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Strength & Conditioning for Dancers

Strength & Conditioning for Dancers

I’ve always enjoyed going to the gym. Even when I was doing daily ballet classes and 8 shows a week on Broadway, I still made the time to get to the gym. I’d do free weights, spin classes, kick boxing, laps in the pool – whatever got my muscles working and heart pumping. I felt strong, had great endurance and a notable lack of injury in a dance career of such longevity. This was decades ago and way before strength training and conditioning was a thing for dancers. But with the evidence now well and truly behind this type of supplemental training, more and more dancers are seeking ways to reduce the risk of injury and improve the “performance” in their performance!

What is Strength and Conditioning Training?

Strength and conditioning consist of a selection of dynamic and static exercises used to even out muscle imbalances and improve and enhance an athlete’s performance. It has been used for years in athletic populations with proven outcomes.  

Strength training

Strength training uses resistance such as weights or body weight to target specific muscles or muscle groups while working at a challenging intensity to achieve strength gains. Squats, lunges, push ups and dead lifts are examples of strength exercises. For strength gains the exercise should be conducted at a challenging intensity, for a specified number of repetitions and sets, about three times a week.

strength training

Conditioning

Conditioning through aerobic and anaerobic training works to improve the cardiovascular system - the performance of the heart and lungs and their ability to uptake and transport oxygen to the working muscles of the body. Jogging, skip rope, cycling and swimming are all examples of aerobic exercise, performed for a prescribed amount of time, to develop cardiorespiratory capacity and endurance. Exercise such as sprinting and burpees on the other hand work to increase anaerobic capacity which is needed for intense energy movements such as a series of grand jete’s.

Conditioning

Why Should Dancers Train This Way?

Traditionally dancers train in dance class, and while classes work to improve technique, artistry, and dance skills, they don’t necessarily develop strength and cardiovascular conditioning.

It doesn’t matter if you’re doing ballet, contemporary or street dance styles, all forms of dance have a disparity between the cardiovascular fitness required for class and rehearsal, compared with what is needed for the dance performance. If fact research shows us that professional ballet and contemporary dancers are only as strong and fit as their healthy, but fairly sedentary, non-dancer counterparts. This may come as a surprise to dancers and dance educators alike – after all, with all the classes most dancers attended each week how can their “fitness” be so ordinary?

If I’m attending hours of dance classes per week, how can my strength and “fitness” be so ordinary?

Read on and I’ll explain…it’s in the way that dancers traditionally train that makes the difference.

Dance classes and cardiorespiratory fitness

Traditional dance classes are for the most part, a stop and start affair. The dancer stops all activity, or gently “marks” the movement, as they learn the next exercise or combination, or to take corrections from the dance educator or choreographer. There may be brief sections, such as traveling across the floor with explosive jumps that can get the dancer really puffing, but that is usually short lived, and only a small part of the overall class. So, the type of cardiovascular exercise provided by dance class will not generally lend itself to cardiorespiratory fitness, and this can prove problematic once performances come around and a dancer’s endurance is really put to the test.

We know through years of research that fatigue is one of the biggest reasons dancers injure themselves. Sadly, a common story I hear from dancers in clinic is they’ve hurt themselves when landing badly from a jump, or falling out of a turn, toward the end of their dance when they were fatigued. The length of a dance number will challenge cardiovascular endurance and those big bursts of energy need anaerobic capacity. Therefore, a long dance with big jumps at the end can be a landmine to navigate for those without capacity to perform them safely. It seems the last decade or so the physical demands placed on a dancer have increased as choreography has become increasingly more challenging with “tricks” and kicks and jumps galore. Professional dancers and students alike are now required to have a higher level of cardiovascular fitness than ever before for them to perform well and safely. 

Dance classes and strength

Strength training is pretty much any type of training you do against an opposing force. When it comes to strength building in dance class there is little resistance, usually only your own body weight as resistance (unless of course you are lifting something or someone). Dancers are usually familiar with the use of elastic bands or tubing as resistance, particularly to strengthen the feet and toes, but are less familiar with using other types of resistance equipment such as dumbbells, barbells, medicine balls, kettle bells and weight machines.  

Some may have stayed away from this type of weighted exercise due to an outdated belief – especially by those in the ballet world - that this type of training would affect the body shape and aesthetics. Thankfully this unfounded concern is being replaced with a focus on strengthening and having a robust tool – the dancer’s body. Most dancers and dance educators now realize the increasing physical demands placed on dancers truly requires additional conditioning to attain the strength and power to optimally perform much of the choreography. Consequently, today’s dancers are happily picking up a kettlebells or dumbbells, in order to improve their performance.

The benefits of strength and conditioning training for dancers

 The body of evidence from research in this field continues to grow and simply amounts to the fact that resistance training can have a significant positive effect on a dancer’s dynamic balance, leg strength (improving hop height and distance) and upper limb stability, without any detrimental effect on aesthetic or artistic elements.

Resistance training also has an osteogenic effect – meaning it helps build bone. A study on pre-pubescent gymnasts who participated in resistance training showed they had stronger bones than age matched gymnasts who did not. This may reduce the risk of bone stress injury or fractures that keep you out of dance training and performances for extended period. There is also the important fact that doing resistance training early in life will reduce the risk of fractures due to osteoporosis later on.

The bottom line is, your regular dance classes may well be improving your technique and artistry, but you could be working in other ways to build your strength and conditioning to improve your dance performance.

How Do I Get Started with a Strength Training and Conditioning Program?

Now that you know strength training and conditioning can improve your performance and help reduce injury risk, you’re keen to know how to get started right? We have Dance Physiotherapists here at PhysioTec that would love to help guide you with an exercise program tailored to your specific strength and conditioning needs.

You can visit the clinic for 1:1 program development, or you might like to find a friend or 2 to train with at Physiotec. We can organise a group training program in our gym with one of our dance physio's at a time that suits you. Please give us a call. You might be surprised how much you enjoy this type of training!

This blog was written by one of our Physiotec Dance Physiotherapists, Joanne Manning

Strength and Conditioning Training for Dancers

If you would like to start your strength and conditioning journey, come along and see one of our friendly dance physios at Physiotec, whether you are a beginner or need some guidance with your current program, our physios will know how to help. Call, email or book online below:

Phone: (07) 3342 4284

Email: [email protected]

Explore Some More Dance Blogs

References

Bronner, S., Ojofeitimi, S., Lora, J., Southwick, H., Kulak, M., Gamboa, J., Rooney, M., Gilman, G. and Gibbs, R., 2014. A Preseason Cardiorespiratory Profile of Dancers in Nine Professional Ballet and Modern Companies. Journal of Dance Medicine & Science, 18(2), pp.74-85. https://doi.org/10.12678/1089-313X.18.2.74

Bronner, S., Codman, E., Hash-Campbell, D. and Ojofeitimi, S., 2016. Differences in Preseason Aerobic Fitness Screening in Professional and Pre-professional Modern Dancers. Journal of Dance Medicine & Science, 20(1), pp.11-22. https://doi.org/10.12678/1089-313X.20.1.11

Rodrigues-Krause, J., Krause, M. and Reischak-Oliveira, Á., 2015. Cardiorespiratory Considerations in Dance: From Classes to Performances. Journal of Dance Medicine & Science, 19(3), pp.91-102. https://doi.org/10.12678/1089-313X.19.3.91

Faulkner, E., 2021. Choreography-Specific Cross-Training and Conditioning Programs. Physical Medicine and Rehabilitation Clinics of North America, 32(1), pp.103-115. https://doi.org/10.1016/j.pmr.2020.09.003.

Rosenthal, M., McPherson, A., Docherty, C. and Klossner, J., 2021. Perceptions and Utilization of Strength Training and Conditioning in Collegiate Contemporary and Ballet Dancers: A Qualitative Approach. Medical Problems of Performing Artists, 36(2), pp.78-87. https://doi.org/10.21091/mppa.2021.2012

Farmer, C. and Brouner, J., 2021. Perceptions of Strength Training in Dance. Journal of Dance Medicine & Science, 25(3), pp.160-168. https://doi.org/10.12678/1089-313X.091521a

Ambegaonkar, J. P., Chong, L., & Joshi, P., 2021. Supplemental Training in Dance: A Systematic Review. Physical medicine and rehabilitation clinics of North America32(1), 117–135. https://doi.org/10.1016/j.pmr.2020.09.006

Koutedakis, Y., Hukam, H., Metsios, G., Nevill, A., Giakas, G., Jamurtas, A., & Myszkewycz, L., 2007. The effects of three months of aerobic and strength training on selected performance- and fitness-related parameters in modern dance students. Journal of strength and conditioning research21(3), 808–812. https://doi.org/10.1519/R-20856.1 

Dowse, R. A., McGuigan, M. R., & Harrison, C., 2020. Effects of a Resistance Training Intervention on Strength, Power, and Performance in Adolescent Dancers. Journal of strength and conditioning research34(12), 3446–3453. https://doi.org/10.1519/JSC.0000000000002288

Needham-Beck, S. C., Wyon, M. A., & Redding, E., 2019. Relationship Between Performance Competence and Cardiorespiratory Fitness in Contemporary Dance. Medical problems of performing artists34(2), 79–84. https://doi.org/10.21091/mppa.2019.2014

Long, K. L., Milidonis, M. K., Wildermuth, V. L., Kruse, A. N., & Parham, U. T., 2021. The Impact of Dance-Specific Neuromuscular Conditioning and Injury Prevention Training on Motor Control, Stability, Balance, Function and Injury in Professional Ballet Dancers: A Mixed-Methods Quasi-Experimental Study. International journal of sports physical therapy16(2), 404–417. https://doi.org/10.26603/001c.21150

Smith, P. J., Gerrie, B. J., Varner, K. E., McCulloch, P. C., Lintner, D. M., & Harris, J. D., 2015. Incidence and Prevalence of Musculoskeletal Injury in Ballet: A Systematic Review. Orthopaedic journal of sports medicine3(7), 2325967115592621. https://doi.org/10.1177/2325967115592621

Bass S, Pearce G, Bradney M, Hendrich E, Delmas PD, Harding A, Seeman E. Exercise before puberty may confer residual benefits in bone density in adulthood: studies in active prepubertal and retired female gymnasts. J Bone Miner Res. 1998;13(3):500–7.

 

Heels Dancing: Tips to look after your body

Heels Dancing: Tips to look after your body

Heels dancing has become increasingly popular from recreational dancers to professionals. Heels is not a style, culture or background in itself but is featured across many genres of dance with commercial heels being the most mainstream, influenced by artists in music videos, touring performances and award shows. Heels are commonly worn in other dance styles including vogueing, waacking, musical theatre, pole, salsa, or latin. However, heels can be worn in any style, even breaking or hip hop! This blog will focus on heels dancing for dancers currently or aiming towards commercial dancing.

It is important for dancers to understand the impact wearing and performing in heels can have on the body. When wearing heels, a person’s centre of mass is shifted forward causing a protruding head, increased arch in the lower back, increased pressure on the forefoot, plus an increased balance requirement due to the reduced base of support.1,2,3 Heels dancing can involve a lot of deep squat positions with weight on the toes rather than the heels. This can be challenging for the knees. It will also place the ankle in a more ‘open position,’ reducing stability and increasing the risk of ankle injury. 

This alteration in biomechanics explains why dancing in heels can be painful, despite Beyonce making it look so effortless. Whether you are a beginner heels dancer or heading towards performing professionally, we have some tips to help you train to become more comfortable dancing in heels and to look after your body.

1. Beginners: Advice to ease your transition into heels dancing

  • Dancing in heels has many similarities to dancing in pointe shoes, it requires adequate training, body awareness and maturity. For a beginner it is important to take classes with similar foundation like jazz or ballet as this will help strengthen your ankles and other muscle groups used when wearing a heel. 
  • Kiira Harper when giving advice for heels dancing admits ‘no heels dancer is a safe dancer’ but there are precautions you can take to ensure you look after your body. When starting out, you may find you need to change into a flat shoe like runners or dance barefoot as your feet will not be used to wearing heels for a whole class. As you build your confidence training in heels, it’s important to practice in your heels such as when rehearsing for a performance so you are training your muscle memory and the correct muscles to work during the routine.
  • Learn from different heels dancing teachers to become versatile, each teacher will teach their own style. Some of the first pioneers to teach heels dancing are Aisha Francis, Danielle Polanco, Anthony Garza, Yanis Marshall, Kiira Harper, Brinn Nicole, and Michelle Jersey Maniscalco. Searching these choreographers on YouTube is a great way to get to know heels dancing and how it differs between choreographers teaching their own style.
  • Train with dance teachers who teach correct heels dancing technique. This can be difficult to decipher but look at their credentials and experience and perhaps reach out to your local dance community via Facebook groups or on Instagram as they can point you in the right direction.

2. SHOES: Carefully select your shoes for heels dancing

  • For younger dancers doing cabaret, theatrical, tap or other types of dance in heels, start with a low, block heel and gradually work your way up as you gain strength and control. For pre-professional and experienced dancers the following guide will help when selecting a shoe for Heels Dancing.
  • Type of shoe - Boot heels are best for beginners as they provide the most ankle support while building up strength in the ankles. Good supportive heels may also have a lace up at front, buckle above the ankle, or a side zipper. These aspects all keep the ankle secure but are still flexible enough to move in. If your heels have laces, ensure they are durable and not touching the floor when tied up as this is a huge tripping hazard, the safest option is to tuck them into your shoe.
  • Width of the front of the shoe and thickness of the sole are important for allowing you to spread out your toes and feel the floor for greater stability. Ensure you have enough room in the front of your shoe and choose thinner soles that allow you to feel the floor better.  You could choose an open-toe shoe or a closed-toe shoe, as long as the toes aren’t cramped together. If your toes are cramped, you will get less feedback about your weight placement on the floor and less control around the foot and ankle.
  • Pumps - A pump may be suitable for more advanced heels dancing, depending on the choreography. A pump is the hardest type of heel to dance in as they require adequate strength to hold the foot within the shoe and it provides the least ankle support. Mishay Petronelli, with credits including The Greatest Showman and Janet Jackson, recommends pumps for pre-professional or professional dancers taking heels training as this will help prepare for any heel a dancer may be given and required to wear during a gig.
  • Avoid platforms if possible - This type of heel has an inflexible platform at the forefoot which can vary in height depending on the shoe. This can increase the risk of ankle injury due increased instability (heels are already unstable!) and less capacity for the dancer to “feel the floor”. Unless you are required to dance in a platform shoe as part of your professional costuming, please avoid them. 
  • Customised shoes – at the end of the day, dancing in heels is going to hurt regardless of what you do, especially if you are at rehearsals or performances for hours on end. You will need to break in new shoes. Gradually increase the time you train in new shoes, it will also take time for your feet to get used to them. To prolong your comfort you can try to get your heels customised to your feet at a shoe maker, they can add extra padding to reduce the pressure on your forefoot, or add rubber soles on bottom so you have a good grip on any surface. An alternative option for grip is to scratch the shoes on concrete to give them more texture, this creates more friction on the shoes while you’re dancing, applying hairspray to the bottoms will assist also. As a last minute option if you are already at class, most dancers will drop a small puddle of water on the floor and dip the bottom of their shoe into it for extra hold.

3. Warm-up: The best exercises to get your body ready for heels dancing

  • Exercises to warm-up when heels dancing don’t differ greatly from those that are conducted in a pointe class. Your warm-up should be done without the heels on so you can work through your feet properly first.
  • Calf rises – aim to achieve 25 single leg calf rises. The principal physiotherapist of the Australian Ballet Sue Mayes has some pointers for the perfect calf rises based on her research in 2003 including: The speed of movement should be slow, take 1 second to rise up, and 1 second to lower down. Your foot should be parallel, with your knee neutral so it is not bent or hyperextended, move through your full pain free range of motion with optimal control, ensure your toes remain long and flat, aim for a smooth motion, movement should be vertical so avoid any rocking forwards, you should see the gastrocnemius muscle active throughout range, for good alignment ensure the mid tibia (shin bone) is aligned with the 2nd metatarsal (2nd toe).4
  • Foot intrinsics – try a long toe push with a light theraband, for this exercise you will place the band around one toe at a time and slowly lift the toe, then lower back to the floor (easiest to perform in sitting), you can also try piano toes where you lower one toe to the floor at a time from smallest to biggest, and for a challenge try lowering in order of the biggest to smallest toe.
  • Balance – stand with your feet together on demi pointe, slowly lower your body to a full knee bend with control then slowly rise back up, this will require engagement of your core to hold you steady. This exercise takes you into a deep squat on the toes a common position in heels choreography. As mentioned earlier this increases the load on the knees and requires very good strength and control. It should only be performed if the action is pain free. If you experience knee pain please seek advice from your physiotherapist.
  • Core – try a tabletop exercise, lying on your back with both legs in a tabletop position with 90 degrees flexion of hips and knees, slowly extend one leg straight at a time. It is important to activate your core as you need to hold it when balancing to keep your centre, especially during turns
  • Bridges – you will need your glute max to help push you up from kneeling to standing when dancing in heels rather than requiring your quads and hamstrings to do all the work, ensure your feet are close to the bottom, then push through your heels to lift the bottom up, you can also try this on one leg for increased difficulty.

4. Cool-down: Take time to recover properly with these tips so your body aches a little less the day after heels dancing

  • Calf stretching can assist in allowing the muscle to relax in a lengthened position again, after working hard in a shortened position while dancing in heels. Other alternatives to release tension include massage or using a foam roller.
  • Lower back – in heels dancing a lot of time is spent with the lower back in a forced arch so it is essential to open up the lower back in the opposite direction. Try a child’s pose stretch with a 30 second hold, a cat-cow stretch on your hands and knees for 10 repetitions, knee rocks side to side to rotate through the lumbar spine, knee hugs into chest for 30 seconds, and slow controlled roll downs from standing for 10 repetitions.
  • Drink lots of water and try to get a good night’s sleep after a heels class, in particular for those classes that go for 3 or more hours or for all day long rehearsals.

Due to the increased demand on the body while heels dancing, it is important to ensure you are incorporating these safe dance practices so you can enjoy all the fun heels dancing provides while looking after your body. Our dance physiotherapists Rhianna and Jo are available for dance assessments if you are wanting to improve your heels dancing technique or have been experiencing pain associated with your dancing.

 

This blog was written by Physiotec Dance Physiotherapist, Rhianna Tunks

If you would like to book with one of our dance physio's, Rhianna or Jo, please call, email or book online below:

Phone: (07) 3342 4284

Email: [email protected]

 

References

  1. Chien HL, Lu TW and Liu MW. Effects of long-term wearing of high-heeled shoes on the control of the body’s center of mass motion in relation to the center of pressure during walking. Gait Posture 2014; 39: 1045–1050.
  2. Silva AM, de Siqueira GR, da Silva GA: Implications of high-heeled shoes on body posture of adolescents. Rev Paul Pediatr 2013; 31(2): 265–71
  3. Yung-Hui L and Wei-Hsien H. Effects of shoe inserts and heel height on foot pressure, impact force, and perceived comfort during walking. Appl Ergon 2005; 36: 355–362.
  4. Mulready R – How To Get Strong Calves. The Australian Ballet 2020. Retrieved from: https://australianballet.com.au/behind-ballet/how-to-get-strong-calves
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!)

Do you want to maximise the benefits you gain from dance, but not sure how to make the most of your dance moves?

Under the supervision of our experienced dance physios Jo and Rhianna, you will be professionally guided along the way, in a safe and effective manner.

Book Now
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!

Have you experienced a dance injury?

Do you want to know how to stay safe whilst dancing and prevent injuries from occurring?

Under the supervision of our experienced dance physios Rhianna and Jo, you will be professionally guided along the way, in a safe and effective manner.

Book Now

 

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 Rhianna or Jo.

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.