Should You Use a Resistance Band to Strengthen Your Feet and Ankles?

Should You Use a Resistance Band to Strengthen Your Feet and Ankles?

Are you ready for a good, old fashioned, 2000+ word blog post, just like I used to do? Yeah you are!

Will this be my last rant of 2016?

Probably. But less of a rant, more of an expansion on a frustration.

This blog post is meant to serve as a follow up to a response I wrote on Facebook to Lisa Howell’s recent blog post on The Ballet Blog, on why dancers should reconsider using a theraband to strengthen their feet. Lisa’s primary issue with pointing into a theraband: Because dancers are likely to scrunch their toes, overwork flexor hallucis longus and other muscles of the calf, and do the exercise wrong. Banded foot-pointery could do more harm than good, so safer not to do it at all. 

Oh wait, I lied! There was a time when I used therabands. At the very least I can console myself in the fact that I was trying to help this dancer with her ankle dorsiflexion, not pointing into the band. But still…

In my commentary on my Facebook page (join me!), I agreed that I don’t often (ever, to this point) use a theraband for foot exercises with training clients, but for slightly different reasons than “they’ll probably do it wrong”. I received some comments on asking for a little more info, disagreeing, or sharing their faith in the band to do good.

 

It’s about time someone questioned my writing:

“using the band save my feet from injury and allow me to strength them in a pretty optimal way so I do not agree. I do when you say that it must be used properly but it’s indeed a really useful tool…”

…band work is a great way to reduce load on the joint, muscles, or tendons during rehab, for example. If a dancer is injured and can’t perform closed chain actions, why wouldn’t you offer band work as an option? A simple solution to the problem of curling the toes is to place the band at the ball of the foot, rather than around the toes. Cue the dancer to keep toes relaxed and point the “foot”, not the toes.”

“Can you comment on restoring ideal movement mechanics?”

I hope to reply to some of those questions/comments now.

My blog post today relates to four primary themes on theraband use:

1) Most peoples’ goals are vague to non-existent when they pick up a resistance band. They don’t know why they’re doing what they’re doing.

2) The open chain nature of banded foot exercises are likely not to contribute to ideal joint mechanics when the foot is on the ground, and area in which dancers need a lot of help.

3) What if the foot isn’t the root of the problem, just a symptom?

4) Will the banded foot-pointery not actually drive dancers deeper into their dance-specific adaptations rather than help them with what they specifically hoped it would? Which brings us right back to point one…

Just what is the goal, exactly?

And don’t say, “to strengthen my arch”, “ankle stability”, or “injury prevention”. That isn’t enough information. Most dancers (and dare I say, some teachers!) doing these exercises aren’t clear on their why.

Image result for start with whyFitting that I just finished reading (audiobooking, rather) Start With Why, by Simon Sinek. SInek says, if you have your “why”, the what and how will follow, but without a why, the what means nothing. And while he is speaking primarily of business, this is true on all other levels of life, including your body.

But also, dance IS your business. Your body is one of your most valuable assets, and maybe it’s time to start treating it as such. What if you tried not just doing shit because so and so does it, or it looks cool, or because someone told you to. Make decisions congruent with your best interest in mind.

Unfortunately, I get the sense that many dancers don’t know what “best interests” means. Or they do, but choose to ignore it.

Let’s start with the “why” in the case of these banded foot pointing exercises- The foot’s equivalent of the sit-up. No one’s saying sit-ups are bad (well, some people are…), but you should know why you’re doing them and understand if it’s a choice that matches your goal.

So…

What’s the goal?

Injury rehabilitation? To strengthen your ankles? More “stability”? To improve the arch of your foot? We need to be more specific, and to do that, we need to know more about you, the individual, and where you are right now.

Let’s say, for example, you landed a jump kind of hard and awkwardly and have some shooting pains in your ankle. Or maybe you changed directions quickly in class, slipped, and sprained your ankle. Is this a job for the band? Surely pointing your foot into a band for five minutes before class will help make your ankle more stable, which is what you need, right?

Let’s consider that the most common injuries in dance are to the foot and ankle. Sprains, shin splints, stress fractures, and broken bones etc.

What do these all have in common? Normally, these types of injuries happen while the foot is on the floor. Do we ever see foot and ankle injuries while the foot is in the air? Maybe through impact and direct trauma, but rarely, if not ever, does someone break their foot or sprain an ankle while it is in the air. 

These injuries happen due to the way the foot and ankle react (or don’t react…) on the floor, in coordination with the rest of the body.

So if the way the foot interacts with the floor is the issue, for example, why the heck is a common solution to strengthen the foot with a band in an open chain? It just doesn’t make much sense.

Let’s go to town.

Open vs. closed chain

Open chain refers to the foot being off the floor, closed chain refers to the foot being in contact with the floor. The supporting leg in an arabesque is closed chain, the “up” leg, is open chain.

In gym-world, a squat is a closed chain exercise, and a seated leg extension is open chain.

Image result for open chain closed chain exercise

Here’s the important bit: The foot and ankle do completely different things in open vs. closed chain.

Gait (walking) is predominantly closed chain (save for early and late swing). The implication is that the majority of what our brains recognize to be “natural” and useful movements for our bodies are in closed chain, walking being what our bodies were primarily set up to do. Working with how the body is designed to move through gait allows us to make incredible changes to how our bodies move, feel, and perform. This means, more often than not, working in closed chain.

In closed chain, the forefoot and rearfoot should move in opposition to each other due to the foot’s need to be in contact with the floor. If this opposition didn’t take place, the foot would act more as one big chunk rather than 33 articulating joints.

In a closed chain, the foot pronates and supinates.

In open chain, without the floor to provide sensory information, the foot does not oppose like it does when we walk. In open chain, the foot everts and inverts.

An important distinction to make here is between pronation and eversion, and supination and inversion. Pronation and supination are tri-planar movements involving opposing inversion and eversion the rearfoot, foorefoot, and toes.

Image result for pronation supination

Because the 1st met is off the ground, the left foot in this image is not supinated, its inverted.

Neither of these movements are good or bad. It simply is important to know the difference in order to make choices that support your goal.

Unfortunately, when it comes to supplementary training, the most popular forms of training for dancers are open chain, lying on the floor. This is fine, but it should not be the only form of exercise they do if we want to prepare them for the demands of dance when they stand up.

Let’s continue with the landing a jump example.

How is it possible for such graceful creatures as dancers to land jumps like a ton of bricks? I’ve been sitting on the exam panel at the dance school I work at this week, and it has honestly been painful to watch the students jump. 

If we look at the foot as the first point of contact with the floor upon landing, much is left to be desired.

Upon landing a jump, the foot must quickly pronate (but not too much or too quickly) which will load the tissues on the bottom of the foot, and, like a spring, automatically resupinate the foot as the muscles catch and react to the force of the movement, propelling off the landing leg.

If we have trained dancers not to pronate (misinterpreting when and why pronation is useful) they will be landing a jump with a rigid foot and ankle, which feels pretty terrible. If we only recommend the use of bands to strengthen ankles and feet, we are never allowing them to access a hugely important component of landing a jump- Letting the bones of the foot spread to absorb force, aka, pronation.

I will speak primarily for ballet and contemporary dance in which the aesthetic of the art often interferes with the “ideal” mechanic for landing a jump. I was taught not to let my feet pronate, to push my knees out past my pinky toes, and keep my butt tucked under while I jumped, keeping “neutral” through my pelvis and spine. This aesthetic makes it nearly impossible to absorb shock, which is why the dance studio turns into a herd of elephants when it’s time to jump. I’m sure you know what I mean…

In fact, I already wrote about this HERE. But no one said much about it or seemed to care either way. It’s cool.

I also gave a talk/workshop on this last year at York University.

Wow, my hair was short!

Let’s talk a bit more about pronation

Pronation is a tri-planar movement:

  • In the sagittal plane the forefoot dorsiflexes and the rearfoot plantarflexes.
  • In the frontal plane the forefoot inverts and the rearfoot everts.
  • In the transverse plane the forefoot abducts (or externally rotates) and the rearfoot internally rotates.

The exact reverse is true for supination.

Recall that in gait, the foot, as a unit, should not invert and evert while on the ground (and even continues to oppose in swing to a degree), because this does not allow for a tripod to be in contact with the ground, or, we end up with a very reduced tripod. 

Pronation is precious.

In the gait cycle pronation happens just once per step we take. 

It is the only time in which the bones on the bottom and medial side of the foot spread open, and the muscles on the bottom of your foot and some of the back of the ankle (achilles tendon, calf), lengthen. This is the way your brain recognizes these muscles lengthening to be safe and useful in order to walk- It’s the way the muscles were set up to decelerate (lengthen under tension) your bones most efficiently as your foot hits the ground.

Sagittally speaking, with each step you take, your plantar fascia, and all the muscles that connect under your foot- tibialis posterior, flexor hallucis longus, flexor digitorum longus and brevis, and all the others under there that support the foot’s arches, will lengthen, and, in response to this lengthening, receive the input required to contract and pull the foot into supination.

As per Gary Ward’s rules of movement from his book What the Foot: A muscle must lengthen before it can contract. We cannot just eliminate one end of the spectrum and expect there not to be consequences.

If, as you walk, dance, and live, you avoid pronation, the muscles of supination will never get a chance to lengthen. Sure you can roll them out with a ball, but that doesn’t change the fact that your foot doesn’t ever use these muscles in movement through their full lengthening-shortening spectrum, they become stuck.

If you are to only train your feet with a band, to contract concentrically, you will have a very hard using muscles to absorb shock as you land a jump, as well as trouble using these muscles to point your foot.

But what about winging? Shouldn’t I use a band to train my ankles not to sickle?

Winging the foot is a weird movement, but by classical standards it looks pretty, so it’s here to stay.

Image result for winged foot ballet

The things we do for winged feet…

Winging, as in the back foot in an arabesque line, is an open chain movement involving:

  • Rearfoot, forefoot, and toe plantarflexion.
  • Rearfoot and forefoot eversion.
  • Whole foot in external rotation.

Not the most natural feeling thing to do…

Maybe your teacher has told you not to sickle your feet, so it’s off to the band to strengthen your feet into a winged position.

But before you set your peroneals on fire with the theraband, or do something silly with the Ballet Footstretcher, consider how this might affect how your feet perform when they are on the floor.

Knowing what you do now about foot opposition when it is on the ground, and the importance of this for shock absorption, and allowing muscles to lengthen and contract (which will actually improve your arch not make it worse), how useful do you think using the band will be for you?

Yes, it will be great for practicing what your foot does when your leg is off the ground, but what if that’s all you do to cross train? What happens when it’s time to jump? Have you prepared your body effectively to cope with that kind of stress?

Conclusions?

I’m not saying don’t use the band, but before you do, consider these two things:

  1. Does using a band match your goal? Do you really need to strengthen your foot muscles, or would it be more useful to give your feet an experience in closed chain, allowing the bottom of your foot to open, lengthening and contracting the tissues through their full range as they were intended to as you move.
  2. If you are using a band specifically to reinforce an adaptation for dance, such as winging and pointing your feet, just make sure you have a strategy to unwind that so that your feet also understand what to do when they are on the floor. It might be interesting to check first, before practicing a specific skill to death, whether enhancing natural movement mechanics will get the job done on its own.

In the end, there are no right or wrong ways to train your body, but you must know why you are doing what you are doing. 

One person’s “wrong” might be your “right”. There may be a time and a place to use a band, just make sure you know what that is for you. 

dancestrongerlogo300In Dance Stronger, we go into more detail, and a few exercises that integrate pronation and supination in full body movements. If you are interested in going deeper into what I’m talking about in this blog post, you might be interested in checking the resource out.

Questions? Comments? Observations? Abuse? Let me know what’s going on in your head.

Re-Framing Injury Prevention for Dancers

Re-Framing Injury Prevention for Dancers


canadian dance expo“I can’t believe I’ve never even thought about this before… But it makes so much sense!”

The response of one dance-parent in a conversation we had following my “injury prevention” seminar at the Canadian Dance Expo this week.

Yes, I had the honour of speaking on the sexiest topic in dance training: How to not get hurt. That thing we try not to think about.

Well, except for you. You’re different. Keep it up.

Needless to say, I didn’t get a crowded room, and to be fair, there were some pretty awesome choreographers holding workshops at the same time. Why talk about injuries when you could dance?? A sentiment I completely understand. That said, I had a great group of dancers, teachers, and parents, and really enjoyed the discussions we had.

But to call it an injury prevention seminar isn’t quite accurate.  We didn’t talk straight up about injury prevention in the conceptual, literal sense, and to be honest, I don’t really like those two words strung together and the frame they conjure up. What comes to mind first, what images, situations, and places, when you hear the words “injury prevention”?

Exactly. It ain’t no dance party.

 

I propose a re-framing of this injury prevention thing.

And so, partway through the workshop I found myself telling a story about pick-pocketing, inquiring into values, and opening a discussion into how people change their habits. Who knows… Maybe they’ll even invite me back to speak next year.

My issue with the way injury prevention is traditionally taught is that it is simply information. We’re trying too hard to educate, re-hashing statistics, scare-mongering, and hoping for the best that something will be retained, and dare I say, maybe even applied. But the injury rates in dance aren’t going down. This information only approach simply doesn’t work. That’s why I can’t remember anything from grade 9 chemistry.

We can’t change the rate and severity of injuries, and the time off dance due to injuries until we can change the value dancers perceive they will get from proactive injury prevention.

Or to quote Gary Ward“We can’t change the way you move until we can change the value you get from it” 

Would you go out of your way to do something if you didn’t see value in it? Hell no. That’s why I can’t remember anything from grade 12 physics.

I think we’re asking the wrong question. We can do better than “how can we lower the dance injury rate?”. Find better questions, get better answers.

The following are some of the questions I asked at the seminar (the ideas that, as the aforementioned dance-mom stated, “we don’t think about”). And honestly, I don’t have all the answers, so I appreciate your feedback and input as to how we can better address these, as well as your ideas on what other questions we could be asking.

What if we could re-frame injury prevention as performance enhancement?

A no-brainer to improve buy-in, right?

Instead of harping on dancers about the risks of injuries, what if we made a painless shift to, “Do you think that if you could dance without pain and worry of injury, you could take more risks, excel technically and artistically, and dance for longer?”

What would happen if you placed just as much value on your self-care, cross-training, and recovery practices as you did on your dancing?  

I asked them, out of 10, how important is it for you, your students, or your children to be able to dance at the best of their abilities, reach their potential, and keep dancing for as long as they want. One dance teacher raised her hand and said “20/10!!”

Imagine if dancers also put a 20/10 importance on their self-care? Game. Changing. Awesomeness.

What would it take to make you care about injury prevention?

An injury.

Kind of sad, but this is the only answer we could come up with. The issue is that after an injury is sometimes too late. So how do we appeal to this shift in priorities before an injury happens? A question that remains unanswered for now, perhaps…

What makes people change their behaviour and want to form new habits?

If we were to treat injury prevention not as a concept, but as behavior modification- a habit, it could be a game changer.

Less: “Do this, do that, get stronger to prevent injuries! You’re gonna hurt yourself if you keep doing that”. Who cares. I don’t want to hear that. When people tell me what to do, naturally, I want to do the opposite, especially if I don’t understand why or have any emotional investment in it.

Remember, we can’t change the state of dance injuries until we change the value dancers perceive of our injury prevention strategies.

What if we asked things like, “Do you value your body? Would you like to enjoy movement more? How long do you see yourself dancing for?”

In The Power of Habit, by Charles Duhigg, the way in which people are described to change their habits is through the structure of trigger, habit, reward.

Trigger: Sit in front of the TV.
Habit: Eat a tub of Tiger Tiger ice-cream (mmmm, my favourite)
Reward: Temporary satisfaction of relaxing and unwinding via the tasty tasty ice-cream flavor

But we can interrupt this pattern by keeping the trigger and reward, but changing the habit.

So…

Trigger: Sit in front of the TV.
NEW Habit: Knitting.
Reward: Satisfaction of relaxing and unwinding born from a sense of mental focus, presence in the moment, and flowing creative juices

In the case of dancers preventing injuries, we can use the example of the typical shitty warm-up (or lack thereof…):

Trigger: Time for dance class!
Habit: Sit in the splits and stretch passively to “warm up”
Reward: Temporary feeling of improved flexibility, and sense of confidence and preparedness from having gone through a meaningful ritual.

But we know this might not be the most sustainable long term. So what if, instead:

Trigger: Time for dance class!
NEW Habit: Treat warm-up as a deep practice of movement, requiring complete presence and awareness, respecting the body’s limits and needs, while preparing it for the demands of dance class.
Reward: Lasting sense of improved connection to the body, range of motion, and a sense of preparedness and confidence that can only come from being totally present in your body.

Same trigger, a more useful habit, and similar (yet superior) reward.

But still the question remains, how do we make the habit change seem valuable in the first place? They have to feel the reward! Just one exposure to something different with a perceived value to it. That’s all it takes. And ideally, this should happen before an injury.

If we consider the performance pyramid hierarchy, at which tier does a dancer’s training generally begin?

If you’re not familiar with this pyramid. That’s it to the right —>

As an early specializing sport, there aren’t many opportunities for dancers to experience to reward of good quality fundamental movement from a young age, and how empowering strength training can be.

We start right out the gate at the top of the pyramid- specific skill, with plies and back-bends without having learned to hip hinge or lunge… Some dance teachers, though I beleive they are a fading generation, still encourage dancers not to participate in any other sport or activity other than dance, limiting their movement options and general physical preparedness.

What if we could include fundamental movement as an important component of a dancers early education?

Does being highly proficient technically automatically infer a strong base of fundamental movement and physical performance?

Nooope. Just ask my mom. I bet she could do more push-ups than I could when I was in the self-proclaimed “best” dancing shape of my life at age 15.

We shouldn’t assume that just because a dancer is strong technically, they are good movers in a fundamental sense, or have a requisite base of strength to perform their best, because they might have unlearned some important human motions in favour of fancy tricks and to fulfill a specific aesthetic and neglected any other forms of cross-training.

Feeling the reward: The simple power of breathing and natural spinal movement

Providing dancers an opportunity to experience the beginnings of a new habit and a superior reward isn’t rocket surgery.  It can be as simple as taking some time to breathe, and explore movements they might not have the opportunity to in classes.

So to close the seminar, we explored some movement.

We checked in.

We breathed. 

We cogged

Some cool stuff happened. One younger dancer’s face lit up. I asked her what she had experienced and, with a smile and tone of wonder to her voice, she told us that all the pain she usually had in her back was gone, and her weight felt even on her feet.

Another gentleman, a parent of one of the dancers who was totally awesome and uninhibited and participated in the movement session, reported something similar.

And by the way, I think it’s so great to get the parents involved in this re-framing process. As parents, one of the most helpful things we can do is to model a behavior and mindset we’d like our children to adopt (but that’s coming from me, a non-parent, what do I know? I know that we can’t fix or change people, that power lies only in the individual, and kids are no different).

If you’d like to learn more about stuff like this, my colleague Bizz Varty and I are currently planning a teacher training workshop based on the concepts and exercises from Dance Stronger, which is tentatively being held in London Ontario on October 3 2016. Just shoot me an email if you’d like to be kept in the loop. This will be our pilot workshop, and hopefully the beginnings of a full length training program for dance teachers. Very stoked.

PS for anyone interested in public speaking, I discovered a cool “trick” that really helped- Nose breathe. Only. No inhaling though your mouth while talking. I found I was able to retain my mental energy and was not drained after presenting. When you practice nose breathing while talking your throat doesn’t get dry, you create natural pauses between sentences to keep the audience engaged and better choose your words. You’re forced to slow down. You become aware of yourself, and fully present in the moment. Game changer, for sure.

I attribute this tip to Steve Donald, who taught a Buteyko breathing method seminar in Toronto a few weeks ago. Among the many benefits of nose breathing over mouth breathing, he brought up the fascinating correlation between effective communication and nose breathing. Not just for performance enhancement and health, nose breathing helps us build better relationships by improving our communication.

mouth breather

 

PPS If you want learn more about what I mean by breathing and cogging, it’s covered in the 30 Day Challenge, something I created with just this intention of changing our habits and the value we get from movement. Sign up for free and check it out.

 

Dance Like a Human (part 3): Movement Variability

Dance Like a Human (part 3): Movement Variability

#Simpsonschallenge. I must  use a Simpsons reference in every blog post. Because that is how I was raised.

Read part 1 here.

Read part 2 here.

And welcome to part 3. In my mission to be more concise, let us get right to the point.

Today we’ll be talking about movement variability.

Movement variability means having options. But not too many options—>

 

Movement variability: An optimal amount of variance within the global movements, due to the infinite changing conditions that occur before and during the movement task.

Here’s what’s on our agenda for today:

  • What is movement variability and what is it good for?
  • How can we appraise it in our bodies?
  • How does higher variability help us as dancers and movers?
  • Other random stuff that comes out of my brain.

Ready?

What is movement variability?

Picture yourself walking down the street. Something shiny catches your eye over the the right. With your eyes in the other direction, you don’t see the uneven patch of concrete and your ankle rolls over  to the outside.

Outcome 1: Sprained ankle. OMG! NO!

Outcome 2: You’re totally fine.

What’s the main factor determining your fate? Could be luck. But it’s more likely that in outcome two, your body understood how to get out of the ankle roll because it had been there before in a more favourable, safe condition, which didn’t result in an ankle sprain.

You and your ankle had the OPTION to get out of the inversion moment because that movement was in your body’s present vocabulary and you knew how to use it reactively without thinking.

This is an example of possessing movement variability, and using it in real life.

Having multiple strategies for joint and segment interaction to accomplish the same movement (walk around while gazing dreamily off in space, crappy sidewalks or no).

Having options (to move your ankle into maximum inversion and get out of it safely).

Having tri-planar movement ability when you want it, where you want it, to do whatever you want with it (to avoid inversion sprains).

The spice of life

Plain food sucks.

Unless you agree with the food shape…

I’m very sorry if that was disturbing for you…

Anyway, as in food, so too in movement; a lack of variability is not only bland, but…

…result in systems that are less adaptable to perturbations, such as those associated with unhealthy pathological states or absence of skillfulness.

~Human movement variability, nonlinear dynamics, and pathology: is there a connection? (Human Movement Science, 2011)

Movement variability provides us the ability to handle errors and make real time adjustments that occur with movement. Not enough variability and we become stuck in a pattern with limited options, increasing the potential for acute or chronic overuse injuries.

Variability creates movement options in multiple planes to cope with volatility (and all life is volatility). How well we get on amidst the volatility is a reflection of how safe or unsafe we feel with this perpetual flux, and how well we can find strategies to deal with it.

INTERESTING ASIDE: A lack of coping strategies is one of the top reasons researchers think dancers get hurt, so variability as a coping mechanism is a huge deal:

…ballet dancers tended to distinguish poorly between pain that is customary in dance performance and pain associated with injury. Pain is typically seen by dancers as an accompanying facet of dance practice, and dancers are prone to “dance through” pain, even when doing so may be detrimental.

…researchers determined that ballet dancers who are taught general psychological coping skills experienced fewer injuries and less time injured.

~Preventing dance injuries: current perspectives (pen Access Journal of Sports Medicine, 2013)

We can also potentially link optimal movement variability with a healthy variability and function of our autonomic nervous system: The ability to relax when we need to (parasympthetic), and to mobilize ourselves into action when necessary (sympathetic). We need to be able to do both to dance.

Evidence also shows us how higher movement variability reduces risk of injury, or, at the very least, is correlated with non-injured states.

You can see that movement variability is a pretty huge deal:

  • More movement options
  • More freedom in movement
  • Ability to reproduce movements reliably in variable environemnts, like, on stage under bright lights and high stress
  • Less injuries
  • Better neuroregulation

Sounds great, eh?

Embrace chaos

What’s interesting is that optimal variability in movement appears “chaotic”, which makes it easy to interpret as “noisy” and not useful. This is incorrect.

One thing I’ve come to appreciate about human movement in the gait cycle, is how freaking chaotic the map of every joint motion seems. But chaotic doesn’t mean unhealthy.

First it is important to distinguish between two different kinds of variability: “End point” and “coordinative variability”.

End point variability: Refers to the product of movement, for example, stride-length, jump height, pirouette, etc. Ideally, this should be low. It’s nice to be able to reliably  perform tasks in a similar way each time we do them. Each step, each turn, minimal surprises.

Coordinative variability: Refers to the variability of the interaction between segments or joints. This should be high, or, within an optimal window that is neither too low nor too high. It’s nice when individuals can use multiple strategies in their bodies to safely achieve the same outcome.

When we look at literature relating movement variability with over-use injuries, the traditional view is that low variability in movement is good, because we want to be able to have a reliable experience when we go and try to use our bodies. Makes sense, BUT this  is only true if we are working with “end-point variability” which refers to the PRODUCT of movement.

When we zoom in, we see that variability in how joints can safely and easily interact should be high.

When we zoom out we can see how variability in the product of the joint and segment interactions should be low.

Having multiple safe and effective routes to drive to the grocery store is more useful than one “perfect” route, and can save you time and stress when 3 of those routes have massive construction.

To put it another way (as stated HERE):

 The path to frailty or injury is identified in this emerging perspective by a loss of variability in fundamental variables reflecting biological function

A loss of freedom. A loss of optionality. Injuries. Disease. Awkward dancing.

Movement variability vs. being skilled at making movement look good

But aren’t dancers already exposed to all kinds of movement? Doesn’t being a dancer imply high movement variability?  

Just because you can make all kinds of movements look good, doesn’t mean you possess the variability to perform the safely, efficiently, without extra compensation, and that you can keep doing them that way for as long as you wish.

Too, many dancers, particularly those who are hypermobile, have so much variability and don’t know how to use it. Too many options is just as troublesome as not having enough options.

This is why as educators, trainers, and health-care practitioners we need to understand how to look at fundamental movement quality.

Dancers need to prepared for infinite movement options, because you just don’t know what the choreographer is going to throw at you.

Ohh Marie Chouinard…

An example is a professional ballet company hiring a contemporary choreogpraher who may ask the ballet dancers to move in ways they are not used to. This often can increase the instance of injuries, despite the technical prowess these dancers possess: They just aren’t prepared for the new physical demand!

The fallacy: Strong technical skill does not equal adaptability, fundamental movement quality, or general strength, although adaptability, movement variability, and physical strength DO create the potential for stronger technical skill. 

So even though we could infer that dancers have high movement variability, this is sometimes an illusion due to skilled, but patterned movement.

As we know, being stuck in one pattern, even one you can do really well, does not create the multitude of options your body craves to perform safely and effectively in a variety of unpredictable situations and environments:

  • Different floors
  • Different lighting
  • Different size or shaped stage
  • Different style of dance
  • External stressor messing up your movement game
  • Uncomfortable shoes

Just consider the injury rate in dance. That should be enough to question: If a non-injured state is correlated with higher movement variability, and dancers are rarely in a non-injured state, how optimal is their variability, really? 

Is it too high, or too low? Where’s the sweet spot?

How did we get this way?

We were all born as bundles of perfect movement potential. Where the heck did things go wrong??

In dance a major factor is that we never mastered the fundamentals. Early specialization plays a role in this.

This is something I discuss all the time in this blog: Never having established, (or lost) a requisite base of fundamental movement. Miguel Aragoncillo wrote something really great on this topic (long term athletic development) a while back, too.

So while many dancers appear to be able to move their bodies in all kinds of ways, they are doing it without a foundation of tri-planar movement to support them, thus desirous coordination and interaction between joints and segments is not happening.

They can make most movement look good (their job as dancers, after all), but when it comes to the fundamentals, they might not be able to demonstrate clean, simple movement.

“Fundamental is not lowest level, but highest importance” ~Source unknown… Probably some Shaolin monk

So maybe you can achieve the range of motion you need, but it comes with an energetic cost, requires some “cheats”, and can cause some problems long term.

How are you doing?

Because I believe that demonstrating the ability to move well in three planes says a lot about you, how you’re doing in life, and the state of your autonomic nervous system. But that’s not really in the scope of my blog, just something I’m observing.

To illustrate the idea of clean, non-compensatory, tri-planar movement, just stand up and give these a try:

  • Can you posteriorally tilt your pelvis without bending your knees?
  • Can you shift your pelvis to one side without also rotating it?
  • Can you rotate your pelvis without also hiking one side?
  • Can you lift your ribcage up without having to lift your chin?
  • Can you shift your ribcage to one side without also tilting your head?
  • Can you tilt your head without shifting your ribcage to one side?
  • Can you inhale without needing to flare your ribs?
  • Can you exhale without thinking you’re going to die?

In other words: Can you do one thing without having to do another thing if you don’t need to? 

How’s your behavioural variability?

As in movement, so too in life…

Can you receive a correction in class without also taking it personally and feeling like a failure for a week?

Can you express yourself and your feelings-be vulnerable, without oversharing unnecessary details. Like that time in Vegas, you know, the incident at the swimming pool, with the peanut butter, and the Elvis impersonator?

Can you eat just one Lay’s chip?

You get the idea. The meta question is, “Do you have the ability to choose?”.

Movement being a behaviour, and behaviour requiring movement, we can see how variability is useful not just for physical performance, but LIFE.

Back to movement though, because this isn’t a behavioural psychology blog.

In an optimally variable system, we should be able to differentiate tri-planar motions, such as in the examples above, meaning, body parts can move in three dimensions independently of others to a certain degree.

Quite often this differentiation is missing: Things get smudged together (technical term). In the motor cortex, areas related to one body part can overlap with others creating this situation in which things HAVE to move at the same time and going through life as a chunk this is not going to feel good for very long.

life as a chink

The “traffic light” variability classification system ©™®;)

Here’s my FMS inspired “red light, yellow light, green light” approach to simplistically classifying potential variability, both for me to observe, and for the individual in question to feel.

I am basing this off results my standard movement screen, part of which uses the Anatomy in Motion model to look at triplanar movement through the pelvis, ribcage, and skull.

I feel that most people can be classified as green, yellow, or red, to varying degrees. Where do you fit in?

GREEN LIGHT:

  • You can differentiate most joints segments and movements with relatively symmetrical ranges right to left, front to back.
  • You are not completely missing one plane of movement.
  • What you feel happening is an accurate representation of what is actually happening.
  • Strategy: Let’s train hard, swing some bell, and kick ass. 

YELLOW LIGHT:

  • You may have difficulty differentiating some (or many) movements.
  • You have some pretty evident asymmetries right to left, and one or more planes of movement may be completely inaccessible
  • There is some discrepancy between what is actually happening and what you feel happening with movement.
  • Strategy: Let’s train the crap out of what you can do well. Spend some time exploring missing movements in reasonable, safe doses. Keep checking in regularly to see if things are improving. 

RED LIGHT:

  • Most of the body finds differentiating movements from one another troublesome and foreign as a concept, often bilaterally.
  • Very apparent asymmetries side to side and/or multiple planes of movement completely inaccessible.
  • Very little ability to distinguish whether movement is happening, in what quantities, and whether the range or quality differs from side to side.
  • Presence of acute pain with some movements.
  • Strategy: Let’s consider the need for rehab. If they don’t need/want rehab, get them breathing well, build in education on the value of movement quality/differentiation into sessions. Emphasize tuning in to how movements feel. Focus on making movement exploration feel safe with a conservative approach to adding intensity.

As a trainer with manual therapy skills, not a rehab professional, my general role is to help already healthy people get even healthier and perform better, yet due to the nature of the gym I work in (which is also a sports medicine clinic) most of my clients are fresh out of physio, and I tend to see a lot of sensitive, red light folks.

Though they have been “cleared” to begin training for fitness or strength or whatever their goals, just because their treatment is “done” it doesn’t mean Red Light Randy is ready to jump into a training program without first building a movement foundation, and learning to differentiate and appreciate his body in 3 dimension.

Randy: A classic Canadian work of art

I think a good chunk of dancers can be classified as red-lights. Surprising? Not really.

Dancers become really, really good at moving in specific patterns. They take great pride in their patterns, and will hold onto them for dear life. Does this sound like someone who can differentiate movement? Does this sound like someone with variability?

If we think of the biases in dance training and performance (those trained in ballet primarily) there are some “patterns” that can become pretty ingrained, such as preferring to stand and turn on the left leg, turning to the right, and gesturing with the right leg.

But it is useful knowing this lateralization is common, reducing our ability to move in various ways, and points to the importance of providing strategies for dancers to enhance and clean up their ability to differentiate body parts and their movement both right and left, in all dimensions.

Can you move it if you can’t feel it?

We need to back up for a moment and consider that if you can’t feel certain parts of your body at rest, it will be difficult to move them, too.

In your brain there is a physical area called the somatosensory cortex that holds a “map” of your body. In this map, the hands and face have the most representation- more brain tissue devoted to them, compared to the rest of the body, meaning we are more sensitive to touch and sensation in these areas.

What is also pretty cool is that the somatosensory cortex also has a motor function when the motor cortex is impaired.  Just shows that the structure in your brain that allows you to sense your body also is important for moving it.

Furthermore, in this monkey study, it was found that overuse of a particular pattern of movement requiring minimal variability, resulted in  motor control deterioration and degradation of body part representation in the somatosensory cortex.

To boot, in this study, there as a link found between somatosensory afferent input and motor control in people with neck issues.

How well you feel your body is linked to how well you move your body. 

This seems pretty common-sensical, but then you look at the number of people who don’t want to take the time to learn to “re-sense” where their heads are at, literally, and just want quick fix stretches and exercises.

I believe that a piece in this optimal variability puzzle is being able to feel each part of your body and have your brain recognize they exist while NOT moving as well as in motion. To me, this somewhat explains the hypermobile people who have all the movement potential in the world, but without an ability to feel their bodies are unable to fully use them.  Would love to hear some thoughts on this.

Can you sit still, close your eyes, and have a conversation, not a monologue, with your body?

“Hey there ribcage, I feel you there, I know you exist, how’s it going today”

“Actually, brain, I’m feeling like you don’t fully appreciate me, but thanks for checking in. Let’s work on this relationship a bit harder”.

This could be the topic of a blog post for another day, but I believe this ability to sense body parts at rest, to distinguish what you can feel clearly and what you cannot is incredibly important for movement.

Maybe I’m talking about meditation, maybe I’m starting to sound esoteric. But what I’m getting at is that differentiated sensory input = differentiated motor output.

How can you expect to get up and perform complex movements when you can’t even feel a body part at rest?

I would love to see more dancers develop an appreciation for the ability to sense themselves and their bodies at rest, and I think adopting this as a daily practice could be a huge asset.

In the ballet class I go to regularly, we begin each class in exactly this way: Lying on the floor, encouraged to explore which parts of our bodies we are able to sense, whatever that means to us. This has had a profound impact on my ability to connect and feel my body in motion and has allowed me to make interesting connections to why some movements are difficult to do, which streamlines my process of making adjustments in training and in life.

I would love if more dance teachers took the first five minutes of class in this way, to help the dancers tune in and appreciate their bodies in stillness before layering on the complexity in which this appreciation can become easily lost.

In martial arts, the “tuning in” part of training is huge. Being able to feel your body. To see yourself doing something in your mind before doing it with your body. Why is it not seen as important in dance? And in other sports?

Conclusions?

  • Higher movement variability (coordinative variability) is linked to being in a healthy, uninjured state, and provides you with multiple useful and safe strategies to perform the same task. Knowing that the world we live in is highly volatile, our ability to adapt and fine tune movement in real time is a crucial ability to possess.
  • Higher movement variability allows us to improve our performance as dancers by improving our ease and freedom in movement, get our joints into the positions we want without strain, and allowing us to easily adapting to new choreographic styles while reducing the risk that we might injure ourselves in the process.
  • The role of cross-training in dance is not limited just to strengthening and improving mobility, but to ensuring strength and mobility are built in a way that enhances movement variability. Often, the choice to participate in a strength training program is enough to enhance variability due to the new novel input.
  • The ability to differentiate the movement of  joints and segments in three planes is a useful way to appraise potential for movement variability, and a great learning experience for the individual.
  • “Tuning in” also plays a role in being able to sense our bodies at rest, which can influence how and what we can move when we are up on our feet. This is something that needs to be discussed and valued more highly in dance training.

That’s all for now. I think I wrote enough. Believe it or not, this post was originally much longer… You’re welcome.

Stay tuned for part 4.

Just the Right Dose of Harm

Just the Right Dose of Harm

Dance science research is always looking for ways to help dancers become injured less.

“Why do dancers get injured?”

Science can help, but science doesn’t dance. We can try to make predictions, but predictions are often imprecise.

Predictions don’t prevent, they predict (without precision)

Think of dance is a fragile art, (which one wouldn’t initially see because the artists themselves appear so strong), because it is negatively asymmetrical, in its approach to training (and I don’t mean anatomical asymmetry).

Positive asymmetry: When what you have to gain is disproportionately larger than what you could lose. The gains are unknown and massive, while the failure and loss is small and known.

Negative asymmetry: When what could be lost is disproportionately larger than what could be gained. The potential losses are large and known, but with an equal (or even slightly lower) upside.

What we would rather see is an upside-downside asymmetry: More positive asymmetry. Small, manageable known-losses, and unlimited gain. We learn how to manage and avoid small losses through experience, not through theory and research (as much as I love theory and research!).

Dance and dancers are fragile.

At any moment, everything could be lost (huge, career threatening injuries).

The risks are large and known compared to the potential reward (larger likelihood of becoming injured than “making it big”.)

There is proportionate risk and reward, perhaps even veering to the side of more risk than reward (when you consider the small number of dancers who “make it”). A dancer can go from feeling invincible one day, to bed-ridden the next.

Help a dancer find a way to achieve positively asymmetric payoffs. Reduce the downside and uncertainty, and increase the upside.

But we do not need to coddle dancers. Treat them like precious flowers who need constant protection. Let them lift heavy things. Let them make mistakes. Let them experience small doses of stress and harm. They need to feel the extremes.

This asymmetry is present in the elements; the downside smaller, yet still present, contributing to the existence of the upside. Like fire needing wind to ignite it: No wind, no fire; too much wind, no fire.

Let dancers play with just the right amount of fire. Experience just the right doses of stress and harm to teach them to cope with the downside; to see there is a downside, and learn to reduce it, by playing with it, to allow for a disproportionately larger upside.

“Provide for the worst; the best can take care of itself” ~Yiddish proverb

What research shows us is that previous injury and lack of coping mechanisms are the highest contributors to future injury.

What research can’t show us, is how injury can teach us to cope, can show us the downside, and if we let it, teach us mechanisms to reduce our fragility in these situations: Small exposure to harm, with proper coping, can result in extreme reward.

You cannot learn to cope without small doses of harm to cope with.

Avoidance of risk cannot teach us anything but to dissociate. And fear that previous injury makes us fragile is unnecessary.

What if instead of asking “What causes injury”, we asked “What can we learn from injury?”.

What I’ve learned from injury is written in this blog, and I continue to learn from it everyday, where reading and theories have failed to show me answers.

 

 

How to Reverse Engineer a Jump Landing for Happier Joints

How to Reverse Engineer a Jump Landing for Happier Joints

The ankle and foot are among the most common site of injuries in dancers, and is it any surprise?

The desired aesthetic for dancers to point their feet, pull up their arches, and push their knees out as far as possible can create the avoidance of some important joint movements (listed a bit further below) which are necessary for shock absorption upon landing a jump.

I have landed from jumps feeling shooting pain through my ankle, but put on a smile and “danced it off” to keep going. Landing a jump well is pretty important.

Often in working with dancers, our initial instinct is to initiate plyometric training in an attempt to teach the dancer how to land more softly, with better mechanics.

Is this wise as a first measure?

What if reducing foot and ankle injuries was less related to training strength and power, and more to practicing the allowance of joint movements necessary to absorb shock upon landing.

Unfortunately, these movements that are commonly avoided for the sake of aesthetics. (I will refer to these movements cumulatively as “loading the spring”).

When you land a jump, you load your spring.

Consider that paradoxically, to clean up a jump, the landing might need to look a little more “ugly” (by ballet standards, anyway).

Guess what, pronation and valgus are not the evil step-children we’ve been avoiding.

Let’s let go of judging what the movement looks like for a moment, and honestly appraise what movements need to happen in the human body for optimal shock absorption to take place.

“Ugly” joint mechanics for optimal shock absorption (AKA loading the spring):

suspension

Looks kind of like this

Rear-foot (calcaneus/talus): Eversion, plantar flexion, internal rotation. Yes, pronation! Which drives…
Ankle: dorsiflexion
Tibia, femur: internal rotation (not turn-out!?)
Knee: flexion, external rotation, valgus
Hip: flexion, external rotation, adduction
Pelvis: lateral hike, anterior tilt
Lumbar/thoracic spine: extension, rotation towards landing leg, side flexion towards landing leg

Wait… Allow pronation, internal rotation, and valgus? Aren’t these “bad”?

In the human body, the above joint actions must occur to eccentrically load the muscles necessary for successfully absorbing shock (plantar fascia, medial quad, glutes, etc). These are not static joint positions, but brief moments (less than a second) that the human body must pass through.

What would happen if we helped dancers to experience these important moments in their bodies, rather than brace and control in conditioned avoidance of “ugly” positions?

Inline image 3

The “suspension” movement to train more optimal shock absorption. Notice the joint actions of the front leg? Think this is ugly?

5 ways classical dance training can alter landing position and limit optimal shock absorption:

 

1. Feet get stiff.

In a closed chain (foot on floor), the rear-foot and fore-foot need to be mobile and move in opposition in each plane, allowing joints to open and close to take the shock of the landing.

In dance, the foot can become very strong and rigid losing mobility and ability to oppose through pronation and supination. Feet can get stuck stiff and inverted or stiff and everted. Neither is ideal.

Add to this that many exercises dancers use to strengthen their feet and ankles are done with a band, open-chain, which does not allow foot opposition and is not specific to how the foot was designed to function on the floor, in gait.

2. Attempting to maintain perfect turnout in foot and leg while landing.

Upon landing, the rear-foot (talus and calcaneus) needs to evert and internally rotate (pronate!) to load the spring of the plantar fascia and windlass mechanism. The rear foot drives the tibia and femur to internally rotate and the knee and hip to open. This is what we want!

Dance often demands that we turn everything out: Foot, ankle, thigh, knee-cap; and by limiting this necessary internal rotation we also limit the ability of the knee and hip to open and absorb shock.

Landing with everything turned-out can limit natural movement and jam up joints rather than “load the spring” to manage impact.

Landing with the foot and leg turned out… Not the type of pronation we want!

Landing with lots of turnout in the foot, tibia, and thigh, limiting shock absorption.

Landing with lots of turnout in the foot, tibia, and thigh, limiting shock absorption.

3. Landing in hip ABduction rather than allowing ADduction (again, that turnout!)

To absorb shock optimally, the hip must adduct in the frontal plane, following what the foot is doing below. In dance, however, we are trained to avoid inward knee movement and deny ourselves this important moment of valgus.

Dancers, wanting to always be turned out to the maximum, tend to land with the knee pushed out and hip abducted, preventing that lovely shock absorption from taking place.

4. Trying to keep the pelvis upright, not allowing an anterior tilt to occur to with landing.

Upon landing, the hemi-pelvis on the landing leg side should anterior tilt to “load the spring” (which in this case is the glutes, which load with anterior tilt). Being cued to tuck under, or keep the pelvis perfectly level all the time and avoiding anterior tilt, again, denies the dancer of this important moment.

5. Chronic extension posture preventing dancer from extending further upon landing

Lumbar and thoracic spine extension is another way to “load the spring”, allowing the dancer to eccentrically load and then use the abdominals to enter and rebound out of the landing.

If a dancer is already stuck in an extended position with static lordosis and rib flare at rest (which is quite common…), this spring-like mechanism will not take place, and vertebrae may compress rather than abs taking load.

patho turnout

 

Do you stand like this at rest? Can’t get out of extension?

Now, you may be thinking…

“But I see so many dancers who land with their knees going in and over-pronating, and that is not a good look.”

“Surely asking a dancer to land with an anterior tilt and extended spine is not safe??”

These movements: Pronation, knee valgus, anterior tilt, and spine extension, are not bad. If you could not perform these movements, I would question how you are able to walk.

These joint movements only become a challenge when a) You get stuck in them, or b) You can’t get into them at all.

Landing WITHOUT permitting a brief moment of pronation will not allow shock absorption.

Landing already IN an anterior tilt and extended spine will not allow shock absorption.

I do not mean that we should coach dancers to land excessively pronated, turned-in, with knee valgus. These are subtle, fleeting moments in a spectrum of movement. Subtle, but important.

If we give dancers activities that allow them to experience naturally moving in and out of these foreign positions safely, they might just choose to store this as a useful pattern and use it in their dancing at the appropriate time without over-coaching and conscious effort.

A good place to start would be the “suspension” movement, which was created by Gary Ward and taught through Anatomy in Motion. Suspension simulates the shock absorption phase of gait following heel-strike. It could be used as a warm-up before class, or as a supplementary exercise as part of a cross-training program.

Notice I’m doing my best to pronate (not easy for me!), internally rotate my leg, and allow my knee to come inside my big toe, while slightly anteriorally tilting my right pelvis and extending my back?

Work in progress…

What you might feel while suspending:

  • Front leg quad getting burny (this is eccentric loading- the muscle contracting as it lenghtens)
  • Front leg glute getting burny (eccentric loading)
  • Front leg plantar fascia stretching and opening
  • Front leg achilles tendon area/calf stretching and opening
  • Back leg hip stretching and opening
  • Back of the neck stretching
  • Abdominals stretching (rectus/obliques)

Give it a try and see what happens.

Please note, however, that I don’t feel it is wise to TRY to land like this. Don’t attempt to change anything about your landing. Simply give your body this experience outside of class, and trust that you have now shown your body some new landing strategies that it may chose to employ the next time you jump, with little conscious effort.  Landing with a few extra degrees of real pronation and ankle dorsiflexion might make a huge difference.

And just for fun…

Exercises from Anatomy in Motion haven’t only been helping me land jumps feeling more safe, but I feel (subjectively, yes) that my developpe height and hip mobility are improved, both on the standing leg, and the gesture leg.

Here’s something I’ve been working on (believe it or not, this is actually easier with a weight over head- Lot’s of great feedback for not falling over):

Transition from side to back in a grand rond de jambe was something I could never do without crazy hip cramping. The other day, after working on some AiM I tried it out, and it felt pretty good! No cramping.  Leg comfortably around 90 degrees. Had to take a video (don’t try this at home unless you feel solid about plain old Turkish get-ups).

Don’t think you’ll be seeing me in a ballet class anytime soon, though ;). These days, I’m loving parallel standing leg, and no one can convince me that turnout is prettier. It’s just a different aesthetic. My choice. My knees…