Your Body: From the Hip
The high kicks of Balanchine’s Who Cares? ended up being the final blow to Abigail Mentzer’s tender left hip joint. After the performance, she knew she had to see a doctor. The Pennsylvania Ballet soloist managed to get through most of the season before learning that she suffered from a labral hip tear. “I couldn’t even walk up the stairs,” she remembers.
Dance, particularly ballet, takes its toll on the hips. Labral tears, snapping hip, and various forms of tendonitis are the most common hip problems. “Most stem from improper technique or alignment, weakness or muscle imbalance, or overtraining,” says Dr. Peter Lavine, an orthopedic surgeon who treats The Washington Ballet’s dancers.
Forcing your turnout proves to be one of the biggest culprits. According to Patrick McCulloch, an orthopedic surgeon with the Methodist Center for Sports Medicine in Houston, while labral tears can result from a traumatic injury like a fall, they often stem from the everyday wear and tear of class and rehearsal. “Because of the extreme range of motion, the labrum can get pinched between the ball and socket of the hip joint,” says McCulloch, who treats Houston Ballet’s dancers.
With a labral tear, a dancer may feel pain in the hip or groin area, stiffness or a limited range of motion, or a locking or catching sensation. Diagnosis usually requires a contrast MRI, where dye is injected into the joint. Treatment usually involves reducing activity, taking anti-inflammatories, and working with a physical therapist to improve core strength, says McCulloch. “Sometimes, tears heal normally and scale down in a way that the pain goes away.” However, if the symptoms do not improve, labral tears can be corrected with arthroscopic surgery. Depending on the type and complexity of the tear, recovery can take anywhere from six weeks to several months.
Snapping hip occurs when a tendon or muscle passes over a bone. McCulloch notes there are two kinds of snapping hip: external, where the iliotibial (IT) band rubs against the greater trochanter; and internal, where the iliopsoas tendon rubs up against the front of the hip. Dancers usually experience little pain, but may notice a snapping or catching feeling. Snapping hip does not cause problems unless tendonitis sets in. Treatment is straightforward.“You need to stretch out what’s tight and doing the snapping,” says McCulloch, who recommends stretching the IT band with a roller for external snapping hip and stretching the iliopsoas for internal snapping hip. “With stretching and anti-inflammatories, most get better.”
Smart Preventive Moves
Although hip injuries can be painful and tricky, dancers can head them off. Make sure that you get enough calcium in your diet and that you develop right-and-left leg strength equally. Some dancers find working on a Pilates reformer lets them focus on building each side equally. Dancers also need to build hip-joint flexibility, including regular IT stretching—for instance lying sideways on a foam roller to roll the IT band out.
Mentzer is well on her way to dancing again. “I was back in PT two weeks after surgery. I have been doing a series of core and glute exercises twice a day,” she says. “I also continue to ice after every exercise set and look forward to incorporating more strengthening.” Lavine urges that dancers cross-train and do Pilates for greater core stability. “Core exercises, and strengthening the abdominals and pelvic stabilizers, are important,” he says. “Ballet class does not do all of this. It only does ballet.”
Nancy Wozny writes about health and the arts from Houston.
Photo by Nathan Sayers.
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Photo from istock.
Step On It
Functional Footprints are a handy tool to improve alignment and better understand turnout. Their swivel design helps dancers to turn out from the hip. The tip mechanism challenges the dancer’s sense of balance, while the degree indicator helps students measure their turnout range. The Footprints also allow a physical therapist to address turnout and placement at the same time. Plus, dancers can get their own pair and practice at home. www.pilates.com.
Photo courtesy pilates.com.