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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
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.
Why should I exercise during and after Pregnancy

Why should I exercise during and after Pregnancy

For Mums and Mums to be…

Have you ever experienced some pain in the pelvis  or in the hips during or after pregnacy?

Poor pelvic control or instability is a condition more common in women and is most likely to occur during or post –pregnancy.  During pregnancy, a hormone called relaxin is released in the body to allow the ligaments to stretch to accommodate the fast growing baby. With another human being growing rapidly, the pelvis does undergo an increase in loading, which some women cope with a little better than others – this can be due to genetic factors such as natural pelvic and ligamentous structure, or the background muscle conditioning you had prior to the pregnancy.

DON’T WORRY THOUGH…. remember that “instability” does not mean your pelvis is physically out of place but rather your muscles around the pelvis are not providing adequate’ force closure’ or mechanical compression or support around the pelvis while the ligaments are lax.

Who is more at risk of developing Pelvic pain due to pelvic instability?

Research has shown that  women who are involved in strenous work, or have a previous history of low back pain and a history of lumbo-pelvic (lower back and pelvis) pain during previous pregnancies are at risk. Although, direct trauma to the pelvis such as a fall can also result in pelvic instability.

How can Physiotherapy Help?

Use of Physical Aids

Physiotherapy can help by identifying the cause of the pain around the pelvis, whether it is originating from the lumbar spine or from pelvic instability. Off loading the pelvis may be important in reducing the symptoms such as using crutches or walking sticks. Tape or pelvic/abdominal belts  can also provide some compression around the pelvis, assisting with stability in the shorter term.

Postural and Movement Education

Being aware of movements or postures that may overload the pelvis, and optimising muscles support around the lumbar spine and pelvis are the most  important factors in managing this condition. Some specific advice on what movements or positions you may need to avoid or adjust can make a big difference in avoiding pain aggravation.

Specific and Appropriate Strengthening Exercises

Improving activation of the deep supporting muscles around the pelvis is also extremely important for providing dynamic control, so despite laxity in the ligaments, your muscles can assist in compensating for the reduced support that ligaments can give during your pregnancy. Using real time ultrasound to train deep abdominals and pelvic floor muscles, and some of the deep hip/pelvic muscles are beneficial to someone who has pelvic instability. This is followed by a progressive strengthening program matched to the needs of the individual. Your physiotherapist can recommend appropriate Pilates and Pilates-based exercises as well as monitor your progress throughout your pregnancy and even after your pregnancy.

Transversus Abdominis Ultrasound At Rest
Ultrasound retraining of the abdominal wall – Transversus abdominis

If you are suffering from pelvic pain due to instability, see a Women’s Health Physiotherapist and get some good advice on pain management, training in deep muscle activation and an appropriate exercise program.

 

Are you currently pregnant?

Do you have pain in your pelvic region?

Not sure what exercises to do?

Our physiotherapists can provide you with a thorough assessment, and provide you with appropriate recommendation on how to approach your pelvic pain, or safely exercise during your pregnancy.

 

Image Courtesy of keerati of freedigitalphotos.net

References:

Vleeming et al. (1992). An integrated therapy for peripartum pelvic instability. A study of the Biomechanical effects of Pelvic Belts. American Journal  of Obstetrics. 166 (4): 1243-1247

Wu et al. (2004). Pregnancy-Related Pelvic Girdle Pain (PPP)I: Terminology, Clinical Presentation and Prevalence. European Spine Journal. 13:575-589

Hypermobility and Injuries: What is their relationship?

Hypermobility and Injuries: What is their relationship?

Hypermobility and Injuries

Have you been told that you are double jointed? You may have heard this term before to describe being more flexible than usual. Well, your joints are not “ double” but passive structures such as ligaments and connective tissue allow more stretch than normal.  Continue reading