Dancing Smart Newsletter: Hyperextension and Pregnancy tips

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Onto the questions....

I returned to ballet about 5 years ago. I have been getting some pain in my knees which was diagnosed by my physiotherapist as anterior knee pain caused by weak thigh muscles.

A new teacher at my ballet school said that my hyperextended knees would also be causing the problem. I am working with her to try and stand straight without locking the knees but I am having problems trying stand properly on one leg while working the other.

Any help that you give would be much appreciated as all my teachers have differing opinions on hyperextended knees.

I am now 28 and also suffer from pronation.

Thank you

Kirsty

The three issues you mentioned, weak thigh muscles, hyperextended knees and pronated feet all go together. The good thing is as you start to address all 3 of them at the same time your knees should start to quickly feel better!

I'm assuming your physiotherapist is giving you quad strengthening exercises - so I won't talk about them except to say that a single leg demi plie is a wonderful strengthener! (As long as your knees and feet are in alignment)

My opinion on hyperextension is that it creates a beautiful line in the air - and - needs to be controlled on the ground. When the knees go back into hyperextension the thighbone rotates inward, and the feet tend to pronate. This definitely opposes your goal of maintaining good turnout!

It's not easy to change a chronic habit of hyperextending the knees - but it is well worth it! You can monitor your knees from your feet, making sure the weight is equal on the 3 points of the feet. You can also catch yourself dropping into your legs (as most dancers with hyperextended knees are rather loosey-goosey) and put your hand on top of your head and press into your hand, lengthening your spine. Practice balancing on one leg (not in hyperextension) to help your nervous system learn where the center of the joints are. It will take some time to change the habit - but I have seen many dancers do it!

Good luck!

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I am just into my pregnancy and work as a contemporary dancer and physical theatre performer. I hope not to stop my work and performances until my 7th or 8th month. However I know that I will have to modify my work and I'm game for that. I can't seem to find a good resource -- a book, a detailed article, anything! -- that explains what activity should be modified and how to modify the activity as time goes on. Most of what I've found is very
general or specific to elite athletes like runners. Do you have any recommendations?

Sincerely
Lucy

I don't know of any specific resources to send you to, Lucy, so I will give you my personal opinion after having 3 of my own - and counseling a few friends through their pregnancy and births.

The first is - your iliopsoas is going to take a beating with being pregnant. As the baby gets bigger, the pull on your lower back is significant. The one stretch you cannot stop doing is some form of iliopsoas stretching. (I actually have a youtube video on 3 different ways to stretch your psoas) The one stretch that I don't have on this video is a sitting stretch - but here it is on the right.

Ballwork all around the pelvis will be very useful for keeping the muscles looser. As your belly pulls the pelvis into a forward tilt, the abdominals contract to counter that and the gluteals also tend to contract more than normal to keep your pelvis upright.

Continuing dancing will help keep the abdominals in good shape - and stretching and ballwork will definitely help the gluts!

Those are my primary tips for a healthy pregnancy. It goes without saying that listening to your body is key - and - it is an amazing process that you are engaged with. Typically, the pregnant dancers I've known have, for the most part, had easier pregnancies than non-dancers. They danced as long as they were comfortable - and easily modified their movement. (for example, rolling down the spine becomes almost impossible - so do hamstring stretches standing with your leg on a chair instead) I truly enjoyed all 3 of my pregnancies. Best wishes and...

Congratulations!

Deborah

"Education is the key to injury prevention"

Dancing Smart Newsletter: Buttock Pain

Greetings!

I hope everyone's Thanksgiving holidays were wonderful.... I am grateful to have all of you in my dance community!

The new website is nearly done.... hoping by the next newsletter it will be up and running!

Here's the question of the week...

My daughter is 14 and has been dancing for 10 years. She started a very intense dance schedule in June. She was dancing nearly 30 hrs, a week for the summer along with a 4 day intensive. She cut back to 21 hrs a week when school started and has been doing very well growing in her dance ability until now. She takes 3 ballet classes, 3 adv. pointe classes (all 1 1/2 hrs each), 4 jazz classes, 3 lyrical classes, salsa and conditioning. She recently started having pain in her right hip where the sciatic nerve runs. A teacher of her is a certified physical therapist. She felt around and noticed the nerves on both sides were moving and the muscles underneath were knotted up. The pain stayed right there and didn't travel so we ruled out sciatica. We have iced and heated the area for a week and rubbed out as many knots as possible. It seemed to help and then she went to a jazz class and over did it and now we can't get the pain to stop for very long. I can feel the knots and deep rubbing seems to help but only for a while. Once she wakes in the morning it starts all over again. What if anything else can we do for it? I know rest is needed but do you have any other advice for knotted muscles? Thank you for your time, Evie

I'm glad you have a physical therapist on board to help you out. I'm wondering whether your daughter could have something called piriformis syndrome. It's a condition where the piriformis muscles which is the largest of the 6 deep muscles that are the 'turnout' muscles irritates the sciatic nerve. Some people only feel pain in the buttock area (this could be your daughter) and sometimes it goes down into the leg,
which is referred pain from the sciatic nerve. The sciatic nerve typically passes underneath the piriformis muscle, but in about 15% of the population the nerve goes through the piriformis muscle increasing it's potential for trouble.

When dancers overwork the piriformis and the other deep rotators as they are trying to achieve more turnout then can create excessive tension in this muscle which presses or compresses on the nerve creating pain depending on where the nerve lies in relationship to the piriformis muscle.


For right now, let's treat your daughter as if she has really irritated both the sciatic nerve and that the turnout muscles are knotted up and very unhappy!


The massage you are doing is good for releasing tension in the gluteal area, as well as using a pinkie ball or a tennis ball to put between the buttock and the wall to do self-massage. With piriformis syndrome I personally would not use any heat - only ice on the area, and would have her ice as much as possible. This might be a time where a few days of an anti inflammatory such as ibuprofen could be helpful. The next thing I would do is to stretch, stretch, stretch, the turnout muscles to help them release from their painful spasm.


She can do this in a variety of ways. To the left is a sitting chair stretch that is very useful as she can easily do a stretch or two while in school!


Another way would be the traditional sitting on the floor with the legs folded and rounding down over the legs, gently moving from side to side to feel the stretch at the back of the buttocks where her pain is. Make sure to switch which leg is in front as that will change the focus of the stretch to the other side.


Rest is the final part of the treatment program. It doesn't mean that she would have to take off from all of her dance classes - but it does mean she needs to significantly reduce the amount of classes that she is taking. Her first goal is to be pain free when she wakes up in the morning. If her pain is reduced by pulling back - or totally off classes, then she can slowly bring more classes back in. Working through the pain at this point will most likely increase the length of time for healing - and make for some poor muscle habits as she is trying to engage and work the turnout muscles while they are tender and tight.


Best wishes for a speedy recovery!


Deborah

Développés

Greetings!
I'm excited to announce that TheBodySeries.com is going through a complete overhaul! I will let you know as soon as it is complete and also let you know of the holiday specials I'll be running to celebrate the new site. Stay tuned!

Onto the question of the week

Hi there!
I was hoping you might be able to help me. I am a professional dancer and for several years I have been struggling with développés, especially when executing this step to the side. I have good range of movement in my hip and I can flex my knee and raise it to a point where my knee is almost touching my shoulder. However, I cannot maintain the height of my thigh as I try to extend the leg. My thigh and consequently the working leg, drops significantly. When shouldering my leg I can let go and hold the working leg at a good height, however I cannot maintain the height of my thigh as I reach the crucial last moment of extension in the développé. I am really hoping you can help me identify why my extensions are not as high as they might be. Perhaps I have a weakness in the iliopsoas muscles or perhaps it is my quadriceps or hamstrings which need strengthening? Any advice would be greatly appreciated!

With Thanks, Beth

Great question, Beth - one a lot of dancers will be interested in!

When doing a développé to the front or side the hip flexors are the prime movers meaning they are the ones most responsible for getting the leg up, and the hamstrings are the antagonist muscles, meaning they need to lengthen to allow the leg to go up higher. You are a smart dancer to ponder both sides of the joint! So often dancers and teachers will only look at one side of the joint, such as the hamstring flexibility when trying to get the legs up higher.

It sounds like your hamstrings are flexible enough as you can bring your leg easily up to the desired position with your hand, then release your hand and then hold it there. I'm less inclined to think there is a challenge with the hamstring flexibility.

This brings us to the front of the joint to the hip flexors. In higher extensions such as développés the iliopsoas is of primary importance at the beginning of the movement and then at the end. The strength of the iliopsoas will help hold your thigh up while the quadriceps straighten the knee.

Normally, dancers are pretty strong with their quads - so let's have you try strengthening the iliopsoas muscle in the upper ranges of extension. I learned this exercise from Karen Clippinger, a marvelous teacher and anatomist.

Start by sitting with your left leg bent in front of you with the foot on the ground and your right leg extended straight on the floor in front of you. You are resting slightly on your hands, which are behind you. You may be slightly on the backside of your pelvis, but you are focusing on stabilizing your pelvis and not allowing yourself to roll onto the sacrum while doing this exercise. Okay - now lift your right leg up, keeping it straight, as far as is easy. You might get to the level of the other knee or you may not.

Once you have lifted it, slightly bend the right knee, bringing your thigh closer to your chest (remember - without rolling back on your pelvis!) Then once you have brought it slightly closer straighten the knee slowly (again - without rolling back on your pelvis!) and then lower the right leg to the starting position on the ground. Repeat several times - and then do the other side. It may take some days or weeks to feel as if you can significantly bring the knee closer to the chest - but you will see a difference in your extensions if you practice this.

You can also do this exercise in turnout. Even though you are keeping the legs in front this new found strength will carry over to your side développés. To make it a bit harder you could put a theraband around both knees giving yourself some resistance as you bring the thigh towards your chest and/or you could put a low level weight around your thigh - just above or below your knee - do not put the ankle weight at the ankle!

Let me know how your extensions improve!

Warmest regards,

Deborah

"Education is the key to injury prevention"

Dancing Smart Newsletter

Greetings!
I haven't gotten to answer any questions over the past few weeks as I've had some special events such as spending time with Lisa Howell, the wonderful Australian dance physiotherapist who authored the Perfect Pointe Book and the Perfect Pointe System! Lisa and I then went off to the IADMS Conference (International Association for Dance Medicine and Science) where I got to meet - some of you!

I so appreciate learning and being inspired by all the good work that is happening in dance medicine from around the world. Thanks to all who stopped to introduce themselves to me!

Onto the questions of the week....

My question concerns soreness around the sits bones during lunges and straddle split stretches (both the kind where you face a wall and push yourself closer and where you lie on your back perpendicular to the wall with your legs dropped open). I'm used to feeling sore there when working on hamstring flexibility, but never before with other stretches. It's especially odd with the lunges, because the soreness is in the buttock of the BACK leg. Rotating the leg inward seems to help a little. Do you have any ideas what may be going on here?

Your turnout muscles also attach in the area of the sits bone. You gave a good clue that rotating the leg inward helps relieve the soreness some. Why don't you try putting a pinkie ball or a tennis ball underneath your pelvis and rolling lightly around. Pay special attention to the sitting bone area. After gently massaging that area do your stretching and see if there is any difference in your response. Let me know if that helps!

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Another dancer writes....

If the hamstrings are tight where might a dancer feel discomfort?

We talked about this in class this morning. It seems logical that if the hamstrings are tight you would feel that tightness at one of the ends of the muscle. Either around the sits bone like the above question - or at the knee. But interestingly, often hamstring tightness and problems show up as lower back aches, and lower back problems will be felt in the hamstrings.

Think about a dancer who has tight hamstrings and is sitting on the floor with one or both of the legs in front of them. As you can see from this picture, the hamstrings aren't being targeted very effectively - rather the back is taking the brunt of the stretch.

Try using the pinkie ball on your back and pelvis. I really should buy stock in a pinkie ball company! - just teasing!

Sometimes releasing muscular tension above or below the hamstrings will help. I have students spend about a minute rolling a pinkie ball underneath one foot. They are massaging the plantar fascia of the foot. Then they go to touch their hands towards the floor and generally at least 50% of them will feel the hamstring loosened up on the side they used the pinkie ball. They didn't stretch the hamstring directly - and it still benefited!

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I promise I'll get back on track with the newsletter. I'm working on updating the website and along with that bringing some new information to you! Stay tune for more info in future newsletters!

Warm regards,
Deborah

Dancing Smart Newsletter

My ballet teacher has been helping me a lot with my feet because they are my weak spot. She said that I am too strong in the outer part of my feet, instead of being strong in the inside part. She said that I am more prone to injury because of this, and that this is incorrect.
I know this is true, especially because my feet are pretty close to flat. I "roll in" my ankle in class and outside of class when just walking around. I try not to roll in as best as I can. I was wondering if there are any exercises to help strengthen my inner part of my foot.

Thanks, Rachel
PS: I have a theraband.

Rachel, I'm not sure what you mean exactly with the stronger outer part versus inner part of your foot. When your foot rolls in it is called pronation and yes, there are definitely exercises you can do to help strengthen the muscles of the feet.

Your first focus is to bring your turnout in to where you feel equal weight between the pads of the big toe, little toe and heel. Check how you are standing when you are waiting in line at lunch – or standing and brushing your teeth. The habit of pronation probably occurs in your regular life as well as in ballet class.

Start with rolling for a moment or two on a tennis ball or pinkie ball to release and relax the foot muscles. Start by simply by 'playing the piano' with your toes. Keeping the pads of the toes on the floor, lift the toes up in the air and starting with your little toe, put it down on the ground, then the 4th toe, etc., with the big toe being the last. Now reverse and lift the big toe up, the 2nd toe next, and so on. You can use your hands to help do this exercise. If your feet start to cramp, stop and roll on the ball for a moment.

The next exercise is to practice pointing your feet by separating your toes as they begin to lengthen. You will start to cramp on this - and again - stop and roll on the ball before trying it again. You can do this exercise easily with putting the theraband around your toes and pressing gently against the theraband as you extend your toes.

Next tip – get rid of your flip-flops! Wear good supportive shoes with an arch support to help you keep from rolling in. Becoming aware of your rolling in or pronating is the first step in changing your feet – and I can't emphasize enough the importance of standing with equal weight on the 3 points of the foot.


I am really late-starter, having taken my first ballet class at 36.
My 6 teachers in the past 4 years adjusted the classes' level to the level of the knowledge of the majority participants. Inevitably, I ended up in a class way over my head or way below my level, which eventually left me with an enhanced ability of copying, and huge gaps in my technique.

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I am a faithful reader of your newsletter and I found your book, Tune up your turn out a great help too. Now at 40, I am taking 3 classes a week, I feel that the largest improvement in my dancing would come from understanding of the muscular recruitment of proper posture.
I can’t seem to get hold of the right balance between my deep abdominals, hip flexors and extensors. I don't know if I am tucking under or holding my center. The visual that I got from my teachers is that I should think belly button to the spine, or lengthen from the bottom of my spine, but I don’t find this very helpful. Should I really be aiming for a straight lower back devoid of its natural curve?

I naturally stand swayback, in a slight turnout with hyper extended knees. Standing in parallel feels really weird, as if my knees are about to knock, and correcting for the exaggerated lordotic curve I end up on bent legs with tight hip flexors and ribs fanning out. I am experimenting with different recruitments, but I am afraid of acquiring bad postural habits, and I certainly don’t need any more of those.

I know that you can’t possibly diagnose my posture by email, but I was hoping that you might have a few tips, or visual images I can try. I know a bit about musculoskeletal anatomy, so to me it would be more useful if someone could address the issue in those terms, as in get out of the quads, use more hip flexors, for example, but this is wishful thinking with the teachers I encountered here.

I would be grateful for your advice.

Zsuzsanna from Budapest, Hungary

Sounds like you have learned a lot over the past 6 years! First – check out whether or not your slight hyperextension is connected to your swayback. Very often it is – and when you bring your knees out of hyperextension, the pelvis comes out of its forward or anterior tilt.

Your lower back will not board straight – and I wouldn't want you to work towards that – clearly as you describe it creates other problems. What if you shift your focus to the pelvic bowl? If you were lying down on your back with your knees bent and your lower back just resting on the floor I would want you to feel that the pubic bone and the two points on your pelvis that feel like they are sticking up are on a level plane. (Those are your ASIS, or anterior/superior iliac crests)

Note that if you flatten your lower back against the floor your ASIS are probably closer to the floor that your pubic bone, and when you arch your back your pubic bone is closer to the floor that your ASIS.

Now come back up to standing. In standing it is more challenging for me to have a sense of the ASIS and pubis relationship so I shift to thinking that my pubis is lifting gently towards my sternum above it. This helps me to maintain the correct torso/pelvis alignment without putting my thinking (and corrections) into my lower back.

I also imagine that the pelvis is a bowl and I keep a small amount of lift between the pubis and my belly button in order to keep the front of the bowl from spilling their abdominal contents out as they do when you go into a swayback.

Let me know how it goes with bringing your knees to neutral when standing (you can hyperextend when its in the air) and bringing the front of your pelvic bowl up.

Best wishes!

Deborah

"Education is the key to injury prevention"

Dancing Smart Newsletter

Greetings!
I'm sending this from the beautiful TCU campus where I have been teaching an intensive course this week to the dance dept. There is nothing like teaching to a group of students who are eager and avid to learn all they can to improve their technique. And an extra perk is the Texas sun and warmth – It's going to be hard to go back to Ohio weather!

Quick reminder that registration for Lisa Howell's Perfect Pointe Workshops ends today. Register at http://theballetblog.com/index.php?option=com_content&task=blogcategory&id=67&Itemid=152

Onto the questions of the week!


Thanks for creating such a valuable resource. I attended your session at the Dance Teacher's Conference in New York back in August and found your information so helpful. One of my legs is a little longer than the other. This does affect my ballet dancing, particularly my turnout and jumps, etc.. I've also noticed that the longer leg is a little more weak than the other. Are there any exercises I can do to help? I am new to your newsletter so please forgive me if you have already addressed this issue. Thanks, Jennifer

Jennifer, if your legs are structurally at different lengths it can influence your alignment. It's tricky to decide whether or not you should insert a small heel lift in your soft slippers. Your spine needs to be looked at to evaluate it's curves and response to the shorter leg. Sometimes the spinal curves become less when the pelvis is balanced by putting a heel lift in - other times it might make your spinal curves worse, in which case you would not correct the leg length difference. I would suggest you see a PT or sports physician who could do an assessment of your spine and leg length.



There are some common patterns with uneven leg length - some of which you have referred to. When you look at the picture on the left you see the dancer has a pelvic shift right, torso shift left. The common pattern is to stand on the long leg, because to stand with more weight on the short leg would require you bend the long leg. You can see her left leg is the shorter leg.

Typically you come down heavier on the short leg side on each and every step. Sometimes dancers prefer to stand on their short leg and use their longer leg as the gesture leg - although I have seen the opposite preference also. It certainly can influence the turnout too. More often I see the long leg side having more challenges with turnout. It is easy to understand that you'd prefer to stand on your long leg and put your shorter leg in front in fifth position.

The dancer in this photo improved her alignment by putting a lift under her left heel. It evened out her shoulder line as well as equalizing the amount of weight through both legs. She put a lift in her every day shoes - as well as in her soft slipper. For modern dancers sometimes it is enough to have a lift in your shoes - keeping the musculature working evening for the majority of the time, then dancing barefoot without a lift.

There aren't any special exercises I would offer to you to even out the two sides, rather I would encourage you to have an evaluation to see if a lift would be useful, and then do your stretches and strengtheners in such a way that you are working to balance out the 2 sides. If you find the muscles around the right hip tighter, but weaker, then do more stretching and strengthening on that side. Don't feel you need to do your workout exactly the same on both sides. It is very common to have one iliopsoas muscle tighter than the other and I tell people if you only have time to do one side - do your right side, as many times as you can throughout the day. Then as the two sides feel more even, you can reflect by stretching more evenly as well.

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I have a student who is complaining of her arches and ball of the foot hurting when she rolls up to pointe. She has fairly flat feet and either tight calves or short achilles tendons - she does not have a very deep demi-plie. She also tends to roll onto the outside of her pointes. Any ideas as to what can be causing her pain (plantar fasciitis?)? Courtney


You've hit upon some of the reasons in your question. Having overly tight calf muscles will pull on the plantar fascia, and encourage such standing patterns such as standing slightly forward onto the ball of the foot. That decreases the pull slightly, but over time, certainly doesn't help to get a deeper plié.

You didn't indicate where she felt her pain when she rolls up to point. Plantar fasciitis is most often felt on the underside of the foot. The diagram to the left illustrates this.

If she is feeling pain down towards the toes, perhaps she is rolling to the outside of her feet as a way to get away from the pain. It would be useful to send to her a good sport podiatrist who may be able to evaluate her feet and make sure she doesn't have any problems such as a sesamoiditis.

Have sesamoiditis once myself I know how easy it is to simply rise a little bit more towards the little toe side to get away from the irritation and inflammation of the area underneath the big toe.

There are other reasons she might feel some discomfort only in relévé, but we won't go into those now. My advise would be to have her get checked out and make sure there isn't anything structural going on.

As far as deepening her demi plié, I would encourage her to do a lot of soleus stretching. Spend 1-3 minutes in the following stretch.


Until next time!

Warm regards,

Deborah


"Education is the key to injury prevention"

Dancing Smart Newsletter

Hello all!

I am including information about Lisa Howell's workshops that will be happening this October! She is a wonderful resource to dancers, dance teachers and dance medicine specialist. She is a physiotherapist who resides in Australia and is coming to the US for a visit. She will be at Oberlin College on October 18th and 19th. That's listed as the Cleveland workshop. I have included her email in this post after our question.

Question of the week...
I am 13 yrs. old and i have been having problems with my knee. I have pain under my knee cap and sometimes it get to the point where it hurts to walk. (It also hurts to walk up and down stairs and especially if I go into a deep plié or a grand plié) I am a very very active dancer and I would like to know what is wrong with my knee. I just went to the doctor two days ago and they said I should stay take about 5 days off of dance and take the anti-inflammatory medicine they prescribed for me, but as the days go on it doesn't seem to be getting any better. I really hope you can tell me a way to help heal my knee so I can start dancing again. Thank you so much for all your help.
-MARIAH

Dear Mariah,
I would first say to follow your doctor's advice, and take the time off from dance - and take the medication to reduce any swelling. If you are having pain while walking or climbing stairs, you certainly shouldn't be in dance class until you can do daily movements without pain.

That being said, once your pain is better you've got to figure out why it started hurting. Have you gone through a recent growth spurt? Bones grow faster than muscles, and knees are often a place that feel those 'growing pains'.

Was their a change in activity prior to your knee hurting? Did you start a new technique class, or start with a new teacher, or just come off summer vacation? It can be a real shock to the body when you are off from dance for a while, and then jump in and start taking daily classes.

What's your turnout like? Is the knee that hurts on the side that has less turnout? Often our turnout is unequal and we compensate by rotating the foot out farther on the side that has less turnout at the hip, and then we put a twist at the knee.

It's also possible that a piece of cartilage got irritated for some reason that will remain unknown - and - by taking care of it, you will be back to dancing in no time at all. Best wishes for a speedy recovery. Continue to ice, rest it, and follow your doctor's suggestions. It's possible that he will put you in physical therapy next so you will be guided in correcting any imbalances of muscle strength and flexibility.

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Email from Lisa Howell.......

I am delighted to announce that I will be commencing a short series of workshops designed for young dancers and dance teachers in Cincinnati, Cleveland and New York City this Fall. I am in America to present at the International Association for Dance Medicine and Science (IADMS) Conference in Cleveland, after winning an award for "The Greatest Contribution to Dance Medicine" at the 2007 Conference.

This is an experience not to be missed, as it provides a different approach to many of the ways dance students are trained in class. Workshops are limited to just 20 participants to allow maximum contact with each student, so get in early to secure your place. Courses run from 13th -16th October in Cincinnati, 18th and 19th October in Cleveland, and 29th and 30th of October in New York City.

I am passionate about the education of dancers; not only to prevent injury, but to extend the boundaries of what each dancer believes is possible. I have done this in some way with our site www.theballetblog.com however, the information that I share online is merely the tip of the iceberg.

I have developed several other programs that are changing the way that dance is taught in many centers. My unique way of combining medical knowledge into a usable form in the studio has allowed teachers all over the world to increase the safely of their classes, while young dancers improve their technique and performance quality. I have run these workshops many times throughout Australia and feel that they are a wonderful way to spread my knowledge further.

The workshops give a fresh approach for young dancers to really learn about their own bodies. They incorporate basic anatomy, safe dance techniques, self treatment strategies and special exercises not normally taught in class. Students leave inspired and empowered, eager to get back into class to use all of their new skills! Teachers often comment that the students are much more focused after attending these sessions, and are much easier to work with in class.

In this series of workshops I also introduce my unique "Front Splits Fast Flexibility Program". This system is like no other program currently in dance schools, as it employs concepts and techniques based on mobilizing the nerves and fascia in the body, rather than stretching muscles. Every student and teacher alike who has participated in this workshop has been astounded at the ease of releasing tension in their body with simple to use techniques, and excited at the possibilities this opens up for them in their training. This program is not available for purchase online at present, and is only available at the courses, with each attendee receiving a dvd as well as a full instruction manual.

The Original 'Perfect Pointe Book' has been developed into a two hour workshop, and again each participant receives a manual and dvd of the program. It takes the girls systematically though a series of tests and exercises, organized into four easy stages, and is rapidly changing the way that the worldwide dance community approaches pointe work. The sequel, "Advanced Foot Control For Dancers" is a progression from the initial resource, and begins to teach older students more detailed anatomy of their feet, along with specific strengthening and massage techniques to accelerate their dancing, and allow optimum recovery from injury.

The workshop series also presents, for the first time, "The Perfect Pointe System," a four hour workshop just for dance teachers, allowing them to learn the finer details of assessing exactly when young students are ready for the progression to toe shoes. It is one thing to know how to teach girls to dance. It is completely something else to know exactly how to test for specific weaknesses that may limit a child en pointe and what to do about those weaknesses. I was devastated when I learnt that dance teachers were not taught this in their formal training, as it is imperative to the health and longevity of their feet, and therefore, their career. I simply had to create these resources to get this kind of specialist information out where it is needed most.

For further information on any of the courses please visit the site at www.theballetblog.com or click here to go directly to the page:

http://theballetblog.com/index.php?option=com_content&task=blogcategory&id=67&Itemid=152

Courses run from 13th -16th October in Cincinnati, 18th and 19th October in Cleveland, and 29th and 30th of October in New York City. All enrollments must be processed by 1st October 2008 to allow printing of all course manuals and dvd's.

This is an experience not to be missed! It is a great chance for your daughter or son to get inspired and educated in a really fun way!

Please do not hesitate to contact me if you have any further questions, and I look forward to seeing you and yours at the workshops!

Kindest Regards,

Lisa Howell

Dancing Smart Newsletter: arabesque

Exciting announcement! Lisa Howell, the wonderful physiotherapist from Australia, who wrote the Perfect Point System – is coming to the US for the IADMS conference!

This conference is being held in Cleveland, OH, and Lisa is going to present a weekend workshop at Oberlin College in Oberlin, OH. I am so excited to meet her in person and learn from her!

Listen to these workshop topics….Advanced Foot Control, Front Splits Fast (I'm really looking forward to that one☺) Core Control, The Perfect Pointe System – to name a few.

I don't know when Lisa will be back on our shores so if you are within flying/driving distance you'll want to really think about coming to Oberlin the weekend of October 18th -19th.

You want to go to

http://clicks.aweber.com/y/ct/?l=NFO_l&m=1a.rs5vy1k9S89&b=0w_sbbHGgjIBMiY7IlCo6w

Lisa is going to cap each workshop at 20 participants in order to give personal attention. Please join me the weekend of Oct. 18-19 when Lisa shares her very valuable information.

An extra bonus – if any of the readers of my Dancing Smart Newsletter come – you can pump me full of questions on Saturday night – maybe we can all go out to dinner together at my favorite Oberlin restaurant.

Don't delay in signing up, though, in order to be one of the 20 participants for Lisa Howell's US weekend workshop! (Definitely cheaper than going 'down under')

No onto the question of the week….

I've got a question about arabesque. Many of my students open their hips more than is necessary as they approach 90 degrees, which makes squaring their shoulders a problem, as well as turning out their base leg and aligning their ribs over their hips, leading to a lack of balance. This year, one of my goals with them is to instill a better sense of squareness. However, as soon as they start to really try to square their hips, their working leg turns in, drops, and the back of the knee softens. Grrr! I understand the meaning of turning out within the hip joint as much as possible, and we do work that, of course, but how exactly do you square your hips and still get any height on a back extension? I'm starting to think I need to concentrate more on the base leg turnout, because they'll be less able to open that working hip if the standing leg is rotated more, right? Sigh........Thanks for any reply........
Jennifer

Delicious question, Jennifer! You have discovered one of the 'myths' of ballet – that you can keep your hips square as you do an arabesque. It's why I created the DVD Analyzing Arabesque!

When you are taking a leg into a back tendu, you can keep your hips square for a short period of time. How long you can keep your hips square has to do with the range of motion of the hip flexors and your own personal boney hip structure. A few dancers can stay totally square for the whole back tendu – more often than not – most dancers have already opened the working hip by the time they reach the end of the tendu.

For an arabesque – I have never seen a dancer stay totally square in an arabesque. It is anatomically impossible. That being said the concept of squareness is one that we should strive for. But how?

You have hit the most important nail on the head and it has to do with the standing leg. The better a dancer gets at maintaining the turnout of the standing leg while doing a back tendu or arabesque, the squarer the hips will appear.

As you know the spine will rotate and spiral away from the leg in arabesque (right leg in arabesque, the spine spirals to the left) in order to keep the upper body focused forward. This also helps to keep the dancer on her standing leg.

The most important areas to work on if your students aren't staying square are
1. flexibility of the hip flexors, especially the iliopsoas (this will help to give them a higher arabesque and an easier time staying up on their standing leg)
2. flexibility and strength of the rotators (this will help them rotate both legs more evenly – instead of focusing on one of the legs more than the other)
3. ability of the standing leg to maintain turnout (to keep the hips square)
4. range of motion of the spine to allow that easy spiral and to keep the upper spine upright (which makes the leg look higher)

Bottom line – the hips will open some – and the pelvis will rotate – effectively 'turning in' the standing leg. And – by focusing on countering that tendency by keeping the weight balanced on the standing foot (not dropping back into the heels as is so common) and thinking stabilizing and rotating the standing leg – you've got your best chance for that elegant line of the arabesque.

Your thinking is on the right track!

Warm regards,
Deborah


"Education is the key to injury prevention"

Dancing Smart Newsletter: Toeing - In

Happy Labor Day weekend! Many of you have already started back into the fall semester and others will start on Tuesday. I hope your fall is getting off to a splendid start!


Onto the question of the week….

I had the great fortune of attending your classes at the DTSC again this year. I was returning after having taken your class 5 years ago - after which I ran right out and purchased some pinky balls. Since that time, my father has taken up working out and has had many successes with that. He has had the occasional ache and pain however, to which I have recommended some of your ball-work. Although he listened, it wasn't until the PT suggested something similar that he gave my suggestions some validity! I'm trying to get him to borrow my ballwork video that I purchased. :)

My question today is in regards to my daughter's feet. At an early age, watching her on the sidelines and even in her own early dance classes - I took notice of something funky going on with her feet. Now, age 6, I have concern still. As she has taken some ballet technique and gymnastics classes - it has become more apparent that her feet appear to turn in while in action. She can stand in first, draw her leg up to passé and keep the knee back, heel forward as long as I remind her. When her movement is stationary or sustained she understands and tries to make corrections... yet when she is dancing her feet turn in..quite a bit. A simple leap - toes turn in, a small arabesque - turned in, on the uneven bars her teacher called me over before coming to the conference because when she circles the barre - her foot turns in. I'm beginning to notice it might be in her right foot more then the left. The pediatrician looked at her feet at the 5 yr. and 6 yr. visit and has determined she is turned in slightly - but it is mild. Although she may never be a professional dancer - it is difficult for me as a dance teacher to see her little feet so turned in when she dances. Should I be concerned or not? Is there anything I can have her do at home to help? What type of orthopedist should I be looking for to look at her feet? If her feet are mildly turned in - is there any concern I should have other then dance related?

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Lovely question! Turning in of the feet or pigeon-toed can come from three different areas – at the feet, the shin bone, or the hips. Let's take a look at each one individually.



When the feet turn in at the feet it is called metatarsus adductus . This is where the bones of the feet turn in. Typically, this is caught before the child even begins walking and the doctor would have suggested massaging and stretching the feet as she grew. Since it was not caught when she was really young, I would rule out this cause for your daughter's turning in of her feet.


We have talked about tibial torsion in other newsletters, more often we talk about external tibial torsion – but there is internal tibial torsion. In dancers I see more external tibial torsion which describes an outward rotation of the shin bone. I often find this in dancers who aren't using their turnout from the hips, but rather are turning out from the knee down. Over time, that stress from standing in too much turnout creates a rotation at the bone that one might think is a good thing – but actually, it means that your knees and the feet won't be lined up and leaves the dancer vulnerable to knee and ankle injuries.

Internal tibial torsion, which your daughter might have is where the shinbone rotates in making for a pigeon-toed walk. This isn't unusual in toddlers and preschoolers, and often corrects itself as they become more active in running and walking – the 5-6 year old stage. Sometimes toeing in lasts into the school years, but usually isn't a problem. In fact there are some sports that favor internal rotation, such as martial arts, soccer, and sometimes basketball.

If the toeing in was happening just from the shin you could sit your daughter on the edge of a table with her knees facing forward and you would see a clear inward rotation of the shin bone – as in the picture to the right.

When the turning in is coming from the hip it is called anteversion. The normal range of turnout and turn in at the hip is 45 degrees for both. When you have more turnout it is called retroversion, when you have more turn in it is called anteversion. This is a structural situation where it describes the angle of the neck of the femur to the shaft or long body of the femur or thigh bone. If you test your daughter's range of motion at the hip by lying her on her stomach that might give you an idea if she has some natural anteversion.

A child with anteversion easily W sits – as shown in this picture. It will be interesting to find out what the relationship is between the two hips – are they even as far as their range, or is one more turned out or more turned in. This is very common, and while it isn't a significant issue, you would want a young dancer to create her first position based on the lesser turned out leg, rather than the more turned out leg.

Watching the recent Olympics and especially the gymnastics competition, I was struck by how many of the gymnasts had a slight tendency to turn in their feet on the balance beam as well as on the floor routines. No one would ever say that their line wasn't beautiful and elongated – even if it wasn't as turned out as what the dance world would like.

All in all, I think I would take a look at these 3 areas on your daughter, see if you can get a better idea where her toeing in is coming from – and then encourage her to be as well-rounded and active in all ways as possible. At 5-6 years of age, I'm prone to suggest going light on the amount of turnout emphasis and focus on the alignment of the hip, knee and foot – which is what you are already doing. Since she can do that when she thinks about it – my intuition says she will improve her ability to automatically line her legs up as she gets older and better able to maintain that specific focus during class. Now you have a way to periodically assess her range of motion and know better where to focus her attention.

Below are pictures of what normal turnout would look like, a retroverted hip (excessive turnout) and an anteverted hip (more turn in than turnout)

Normal amt. of turnout - 45 degrees



Retroversion - more than normal turnout (leg is resting on other thigh)


Anteversion: more than normal amt. of turn in




Until next time,

Be well,

Deborah

"Education is the key to injury prevention"

Hello!
Anyone besides me feeling the fast descent into fall? I remind myself to enjoy every moment of the sun and warmth during this busy time. I have a request. When I was recently in New York at the Dance Teacher Summer Conference (great workshops:) there were a few teachers who said they found good online sources for pinkie balls. If you have a source, or a website where you have found the pinkie balls - will you email me? I will post them in an upcoming newsletter. Sometimes they are hard to find - and since I'm one of the lucky ones whose local store carries them - I need your help to find out where you are purchasing them!

Onto the question of the week......

My name is Yekta, 22, and I'm a sociology student at the university of Toronto in Canada. I'm really interested in dance and I did Persian dance and ballet when I was in Elementary school. I restarted my ballet at the university from May. I have very good dance instructor because she really understood my hyper mobility particularly my hyper extended knees and she really does not push me to do lots of work. She gave me some kinds of exercises to strengthen my muscles, because, I have lots of problems in maintaining my balance in passe, arabesque and this kind of things although I'm very good at pointing my feet. I want to get your hints for making my feet muscles strong in order to maintain my balance well and less painfully. What shall I do right now? Regards, Yekta

You bring up a good point that sometimes dancers with extreme flexibility have to work harder in order to stabilize their movement. My suggestion to you would be to begin doing a lot of balance exercises. You will see definite improvement in both your balance and alignment.

The first exercise is a simple one – whenever standing in one place for a minute or so, lift up one foot and balance. Standing at the bathroom sink brushing your teeth, and waiting in line at the bank are examples of when you can get a quick practice session in. Make sure that when you are standing on one leg you are NOT hyperextending. I realize that it will feel as if you are standing with a slightly bent leg, but you want to make sure your hip, knee and ankle are in alignment. Standing and balancing will also strengthen some of the weaker muscles around the knee and ankle.

Then take your shoes off and try standing on your bed or a sofa cushion placed on the floor and toss a small ball between your hands for up to 3 minutes. If you don't have a ball available do port de bras, including head movement. Standing on one leg and turning your head right and left will be hugely challenging for many people.

If you want to focus on improving strength as well as balance, practice doing small demi plies on one leg! These are baby demi plies – smaller than your normal demi plié. You should not feel any strain at your knees while doing them. If you do feel strain it means you are not in alignment. Always monitor your feet to make sure the weight is even between the pads of the big toe, little toe and heel.

Good luck!

Deborah

"Education is the key to injury prevention"

Pronated versus flat feet

Greetings!
It was so wonderful to meet some of you last weekend in New York at the Javitts Center! Yea to Dance Teacher magazine for putting on a wonderful conference! This sunday I'll be in Brockport, NY for the Dance Rochester workshop.

Onto the question of the week...

My daughter has danced for 10 years and had hoped to start pointe this year. Her teacher says she cannot start point due to the fact that she tends to roll her ankles inward, it seems as though she is flat footed. I took her to an orthopedic specialist who said it was a common problem and not severe enough to do anything about it. He said everyone is built differently and people should not be so critical! Is this a problem that should cause her to delay pointe classes or should we look for a new dance instructor?

Believe it or not – I'm going to side with the dance teacher. She caught your daughter pronating her feet, which is rolling in on the arches. That is a different situation from having flat feet. When you have flat feet it means there is no visual instep. Someone with flat feet can be a very strong dancer, they simply won't look like they have as high of an arch as most people. This is a structural issue, not a functional. Asians and African Americans, for example, have more of a genetic tendency towards structural flat feet.


This image is of pronated feet - these are not flat - rather they are rolling in. If you look at flat feet from the back the heel and heel bone would be straight, not curved towards the floor.







From the side you can see that a flat foot has little or no space between the arch and the floor.







Pronated feet, on the other hand, means the weight is not being evenly divided on the foot and there is more weight on the inner border of the feet. If left unattended, that is a problem and concern for a dancer. You want to see the weight evenly divided between the pads of the big toe, little toe and heel.

Your doctor isn't the first one who thinks that pronation is something the average youngster will grow out of. What they don't understand is the challenge of turnout and standing in first position to pronation. The child who is primarily in sneakers (with an arch support) and running around or involved in sports is using their legs primarily in a parallel stance. I can't tell you how many young dancers I have seen who begin pronating because they are over turning out their feet. Ballet is a wonderful activity - and I love dance – and – pronation is a problem that needs to be addressed as early as possible.

What I would suggest for your daughter, if she really wants to go on pointe this year – she is going to have to prove to the teacher she can stand in first position (or any other position for that matter) without rolling in her arches. It will take first and foremost awareness on her part of when she is rolling in.

If she is in the habit of wearing flip flops – she needs to temporarily stop. They are not good for growing feet with the exception of walking from the car to the beach. Speaking of beaches – walking on the sand barefoot is a wonderful strengthening for the feet and the calves!

She can practice balancing on one foot while tossing a ball back and forth between her hands – again – not allowing herself to roll in, and maintaining good alignment as she is doing so.

She can focus on strengthening the foot and calf muscles. You can find useful exercises in my Tune Up Your Turnout book – as well as in many other useful dance books. Lisa Howell has written a fantastic ebook called the Perfect Pointe Manual. You can check it out at www.theperfectpointebook.com/PerfectPointeBook/?hop=home2php&gclid=CJDJtNvyjZUCFRKLxwody1etfw

Your doctor isn't stupid for not knowing how to guide you in this situation – I think he/she just doesn't have the insight into the specific challenges for dancers. I remember taking my son to the doctors after he twisted his ankle pretty badly when he was 8. My doctor said I didn't need to give him an anti-inflammatory or ice or do rehab – that he was active and would work his way out of it. I needed the doctor to rule out anything more significant – which is what you needed to do with your daughter. But after I got that information I went to work with icing and then doing some rehab with my son. Some fun things like each of us standing on one foot and tossing a ball back and forth to each other and slowly increasing the distance. It helped his joints relearn where center is because as soon as you have an injury or a dysfunctional pattern, the body compensates.

With continued guidance and some extra work on your daughter's part – I'm sure she'll be ready for pointe work in no time!

Warm regards,

Deborah

"Education is the key to injury prevention"

August 8, 2008

This week's newsletter has a different focus. Instead of answering a question, I'd like to share an excerpt from Train Your Brain: A Teen's Guide to Well Being, my newest book. This book isn't just for dancers – I took some of the brain concepts I have learned and use in my own life and made them teen friendly.

The following is from the back cover of the book.

Being a teen is not for the weak – and you can be stronger.
You can be smarter.
And you can be happier.
All you need to do is pump a little iron…with your brain!

Train Your Brain: a Teen’s Guide to Well Being is like a set of barbells for your mind. In these pages, you’ll learn life-changing workout routines that will help you:

• Perform like a pro – on the court, in the classroom, anywhere and everywhere
• Be a better friend and meet new friends
• Take charge of your feelings
• Dream up goals and make them happen

Follow eight kids with problems just like yours as they discover how to pump up their lives…by changing their minds. Using techniques like:

• Mental Rehearsing
• Creating a Feeling
• Refocusing
• and the very powerful Acting as If

combined with lots of fun activities and little-known secrets about your mind, you can begin to create new paths in your brain – and in your life!

*************

This 48-page book is packed with wonderful ideas and strategies for teens as well as younger children to feel more confident and empowered in their life. I'd like to share Chelsea's section. She is 10 years old and loves ballet. She is the only ballet dancer out of the 8 characters – there are boys who play basketball and topics such as school, family and friends that are touched upon. Enjoy!

*************

Name: Chelsea
Age: 13
Likes: ballet, baking, talking on the phone, and eating cookies
Dislikes: big dogs and the dark

If you saw Chelsea playing with her brothers or talking in class, you’d think she was always happy and carefree. But, if you saw Chelsea walk into her ballet class, you’d see a whole new girl. For some reason, Chelsea got nervous when dance class rolled around. She didn’t know why and didn’t want to quit because she loved dancing…and had been doing it since she was three. But for the last few months she’d become so nervous-everyone was improving it seemed, except for her. Chelsea’s body started feeling stiff and her feet felt like lead. She was clumsy and her dancing wasn’t smooth at all. Even stretching was hard for her…she felt as if her muscles were too short for her body. Chelsea wasn’t sure what to do but she knew that she didn’t want to keep going to class if it was going to be like this. Was it time to quit doing something she loved?

Ahhhh, another perfect example of a situation that needs help from the brain. Chelsea needs something that can help her to calm down and focus her attention back on the fun of dancing. This brings us to Brain Fact #2: Create a Feeling.

This may sound confusing but it’s really easy. Before I tell you how to do, let me share a little brain secret. Your brain if full of little paths, like roads, that are formed whenever you do something or think something. So, let’s say you eat 10 hot dogs and then you throw up. Well, you created a path. So then, the next time you eat a hot dog, your brain will return to the path that goes with hot dogs. Along that path is also throwing up. So, now, when you think hot dogs you also think throwing up. And when you think throwing up, you think hot dogs. And each time you think those thoughts, the path becomes stronger…kind of like putting new cement on the road so it’s stronger.

The cool thing about these paths is that we can purposely create paths that help us. That is what Create a Feeling is all about. We’re going to connect a simple action (like making a fist or curling your toes) with positive, confident thoughts. That way, you’ve created a path. And you know that positive, confident thoughts create positive, confident feelings. So, when you need those positive, confident feelings, you’ll be able to do a simple action that is connected to those good thoughts and BAM, positive, confident feelings come along.

Let’s Rewind and Replay Chelsea’s dance problem and see if Create a Feeling can help her out…

If you saw Chelsea playing with her brothers or talking in class, you’d think she was always happy and carefree. But, if you saw Chelsea walk into her ballet class, you’d see a whole new girl. For some reason, Chelsea got nervous when dance class rolled around. She didn’t know why and didn’t want to quit because she loved dancing…and had been doing it since she was three. But for the last few months she’d become so nervous in class that she could barely move. Chelsea wasn’t sure what to do but she knew that she didn’t want to keep going to class if it was going to be like this. She needed to find a way to start enjoying dance class again. She decided to get her brain to help her find a way to get her confidence and joy back. She decided to create a path. First, she came up with a small action. She decided she would take a deep breath in and slowly let it out. At the same time she thought of her past dance recitals. She remembered how comfortable her body felt dancing, how loud the clapping was when she bowed, how her legs moved to the music. She practiced taking a deep breath in and slowly exhaling while thinking these positive thoughts a few times everyday. By the time dance class rolled around, Chelsea was ready. When she felt her body start to freeze up at the dance studio doors, Chelsea took a deep breath. Automatically, her body relaxed and the confident, positive feelings of past recitals flooded her body. Chelsea smiled; she’d created a path that would help her look forward to dancing again!

I hope you enjoyed this excerpt from Train Your Brain: A Teen's Guide to Well Being!

I'm off to the Dance Teachers Summer Conference tomorrow. I'm going to bring some extra copies of Train Your Brain: A Teen's Guide to Well Being. I don't have a booth this year, so if you would like to look through this book please come to one of my workshops! Hope to see you there!

Until next week,

Deborah

"Education is the key to injury prevention"

Dancing Smart Newsletter: Bowed legs

Quick announcement: I'll be in NYC for the Dance Teachers Summer Conference sponsored by Dance Teacher Magazine and MacFadden Performing Arts Media. I hope to see many of my loyal readers! The subject of my two classes will be, Conditioning the Body for Jumps and 10 Tips Towards Keeping Teachers in Top Shape.


Hope to see you August 9-11!

I have read lot about bow legged issues in ballet, seeing as how I have them myself. Only it seems I was not only born with bowlegs, but my feet naturally turn out at the ankle. (My mother has told me stories of being told to massage my feet and ankles so that they will eventually correct themselves) It leads to awkward moments when I am fussed at for not placing my weight into the correct spot. (I tend to lean out towards my pinky toe both in basic walking and in ballet)

I have tried the ankle circles with the theraband, the relevés on both one foot, and both feet. I am missing something?

Thank you,
Krystal

Bowlegs are a structural challenge versus a muscular one. It is not at all uncommon to have a dancer with bowlegs who also turns out at the ankle. That is a logical compensation the body creates to put the feet flat on the ground. As you noted, otherwise bowlegged dancers have a tendency to supinate, or lean out towards your pinky toe in walking.

(note that the right leg in the photo looks as if it is either slightly longer or more hyperextended than the left. Also note that the knees are not facing the same direction as the feet. The feet are in parallel, and the knees are turned in)

Having bowed legs does not mean you can't be a dancer – but there are a few things I want to draw your attention to. The first is making sure you are not hyperextending your knees while standing. You didn't say whether what your joint flexibility is –but as we have discussed in previous newsletters, when you allow the knees to move into hyperextension, the thigh bone rotates inward, and the knees move apart – effectively creating bowlegs. In fact I have worked with dancers who thought they had bowlegs – but when their legs were in neutral position and straight had the hip, knee and ankle in alignment. It was only when they pushed into their hyperextension they looked like they were bowlegged. I don't think this is the case with you as your mother and docs were aware of your leg alignment from an early age.

The second is to focus your turnout as efficiently as you can at the hip rather than relying on the turnout created by the feet. This will help prevent foot, ankle and knee strain. You have more turnout at your feet, probably because of tibial torsion. This again is a structural issue where the shin bone rotates over time, while growing, in response to the foot's desire to be flat on the ground.
Dancers who have external tibial torsion as you do, can 't line up their knees and feet well. If you try and pull your knees out to line up with your feet it shifts you to the outside of your foot – and creates strain at the outside of the thigh.

As always, I would encourage you to stay focused on where your weight is on your feet. Keep it as even as possible between the three points of the foot. Pad of the big toe, pad of the little toe and heel. Your feet are your connection to the ground and you need it to be stable. How do dancers sprain their ankle? By rolling on the outside of the foot.

It's not so much that you are missing something with working with bowlegs – it is more that efficient alignment is even more important. You need to keep the weight of the body from dropping into your legs. This is done by making sure your pelvis efficiently lined up, with deep abdominal support and imagining your legs and spine lengthening away from the floor.

No matter what your age is, even if you are at the end of your growth, you can become a beautiful dancer by developing good muscle balance and range of motion along with efficient alignment. Just remember that the way you stand and move outside of class has an enormous amount to do with what happens inside of class and keep up the good posture even when those around you are all slouched and slumped over.

Until next time,

Deborah

"Education is the key to injury prevention"

Dancing Smart Newsletter: 7/23/08

It was brought to my attention that some of you were receiving blank emails when I was sending out the notice of another newsletter being posted. I have hopefully resolved this issue! I appreciate those who took the time to let me know all was not right!

Here's the Q&A for today.

Deborah, I have been thrilled to find your web site, thank you, thank you! My question- I have an advanced male student who was a former gymnast. His hyper-flexible back and anterior pelvic tilt leave him loose and improperly aligned in his movement. His entire mid section, ribs, abdominals and spine are too flexible and unstable for classical ballet. Since he has been performing more and training less, I have noticed it getting worse and want to give him a workout to do outside of the classroom. I would love your input on specific exercises to teach his core muscles control and stability. I know that crunches and sit-ups are not the answer.

Great question! It is so true that simply doing crunches and sit-ups in the normal way won't give you the functional control that dancers need. I've got a few suggestions for your loosey-goosey gymnast.

There are a few tweaks we can give to the traditional exercises, which will pack a lot more punch for the time spent. I'm going to suggest that your dancer purchase a big physioball to work with, although I will also give you ways to do these without a physioball.

Physioball sit-ups
Begin by sitting on the physioball and slowly walk your feet away from the ball until your lower and middle back is resting on the ball. (you are arching back over the ball as in a bridge position) Clasp your hands behind your head, keeping your elbows out to the side as you slowly do a sit-up, keeping your lower back on the ball and your feet secure on the floor or even with your feet on the floor and toes touching a wall so they don't slide. Exhale while doing the half sit-up.

You are going from an arched position to a contracted one. This is more challenging than going from a neutral position of lying flat on the floor to the half sit-up position. A variation without the physioball would be to rest on the bed with your knees bent and just the shoulder blades, shoulders and head hanging off the bed. Then slowly exhale as you do your half sit-up. You could do that with your legs straight, but only if you don't have tight hip flexors.

Leg Lowering
You'll begin lying on your back with your knees bent and feet resting on the floor with your spine lengthened and at rest. Deepening in the front of the hip joint, softly flex at the hips and lift each foot off the ground without tucking your pelvis under or pushing your low back against the floor. This will be your starting position.

You are doing a variation of leg lowering that will teach you to use the abdominals to stabilize your movement. Keeping the knee bent, slowly take one leg away from your chest, keeping the lower leg parallel to the floor. You are going to monitor your low back and stop when your low back starts to arch away from the floor. Bring that leg back in towards your chest as you switch legs and begin to extend the other leg away from your body. When you first begin to do this exercise your legs won't travel very far away from your body. As you develop the core strength of the deeper abdominal muscles you will be able to extend your legs all the way to straight.

I want to emphasize that you must set up the abdominals before you ever move a muscle Think of the bellybutton being drawn to the back of the spine, or the abdominal area having one of those girdle supports that employees wear to lift heavy objects. The focus is on maintaining your support and control - not simply engaging at the point when you start to feel your pelvis tipping.

Alternate your legs as slowly as you need to be able to maintain that support. If you want to work harder, don't bring your knee back as far towards your chest. This will load your abdominal muscles keeping them at a higher engagement level. Remember, when you use those deep abdominals it means that you will have a sense of engagement even when you are inhaling, but you will need to keep breathing! Too many dancers forget to breath when they are using their abdominals - definitely a bad habit!


Pelvis tipping forward
Even though dancers can have a lot of flexibility in their legs and back, they can also have tight hip flexors that pull the pelvis down in front giving the back that arched look. So let’s talk about how a tight iliopsoas muscle can influence your abdominal usage. We know that the iliopsoas muscle is a major postural muscle. It attaches from the middle area of the spine (T-12) and at the lesser trochanter of the femur (at the inside top of the femur, close to the groin.) The deeper muscles are in the body, the more they influence the alignment of the bones. The iliopsoas muscle, when it is overly tight, will pull the low back into a swayback. You could do 50 sit ups a day to strengthen your abdominal muscles, and stand up and still look like you had weak abdominals. So, the first step is to make sure that your iliopsoas muscle is stretched and has enough flexibility that when you are standing there is not a pull on the low back. Then the abdominal muscles have a chance to do their job of keeping the pelvic bowl upright which allows the weight of the upper body to transfer correctly down the spine onto the back of the pelvis and through to the legs in standing or the ischial tuberosities or sitting bones when sitting. One of the simplest way to stretch the iliopsoas muscle is by doing the runners lunge stretch.

I'll end with a quote from Ted Shawn. "Dance is the only art in which we ourselves are the stuff of which it is made."

Until next time,
Warm regards,

Deborah

"Education is the key to injury prevention"

Dancing Smart Newsletter: 7/9/08

Quick announcement: I'll be in NYC for the Dance Teachers Summer Conference sponsored by Dance Teacher Magazine and MacFadden Performing Arts Media. I hope to see many of my loyal readers! The subject of my two classes will be, Conditioning the Body for Jumps and 10 Tips Towards Keeping Teachers in Top Shape. Hope to see you August 9-11!

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Recently I've been doing a lot of tendus and the like daily to increase the strength and stop my toes "crunching" while pointing. Over the past few days the tendon/muscle going from the top of my toe over the arch has become incredibly sore and "crunches' when I flex and pointe. After some very brief research on the net, I found that this could be tendonitis. More research also points to a small bone fracture or something to do with the tissue. I was just wondering what you think this is and how to treat it?
Regards,
Jane

My recommendation would be to use the pinkie ball to see if releasing tension from the anterior tibialis muscle will release the discomfort on the top of your arch. That muscle contracts when you flex your foot and needs to stretch and lengthen when you are pointing.

You'll want to gently kneel on the pinkie ball to massage the front, outside portion of your calf where the anterior Tibialis muscle is. After doing the front of the calf, take some time to massage the bottom of your foot by standing and rolling your foot over the ball. If you are practicing your tendus and lengthening the toes you are strengthening the intrinsic muscles of the foot – always a good idea! That, along with lengthening the front of the ankle is what creates a beautiful tendu.

If releasing the pull from the muscles around the ankle helps – super! If the top of your foot continues to feel sore, and you are hearing crunching or cracking noises – I would encourage you to go to the doctors and get some x-rays in order to rule out a stress fracture or other boney problem.

The doctor should also look carefully at your standing alignment to make sure your foot is not pronating, which so strongly affects the muscle balance around the foot.

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I am suffering from Plantar fasciitis...I am doing everything (ice, taking time off, walk with heels, massage, exercises for the feet and legs, hamstring and calf lengthening and ease) and there is no change. What do you recommend?

I was diagnosed by a foot doctor.
Lori

Lori, you are following the traditional protocols for plantar fasciitis, and since it is not getting better I would look at other potential factors. Is one foot or both bothering you? Did it start all of a sudden, or come on more gradually? Were there any precipitating events?

It appears that you are going to need to put on your detective's cap to figure this one out. I would check for any imbalances between the two legs. Could there be a leg length driving this problem? Does one foot have a tendency to pronate more than the other? Do you have a difference in your turnout between the two legs? Are you able to walk more comfortably when your arch is taped up for pronation? Often, that will help ease the pull and strain to the plantar fascia, which will help it heal.

As far as immediately trying to release the strain – I would encourage you to find a practitioner who has been certified by Tom Meyers, who wrote Anatomy Trains, the best book on understanding the myofascial relationships in the body, in my humble opinion. Here is the link to his practitioner list. http://www.anatomytrains.com/kmi/practitioners

There are massage therapists who have studied other myofascial techniques that could also be useful. My focus would be on releasing the entire line of fascia that runs from the bottom of your foot all the way up the back of your leg, spine, neck, and finally ending on your head. It could be that other areas are feeding this posterior line of fascia and once they are released the weight and pull on the plantar fascia will be released.

Plantar fasciitis can be a very tenacious problem – I wish you the very best for a speedy recovery!

Warm regards,
Deborah

"Education is the key to injury prevention"