Ligament Pathologies in Dancers- Things You Need to Know

Ligament Pathologies in Dancers- Things You Need to Know

 I also could have titled this blog post, “Getting My Geek On With the Postural Restoration Institute“, as that is where I spent this past weekend geeking out, and inspired what I’m writing about today.

I had the pleasure of attending a Postural Restoration Institute course- Myokinematic Restoration, a course addressing issues of the lumbo-pelvic-femoral variety (so hips and pelvis mostly). This is a course that’s been on my wishlist for over a year now, so I was pretty stoked to be there.

What is the Postural Restoration Institute, and what do they teach? Long story short (very, very short), the PRI is big on the getting the body as symmetrical as possible (which is kind of impossible), because life tends to take us farther from symmetrical than is optimal. The more asymmetrical your body gets, the more dysfunctional too, which can lead to pain and crappy movement qualities.

Along with an overdose on functional anatomy, I got some answers to questions like,

“Why is it so hard to activate my glutes?”

“Oh good, and it looks like I can’t activate my hamstrings either” (not a question, I know)

“Why have my hips been in pain since I was 15?”

“How much butter should I eat for optimal brain function when studying advanced functional anatomy for 8 hours a day?” (to answer that last question- I ate a lot of butter, and my brain was ON).

But other than learning how much butter I can eat in a weekend, I’d like to summarize a few other important things I learned from PRI, particularly as it relates to you dancers, dance educators, and other bendy people.

The biggest thing I learned from PRI, when it comes to dancers?

Dancing is horrible for your body. As if you didn’t know that already…

In all seriousness though, and more specifically, dancing will probably end up severely over-stretching many of the ligaments attaching to your pelvis, if it hasn’t already.  I’ve talked about this already HERE, as it relates to your hip flexors, and why you should stop trying to stretch them out.

That dancing can overstretch ligaments and increase joint instability isn’t anything new. But only now after studying with PRI do I understand the extent of the damage done, and the importance of supplementary exercise to bravely attempt to rebuild our broken pelvises (pelvii? Anyone know the plural for pelvis?).

Remember that ligaments, after having been stretched beyond a certain point, can never return to their original length and elasticity, which means they won’t really do anything for ya anymore.

According to the PRI assessments and testing process,  I’ve compromised every major pelvic ligament classifying me as “pathological”. I scored 0 on all the tests, as in, I wasn’t even able to get my body into the testing position. My ego was hurtin’. I’m somewhat concerned about my body. And if I have reason to be concerned, then you probably do too!

If you dance, or are a bendy person, then you probably have ligament pathologies, too, and you’ll want to try to correct that. 

If you are a younger dancer and reading this, then I have good news- The sooner you realize the risks of overstretching ligaments and start to strengthen your body, the less of a beating it will take later on in life. Start strengthening while you’re still young and growing!

So my ligaments are poop. What now?

PRI teaches that the goal for people like you and me, (bendy dancer, in chronic pain, no more ligament support), should be to re-activate and strengthen specific muscles in a particular sequence so that they will act as ligaments for you, since yours are poop. Technical term. Let’s refer to these specific muscles as “ligament muscles” (and I’ll talk more about those later).

To be extremely redundant, because I want to make sure you understand, you have to try to rebuild ligamentous support by strengthening specific muscles. Because you’ve exploded your ligaments. Make sense?

The key ligaments I’m talking about are:

  •  Iliofemoral ligaments (the “Y” shaped ones, attaching your femur to the front of the pelvis)
  •  Pubofemoral ligament (another one attaching the femur to the front of the pelvis),
  • Ischiofemoral ligament (attaching the femur to the back of the pelvis)
  • Iliolumbar ligament (attaching your lumar spine to the pelvis)
  • Sacrotuberous ligament (which attaches the sacrum to your “sit bones” and blends into the hamstrings)

anterior pelvic ligaments

more ligaments attaching your leg to your body


Posterior pelvic ligaments


If I wasn’t clear before, I’ll say it again: if you’ve been dancing for some time now, chances are you’re a walking ball of ligament pathology.

And even if you don’t fall into the category of “bendy dancer”, you could still have a few ligaments that have been overstretched, so this still pertains to you. Also pay attention if you are trying to improve your flexibility, because you’ll want to try to do that safely (you don’t want to end up like me!).

Pathological ligament laxity is pretty fun, don’t get me wrong. Being absurdly flexible is a great party trick, and makes dancing a lot easier in some ways. But you know what else it makes easier? Getting injured and taking a super long time to recover.

But it looks so pretty!

Super lax ligaments also make activating muscles kind of difficult due to the fact that your joints won’t be in an optimal alignment to produce and absorb force. This is called a mechanical disadvantage, and will limit your strength due to the sub-optimal position you’re working in.

Because of this poor positioning, I had a hard time with even the lowest level of the PRI repositioning exercises. I felt them in all the wrong places, and it was very, very frustrating.

Some other PRI red flags for dancers to look out for (signs you need to do some additional alignment and strengthening work):

 1) Very little internal hip rotation compared to massive amounts of external rotation, and with different rotational values on each side in some cases (ideally you want to have about 40 degrees of internal rotation, and 60 degrees of external rotation, and be pretty symmetrical on both sides)
2) Ribcage flaring out (does your dance teacher ever tell you not to stick your ribcage out?) This could be due to a faulty breathing pattern. Check out this video in which Dean Somerset explains some of the ways breathing can go wrong:

3) Uncontrollable lumbar extension and inability to flex at the lumbar spine.  Instead of extending your hips, you probably extend with your spine. You also probably end up standing with all your weight resting on your lumbar spine, which can eventually cause injuries like spondylysis (an over-extension injury to the spine)

 4) Way too much lumbar spine rotation. This usually happens when your hips lose their ability to rotate properly (and is indicative of an overly lax iliolumbar ligament).

Like I mentioned before (for like, the 100th time now), you’ll  want to reactivate some muscles, in a specific order, to build yourself some new ligament support. You need muscles to support you where your ligaments are now shot.

From the PRI manual… optimal ranges of motion at the hip, and muscles to strengthen corresponding to their ligaments

Muscles you should focus on strengthening:

Hamstrings group

1) Hamstrings. These are important postural muscles, bringing the pelvis back closer to a neutral alignment. Your hamstrings are at higher risk of injury if ligaments become compromised due to the extra need for them to stabilize the pelvis. Unfortunately, your hamstrings are probably weak and overstretched, so they tend to get strained- trying to both stabilize the pelvis and keep up with the demands of dancing. This happened to me! Not fun.

If you have trouble feeling your hamstrings during hamstring exercises (maybe you feel your quads instead), your first order of business should be to release chronic tension from your lower back muscles, because they might be holding your back from getting into a neutral spine.

Try this exercise to reduce the tonicity of your lumbar erectors and activate the abdominals:

You can do this one without the bands. You can regress it further by lying on your back on the floor too. Make sure you breathe!

adductor group

2)  Adductors. These guys help internally rotate your legs and bring them towards the center of your body. The opposite of doing the splits… They are necessary to have strong again to balance the fact that you’ve overstretched the ligaments at the front of your pelvis, especially the pubofemoral ligaments, which check the same movement as the adductor group.



3)  Glute med. Helps to internally rotate the leg, which is important, because remember, the ligaments that help stabilize the leg in internal rotation have been overstretched, especially the iliofemoral ligament. Also is an important muscle for keeping you solid on one leg.

the glutes

4) Glute max. Your power muscle! The king of the pelvic floor. Necessary for good pelvic positioning and strength. When your glute max is weak, you’ve got problems.

And then, if you can successfully get these muscle back online, will you be “fixed”? Probably not entirely, because you still don’t have any ligament support. But you’ll be dancing better, feel stronger, have better pelvic alignment, and probably not get hurt as easily. Score!

A question still on my mind is, do dancers need to have pathologically lax ligaments? It’s true that we need that excessive range of motion, and even if someone had told me at a young age of the risks that come with overstretching ligaments, I’m sure I would have willingly compromised them anyway. And proudly too (I am a Leo after all).

But,what’s the optimal balance? How flexible is too flexible? Can we still dance at an elite level without ligament pathology? Would practicing techniques, such as the ones taught by the Postural Restoration Institute, have been enough to prevent career ending injuries, such as my hamstring injury?

I don’t know the answers to these questions yet, but I know without a doubt that learning to reposition your pelvis, and increase the strength of it’s supporting muscles won’t make things worse. Probably much, much better.

Anyway. I ended up making this post way too long (my usual concision fail). I hope this was helpful, and helped you understand more fully why it’s important to strengthen the muscles of your hips and pelvis. Shoot me an email if you have any questions, I’ll do my best to help