrition and hydration, good sleeping patterns and alternative lifestyle physical activities such as walking, swimming, Pilates, Yoga etc. to maintain a healthy and fit body. A healthy body provides a dancer with the ability to maintain a positive and confident attitude which will enhance their performance quality and portrayal of their work.
Undertaking the H.S.C. Dance Course is an excellent foundation for an individual’s future career in dance. Obtaining knowledge and understanding of the anatomical mechanics of the body; injury prevention practices; and mental preparation skills; are integral elements for establishing a well-rounded dancer and increasing the longevity of their professional dancing career.
Katelyn Boshell has over 20 years of experience in the field of Dance. Experience includes but not limited to; NSW Department of Education trained Primary and Secondary teacher (B. Arts/B. Education Honours UNSW) specialising in Dance and Schools Spectacular choreographer for the past 6 years.
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Are Injuries Preventable
by
Louisa McGinness
easternsuburbssportsmed.com.au |
essmc@iinet.net.au |
02 9389 2766
“Up to 75% of dance injuries are preventable – so how can I reduce the risk of getting injured?”
Research has estimated that up to 75% of all dancers’ injuries are due to overuse1, regardless of the age, gender or training level of the dancer2.
Overuse injuries develop over time and are a result of repetitive pulling, twisting or compression. A key to avoiding injury as a dancer can be as simple as avoiding significant changes in overall dance training – a concept referred to as
‘load management’ in sports medicine. The long hours involved in dance training do not cause injury – it’s how you build up to long training periods that is important
3 in injury prevention.
Situations which commonly involve significant change in training load for dancers include: commencing fulltime training, starting a new contract after a period of time off, returning to dance training after holidays, starting new choreography, or an increase in classes or rehearsals prior to exams or performances.
It is important to anticipate upcoming changes in load, and to plan ahead. Preventing injuries can be as simple as maintaining some level of training or physical activity during holidays, or slowly increasing your training in anticipation of an increase in your load after commencing fulltime training.
A common tool used by elite athletes to monitor training load change is called the ‘acute: chronic workload ratio’. An example for dance students may involve calculating the average of the hours spent in classes or rehearsals over 4 weeks. If a dancer increases their hours of training by more than 1.5 times the average of the previous 4 weeks, they may be 2–4 times more likely to sustain an injury in the subsequent 7 days3.
The longer you are involved in fulltime training, the less likely you are to be injured4. Overload injuries may also be more common in periods of rapid growth – it may be worth tracking your growth on the wall during your teenage years.
‘Acute’ and ‘Overuse’ injuries – how do I manage them?
An acute injury is a sudden onset of pain associated with a particular movement or incident, such as a sprained ankle, strained muscle or an injury due to direct impact. Rest, ice, compression and elevation are the essential first steps to reduce the tissue damage that occurs from swelling and bruising.
Ice can also be effective in the short-term management of overuse-type injuries, providing relief from swelling and inflammation, which can often accompany pain.
With both acute and overuse injuries, it is important to have the injury promptly diagnosed and managed by a health professional who understands the demands of dance training. Health professionals with experience working with dancers are able to help you resume your training in a modified capacity as soon as possible, minimising loss of fitness and strength associated with injury. Acute and overuse injuries can worsen if dancers delay seeking appropriate advice and treatment. Prompt injury diagnosis and correct management, as early as possible, can significantly reduce the recovery time associated with injury.
If you are suffering an overuse-type injury following an increase in training, see your physiotherapist or doctor as soon as possible to facilitate a speedy recovery.
Louisa McGinness is a Sports Physiotherapist at Eastern Suburbs Sports Medicine Centre. She was the full-time physiotherapist for Matilda the Musical through their Sydney and Melbourne seasons and the physiotherapist for the Top 20 of So you Think You Can Dance Australia in 2014. Verity Wright, Sports Podiatrist, is also able to provide treatment and advice tailored to dancers. Louisa and Verity have extensive dance training and are available for consultation at Eastern Suburbs Sports Medicine Centre.
Podiatry for Dancers – Verity Wright
Our feet are the foundation of our dance.
Barefoot and shod dancing can both elicit abnormal stresses on our feet and toes.
Excessive pain and discomfort in the feet and toes tolerated over a period of time can lead to chronic and degenerative concerns.
Having your feet assessed by a Podiatrist will allow your foot health to be assessed and management options explored. Treatment can include; mobilisation to the joints, taping techniques to offload inflammation, special toe devices to unload pressure, special dancing inserts to redistribute pressure areas.
Additionally our skin and nail health can be severely disrupted by our dance practice. Skin and nail issues can be best treated by your Podiatrist.
1. Smith, P. J., Gerrie, B. J., Varner, K. E., McCulloch, P. C., Lintner, D. M., & Harris, J. D. (2015). Incidence and prevalence of musculoskeletal injury in ballet: a systematic review. Orthopaedic journal of sports medicine, 3(7), 2325967115592621.
2. Yau, R. K., Golightly, Y. M., Richardson, D. B., Runfola, C. D., Waller, A. E., & Marshall, S. W. (2017). Potential Predictors of Injury Among Pre-Professional Ballet and Contemporary Dancers. Journal of Dance Medicine & Science, 21(2), 53-63.
3. Hulin BT, Gabbett TJ, Blanch P, et al. Spikes in acute workload are associated with increased injury risk in elite cricket fast bowlers. Br J Sports Med 2014;48:708–12
4. Caine, D., Bergeron, G., Goodwin, B. J., Thomas, J., Caine, C. G., Steinfeld, S., ... & André, S. (2016). A survey of injuries affecting pre-professional ballet dancers. Journal of Dance Medicine & Science, 20(3), 115-126.
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Dentist or Dance Physiotherapist? BOTH!
By
Susie Bond
evolutionpilates.com.au |
info@evolutionpilates.com.au |
02 9518 5009
Would just two visits a year to a specialist dance physiotherapist make a significant impact to injury prevention?
Dance physiotherapists love to assist dancers achieve their top goals in dance. Everyone visits the dentist regularly to prevent dental problems. Regular visits to a specialist dance physio should be made, in the case for dancers going through rapid growth spurts. Simple core stability, joint strengthening and leg alignment exercises can make all the difference for injury prevention.
“When I give a specific strengthening exercise to a dancer, I often say “this is like a ‘cleaning the teeth’ exercise”, that is something you would do every day.”
Research shows that dancers are more prone to injury (e.g. Knee), as a teenager, when number of hours of dance load increase per week. It is good to a see a specialist dance physiotherapist to manage an injury and do a Pre pointe assessment. It is also important to check out physical niggles and limb and trunk alignment issues, before a big problem arises. A regular visit to the dance physiotherapist at least 1-2 times each year, will help guide the dancer, their parents and teachers through the many changes during the adolescent growth time.
Susie Bond is the Director of Evolution Pilates and MG Pilates, she is a Physiotherapist, Pilates Instructor, Dancer Physiotherapist and commenced dance training when she was 5. Susie runs regular lectures to Pilates teachers, dance schools and post Dance degree courses in Australia and UK. She is a founding committee member of the special Dance Network, in the Sports Australia group of the Australian Physiotherapy Association, which organised lectures to teach physios how best to treat dancers. She is a member of the Australian Pilates Method Association and of the International Assoc. for Dance Medicine and Science. Her passion is for dance, performance enhancement, healing physio treatment and injury prevention.
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Weight Watching & Your Identity
by
Jocelyn Penna
performancepsychology.com.au |
jocelyn@performancepsychology.com.au
People drawn to dance possess many amazing traits, beliefs and values that enable them to excel such as determination, emotional connection and focus. Yet, these same characteristics can place dancers at risk of suffering from stress and high pressure. Developing awareness of your strengths and vulnerabilities can help you keep a healthy, productive and enjoyable balance.
When Weight Watching is turning into something harmful.
Dancers bodies are their instrument, and not only are they required to keep it in good working order, but they can also feel the pressure to keep it looking a certain way. Being externally judged means that dancers often watch and scrutinise their own bodies more closely than other people may. This scrutiny can become problematic.
Weight watching may be turning into something harmful if you are significantly restricting food intake, feeling overly tired, thinking or talking about appearance often, comparing what you eat to other people, fear gaining weight, making excuses about what you are eating or are eating in private.
All people benefit from a healthy diet. We all need differing amounts of nutrients and energy for our body to perform optimally. Unhealthy weight management habits can quickly result in you being unable to perform, hinder your future in dance, and lead to permanent detrimental changes in body and brain functioning. More information about disordered eating can be found on the Butterfly Foundation website- thebutterflyfoundation.org.au.
You cannot perform your best if you are not physically and mentally healthy. If you’re not sure if your nutrition is meeting your needs, consult a sport dietitian who works with dancers. If your mind is stuck on thoughts about body image, or you don’t feel good about yourself for any reason, then talk to someone you know who cares about you, or consult a sport psychologist familiar with the demands of dance.
Identity
Dancers often become passionate about their craft at a young age. They can identify strongly with dance and become personally and emotional involved in their roles. Identifying strongly with something is great, it means you are passionate, committed and have great potential to be an expressive and animated performer.
“Dancing is what you do and what you love, but you are much more.”
You could be a loyal friend, caring daughter or son, committed activist, passionate thinker, strong leader, and many other things.
Performances face external judgement, which despite being subjective, can be taken personally. So those with a narrow identity may struggle when faced with the challenges of being a performer. If your worth is being pushed around by nerves, performance results, body image or injury, it’s valuable to explore why. When you appreciate seeing yourself as you really are, you allow your performance and enjoyment to grow enormously.
Jocelyn Penna from Focus Performance has 15 years experience working with professional and developing performing artists. She enjoyed background in dance and now studies the psychological challenges and rewards of being involved in the field.
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Happy Hips?
by
Deborah Chen
inspiredphysio.com.au |
info@inspiredphysio.com.au
As dancers continue to push their body right to the extent of their flexibility I’m seeing an increase in hip pain complaints – particularly a pinching in the front of their hip when doing front kicks or developping leg to devant. Sometimes the pinch is only there with those particular activities and other times the pinch turns into a deep, dull ache that can last for a few hours and can eventually become constant.
This pain could be caused by a couple of different things – it could be something as simple as adjusting technique because of an overactive hip flexor muscle and as complex as torn hip cartilage (also known as a labral tear). Having been someone who has ‘faked’ her turnout for most of my dancing life, experienced labral tears in both my hips and had two hip arthroscopy surgeries to repair them I am a big advocate for learning about your true turnout muscles or deep hip rotators and stabilisers.
There are six muscles that work to exclusively rotate your thigh bone or femur outwards – they are your piriformis, quadratus femoris, obturator internus, obturator externus, superior gemilli and inferior gemilli. These muscles work to give you standing leg turnout as well as active turnout for things like demi plie or maintaining turnout when your leg is en lair in a developpe. If you’re looking for whether you’re working the turnout muscles correctly you should feel them contract around your lower bottom around the bottom of your leotard. Try this by standing with your feet together in parallel and rotate your thigh bones outwards – you may notice your knee caps now face directly forwards and feel your lower bottom muscles contracting.
Activating your turnout muscles should take some pressure of the hip flexors doing all the work but you also need to stabilize your thigh bone in its socket. To do this we need to activate the illiacus. The illiacus is a bit of a secret muscle – it sits inside the front of your pelvis and combines with the psoas to become the iliopsoas. The hip joint is a ball and socket joint and the illiacus is there to help hold the ball centrally in the socket. If you’ve loosened up your hip flexors and are still getting a pinch or blocked feeling in the front of your hip you could be experiencing anterior hip instability as a result of an underactive illiacus. This could potentially be reducing the height of your kicks and developpes in devant.
“Many dancers are also told that they are ‘hypermobile’ or ‘lax’ in their ligaments – which is fun when you want to be flexy but less fun if you’re experiencing pain due to lack of muscle/ligament control.”
Something as simple as learning to activate your illiacus muscle may help to reduce laxity pain you experience in your hips and may even reduce clicking of the hips.
I can’t stress enough, the importance of acting on pain or restriction as soon as you notice them. It doesn’t always mean you’ll need to stop dancing – it may mean an adjustment in your technique and learning to activate the correct muscles to rehab and prevent further injury. Don’t be scared to speak up and let your teachers know if you’re struggling – it could very well be what prevents long term injuries in the future.
Deborah Chen Registered Physiotherapist B.App.Sc. (MRS-RT), Master of Physiotherapy from Inspired Physiotherapy
Deborah studied dance as a child completing her Major 3 level in Ballet (Australian Dance Assessment Program). She has also taught ballet and lyrical in the Hills area of Sydney.
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Turnout – what is it?
by
Samantha Jakelic
kineticaphysiotherapy.com.au |
enquiries@kineticaphysio.com.au |
02 9948 6188
Dance teachers and students are constantly talking about and working on making the most of turnout. It is what makes Ballet fundamentally unique. Turnout is the ability to outwardly rotate the leg so that the knees and toes turn away from the midline. The “perfect” 180o turnout is often desired amongst dancers and choreographers because of its aesthetic appeal. However, did you know that turnout has also been shown to allow more efficient weight transfer, better control of extensions and reduce the risk of injury?1
What does turnout really mean?
The vast majority of turnout is achieved by external rotation of the hips within their sockets and is often referred to as pure turnout. This pure rotation from the hip joints when combined with a small amount of outward rotation of the knees and ankles this is called your functional turnout. Pure hip rotation is the key area for working your turnout – it should contribute 80-90% to the standing in 1st position functional turnout. Using too little from the hip and too much from the knee, shin and foot can increase the risk of injury. Turnout can be influenced by the strength and flexibility of the surrounding muscles, bony architecture of the joints and laxity of the ligaments. As a result, we think about turnout in two different ways – how much can the hip joint give you (in the joint, ligaments and tissues) and how much strength do you have in your turnout muscles (actively).
Passive turnout (Your turnout potential!):
Passive turnout is the maximal possible amount of movement at the joints. It is achieved without the use of any muscles and is largely dependent upon the orientation and shape of the bones, laxity of the ligaments and joint capsules. Subtle differences in pelvis and hip joint development influence the passive hip turnout potential. The depth of the hip socket, the direction of the hip socket and many other factors all affect the potential turnout. When we measure turnout, we examine the relaxed amount in the hip joint with the leg in neutral – this represents what we traditionally consider our hip turnout – the passive amount in 1st position. Passive turnout is achieved when a therapist or teacher turns a dancer’s legs into turnout while the dancer is lying relaxed on a bed. However there are other places where turnout is important and limited by the bones and joint structure. We also need to consider:
turnout capacity elevated at the front (attitude and arabesque)
turnout capacity while elevating into 2nd
turnout capacity while elevating behind you
Active turnout (Your strength):
Active turnout is achieved when a dancer moves into turnout on their own such as when standing in 1st position. It relies on the activation of the muscles that move the leg into turnout and the relaxation of the muscles that oppose this movement.
Literature2 has shown that passive turnout range in the hip joint unfortunately does not improve across childhood or adolescence. Gains in turnout range is to do with strengthening our hip rotators and stretching the opposition muscles. So in order to improve our turnout we should be focused on exercising the muscles that help us move into turnout. It is important to work safely within your joint capacity! Strengthen but work safely and smartly with your physiotherapist and teacher to maximise your strength.
Does dancing help or hinder my turnout?
By repetitively practising the precise movements that are specific to the artistry of ballet will actually help you improve your turnout. Research3 has shown that strength in the muscles of the hip improved with training and continues to build through the first year of a full time program to a greater extent in dancers than in non-dancers. So it is more likely that dancing will help rather than hinder your turnout.
What can I do to improve my turnout?
1. Strengthen the deep hip external rotators: The deep muscles that sit closest to the hip joint (quadratus femoris being the main one) are responsible for actively moving our hip into external rotation. These are the muscles we want to target to improve our active turnout range.
2. Improve core activation to ensure neutral lumbo-pelvic-hip alignment: A neutral line through low back, pelvis and hip will ensure efficient activation of our deep hip rotators and help to optimise movement.
3. Ensure adequate flexibility of the hip internal rotators: A lack of flexibility of the hip internal rotators (adductors, tensor fascia latae, iliopsoas and pectineus) will restrict active hip outward rotation. Releasing these muscles will help to maximise turnout range.
We strongly advise arranging a consultation with your friendly dance physiotherapist for an assessment to determine the specific exercises that will help you improve your turnout.
Does not having “perfect” 180o turnout mean I will never become a professional dancer?
The “perfect” turnout is measured in first position and is described as 180o of leg external rotation. Experts agree that this is rarely attainable due to the structure of our hip bones. Overcompensating and attempting to maintain rotation beyond the strength and joint capacity can place the dancer at risk of pelvic and hip pain, shin splint and knee injury. Ideally, we want almost all of our turnout to come from hip external rotation rather than forcing it from our knees and ankles. This means that for most people 180o of turnout is not physically possible.
Many professional dancers with successful careers do not have the “perfect” turnout with the most recent research showing company level classical dancers averaged 60o of passive external rotation (from each hip), 35o of active hip external rotation and 133o of functional turnout when standing in first position. At the enthusiast level, dance physiotherapists see normal range at 45o of passive rotation potential but this number varies enormously.
“Dance encompasses a whole lot more than just perfect turnout – artistry, grace and musicality. Maximising your strength and learning to use it by keeping knees in alignment with toes, there is every possibility that less than perfect turnout will still permit you to have a successful dance career.”
1 Pata, D., Welsh, T., Bailey, J., & Range, V. (2014). Improving turnout in university dancers. Journal of Dance Medicine & Science, 18(4), 169-177.
2 Steinberg, N., Hershkovitz, I., Peleg, S., Dar, G., Masharawi, Y., Heim, M., & Siev-Ner, I. (2006). Range of joint movement in female dancers and nondancers aged 8 to 16 years. The American journal of sports medicine, 34(5), 814-823.
3 Bennell, K. L., Khan, K. M., Matthews, B. L., & Singleton, C. (2001). Changes in hip and ankle range of motion and hip muscle strength in 8–11 year old novice female ballet dancers and controls: a 12 month follow up study. British journal of sports medicine, 35(1), 54-59.
4 Washington, I., Mayes, S., Ganderton, C., & Pizzari, T. (2016). Differentials in Turnout Among Professional Classical Ballet Dancers. Medical problems of performing artists, 31(3), 160.
Samantha Jakelic Physiotherapist APAM. Samantha was a former dance student herself, she understands the importance of preventing injuries, chronic injury management and fixing those niggles fast. Sam understands that providing alternative activities to maintain fitness, strength, and flexibility when an injury occurs is the cornerstone to a dancer’s recovery through every part of their lifespan.
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Remedial Coaching
by
Suzanne Way
professionalballetcoaching.com |
professionalballetcoaching@gmail.com |
0407 010 286
What is something dancers really struggle with when they get injured?
In my experience I have found dancers struggle with the time frame of their injury. How long will I be out of class and rehearsal? What opportunities will be missed? These questions immediately set up a stress reaction in the body and must be dealt with carefully.
Why should dancers continue to do class whilst recovering from an injury?
The prime function of remedial coaching is to work with the injured dancer privately at their own pace to restore strength and integrity to the area and most importantly to correct the posture and technical weakness which created the injury in the first place. To join class is to work at the pace of the other dancers and would not be recommended until I felt confident the dancer could cope with the demands of class without compromising the results already achieved. By all accounts the first experience rejoining class must be positive, essential to restoring confidence and self esteem.
What advice do you offer dancers during this very trying time?
Mentoring is paramount, psychologically the expectation of pain either continuing or returning is always present. Will the injury hold up under normal class/rehearsal conditions?
Questions the dancers ask themselves, Will my injury support multiple pirouettes? Will my injury sustain working en pointe? Will my injury support my body through allegro work without cause of re injury?
Strengthening the mind, trust, encouraging the belief system to remove the mental blocks associated with the healing process can not only benefit but encourage a very positive recovery with a stronger disposition and less risk of self sabotaging in the future.
What should dancer and parent do?
As an experienced remedial coach I feel both the dancer and the parents must trust and be invested in the structured plan suggested and the time involved for recovery. To date this has been highly successful with outstanding results, the dancer is proactive armed with the knowledge and resources to prevent and overcome further injuries. Students do return from overseas to be coached privately, they trust me implicitly and know they have my best interests and confidentiality at heart.
Suzanne Way A.R.A.D. director of Professional Ballet Coaching Australia is now specialising in remedial coaching. A life member of the Royal Academy of Dance she trained at both The Australian Ballet School and The Royal Ballet School in London. She has an extensive career in classical ballet including The Royal Ballet and The Australian Ballet. Suzanne has created successful curriculum for full time students in both the U.S.A and Australia and now due to success devoting her time to remedial coaching.
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The Importance of a Dance-Specific Musculoskeletal Assessment
by
Shannon Trotter
ssphysio.com.au |
info@ssphysio.com.au |
02 9527 4099
A dance assessment carried out by a physiotherapist who specialises in treating dancers can be used to identify a dancers’ strengths and weaknesses which in turn may decrease their risk of injury. It is also used to assess readiness for pointe work and for general improvement in technique and performance. Often, dancers will present to our clinic with injuries that could have been avoided with prior assessment and appropriate management programs. The long term benefits are immense with reduced risk of injury, less time off dancing and improved performance.
A study posted in the Journal of Athletic Training shows that 42% of dancers before the age of 8 had previously sustained an injury. The physical demands of repetitive practice puts a large amount of strain on a young dancers growing body. Growth spurts usually occur from ages 8-12 (girls) and 10-14 (boys). During this time, extra stress placed on the body through dance can cause stress fractures, tendinopathies, torn ligaments and various other injuries.
A typical dance assessment may include;
- A thorough dance history and injury history
- Postural assessment
- Assessment of range of motion of joints – particularly those in the lower limbs and feet
- Assessment of turnout range of motion as well as strength of deep hip rotators
- Pelvis and trunk stability – this is the ability to activate the deep core muscles dynamically to control movement and protect the spine
- Intrinsic foot muscle strength as well as ankle and foot stability
- A range of dance specific skills
- Growth – physical and mental development and readiness
Other than biomechanical risk factors assessed by the physiotherapist, another key to preventing dance injuries is being aware of young dancers growing bodies and educating dance teachers, adjudicators and parents on the dangers of pushing young dancers beyond their physical limits. Dancers have an amazing sense of body awareness; however often struggle to understand the difference between muscle fatigue from exercise and “bad” pain from an injury.
Tips for safe dance practice;
- Don’t keep dancing on an old injury. If you have had an injury for more than a few weeks and are hoping it will “just go away by itself” – chances are it won’t, and you are more likely to make it worse with more dancing. As a rough guide, any pain that lasts more than 3 days should be assessed.
- Full rehabilitation of an injury is essential. The absence of pain does not necessarily mean your injury has recovered. It is imperative that you recover full range of motion, strength and dance specific skills so that you are able to dance to your full potential without becoming injured again.
- Know the difference between “good” and “bad” pain. Listen to your body. Dancers will often push through pain with the fear that they won’t be able to dance at all.
- If you’re injured, you can’t keep doing the same thing.” If you don’t change what you’re doing- then expect the same results”. If you have an injury and keep aggravating it, it will never improve. It is important to listen to your physiotherapists instructions on what you can and can’t do. It is highly unlikely that your physio will ever prescribe total rest for an injury. It is likely they will send you back to dancing as soon as possible with a modified dance program.
- See a physiotherapist who specialises in dance. We all know dancers are not your average humans. They are expected to be able to achieve so much more in regards to flexibility and strength. Physiotherapists with dance experience will have the knowledge of what you are likely to do in each class and therefore can more easily fine tune a modified dance program for you. Their knowledge is also essential in the end stage of rehabilitation where dance specific training and exercises are necessary for an injury-free return to full dancing.
Whether you have an injury or you just would like to improve your technique, undergoing a dance-specific musculoskeletal assessment will put you in a strong position to enjoy injury-free dancing and enhance your performance.
Shannon is a Physiotherapist at Southside Physiotherapy & Sports Injury Centre. Her love of dance began when she started ballet at 3 years old. Shannon is able to bring together the knowledge and skills she has as both a dance teacher and physiotherapist to successfully treat dancers in her clinic.
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Starting Pointe Work
by
Louise Drysdale
pondera.com.au |
admin@pondera.com.au |
07 3846 1488
Do growth plates in the foot affect the ability for the dancer to commence pointe work and can commencing pointe work too early create long term negative side effects?
These are difficult questions to answer because there is a lack of research explicitly investigating this. Growth plates are a bit like elastic in pregnancy pants – in young dancers, they are not yet comprised of fully calcified bone, in fact they are cartilaginous and ready to expand and grow as a dancer gets taller. Growth plates (around the ankle) generally fuse at age 14 for girls and age 16 for boys. Most girls I see progress to pointe are 11.5- 16 years of age. The International Association of Dance Medicine and Science recommends age 12 as an appropriate age to start or start preparing for pointe work.
Commonly,
the injuries we see that are usually aggravated or occur during pointe work include ankle sprains, foot bone stress reactions, posterior ankle impingement and tendon pain, most of which can be resolved with good movement analysis, treatment and management. A comprehensive pre -pointe assessment allows the opportunity to educate dancers about their bodies to minimise the risk of these occurring.
Perhaps the real question (which we also don’t know the answer to) is – what would happen if a dancer were to start pointe at 15 years instead of 10 years? Would their chances as a professional dancer be hindered? Would they be stronger and have had more time to work on developing technical proficiency?
There are many factors to the dancer being ready for pointe work but what are you looking at in the foot for pointe shoe readiness?
To align yourself en pointe, you need to be able to achieve 180 degrees (a straight line) through your shin, ankle joint and metatarsals. Sometimes, even with exercises and physiotherapy help, a dancer cannot achieve 180 degrees. It is then that the student, teacher and physiotherapist should consider the safety of the dancer in making the decision to go ahead with pointe work.
A hypermobile (flexible) foot can be problematic. Dancers who have no trouble achieving 180 degrees (and more) often find it difficult not to sink into the pointe shoe or balance on one leg on a flat foot in a pointe shoe because their muscles aren’t strong enough to control the ankle or small joints through the midfoot. I always test simple toe co-ordination foot lumbrical muscle exercises and make this part of an everyday routine.
“If you are a dance teacher and have students preparing for pointe, ask them to take barre in bare feet occasionally – it will reveal many secrets hidden beneath the canvas flat!”
Sickling and over fishing are equally undesirable habits, so care should be taken to correct these in everyday rises, tendus, jumps etc.
What are some of the more common issue that prevent dancers going on pointe that can be assisted with physio and Pilates exercises?
1. Old or current injuries! This is a familiar scenario- a dancer will present for a pre-pointe assessment, although with questioning they reveal back, knee or hip pain that currently affects their dancing and hasn’t been addressed. It’s very hard to develop competency en pointe when you are already compensating for pain somewhere else.
2. Optimal use of turn out from the hip. It is absolutely possible to dance professionally without having “flat” turn out. However, activation of the deep external rotators of the hip during basic ballet movements is often lacking.
3. I will ask a dancer to do “as many calf rises as they can” on a single leg in parallel, with good foot (controlling sickling and fishing), knee, hip and trunk alignment. Depending on the age and experience level of the dancer, 25-35+ calf rises is a good target.
4. Whole body trunk and pelvic co- ordination in ballet and non- ballet context. The “Airplane Test” is (according to research) viewed by therapists and dance teachers alike as a good indicator of pointe readiness. There is a handy YouTube video of this test in cyberspace.
When starting pointe work, you should be making a commitment to yourself to really look after your body and dedicate time and energy to ballet and conditioning exercises beyond that of “just a hobby”. Chronological age and skeletal maturity are only part of the puzzle. All clients who visit for a pre-pointe assessment leave with homework, even if the answer is “yes” to pointe shoes. Such is the life of a dancer!
Louise is a physiotherapist at Pondera Physiotherapy and Pilates in Brisbane. She has a keen interest in dance injury management and prevention- from budding students to seasoned professionals. She is currently Assistant Physiotherapist to Queensland Ballet and Queensland Ballet Academy.
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Injectables
by
Andrew Cobb
sports-spinal.com.au |
bellbird@sports-spinal.com.au |
03 9878 8088
Osteoarthritis (OA) of the knee is quite common as you age but can develop much earlier when someone has suffered a significant knee injury. A classic example of this is when an athlete ruptures their anterior cruciate ligament (ACL), regardless of the treatment sought you can expect to see OA changes in the knee within 20 years. Quite often these athletes are still young and having major surgery like a partial knee replacement is best to be avoided for as long as possible. In these circumstances, there is a growing demand for injectables to delay the need for surgery. For all of these injections you need to discuss the appropriateness of them with your GP, sports physician or orthopaedic surgeon.
Corticosteroid (Cortisone) injections have been used in OA joints for years to help settle down pain and swelling. They give relatively quick relief and they aren’t cost prohibitive like some of the newer injectables. One of the bigger issues with corticosteroid injections is they can cause cartilage break down which would eventually make the OA worse. These injections should be used sparingly, they appear to be a quick fix but can’t be used long term.
Platelet Rich Plasma (PRP) injections have become more common in the last 5 years for management of OA knees. PRP is usually derived from a blood sample from the patient that is spun in a centrifuge to separate the blood into different layers. Once spun the Platelet layer is collected and used for the injection. The reported benefits of a PRP injection are reduced pain, stiffness and potentially slowing down cartilage degeneration. In theory, this delays the need for surgery however it doesn’t work for everyone. Given the promising early results more research is being done about the make-up of the PRP injection and which conditions and patients respond well.
Hyaluronic Acid (HA) Injections are an option as the knee becomes more painful and normal anti- inflammatory drugs aren’t helping control the pain or swelling. HA is normally found inside the synovial fluid that lubricates the knee joint however in a joint that is suffering from OA the HA starts to break down making the synovial fluid less effective and the joint painful and stiff. You normally would have 3-5 injections spaced 1-2 weeks apart. There is now limited evidence that shows that some people get relief from HA injections and it can help people delay more invasive operations. It takes some months before the benefit of an HA injection is seen.
Mesenchymal Stem Cell injections are getting a lot of media attention at the moment, but despite the excitement and huge cost there is currently no substantial evidence that supports the use of these injections in a OA knee. The Australian College of Sports Physicians recent position statement was updated saying they have “specific concerns about patient safety” and that further “rigorous clinical research” needs to be done.
Andrew Cobb is an APA Sports Physiotherapist and Director of Bellbird Sports & Spinal. He has over 15 years clinical experience and treats a large number of dancers and gymnasts. Andrew is also a qualified Clinical Pilates instructor and draws on his 15 years as a ballet dancer when treating and rehabilitating performers.
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Tips To Help Your Body During Exam & Comp Time
by
Charissa Fermelis
charissafermelis.com |
info@charissafermelis.com |
0438 020 167
The winter dance competition season has come and gone, and fast approaching is the spring exam timetable and soon enough, we will be in the midst of concert preparation. The yearly dance calendar can be quite a confronting routine, punctuated with extra rehearsals and private lessons; there are few opportunities for ‘down time’ or an ‘off season’ where rest and recuperation are allowed.
Add to a dance student’s busy diary their high intrinsic expectation and perceived external pressure from teachers and parents – the result can be a physically exhausted and emotionally drained young person.
I remember this all too well. In amongst all this dancing, I somehow needed to find time to stay abreast of school study, engage with my non-dancing peers and also just chill out!
Outlined below are some methods to assist with physical recovery during those heavy dance periods, to reduce muscle soreness, begin the tissue repair process and restore function in order to maximise performance potential and help minimise the risk of injury.
- Stretch following activity – long indulgent stretches, working through all the major muscle groups, holding the stretch for 30 seconds but repeating each 3 to 5 times
- Ice pack – utilise an ice pack at home (or a bag of trusty frozen peas!) on any acute injuries to help reduce pain, swelling, bruising and inflammation
- Soak feet in cold water – to soothe tired feet, especially helpful after dancing en pointe
- Injury management – have any new niggles assessed by a dance physiotherapist to establish a treatment plan, or implement your self-management regime at home to stabilise ongoing or chronic issues
- Massage – either by making an appointment with a myotherapist or massage therapist, or by self-massaging on a foam roller or spikey massage ball at home
- Compression garments – wearing compression leggings or compression socks on long car trips home after dancing will help prevent swelling pooling in the feet and assist with blood circulation
- Postural drainage – resting with the feet elevated up the wall or on the edge of the couch helps with venous return
- Adequate sleep – the National Sleep Foundation recommends a teenager aim for between 8 and 11 hours of sleep per night
- Optimal nutrition – replenish glycogen and protein, water rehydration
“Add to a dance student’s busy diary their high intrinsic expectation and perceived external pressure from teachers and parents – the result can be a physically exhausted and emotionally drained young person.”
Charissa Fermelis is a physiotherapist and Pilates practitioner with a Bachelor of Physiotherapy degree and Pilates teaching qualification through the Australian Pilates Method Association. Charissa has a passion for dance injury rehabilitation and technique integration in the adolescent dancer, intertwining scientific-based clinical medicine with a holistic and grounded approach to wellbeing. Charissa has worked alongside renowned physiotherapists of the Victorian College of the Arts and dance community to develop highly regarded dance physiotherapy assessment procedures. She currently consults in Melbourne and the Gold Coast, and at regional dance schools around Victoria.
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The Importance of the Intrinsic Muscles in the Feet
by
Gabrielle Davidson & Joanne Maskrey
insyncphysiopilates.com.au |
insync@live.com.au |
03 9813 2188
The humble foot is a highly mobile collection of joints, ligament and muscles that allow for flexibility of the ankle in demi-plies, the beautiful arc of the pointed foot, the explosive push off, and the light, quiet landing of allegro. Dancers are able to execute these movements precisely with the activation and control of highly trained intrinsic muscles of their feet.
The intrinsic foot muscles are a vital part of the technique for every dancer, male and female. The strength of these relatively small but essential muscles govern how far the foot can arch, which creates the aesthetically pleasing line all dancers desire. Long toes when jumping are the springs at the end of your feet, as the longer levers of lengthened toes give your jump more power.
When the concept of pointing the foot is first introduced to little ballet dancers they will naturally curl their toes. This is because the intrinsic muscles don’t switch on automatically. Watching how the foot works without shoes lets dancers see what their toes are doing.
As young dancers get older they become more able to select the muscles they use to execute movements. Students can then spend time learning how to activate and work their intrinsic foot muscles.
Class work becomes harder and more complex with the introduction of larger jumps, pirouettes, balancing on demi-pointe and full pointe. This puts much greater stress on the bones of the feet.
The intrinsic muscles of the feet, by their attachment to the bones, offer columns of muscular support to maintain the health of the bones and joints. Common dance injuries such as posterior ankle impingement and stress fractures of the metatarsals can often be traced back to weakness of these little muscles.
The Australian Ballet’s medical team is at the forefront of dance medicine research. It has discovered that intrinsic muscles help prevent posterior ankle impingement by acting as a counterbalance to the strong pull of the calf muscles that can compress the back of the ankle joint as the dancer pointes their feet.
Another role of these important little muscles is to support the arches of the feet. Rolling the feet (when the arches drop and are no longer visible when standing in first position) sends twisting forces through the knees and subsequently makes turnout more difficult at the hips. This can then affect the back and limit the biomechanical efficiency of the dancer’s entire lower limb.
There are many exercises available to help dancers activate and strengthen their feet. A dance physiotherapist or experienced dance teacher can provide individual assessments and targeted strength programs to suit specific needs.
Ultimately, the dancer must be able to integrate the new technique into their everyday dance classes. This can take a little while, because the dancer might need to change how they point their feet and habitual motor patterns take time to change, such as the way the dancer points their feet, so it is important to keep working with focus and concentration.
The tendu is the best way to engage and strengthen the foot intrinsic muscles in class. Done at the beginning of the class, dancers can warm up their feet and achieve greater articulation to prepare for more complex choreography.
Rising to demi pointe is also an important way to keep working and strengthening intrinsics. Toes should be able to remain lengthened and not shorten or curl. This will give the foot the long lever in the take off for a jump or to keep rising to pointe.
It is just as important to release the intrinsic muscles after class. Using a spikey ball and self-massaging can help keep your feet supple.
Remember, as tempting as it is to use passive joint stretches to increase the arch, these only add strain and stress to the ligaments and joints without creating muscular support. So put in time to develop good use of your muscles around the foot and ankle, particularly your intrinsic muscles. It will stand you in good stead for stronger and healthier feet, and a better pointe. Happy doming!
Gabrielle Davidson ( B.PHTY (HONS) and Joanne Maskrey (B.PHTY) are both Dance Physiotherapists at InSync Physiotherapy & Pilates with an extensive knowledge and history of treating dancers.
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