Once, while teaching in an opera house in Switzerland, Janet Panetta came upon a talented dancer wearing a knee brace. She noticed he was extremely over-rotated in first and second position, and suggested he pull back a little. He respectfully declined her advice, not wanting to disturb his line. “He had knee troubles, and probably shortened his dance life by a number of years based on that insistence," she says. “That was really hard for him to change."
The concept of turnout is frequently misunderstood and controversial. While 180-degree turnout has long been considered ideal, most dancers lack the facility to achieve it. Many agree that forcing rotation from the knees and ankles, as opposed to working from the hip down, causes counterproductive and unhealthy results. But by understanding the true nuts and bolts of turnout—its anatomical source as well as how to stabilize it—dancers can maximize their natural range and prevent injury.
“I think the term 'turnout' is very misleading because it creates an image of the feet at a 180-degree angle," says Panetta, who teaches ballet for contemporary dancers at Gibney Dance Center in New York City. “Turnout is actually a rotation of the legs in the hip sockets. I think the phrase 'rotation,' as opposed to 'turnout,' creates an image that's easier to understand."
Physical therapist Marika Molnar, founder and president of Westside Dance Physical Therapy in New York City, believes that turnout starts higher than the hips. “The whole pelvic girdle has to be in good alignment in order to let the hip rotate adequately," she says, noting that the hip has its most range of motion in a neutral position, as opposed to a swayed lower back and forward-tipped pelvis. “If the lumbar spine and pelvis are not correctly aligned, you'll struggle most of the time."
Alexei Kremnev, artistic director of the Joffrey Academy of Dance in Chicago, agrees, and implements this idea in the school's beginning level. Children first learn exercises in parallel to practice proper alignment. “Once the spine and tailbone are in an exact position, then we start turning out from the hips," says Kremnev. “Otherwise, you have to go back and fix their alignment a few years down the road."
According to “Turnout for Dancers: Hip Anatomy and Factors Affecting Turnout," a resource paper written by Virginia Wilmerding and Donna Krasnow and published by the International Association for Dance Medicine and Science (IADMS), approximately 60 percent of turnout comes from the hip joint and 20 to 30 percent from the ankle. The knee and tibia pick up the rest. In addition, specific muscle groups aid in rotation and help dancers sustain turnout. The lateral rotators—a set of six small muscles located underneath the gluteus maximus near the pelvic floor—help pull the greater trochanter out and back. The sartorius and inner thigh muscles (or adductors) also contribute to external rotation, while the abdominals stabilize the pelvis.
Variables such as the femoral neck's shape, length, and angle; placement of the hip socket; muscle tightness; and ligament flexibility can help or hinder a dancer's rotation. Kremnev is sensitive to individual differences, and approaches each student differently to accommodate their physical abilities early on. For those with limited turnout, he implements a gradual, gentle stretching regimen. “We practice extending the muscles and then relaxing so they can reach their maximum," he says. “As the muscles get longer and looser, we try a little bit more. It's a step-by-step approach."
After age 13 or 14, there's not much a dancer can do to increase their natural range, but strengthening the proper muscles can help. “Many dancers think they don't have enough turnout," says Molnar. “But what they really lack is strength at the very end range of motion, so they can't hold it." She recommends supplemental strengthening exercises provided on the IADMS website. “If you increase your strength, you improve your ability to reach your maximum."
Forcing that maximum by torquing the knees and ankles can have damaging results. Wear and tear on the hip joint's surface can result in arthritic changes and impingements. Over-rotating from the knee and ankle can cause kneecap subluxation in adolescents, strain ligaments, break down the arches (causing feet to roll in), and increase the likelihood of bunions.
“The top of the leg is the real barometer for turnout," says Susan Jaffe, dean of dance at the University of North Carolina School of the Arts, who sees poor knee-over-toe alignment, cupped feet, and gripping toes as signs of over-rotation. She observes that many students lack a clear comprehension of how to sustain their turnout. “Most people understand turning out from the front of the leg," she says. “But there's a circular spiraling that happens throughout the entire leg, not just the front."
Jaffe stresses that the abdominals should feel scooped in and up to create space for the legs, as opposed to held statically. In addition, she tells students to visualize their leg muscles wrapping around their bones, and emphasizes activating the muscles surrounding the hamstring insertion. “If you're not engaging that little one-inch space of the buns, right above the hamstring, then you can't get to the top of your turnout."
Many confuse that with gripping the larger gluteal muscles. “A lot of people think turnout comes from the butt," says Molnar. “But the deep rotators are located more in the center of the body going outward towards the top of the greater trochanter. The bigger muscles—the buttocks, quads, and hamstrings—are your moving muscles. But to correctly position your femur into the hip joint, the small, local muscles need to work."
Molnar, Panetta, and Jaffe note that turnout is often taught as a static concept, rather than a whole body experience. “Some people put a huge emphasis on standing in turnout, but how often do we actually stand in fifth without moving?" Molnar says. “The amount of turnout you need is dependent on what it is you're doing." Kremnev notes that teachers can help dancers develop a visual understanding to improve their lines, using other aspects like épaulement and foot positions.
“The element of turnout is important, of course, but it's a whole-body experience," says Jaffe. “We're not only training to be beautiful—we're training to be healthy."