The Problem With Dancers Today

We have problems

No, not “dancer-problems”, like those mentioned in this moderately humerous video. But rather, the problem WITH dancers.

There are a number of them. And the one thing they all have in common is that they are
self-imposed, avoidable, and have a direct correlation to the staggeringly high rate of injuries associated with the profession. The problems I speak of aren’t just physiological, but also psychological in nature- Both feeding off of each other in a vicious, cyclical fashion. A perpetual-motion machine of sorts, accelerating down a seemingly endless highway, not an obstacle in sight. Endless that is, until the inevitable brick wall. What happens if you ignore the brick wall?

But I recall fondly what my favourite philosophy professor once said, “The best analogy for the thing in question, is the thing itself.” And so I digress.

I am nearly done the initial interview process of my program, and it is really fascinating. I want to thank all my dancers for letting me delve into their psyche. Among one of the most interesting questions for me to ask was why they dance. What kept them motivated, and what in particular they like about it? It is important to note how some of them couldn’t pin point specifically what they liked about it. By the way, every dancer I interviewed reported some kind of repetitive injury, in varying degrees to either their back, knees, ankles, hips or rotator cuff. Or all of the above. It was fascinating to hear why they kept at it, despite constantly sustaining these injuries.

To the general masses of people, and many athletes even, injuries and pain tend to stop them from continuing to do the activities which hurt them, time and time again. At the very least, they alter what they are doing so that it hurts less. This lead to problem #1 with dancers:

They don’t listen to their bodies.

Call it suffering for your art, or whatever you want, but if you don’t listen to the messages your body is sending you, there will come a time, when you won’t have a functional body to create your art with. These messages are actually really easy to interpret: Pain means stop, no pain means go (or rather, proceed with caution). Pain is generally your body telling you to slow down, and stop, because what you’re doing to it feels really bad. If you do not stop, your body will stop you, eventually, and it won’t be pleasant. You will be out of commission for longer than if you had initially listened to your body, and be stuck on the sidelines, watching your peers (which can actually be an excellent learning experience if you let it). Being stuck on the sidelines is damaging for the ego. As Stephanie Hanrahan points out,

“When injured, dancers are expected to watch classes. Although a few found they could learn something while in the role of spectator, no one enjoys the role. Many would rather dance on an injury instead of observe. Additionally there is the underlying stress of others improving and looking good when the individual cannot participate because of illness or injury.”

It is clearly more intelligent to avoid injury in the first place, by not doing stupid things, but many of us must learn the hard way. Such is life, I suppose.

There is obviously a difference between good pain, and bad pain. If you have to stop and consider whether it is a good pain or not, it probably isn’t. I read something interesting on Rusty Moore’s fitness blog, Fitness Black Book. His article was titled: “Are you in shape or do you just have a high pain tolerance?” Having a high pain tolerance certainly can help one to push through a tough performance, class or training session, but if you don’t have a great level of fitness (which we’ve previously established that most dancers don’t) and still push through the pain, the benefits are likely to be limited, or even non-existent verging on harmful.

Their use of imagery is inefficient

Rather than have to consciously apply a visualization to a movement every time you do it, wouldn’t it be nice to just have that feeling automatically, every time? My philosophy for training dancers is not to give suggestions for what kind of imagery you could use during classes, but rather to instill that feeling in the dancer at a very basic lecvel, which they will then bring into class during more complex work.

The first phase of my training program is inspired by Dr. Stuart McGill’s method of training athletes while sparing their backs and other joints. His first phase is named,“grooving motion and motor patterns”, and this is where physiological adaptations are made which not only provide you with the appropriate imagery, but gets it stuck in your system. This trains your muscles to fire automatically, as needed: You won’t have to visualize youself as “ a tree, growing out of the earth” to get on your leg, or “water flowing off of your arms”, to find the proper arm position. This just wasn’t my style, and for many dancers, it doesn’t work.

Instead, a better method is the anatomical education of what specific muscles need to work, and what muscles don’t. Then, train the appropriate muscles to become hyper-responsive. Many people, even dancers, don’t know what it feel like to use the right muscles, and the best way to teach this is through the use of imagery.

It has been found that it is most effective to apply different types of imagery for any given exercise. In a study published in the Journal of Dance Medicine and Science, it was  determined that using kinesthetic imagery (imagining a feeling) was more useful to improve turn-out during a plie exercise, but using visual imagery, (picturing your body from an external point of view), was more helpful for jumping.  They concluded that,

the success of motor imagery in improving performance may be task-specific. Dancers may benefit from matching imagery modality to technical tasks in order to improve alignment and thereby avoid chronic injury”.

In fact, many dancers I interviewed told me they did indeed use a mixture of internal and external imagery.

Once one has this proper “feeling”, the muscles can then be made stronger. If the muscles you need to be “on your leg” (aka, the hamstrings, glutes, and abdominals, working in harmony) are strong and hyper-reactive, then they will react, and strongly, when you need them. Makes sense, no? The less you have to think about what your body is doing, the more room there will be for you to blossom artistically by focusing on what really matters- Your emotional expression. Think less, feel more. Isn’t that what art is about?

Another study conducted by the Auckland University Sports and Medicine department found that using kinesthetic imagery was more effective for motor control that visual imagery, or rather: Focusing on what it felt like to use your body was more effective in activating the right muscles than was visualizing what it should look like. My interpretation of this is that because though many of us know what certain positions should look like, we often don’t have a clear and distinct image of what our own bodies will look like doing that very thing. I believe many dance teachers would agree that it is more effective to find your own unique “feel” for a movement. This way we not only activate the appropriate muscles with more strength, but we also don’t get that awkward “trying to dance like someone we’re not” look. An intangible, but very difficult to hide, quality of movement.

Appropriately applied kinesthetic imagery allows the dancer to simply dance as the best versions of themselves without comparison or judgement. Once the appropriate imagery in ingrained in the dancer, then I believe that visual imagery can be used as a supplement, such as in jumps.  To jump higher, is a visualization that is universal, which is likely why the study found visual imagery helped the dancers during jumping exercises.

But enough about imagery, I could say more, so perhaps a whole post should be devoted to the subject instead. On to dancer problem #3:

They have weak arms

When I told my physiotherapist that I could do chin ups, he said “And you call yourself a dancer? You should be ashamed”. Obviously he was joking, but it just points to the fact that people don’t associate dancers with having arm strength. But why shouldn’t they have strong arms?

The thing is, dance, by definition, allows for an unlimited range of movements. Often times, in modern choreography, dancers need to propel themselves with the use of their arms, or lift each other. Gender lines are crossing, and it is not uncommon for a female dancer to lift a male dancer. In actual fact, dancers need strong arms, because the possibilities in choreography are endless!

Maybe today, the current piece you’re working on does not require you to lift anyone, but next week, your choreographer might ask you to balance on one arm, to perform a dive-roll and land by absorbing the shock of impact with your arms,  Maybe you’ll have to lift another dancer over your head. What happens if you aren’t ready for these challenges? You get injured.

A recent study by the Sports Medicine Assessment Research and Testing Laboratory, and the Performing Arts Medicine Program, at George Mason University, showed that dancers could benefit from strengthening their arms to reduce risk of injury due to the potential high upper-body demands of modern dance choreography:

“…Our preliminary work suggests that modern dance alone may not produce upper-body muscle endurance gains. Hence, it is suggested that modern dancers should engage in strength and conditioning training programs to enhance upper-body endurance.”

No kidding.

They may be susceptible to having weaker bones

Because dancers are often inside, dancing in the studio, and not outside, frolicking in the sunshine (sigh), they may be at risk for vitamin D deficiency when compared to other athletes with similar work-loads. Lack of vitamin D could potentially increase one’s susceptibility to illness. Vitamin D has been shown to boost the immune system, and taking too much time off to rest because of illness, may cause your technical progression to stall. Not to mention, if you come to class sick, you’re at a higher likelihood of injuring yourself in your weakened state.

One also needs vitamin D to properly absorb the calcium necessary for strong bones. Now, because we’ve already established that dancers are relatively unfit in general, they may not have bones as strong as they should when compared with the high volume work-load they take on. Supplementing with vitamin D and adding strength-training to their routine ensures they won’t break any (or at least not too many) bones prematurely.

In a recent study done by the Department of Kinesiology at Pennsylvania State, it was shown that more than half of highly-trained young male ballet dancers presented with low levels of vitamin D in winter. However further investigations were stated as necessary to determine if this could negatively impact bone growth and place them at higher risk for musculoskeletal injuries.

Vitamin D also has been shown to promote a general “good feeling”- Which all dancers could use a little more of every now and again.

They don’t warm up.

Need I list the benefits, or rather, the necessity, of performing a proper warm-up? I get tired of repeating myself, but, not warming up properly, or neglecting it completely, is a huge contributor to the elevated dancer-injury rate.

Here is the warm-up I did on the day I sustained my acute hamstring strain:

1)      Rubbed some Tiger Balm on hamstring.

2)      Stretched hamstring for about 30 seconds.

3)      Sat in center splits for a couple minutes.

Ready for class!!

Can you see the problem there? I have since reformed my ways. Stretching does not a proper warm-up, make! Instead, do some jumping jacks, or do your own mini-barre. Then maybe some self myofascial release to any particularly painful areas with a hard rubber ball, or a foam roller (just get a lacrosse ball from Canadian Tire for four bucks).  Do some dynamic stretches that move you through a sub-maximal range of motion. Roll around on the floor a bit. Hold plank, for a minute or two. Do some push ups. SITTING IN YOUR SPLITS IS NOT A WARM-UP! Do not weaken the muscles you will be needing in class by lengthening them right before you need to use them. But you all knew that, right?

They have postural issues that they are generally unaware of

I was always under the impression that, because I was a dancer, naturally I must have excellent posture. That is, until it was pointed out to me just how bad it really was.

My shoulders used to round forward excessively, my head was about an inch forward of where it should be, putting excess pressure on my spine (they say that even having your head forward an inch of where it should be, is like adding the weight of an extra head). My pelvis was tilted forward, and I walked with my toes pointing out. All these things combined with a heavy volume of work puts a great deal of stress on places that aren’t designed to handle it. It is no wonder I had chronic back pain for years, which later cumulated to three consecutive back injuries, chronic knee pain, ankle pain, biceps femoris tendonitis, leading to a second degree hamstring strain, followed by ischial bursitis in my left hip. I could probably list more. I’m pretty sure I strained my groin a few times, but it’s hard to keep track. The point is, they all could have been avoided had I corrected my muscular imbalances, fixed my “normal person” posture, and thus improving my “dancer posture”.

It was shown, in a recent study comparing the postural stability of injured dancers and non-dancers, that although the injured dancers received ballet training, their postural stability may still be inferior to that of the non-dancers.

They take pride in walking with turn out and being hyper-mobile

Not only does walking with your toes pointing out put excess stress on your knees, hips and ankles, but it looks really weird. I spend a lot of time people-watching (if you don’t, you should try it, especially in Toronto. It’s really interesting), and one thing I’ve observed is this: The only people who walk with excessive turn-out are dancers, and people who aren’t all together in the head. Seriously.

Could I be alluding something to the mental state of dancers? Perhaps… But mostly, I just want for you to not have knee, hip, lower back and ankle pain.

In a study done by the Wales Centre for Podiatric Studies, a link was found between the number of injuries, and the degree of turn-out with which the dancer tended to walk:

“A significant relationship was noted between the Foot Posture Index and angle of turnout, and between the number of reported injuries and change in foot posture in the angle of turnout”.

Dancers are also oddly proud of having hyper-mobile joints. Strange how we’re so proud of the things that cause us so much harm. I’m starting to believe dancers really do have something inherently wrong with their ontology…

Hyper-mobility does not make you dance better. It only makes you better at getting into high risk positions, from which you don’t have the strength to return. 

When your joints are more mobile than they are strong, and I’m talking about the HUGE discrepancy most dancers have, it puts the ligaments and tendons at high risk of injury. Dancers often sit on the sidelines stretching, but too few actually take the time to strengthen. My theory is because it takes more actual “work” to strengthen a muscle than it does for the already-flexible dancer to flop into a split. People just don’t like to do the things that are good for them, that is, until they realize how good it can feel when they do. Which is why I didn’t eat vegetables until I was 19. That’s a bit of an exaggeration. But again, I digress.

But Why?

I joke about dancers being stupid, but really, we aren’t. Dancers have to be extremely intelligent to do what they do. So is the madness really about making sacrifices for the sake of art? 

I think the problem is, that dance, from the beginning, was all about control. In the courts, where dance became highly popular among royalty, they had to maintain a certain control and poise. I can imagine King Louis probably had a lot of problems himself, and he pretty well invented ballet as we know it today. Interesting foreshadowing…

As dance progressed and pointe shoes were invented, dancers had to display their control and poise, despite wearing ridiculously designed shoes (for some reason deemed aesthetically pleasing) and while withstanding enormous pain. It has since been ingrained in our souls, that we as dancers mustn’t show pain, but rather hide it. Dance is painful, therefore pain is beautiful, so pain and dance must go together. We mustn’t ask for help. If something is too hard, we don’t say no, we do it and if we get hurt, so be it, we’ll keep dancing because we are in control. Are we though?

It goes back to the question of “why do you dance?” Why haven’t you quit despite the criticism, the injuries, the feelings of inadequacy, the hard, hard work, for hours a day.

This is what my dancers told me: They said they dance because they want to express themselves. They love to move. Nothing can stop them from doing it because the feeling of expression through movement is unrivaled.

So why then, if you love to move, do you do things that will ensure you won’t have a functional body to move with about 20 years from now? And if you love to express yourself physically, why do you damage the very vehicle for your expression?

And do you know what the answer was to that question? Recognition. Praise. Feeling accomplished. Having your hard work acknowledged. Dancers are highly critical, and though they are good at putting on a show of confidence, all they really want, or rather need, is someone to tell them they’re good enough. I’m starting to be really convinced that if dancers are willing to put their bodies through hell and back, just to be acknowledged, there must be something very wrong with us all in the head.

I firmly believe that the arts are the only thing that can simultaneously keep you young, yet mature you beyond your years. The arts take immense intelligence, but require foolish risk.

What you should take from this article, is not that I am criticizing dancers for wanting to be good at what they do, but I am criticizing the lengths they take, and their questionable methods to get the praise they want so badly. I’ve been there, but I’ve since discovered that it is better to be kind to your body.

Stay strong, dancers.


P.S. To read Rusty’s blog post on fitness vs. pain tolerance:

Ambegaonkar, J., Caswell, S., Winchester, J., Caswell, A., & Andre, M. (2012). Upper-body muscular endurance in female university-level modern dancers: a pilot study. Journal of Dance Medicine and Science, 3-7.

Cimelli, S., & Curran , S. (2012). Influence of turnout on foot posture and its relationship to overuse musculoskeletal injury in professional contemporary dancers: a preliminary investigation. Journal of the American Podiatric Medical Association, 25-33.

Ducher, G., Kukuljan, S., Hill, B., Garnham, A., Nowson, C., Kimlin , M., & Cook, J. (2011). Vitamin d status and musculoskeletal health in adolescent male ballet dancers a pilot study. Journal of Dance Medicine and Science, 99-107.

Giron, E., McIsaac, T., & Nilsen, D. (2012). Effects of kinesthetic versus visual imagery practice on two technical dance movements: a pilot study. Journal of Dance Medecine and Science, 36-38.

Hanrahan, Stephanie J. (1996) Dancers’ perceptions of psychological skills 9-10, 19-27

Lin, C., Lee, I., Liao, J., Wu, H., & Su, F. (2011). Comparison of postural stability between injured and uninjured ballet dancers. American Journal of Sports Medecine, 1324-31.

Stinear, C., Byblow, W., & Steyvers, M. (2006). Kinesthetic, but not visual, motor imagery modulates corticomotor excitability. Experimental Brain Research, 157-164.