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Shall we dance? The health benefits of dancing at any age

Shall we dance? The health benefits of dancing at any age

Patients often ask me, “what is the best form of exercise?”. The answer I usually give is “The kind you enjoy”. My reasoning is, if you enjoy doing something then it is far more likely you will find the time to do it – an opinion supported by research1. So, if the gym isn’t your cup of tea, you don’t fancy a jog around the neighbourhood or it’s too cold for a swim – have you thought about dance as a form of exercise? Enjoyment is merely one reason to dance – once you hear about all the health benefits of dance, you’ll be shimmying back for more!

Dancing is great for fitness

Dance as exercise really is the allrounder when it comes to physical health benefits2. Studies show dance classes are as good for you, if not better, than other forms of structured exercise3. With so many types of dance available, you’re almost certain to find one you’ll enjoy. You can begin dancing at almost any age, so whether you’re 5 or 95, interested in ballet or belly-dancing, tap or tango, read on and see how dancing can help improve your health and wellness!

Cardiovascular improvement

Most of us know that physical activity and getting our heart pumping can help improve the function of our heart and lungs. The Australian government guidelines for exercise recommends adults participate in 2 ½ to 5 hours of moderate intensity physical activity (you can talk but not sing during the activity) or 1 ¼ to 2 ½ hour of vigorous activity (can’t say more than a few words without stopping for breath) each week4. A US intergenerational program showed both children and adults can reach their target heart rates through dance5. By incorporating ballet classes or line dancing lessons a couple of times a week and enjoying the petite allegro or Boot Scootin’ Boogie, you can gain the wonderful heart-pumping benefits that dancing can provide6.

Muscle strength and endurance

Ever admired the toned legs of a ballet dancer or the stamina of couples competing on dance tv shows? You too can enjoy strengthening your lower limbs and improve your endurance by attending regular dance classes.  Studies show that regardless of the type of dance, if you attend 3 hour-long classes a week, you’ll likely develop stronger legs and improved endurance in just 12 weeks7.

Balance and posture

Most everyday activity, such as walking, has us travelling in fairly straight lines without too much change in the level of our heads. Even when you’re at the gym – be it on a treadmill, stair climber or stationary bike – your movement is fairly limited. Dance on the other hand has us moving in all directions – forward, backward, sideways – often covering a lot of area. In addition to moving more in all directions, dancing often includes turns, jumps and sometimes even floor work.  When you’re performing that tango turn or jazz pirouette, you’ll be challenging your balance and dynamic postural control. This makes most forms of dancing ideal for improving our balance, and helping reduce the risk of falls, particularly as we age7,8,9.

Mobility and flexibility

We know that staying active and moving the joints is beneficial to joint health but there is some perception that dancing, particularly ballet, can lead to wear and tear on the hips.  This has not proven to be the case with an Australian study showing no difference in hip joint changes between professional ballet dancers and other athletes10. In fact, movement of the limbs during dance can help maintain flexibility, strengthen joint supporting muscles and keep the joints healthy9. Dance lessons have also been shown to help people with mobility issues, such as those with Parkinson’s disease. Recent research revealed regular dance classes improved the functional ability of people with Parkinson’s making it easier for them to move and get around11.

Dancing engages the brain and has “feel good” benefits

Not only do we see physical benefits in those who regularly participate in dance lessons, but dance can also give your brain a boost and improve your emotional wellbeing.

Memory and attention

If you’ve already attended a dance class, you’ll know how challenging remembering the combination of steps and movements can be. Perhaps you’ve also marvelled at more experienced classmates and their ability to pick up steps quickly or remember the choreography. Learning a dance sequence is like doing mental push-ups or a physical crossword for the brain, and the more you dance the better you’ll become. Challenging the brain to remember the steps and putting them all together in movement improves our “brain plasticity” and helps build our grey and white matter. In fact,  dancing improves our brains function much better than conventional exercise and can help stave off age-related mental impairments like poor memory and attention12.

Mental health and social connection

While those of us getting older will be especially keen on the mobility and memory benefits that dancing provides, there are also emotional benefits for people of all ages. Dancing can be a great way for adolescents (or people of any age) to deal with emotional distress.

A recent study found that teenage girls showed less nervousness, anxiety and and even reported less headaches and stomach aches while attending regular dance classes13.  Other studies have show similar benefits; A 12 week dance course lowered depression in a group of university students14 and a group of 60 – 82 year old’s reported improved social activities and networks through dance classes15. Regardless of dance style, people of all ages and cultural groups report a greater sense of happiness, social connectedness and life satisfaction through dance participation15.

Dance is great, whatever your age

Now that you know dancing can significantly improve balance, strength, endurance, mobility, memory and wellbeing, why not take a look to see what dance classes are available near you? Many dance schools offer classes for all ages including beginner classes for adults or those returning after a long hiatus. So grab a friend, sign up for a class and get moving!

(And if you’re isolating – there’s never been a better time to dance like nobody’s watching!)

 

As with undertaking any new form of exercise, if you have any medical concerns, please check with your doctor. Or should you feel worried about a particular physical issue – unsure if you can boogie with a “bad knee” or practice ballet with a bunion – come see us here at PhysioTec. We’ll do a thorough assessment and provide you with some individualised exercises and advice in preparation to really enjoy and gain the most from your dance classes.

Joanne Manning is a qualified physiotherapist with a special interest in dance rehabilitation and injury prevention. Call 3342 4284 to book an appointment with Joanne.

 

References

1. Dishman, R. e. (2005). Enjoyment Mediates Effects of a School-Based Physical-Activity Intervention. Medicine & Science in Sports & Exercise, Volume 37 – Issue 3 – p 478-487 doi: 10.1249/01.MSS.0000155391.62733.A7.

2. Hwang PW, B. K. (2015). The Effectiveness of Dance Interventions to Improve Older Adults’ Health: A Systematic Literature Review. Alternative Therapies in Health and Medicine, 21(5):64-70.

3. Fong Yan, A. C. (2018). The Effectiveness of Dance Interventions on Physical Health Outcomes Compared to Other Forms of Physical Activity: A Systematic Review and Meta-Analysis. Sports Medicine, 48, 933–951.

4. Government, A. (2021, March 30). Factsheet: Adults 18-64. Retrieved from The Department of Health: https://www1.health.gov.au/internet/main/publishing.nsf/Content/fs-18-64 years

5. Schroeder K, R. S. (2017). Dance for Health: An Intergenerational Program to Increase Access to Physical Activity.  Journal of Pediatric Nursing, 37:29-34.

6. Gronek P, W. D. (2020 ). A Review of Exercise as Medicine in Cardiovascular Disease: Pathology and Mechanism. Ageing and Disease , Mar 9;11(2):327-340.

7. Rodrigues-Krause J, K. M.-O. (2019 ). Dancing for Healthy Aging: Functional and Metabolic Perspectives. Alternative Therapies in Health and Medicine, Jan;25(1):44-63.

8. Wallmann HW, G. C. (2008). The effect of a senior jazz dance class on static balance in healthy women over 50 years of age: a pilot study. Biological Research for Nursing, 10(3):257–266.

9. Joung HJ, L. Y. (2019). Effect of Creative Dance on Fitness, Functional Balance, and Mobility Control in the Elderly. Gerontology, 65(5):537-546.

10. Mayes S, F. A. (2016 ). Professional ballet dancers have a similar prevalence of articular cartilage defects compared to age- and sex-matched non-dancing athletes. Clinical Rheumatology, 35(12):3037-3043.

11. Carapellotti AM, S. R. ( 2020). The efficacy of dance for improving motor impairments, non-motor symptoms, and quality of life in Parkinson’s disease: A systematic review and meta-analysis. PLoS One, 15(8):e0236820.

12. Rehfeld K, L. A. (2018 ). Dance training is superior to repetitive physical exercise in inducing brain plasticity in the elderly. PLoS One, Jul 11;13(7).

13. Mansfield L, K. T. (2018). Sport and dance interventions for healthy young people (15–24 years) to promote subjective well-being: a systematic review. BMJ Open, 8:e020959.

14. Akandere M, D. B. (2011). The effect of dance over depression. Coll Antropol , 35:651–6.

15. Sheppard A, B. M. ( 2020). Promoting wellbeing and health through active participation in music and dance: a systematic review. International Journal of Qualitative Studies in Health and Well-being, 15(1):1732526.

How can we prevent dance injuries ?

How can we prevent dance injuries ?

One of the most common questions I get asked as a physiotherapist with a special interest in dance rehabilitation and injury prevention is, “How can we prevent dance injuries?”.

GOOD QUESTION!

It’s a very valid question considering:

  • the rate of injury in young and adolescent dancers is higher than that reported in young soccer players or gymnasts
  • the injury rate of dancers aged between 9 -18 years is even higher than that of professional ballet and contemporary dancers!4,7

Why do dance injuries occur?

First, let’s take a look at why dance injuries happen.

The reason for young dancers reporting more injuries than their counterparts in other sports is partly due to growth spurts in this age group, coupled with the high physical demands of dance. There are also numerous other factors that have been identified as risks for injury. Some are intrinsic – related to the individual such as growth, hormones or previous injuries1 – and others are extrinsic or external, such as environmental factors like dance floors, equipment or training load.2 Research on both intrinsic and extrinsic risk factors, and their relationship to dance injuries is a growing area of research and hence, more information will continue to emerge.

There does seem to be a growing consensus that the majority of dance injuries in ballet dancers is due to overuse3,6,9. Dancers are familiar with the repetitive nature of dance training – having to repeat a move over and over again in order to learn and perfect a new skill or piece of choreography. This can prove somewhat tricky to manage among aspiring young dancers. In addition to this, the rigors of dance can increase at particular times of the year4, and we certainly see more injured dancers here in clinic around exam and performance periods.

What are the most common injuries for dancers?

In young dancers of ballet, tap, jazz, hip hop, contemporary, ballroom and Irish dancing, it may be no surprise that the lower limb (leg) is most commonly injured. This includes the knee, ankle and foot – with rate of occurrence in that order – followed by the hip and spine. Ligaments tend to be the most commonly injured soft tissue, with muscles and tendons making up about 30% of injuries, while bone injuries make up around 20% of all injuries.5

Acute versus chronic dance injuries

Traumatic injuries are usually referred to as acute injuries, while injuries relating to overuse are often longer lasting or slowly developing injuries, referred to as chronic injuries. Research has shown that the majority of injuries sustained by young ballet dancers are of the ‘overuse’ type, with more than three quarters of all injuries falling into this category.6 With overuse-type injuries, the dancer is usually unable to pinpoint exactly what caused the injury and often reports pain increasing over time. Tendinopathy and bone stress reaction/stress fractures are examples of this type of injury, typically caused by repetitive stress and/or overloading.  Other causes of chronic injuries can be structural or genetic in nature, such as hyperextended knees usually seen in the hypermobile population.

Acute injuries are usually a result of an “accident”. Examples of an acute injury are a slip on the floor or landing poorly from a jump, resulting in a muscle strain or ankle sprain.

So, what can we do to help prevent dance injuries?

Accidents do happen, however the majority of dance injuries can be prevented, and there are ways of reducing a dancer’s risk of injury.15 Some of the ways we can help reduce the risk of dance injuries are:

Dance Screenings or Dance Profiles

Dance screenings have long been performed by qualified physiotherapists to identify areas of weakness or concern, with the aim being to prevent dance injuries. Pre-pointe assessments or pre-pointe profiling (a term we prefer) is a good example. Although there is not a great consensus as to what elements and tests can accurately predict who is more likely to be injured, it is highly beneficial in identifying possible risk factors and facilitating improvements in strength and technique.

Screening dancers should not be limited to girls wishing to progress onto pointe. Research shows male dancers sustain dance injuries at the same rate as females, and as they mature, male dancers require higher levels of dance strength and flexibility. It is therefore a logical course of action that, during the important period of growth and adolescence, young men undertake a dance profile to identify any potential injury risks and develop appropriate and individualised training goals.

A good time of year to undertake a screening is during the school holidays. During this period, the student usually has more time to address any strength or flexibility deficits that may have been identified by the physiotherapist. They can use the extra time over the holidays to focus on these areas and begin the year a step ahead.

Check out the dance environment for potential injury risks

Acute injuries are sometimes a result of an environmental factor, and are therefore preventable. For example, purpose-built dance floors are an extremely important factor for keeping a dancer safe. Checking the floors for spills or items that may cause injury is another way of preventing accidents. Wearing properly fitting clothing and professionally fitted shoes appropriate to the style of dance can also help prevent environment-related injuries.

Always warm up before dancing

It is vital that dancers warm up before class, rehearsal or performance – skipping a warm up can lead to injury. The goal of a warm up is to raise the heartrate, warm up the muscles and mobilise the joints. This should be a gradual process conducted in phases. First a light sweat should be achieved by raising the heartrate and getting the big muscles working, for example, jogging, skipping or lunges. Then, dynamic stretches should be done.

It’s important, especially for young dancers, to understand that static stretches should not be done in early warm up. Static stretches should instead be left for the end of class, during cool-down.

Keep your body Dance-Fit with an individualized dance conditioning and exercise program

Individualized conditioning programs have been shown to reduce the rate of injury in professional dancers.7 These types of programs are created using information obtained during the dance profile, and takes into consideration the dancer’s history and previous injuries. Historically, supplementary strength and conditioning programs were avoided by ballet dancers,  who were concerned that this type of training would result in reduced flexibility or a non-aesthetic physique. There is, however, little evidence supporting this theory, and this opinion has now mostly been replaced by integrating elements from sports research showing the benefit of such programs8 with a dance-specific approach. Physiotherapists, especially those with extensive dance knowledge, are perfectly placed to guide  young dancers in their supplemental training.

Get enough rest and monitor your loading to help prevent dance injuries 

Finally, and of great importance to young dancers, is rest and load management. Since research shows ‘overuse’ as the main cause of injury in young dancers, monitoring their loading is of paramount importance.9-10 Young athletes who train in the same sport for more hours per week than their age (in years), were shown to have 70 percent more overuse injuries13. Furthermore, a 2014 study showed that young athletes who had less than 8 hours of sleep each night were more likely to sustain injuries than those who slept 8 hours or more.14

 

So, a short answer to the question of how to prevent dance injuries is….

Ensure the young dancer has a healthy dance schedule, has been screened for deficits and potential injury risks, and has an individualised conditioning program.

The dancer, as well as their family, dance teachers and health professionals, all need to work together to help the young dancer remain as injury-free and healthy as possible!

For more information about PhysioTec’s Dance Physiotherapy services, including dance screenings and pre-point profiling, injury rehabilitiation or dance-specific strength and conditioning, click here or call 3342 4284 to book an appointment with Joanne Manning.

 

References

  1. Kenny SJ, Whittaker JL, Emery CA. Risk factors for musculoskeletal injury in preprofessional dancers: a systematic review. Br J Sports Med. 2016;50(16):997–1003.
  2. Russell JA. Preventing dance injuries: current perspectives. Open Access J Sports Med. 2013;4:199–210.
  3. Leanderson C, Leanderson J, Wykman A, Strender LE, Johansson SE, Sundquist K. Musculoskeletal injuries in young ballet dancers. Knee Surg Sports Traumatol Arthrosc. 2011;19(9):1531–5.
  4. Prevention of Injuries in the Young Dancer (Contemporary Pediatric and Adolescent Sports Medicine). Springer International Publishing. Kindle Edition.
  5. Fuller M, Moyle GM, Hunt AP, Minett GM. Injuries during transition periods across the year in pre-professional and professional ballet and contemporary dancers: a systematic review and meta-analysis. Phys Ther Sport. 2020 Apr 3;44:14-23.
  6. Shah S, Weiss DS, Burchette RJ. Injuries in professional modern dancers: incidence, risk factors, and management. J Dance Med Sci. 2012;16(1):17–25.
  7. Steinberg N, Aujla I, Zeev A, Redding E. Injuries among talented young dancers: findings from the U.K. Centres for advanced Training. Int J Sports Med. 2014;35(3):238–44.
  8. Faigenbaum AD, Kraemer WJ, Blimkie CJ, Jeffreys I, Micheli LJ, Nitka M, et al. Youth resistance training: updated position statement paper from the national strength and conditioning association. J Strength Cond Res. 2009;23(5 Suppl):S60–79.
  9. Prevention of Injuries in the Young Dancer (Contemporary Pediatric and Adolescent Sports Medicine). Springer International Publishing. Kindle Edition.
  10. Allen N, Nevill AM, Brooks JH, Koutedakis Y, Wyon MA. The effect of a comprehensive injury audit program on injury incidence in ballet: a 3-year prospective study. Clin J Sport Med. 2013;23(5):373–8.
  11. Ekegren CL, Quested R, Brodrick A. Injuries in pre-professional ballet dancers: incidence, characteristics and consequences. J Sci Med sport. 2014;17(3):271–5.