Dancers Improve Your Performance Right Now

You are probably used to coaches, teachers, and choreographers asking for 100% or more, over, and over, and over again. Over the holidays, there is a good chance that you might get a few days or even a week or two off. So, what can you do right now to improve your own performance and get an edge on the competition?

The answer is a word that dancers often don’t like to hear: REST.

Dancer ankle sprains: A serious consideration

Why is even a minor ankle sprain taken so seriously in dance, yet other athletes tape them up an play on them?


The most commonly sprained ligament is called the Anterior Talofibular Ligament (ATFL). It can be injured at a specific moment in time, or the injury can be from repetitive overstretching of the foot into a pointy position (or performance of releve with weight slightly to the outside of the foot).

During releve, the ATFL becomes almost perpendicular to the ground, creating an overstretch situation. If the ligament is already injured, this will likely contribute to making the injury more and more chronic. Even with elastic tape to improve proprioception, there is no evidence that this will decrease the long term complications associated with pushing through the injury to continue dancing.

Even with proper care and rest from sport for 4-6 weeks, one study shows that 40% of athletic patients have pain and dysfunction for 6 months after proper rehabilitation (Gerber, et al,). However, if not properly treated, over 40% of ankle sprains lead to chronic pain and injury even beyond this time (Bennett and Safran).

You can read more about ankle sprains and their management in the Current Commentary from the American College of Sports Medicine.

This article was written by Meredith Butulis, DPT, who works out of our Eden Prairie Office. 

References: 

Bennett WF. Lateral ankle sprains. Part II: acute and chronic treatment. Orthop Rev. 1994;23:504–10.

Gerber, JP, et al (1998). Persistent disability associated with ankle sprains. Foot & Ankle International. 19(10): 653-60.

Safran MR, Benedetti RS, Bartolozzi AR 3d, Mandelbaum BR. Lateral ankle sprains: a comprehensive review. Part 1: etiology, pathoanatomy, histopathogenesis, and diagnosis. Med Sci Sports Exerc. 199931(7 suppl):S429–37.

Over stretching injuries

With our winter dance team season back in session, the number of over stretching injuries have been increasing dramatically. These injuries are not exclusive to dance team though. They are commonly seen in other forms of dance, yoga, and runners.

The most typical injuries I see in this category are the ischial tuberosity stress injury and growth plate injuries.

If you suspect this injury, the most important thing to do is STOP stretching the hamstring on the injured side.

Other things you can do at home that typically help include rest, ice, and foam rolling.



Have questions or comments to share? Please leave us a post!

This article is written by OSR Physical Therapist, Meredith Butulis. Meredith practices in our Eden Prairie office. 

Note: This blog post is not intended as a substitute for appropriate medical evaluation and treatment of injury or suspected injury.

Dance: Go Pro or Go to College?

During the course of a teen's injuries in and out of Physical Therapy, I'm often asked questions about dancer career paths. Depending on your passions and interests, both college and a dance career may be possible.

Here is an interesting blog article about a parent and her teen's professional ballet career.

Ask the Experts Series: Hip Follow Up

OSR Physical Therapist, Meredith Butulis, presented on hip performance and injury prevention as part of the Minnesota Dance Medicine Foundation's Ask the Experts Series on 10/20/13. Here are some key take aways noted by the participants:

1. The hip is like a house with 4 sides. You need to strengthen all of them to have a strong foundation.

2. Pelvis alignment is key! Before strengthening or performing exercises, be sure that the pelvis lines up front to back and side to side.

3. If the pelvis won't stay aligned, see if the ribs are aligned. Performing exercises like child's pose breathing and upper body clocks can allow mobility higher up in the spine that then allows for appropriate pelvis alignment.

4. Activate-strengthen-integrate. When a muscle is inhibited or weak, it cannot contribute to movement correctly, so you get compensations. Compensations over time do lead to injury. Each muscle has a series of possible exercises to activate, then strengthen, then integrate. For example, the psoas can be activated by lying on your back propped up on elbows and then performing a marching of the legs while focusing on core and psoas activation. Adding resistance to this will move to the strengthening step. Performing front battements is an example of integrating this muscle.

5. The TFL and rectus femoris like to compensate for the psoas. The psoas, however, is the only muscle that can flex the hip > 90 degrees with external rotation safely. Therefore finding it, and using it is a critical step in hip health.

Ask the Experts Series Registration now open!

As part of the Ask the Experts series, Meredith Butulis, DPT will be presenting on prevention of hip pain in dancers on Sunday 10/20/13.

Location: Cowles Center, Minneapolis, Studio 7A
Time: 4-6 PM CST
Cost: By donation to the Minnesota Dance Medicine Foundation
Audience: Dancers, parents, teachers, coaches
Register via this link

Dancer taping for cuboid subluxation and navicular support

Minnesota Dance Medicine Conference Recap

Interested in reviewing the handouts from the Minnesota Dance Medicine conference?

Some of them are available via this link!

Hip stability--a key to injury prevention and performance

One of our Physical Therapists, Meredith Butulis, recently presented at the Minnesota Dance Medicine Conference on August 17th and 18th in Minneapolis. She presented on hip strengthening program designs. This included not only exercises, but also sets, reps, technique, and timing to get the maximal benefit.

One recurrent theme in many presentations was hip stability. Hip exercises are not only used for hip injuries and strengthening for kicks and leaps, but also in ankle, knee, and back injury prevention and rehabilitation.

3 exercises that you can incorporate into your daily pre-class warm up are:
1. sidelying leg raises for gluteus medius activation
2. bridges for gluteus maximus activation
3. clams for piriformis/turnout muscle activation

These are 3 muscle groups that determine the stability of your standing leg. The stability of your standing leg not only determines the safety of your hip, knee, and ankle, but also how well your moving leg performs.

Stay tuned next week for how to videos.

Minnesota Dance Medicine Conference

The Minnesota Dance Medicine Foundation is hosting their conference at the Cowles in Minneapolis on August 17th and 18th. Check out their Facebook page to see what types of things you will learn and who is presenting (including one of OSR's PTs)! See their web page for registration.

• Saturday 8/17 event is for Medical/Allied Health Professionals
• Sunday 8/18 event is for dancers, teachers, coaches, and parents

Want to improve your turnout?

Start with the basics of understanding myth vs. fact via this link.

 

Stay tuned as we write more about this topic, tips, and tricks in August!

Have questions or ideas to share? Leave us a post!

Last chance for free admission to MDMF conference

Want to learn about injury prevention, nutrition, common injuries, strengthening exercises, and more just for dancers? Come to the Minnesota Dance Medicine Foundation 6th annual conference at the Cowles in Minneapolis on Sunday, August 18th. You will learn from medical doctors, dance physical therapists, and other allied health dance medicine professionals. The last chance to enter into a drawing for free admission is this Wednesday 7/31!

You can enter into this drawing by liking us on Facebook (https://www.facebook.com/OSRPTEP) and then sharing the 7/28 post that states: Last chance! MDMF Contest! SHARE this post before July 31st and you will be entered into a drawing for free admission at our 2013 MDMF Conference on SUNDAY 8/18 at the Cowles Center in Minneapolis!

More information on the conference, including the schedule, is available via this link. 

Facebook top picks

As a dancer, keeping your body in great condition is a top priority! Here are two of my top Facebook picks that can offer you credible information to help:

International Association of Dance Medicine and Science

Minnesota Dance Medicine Foundation

The Minnesota Dance Medicine Foundation will be holding their 6th Annual Conference in Minneapolis on August 17th and 18th.

• August 17th: Medical and Allied Health Professionals
• August 18th: Dancers, Parents, Coaches, and Teachers

Click here for more information, including registration. Follow MDMF on Facebook to see what types of things you will learn, ranging from nutrition, to rehab, to performance improvement tips and exercises!


Have others that you want to share? Leave us a post!

Hamstring flexibility

As many area dancers head off to camp, we find hamstring and ischial tuberosity injuries to be among the most frequent. Here is a quick tip on how to warm up your hamstring quickly as part of your injury prevention and peak performance program:


Have questions or ideas to share? Leave us a post!

Ice or heat?

With dance camps in full swing, many dancers will experience muscle strains and other aches and pains. This is often at least partially due to a sudden increase in the amount of activity being performed. Once you have pain, you might ask yourself--ice or heat? Here is a link to a WebMD article to help answer this question and more!

As a quick note for teen dancers, if you feel pain in the following areas, please consider having your injury evaluated as soon as possible:

• Where hamstring inserts onto sits bones
• Shins
• Feet
• low back
• Groin
• Deep pain in front of hip

These are locations of dance injuries that are typically NOT from a muscle strain. Prompt correct diagnoses by a Doctor/Physical Therapist familiar with dance injuries can help you successfully get back to dance and stay in dance as fast as possible.

Eden Praire Dance Team follow up

In follow up to our EP Dance Team Training, the number one cause of injury is fatigue. There are several factors that contribute to fatigue, including:
1. Lack of sleep
2. Dehydration
3. Nutrition habits
4. Muscle imbalances

Be sure to check out the above hyperlinks to learn more about sleep, proper hydration, and nutrition basics for dancers. 

This blog post focuses on getting the most out of your exercises, and the selected exercises are based off of the most typical muscle imbalances that I see in dance team dancers. 

Here are how to videos on how to perform some of my favorite dancer strengthening exercises. (Parents--these can be great for your conditioning program, and many of them work for other sports too!)

These videos demonstrate tips on the:
1. Plank
2. Monster walk (side)
3. Lunge
4. Kneeling attitude (bonus exercise--not covered in the live session!)
5. Bird dog
6. Airplane
7. Hip flexor stretch

I also recommend stretching hip flexors. Here is a how to video:

If you have pain with any of these exercises, please discontinue them.

Have questions? Want to read an article about another dancer topic? Leave us a post, and we will respond!

Taping to enhance shoulder stability

Dancers tend to be very flexible and even hypermobile in many joints. Here is a quick idea on how you can tape a shoulder to enhance your ability to keep your shoulder stable while dancing! Have questions? Have another favorite technique? Leave us a post!

Dancer First Aid

With the local competitive dance season in full swing, it is important to understand how to address injuries. Here are the recommendations from the International Association of Dance Medicine and Science.

 

Used the acronym "PRICED" to provide first aid to injuries.

P-Protect the injured area from further harm. Harm can include further exercise, dance, massage, or heat on a newly aggravated injury.

R-Rest. Stop dancing and stop moving the injured area.

I-Ice. Apply ice to the injured area for 20 minutes. Repeat every 2 hours. Note: Do not place ice directly on your skin.

C-Compress. Use an elastic bandage to wrap the injured area to help decrease swelling.

E-Elevate the injured area above the heart as much as possible.

D-Diagnosis. Get the injury evaluated by a medical professional so that you understand what to do, what not to do, and what time frames are involved.

This information is a brief synopsis of "First Aid for Dancers," a position paper published by the International Association of Dance Medicine and Science.

Backstage Warm Up

When explaining an injury, many times dancers come to me and say "I did a leap/kick without warming up first."

Do you need a quick backstage warm up that doesn't require you to memorize a lot of choreography? Try this warm up for yourself or with your team/line. It can take anywhere from 2 min - 10 min, depending on how many repetitions you chose to perform.

Want to know more about why you should warm up? Check out our post from 2 weeks ago, which hi-lights some benefits of a warm up.

Ready for the stage?

Dance studio competition season is in full swing here in Minnesota. Often, this involves long days with multiple periods of being on and off stage. As part of your injury prevention and peak performance, it is important to make sure that you are warmed up prior to taking the stage.

 

Here are some benefits of a proper warm-up:

• Increase blood flow to increase oxygen to working muscles. Have you ever found yourself in a cold performance hall, and you just can't seem to get your toes warm? This affects how well you point your feet, balance, and jump; getting oxygen to the tissues before you take the stage is very important!
• Increased joint and muscle mobility. We all know the dancer that "pulled a hamstring" (or other muscle) while performing without a warm up. Prepare yourself, and be rewarded by less chance of muscle strain, and achieving your full extensions on stage!
• Improve your mental focus. In sport, we often hear phrases like "keep your head in the game;" this focus is essential for dancers too!

Next week, we will share some specific ideas that you can use in your own backstage warm ups!

Dancer Foot and Ankle Injuries

Don't miss this opportunity to hear Dr. Moser speak on foot and ankle injuries and prevention for dancers!

Where: Cowles Center, (Minneapolis) Studio 7A
When: Saturday 3/30, 10 AM -Noon



For more information/registration, on this talk an other talks as part of the "Ask the Expert" series please see: http://www.mndancemed.org/education.html

*Complimentary injury screenings to follow presentation

Neck and Upper Back Exercises for Lake Harriet Dancers

In follow up to OSR Physical Therapy's screening at Lake Harriet, here are your neck and upper back exercise recommendations. Please check your individual sheets to see which exercises were specific for you. Please perform exercises only in pain free ranges.

Stretches for Lake Harriet Dancers

In follow up to OSR Physical Therapy's screenings at Lake Harriet, here are some stretches. Be sure to check your individual forms to know which ones are recommended for you. Remember that stretches should be kept in pain free ranges.

Lower Body Exercises for Lake Harriet Dancers

In follow up to OSR Physical Therapy's Lake Harriet Dance Screenings, here are some lower body exercises. Please check your individual sheets to know which ones are recommended for you. Remember that all exercises should be pain free other than the "muscle burn" that may occur from working a specific area.

Priarie School of Dance

We were delighted to share some pearls of injury prevention wisdom with our local dancers at Prairie School this past week. In review, here is a video with details on how to activate the glutes:

 

Good luck at State!

We wish all of the teams from our communities good luck as they prepare for state this week!



Here are a few tips to stay at the top of your game!

1. Focus on your performance qualities this week, while minimizing your emphasis on general conditioning.

2. Fatigue is the number one factor associated with dance injury. Make sure you are getting adequate sleep each night. For a teen dancer research shows that this should be 7-10 hours/night.

3. Hydration is key! Here are some tips for practices over 1 hour. A simple way to stay hydrated is consuming 4 oz of a sports drink/hour of practice. Also try to consume 2 cups of water 2 hours before practice, and another cup of water 1 hour before practice. (1)

4. Taking a break between run throughs supports how the body is made to work and recover. For example, run the routine 1-2 times. If that takes you 6 minutes, then take 6-12 minutes to recover before repeating. A quick way to recover is by walking a few laps slowly around the gym.

(1) ¨Glace, B (2008). Nutrition, Hydration, Metabolism, and Thinness. Dance Medicine: Strategies for the Prevention and Care of Injuries to Dancers. American Physical Therapy Association.

Understanding Turnout

Dancers very commonly ask me "what stretches should I do to improve my turnout?" I then ask the dancer what move he/she is trying to improve turnout on. This allows me to decided whether to look for a range of motion deficit, a strength deficit, or a neuromuscular control deficit.

More than 50% of the time, I find that the deficit is NOT a range of motion problem, but rather a strength or neuromuscular control challenge.

This article explains where turnout comes from in the dancer. It will allow us to have further articles and discussions on how to "work turnout" safely and appropriately.

This is a slide from a presentation I gave at the Minnesota Sports Medicine Conference in 2010. Research in anatomy shows that turnout in dancers is created by the following:

1. Hip joint: 34-70 degrees. This means that the hip alone will not allow a foot to face the side of the room.
2. Tibial torsion: 16-60 degrees. Some dancers can get their feet to point to the sides of the room if they have a high degree of tibial torsion. Tibial torsion is how much spiral is in the shin bone. This cannot be changed with exercises.
3. The last 10 degrees comes form the ankle and knee structure.

These key findings indicate that:
1. Not every dancer can have 180 degrees of turnout
2. Dancers may be able to focus on hip exercises to improve turnout

Some of our follow up articles will discuss what types of hip exercises might be appropriate, and what types may be less appropriate.