What You're Doing That's Making Dance Medicine Experts Cringe
Dancers today are smarter about their bodies than ever before. The field of dance medicine, led by organizations such as the International Association for Dance Medicine & Science, founded in 1990, and Performing Arts Medicine Association, founded in 1989, has revolutionized our approach to dancer health. It's become commonplace for major companies and schools to offer cross-training, nutrition advice and access to health professionals as the entire dance community has become more focused on wellness and healthy best practices.
Still, the injury rate remains high. Dance remains a tradition based on a treasured aesthetic, not the limitations of the human body. Although we may have a better understanding of our kinesiology, the increasing technical expectations and today's focus on hypermobility put dancers at greater risk. After all, research can only do so much—it's up to dancers to follow experts' findings and advice. So what do dance medicine professionals see as the biggest mistakes dancers are still making?
Starting with Static Stretching
Photos by Nathan Sayer.
Before class, you still see dancers resting their legs on the barre, posing as if they were in a Degas painting. Yet dance health experts insist dancers should instead be doing dynamic stretches: large movements, like lunges, performed at a moderate rate to get the blood flowing. “We know from science that static stretching temporarily weakens muscles, impairs coordination, reduces balance and jump height," says Dr. Nancy Kadel, co-chair of the Dance/USA Task Force on Dancer Health. “Static stretching is not warming up. It's much better to walk, or do anything else to elevate the heart rate."
Misunderstanding the Core
The core is still not entirely understood in the dance community. When we say we need to strengthen “the core," that often translates to simply doing ab exercises. This can lead to key weaknesses in supporting the whole body in action. “Core control is much more than just abdominal strength," says Jan Dunn, a former president of IADMS and current dance wellness editor of 4dancers.org. “It refers to back stabilization, and involves the coordinated effort of several different muscles in the torso to stabilize the spine."
Insisting on an MRI
Getting an MRI doesn't always mean you'll recover sooner. Yet dancers often panic and seek one out, says Jennifer M. Gamboa, DPT, founder of Body Dynamics in Virginia. “The results show inflammation (no surprise), and don't change initial course of care." Since the majority of musculoskeletal injuries resolve without any need for imaging, she urges dancers not to panic. “Early imaging will not change healing," says Gamboa. “It is only necessary in obvious fractures or ruptures, or if conservative care does not produce expected healing."
Screwing your feet into an unnaturally tight fifth position wreaks havoc on everything from the bunions on up. But some of the stretches dancers do to try to increase their hip rotation can be equally dangerous. The worst offender is young dancers sitting in splits or over-splits for 10 minutes or longer. Another culprit is the frog stretch, where dancers lie on their bellies with their legs bent in a diamond shape behind them (sometimes with a friend forcing the feet down). “This puts stress on the knees, the hips and the lower back," says Kadel. She suggests active rather than passive stretching and exercises that increase the strength of your rotation. “It's much better to do the clam exercise, where you lie on your side with your knees bent and your feet in line with your spine while opening and closing your top knee. That way you work toward supporting the turnout that you have." (For more on accessing your full turnout potential, see Your Body, on page 44.)
Self-Treating with Ibuprofen
Your dance bag should not be a drugstore. While it's tempting to treat every ache and pain with a pill, it could backfire. “Inflammation is your body's way of dealing with injury and we don't always want to suppress it," says Kadel. “Studies tell us that taking ibuprofen when not necessary can impede soft tissue and bone healing." An anti-inflammatory habit could also cover up something more serious. “If you have three days of consecutive pain, see the doctor," says Kadel. “You may end up back onstage sooner."
Getting Medical Advice Online
When it comes to dispensing medical information, the internet has been a game changer, but with that windfall has come a great deal of misinformation. Beware of getting wellness advice from individuals without proper credentials, especially when they want to charge you for it. Who qualifies as a dance medicine expert? Look for degrees such as PhD, MS, PT or ATC in a related field, plus experience as a dancer or working with professional dancers, says Dunn. “If someone is promoting a strength-training program for dancers, do they have credentials in that field, such as a Pilates or American College of Sports Medicine certification?" she asks. The author should provide clear references and sources for their information, indicating that they are current with the latest dance medicine and science research.
Skipping Aerobic Work
Dancers need to do more than class to stay injury-free. The stop-start nature of most classes and rehearsals doesn't build the stamina necessary for performance. “Dancers need to do some form of aerobic exercise that keeps their heart rate elevated for 30 minutes at least three times a week," says Kadel. “You should be sweating but still be able to speak." Elliptical, cycling, swimming and running are all excellent choices. Not only can this reduce your risk of injury, Kadel says studies show that dancers who complete supplemental conditioning programs show improvement in aesthetic performance: “Stronger, fitter dancers use less effort, have better core control, fatigue later and thus are better able to dance full-out and take more risks onstage."
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