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If the words "hip replacement surgery" inspire a twinge of panic, read on: The topic is cloaked in misconceptions. Dancers endure more injuries on the job than, say, bankers, but are we all-after decades of plies, leaps, and extensions-fated to the operating table by age 50? No, say our experts. Proper mechanics and dietary choices are key; listening to pain and slowing down in the face of injury can go a long way. Interestingly, however, genetics-not career choice-is still the strongest determinant of hip arthritis.
Dance Magazine spoke with Dr. Mark Sinnreich, orthopedic surgeon and lead medical consultant for Miami City Ballet; Dr. William Jaffe, Clinical Professor and Vice Chairman of Orthopedics at NYU Hospital for Joint Diseases and an expert in total hip replacement who has helped in their design; and Ruth Solomon, Dance Medicine Research Coordinator, Division of Sports Medicine, Harvard Medical Center. Additional information was adapted from the website of the Harkness Center for Dance Injuries (www.med.nyu.edu/hjd/harkness). The International Associatoin for Dance Medicine & Science also has a helpful website (www.iadms.org).
-Signs of arthritis are decreased range of motion; deep and aching pain in the groin (which refers to the socket) or thigh pain (which refers to the ball) and the surrounding muscles; joint stiffness; increased pain when you are dancing, and continuous pain when at rest. An X-ray can confirm a diagnosis of arthritis.
-Decrease inflammation naturally with a diet high in glucose, fish oils, and Omega-3 fatty acids, says Dr. Sinnreich. Keep bones strong with calcium.
-Maintain flexibility in the hip joints, as well as strengthen muscular balance on both legs. Avoid repetitive trauma when you sense an injury coming on.
-Ruth Solomon adds that pelvis tilts (which open up the anterior hip) and core strengtheners, which stabilize and balance the area, may also help. (Pilates is great for this.)
-If you are too young for a hip replacement, you have a variety of options. With the help of a doctor, you can manage the pain with topical analgesic products and NSAID's (non-steroids), which reduce both pain and inflammation. But remember: NSAID's will mask the pain and can eventually lead to further tissue injury if the area goes untreated.
Years of turn-out may cause hip arthritis: "There have been no studies to my knowledge to confirm that hypothesis," says Dr. Sinnreich. "There are also none to refute it, but I think all dancers would get arthritic hips if this was a risk factor." Dr. Jaffe agrees: "I doubt if external rotation in a finely trained dancer would cause a problem."
I can't get a hip replaced before a certain age: "There is no age limit for hip replacement surgery," says Dr. Jaffe. "But we are reluctant to do hip replacements in young active patients unless they are severely disabled. In those cases we do the procedure with the understanding that they will require additional revision surgery at a later date."
If I dance, I am doomed to need my hips replaced by age 50: Even with all the wear and tear that dancers endure, genetics still play the biggest role in determining whether you are at high risk for arthritis. "If you're going to get it," says Dr. Sinnreich, "you're going to get it."
Hip Resurfacing is a good option for younger dancers: Not true, says Dr. Jaffe. There is a false assumption that hip resurfacing (see below) has a longer lifespan than a total hip replacement (which lasts a minimum of 15 years). Other downsides? Resurfacing does not allow for increased physical activity; the procedure is almost as invasive as hip replacement surgery; and you still run the risk of dislocating the hip post-op.
Labral Tear: a tear in the fibrocartilage that interfaces between the head of the femur and the acetabulum, or socket. "It can get torn with various injuries such as in the extremes of motion that a dancer may encounter," says Dr. Jaffe. A tear can be repaired with arthroscopic surgery. It may lead to arthritis.
Acetabular dysplasia: a congenital condition which results in a shallow hip socket that does not effectively enclose the head of the femur. "In the milder forms," says Dr. Jaffe, "it increases the risk of developing secondary osteoarthritis in adulthood. This condition is much more common in women." Dancers who are naturally very turned out may have this.
Hip Resurfacing: An alternative to total hip replacement. The head of the femur is not removed, but "is ground down to a smaller ball," says Dr. Jaffe. "A metal ball is cemented over the remaining head fragment to articulate with the previously placed, artificial (metal) socket."
Mash-ups aren't uncommon in the dance world: Performers of varying styles have been known to share the stage, from ballerina Tiler Peck and famed clown Bill Irwin to Michelle Dorrance, who's mixed tappers and break-dancers. Likewise, collaborations between choreographers and artists from seemingly mismatched disciplines have produced magical creations, such as Alexei Ratmansky's Whipped Cream, featuring Mark Ryden's whimsical and even grotesque designs and costumes.
But the Israeli troupe Ka'et Contemporary Dance Ensemble has found success in one of the most unlikely partnerships: Secular contemporary choreographer Ronen Itzhaki creates movement for a group of rabbis.
While undoubtedly best known for her dancing, American Ballet Theatre principal Isabella Boylston has also been getting noticed for her style by Allure and Vogue—and with good reason. Her Instagram feed features a mix of on-trend athleisure wear and detailed dresses from runway designers like Valentino and Anna Sui, none of which would be complete without the makeup and hair to match. With a penchant for skin care and an ever-growing lipstick collection, Boylston talked us through some of her beauty must-haves on and off the stage.
Photo by Jayme Thornton
Before she became the 20th century's most revered ballet pedagogue, Agrippina Vaganova was a frustrated ballerina. "I was not progressing and that was a terrible thing to realize," she wrote in a rough draft of her memoirs.
She retired from the Imperial Ballet stage in 1916, and for the next 30-plus years, devoted herself to creating a "science of ballet." Her new, dynamic teaching method produced stars like Rudolf Nureyev, Alla Osipenko, and Galina Ulanova and later Natalia Makarova and Mikhail Baryshnikov. And her approach continues to influence how we think about ballet training to this day.
But is the ballet class due for an update? Demands and aesthetics have changed. So should the way dancers train change too?
For many dancers, a "warmup" consists of sitting on the floor stretching their legs in various positions. But this strategy only reduces your muscles' ability to work properly—it negatively affects your strength, endurance, balance and speed for up to an hour.
Save your flexibility training for the end of the day. Instead, follow a warmup that will actually help prevent injury and improve your body's performance.
According to the International Association of Dance Medicine and Science, a smart warmup has four parts: "a gentle pulse-raising section, a joint mobilization section, a muscle lengthening section and a strength/balance building section."
DanceBreak came roaring back to life on Monday after seven years on hiatus, and six choreographers now have the opportunity to be the next Andy Blankenbuehler. Or Joshua Bergasse, Kelly Devine, Casey Nicholaw, Josh Prince or Josh Rhodes. These stellar Broadway choreographers all got their first big shows after Melinda Atwood's musical-theater launching pad let them show the industry what they could do.
Since 2002, DanceBreak has been a sort of "So You Think You Can Choreograph" for Broadway. Although not everyone goes straight there—Mandy Moore and Mia Michaels are alumni, too—the program is meant to funnel talented choreographers to the Broadway stage by providing a platform for their work. Prince, who introduced Atwood to the cheering crowd, has paid DanceBreak the ultimate compliment, creating his own non-profit incubator for theater choreographers, Broadway Dance Lab. On Monday, he recalled the story of how he was offered the role of choreographer on Broadway's Shrek just days after its director saw the 2007 edition.
When caring for your feet or trying to make them look good, it's tempting to seek shortcuts. Bad ideas—like dangerous stretches that promise perfect lines or ointments that were never meant to go on your toes—catch on all too easily backstage.
We asked podiatrists who've seen their dance clients try it all share the habits they'd like to see gone for good.
My dance coach wants my word that I'll keep competing under his school's name for the next year and not audition. I'm 18 years old and already doing lead roles and winning medals. I love his teaching, but shouldn't I be ready to go out and get a job?
—Gil, Las Vegas, NV
How do we make ballet, a traditionally homogeneous art form, relevant to and reflective of an increasingly diverse and globalized era? While established companies are shifting slowly, Richard Siegal/Ballet of Difference, though less than 2 years old, has something of a head start. The guiding force of the company, which is based in Germany, is bringing differences together in the same room and, ultimately, on the same stage.
Claude Debussy's only completed opera, Pelléas et Mélisande, emphasizes clarity and subtlety over high-flung drama as a deadly love triangle unfolds. Opera Vlaanderen and Royal Ballet of Flanders are commemorating the 100th anniversary of the composer's death with a new production of the landmark opera that is sure to be anything but traditional: Sidi Larbi Cherkaoui and Damien Jalet are choreographing and directing, while boundary-pushing performance artist Marina Abramović collaborates on the design. Antwerp, Feb. 2–13. Ghent, Feb. 23–March 4. operaballet.be/en.
Black History Month offers a time to reflect on the artists who have shaped the dance field as we know it today. But equally important is celebrating the black artists who represent the next generation. These seven up-and-comers are making waves across all kinds of styles and across the country: