Health practitioners who work with dancers are a dedicated tribe. They love the art and its performers, hoping for long careers, less injury, and years of pain-free dancing. Yet frustrations mount when they see easily preventable problems in their patients day after day. Sometimes it's not rocket science but a small change, like how you walk, what you do outside of class, or a hand placement at the barre, that can make a huge difference. Larger mistakes take more consideration and may need reeducation about how our bodies really work.
Dance Magazine spoke with three leaders in dance science to get their gripes out in the open, which could possibly lead to healthier choices. So, listen up: The experts know their turf.
Know Your Stretching
“I wish dancers wouldn't stretch the way they do," sighs Jennifer Gamboa, president of Body Dynamics, Inc., in Arlington, Virginia. “They love to plop down before class and stretch out, using static instead of dynamic stretching."
Here's the problem: According to recent studies, static stretching before an activity decreases strength and power. A static (or passive) stretch is one where you assume a position and hold it with some other part of your body, or with the assistance of a partner or some other apparatus, such as hoisting a leg onto the barre and just hanging out there. “If you stretch a chain-link fence, it becomes deformed. The same thing happens to the muscle fibers," says Gamboa, who works with Washington Ballet's dancers. “The brain has to adapt to that change, so the muscles are not as strong and less able to produce speed. Plus, you have less agility. Static stretching before classes decreases strength, speed, agility, and useful range of motion." The worst part is that she sees static stretching at the wrong time in a dancer's daily schedule. “I find dancers doing static stretching between the barre and center work, and again before rehearsal, where often speed, power, and agility may be in demand."
It's not that static stretching is bad in and of itself, but it puts you at risk. “You are more likely to land incorrectly, and are more susceptible to injury," she adds.
Gamboa prefers dynamic stretching, which involves movement that is of low intensity and uses a broad range of motion. Leg brushes, arm circles, trunk rotations, lunges across the floor, and other large movements constitute dynamic stretching. “Even walking or biking to class is an ideal way to get the blood moving and raise the body's temperature. Simply put, the body needs movement to get ready to dance."
You don't have to stop having those long, luxurious stretch experiences. “Static stretching should be done at the end of class, the end of rehearsal, and the end of the day," Gamboa says.
Walk Like Normal People
Marika Molnar, president and founder of Westside Dance Physical Therapy, hopes that some day dancers might quit walking like ducks. “Walking with the hips and the feet turned out on a daily basis creates too much stress, especially on the feet and ankles," says Molnar, who works with New York City Ballet dancers. “You end up rolling medially over your arch and putting stress on your posterior tibial and flexor hallucis tendon. You also put too much stress on the medial knee, which can affect the stability of the patella. Dancers immediately try to hit 180-degree turnout before they prepare properly."
Turning out in class is one thing, but turning out 24/7 quite another. “The gait pattern is a bad habit, a sort of identity," she says. “The 180-degree first position happens because that's what they were taught early on. We need to bring awareness to the importance of walking correctly. Dancers should get to class earlier and warm up their bodies before assuming the strict ballet position. Teaching good walking skills nurtures the spine, hips, and feet."
Another major pet peeve for Molnar is when dancers hold on to the barre with the hand directly to the side instead of slightly forward. The position can wreak havoc in your alignment. If your hand is not in your peripheral vision, chances are it's too far back. “When the hand is back on the barre it may cause the elbow to be behind the body, which then destabilizes the scapulothoracic area of the back [the shoulder blade wings off the rib cage]," says Molnar. “This is a very unstable position for the arms, and can be the cause of shoulder subluxations."
Turnout, Bones, & the Gym
Bridget Quinn, MD, has a long list of things she wishes she could change in a dancer's perception of health. Pushing turnout tops the list. “Forcing turnout is the source of lordosis, increased strain on the sacroiliac joint, and torque on the kneecap—which can lead to patella and anterior knee pain," says Quinn, who works with Boston Ballet's dancers. “It affects the whole kinetic chain."
Quinn finds that the common habit of planting and screwing the feet in fifth position is often the culprit in forcing turnout. “Then dancers tend to pronate the foot, which can lead to flexor hallucis longus (FHL) trouble, the Achilles of dancer's foot," she adds.
There are safe ways for dancers to improve their turnout. First they need to remember that turnout starts at the hip. “You can build deep external rotation strength," says Quinn, “and improve the flexibility of the iliofemoral ligaments." She suggests the classic clamshell exercise to improve the hip's external rotators. Lie on your side with your knees bent. Without moving your hip back and forth, open and close the top leg. You can increase the tension by using a Thera-Band as resistance.
Quinn would like to dispel the myth that all great ballet dancers had perfect turnout. Many did not have 180-degree turnout, and went on to highly successful careers. “They danced," Quinn says, “and we never noticed their turnout."
Another trouble spot is the belief that you can get all you need within technique class. “Dance is an art form, not a whole-body conditioning regime," says Quinn. “There are still too many dancers who do not do any cross-training. Class alone leads to imbalances and weaknesses, and there are not enough aerobic challenges."
Bottom line, the rate of injury for dancers is too high. The quality of teaching continues to improve and dancers are becoming more informed on injury prevention. Yet the technical legacy comes with some immovable issues. What dancers need to change is in their control. Listen to the experts. They speak from love and experience for the form and its practitioners.