Injury of the Month- 6 Things to do When Your SI Joint Feels Funky

Injury of the Month- 6 Things to do When Your SI Joint Feels Funky

A little while back, Bizz Varty wrote an awesome two-part article for me on the topic of the sacroiliac joint- That fun little joint where your sacrum and ilium meet.

Though it’s a topic that’s already been given some deserved attention, I feel as if it’s time to touch on it again (though I’m no SI joint whisperer, like Bizz claims to be). And if you’re reading this, Bizz, I’m still waiting for my magical SIJ adjustment ;).

There are a couple of reasons that I’m dedicating another post to the SIJ:

1)      Bizz’s original SI joint article continues to be one of the most popular ones on my site. I’ve even had some readers email me out of the blue asking what they can do about their SI joint issues after having read Bizz’s SIJ saga. Clearly, this is something people want to know more about, and who am I to deny the people what they want??

2)       I recently took an online seminar, presented by Rick Kaselj, and learned a bunch of cool stuff about SIJ pain, and exercises to eliminate said pain. I’ll be quoting a lot fun facts I learned from his presentation. Rick is a super smart guy, an I can honestly say I wouldn’t know half of what I know today if it weren’t for him and the great information he makes available to industry professionals like myself.

3)      My SIJ has been bothering me for about a month now, and I know exactly why, and I’m going to share it with you, and what I’m doing to help it.

4)      All the dancers I’ve worked with recently seem to have at least one funky SIJ. And it’s usually their right one.

So here we go! Here’s to hoping I can live up to Bizz’s glory. I’ve got some big shoes to fill. She did a really good job outlining the anatomy stuff in her article, so I’m not going to re-hash it all. And if you haven’t read it yet, CLICK HERE and then HERE. Seriously, it’s about time.

As I mentioned, I have been dealing with a bit of a cranky SI joint lately. I have a couple of educated guesses as to why:

1)      I have been training harder and heavier than usual.

2)      I have been sitting at my computer more than usual.

3)      I have been paying less attention to my pelvic alignment.

4)      I have stopped doing nearly all extra core training.

5)      I’m probably more stressed than I realize.

6)      I am a woman.

In case you didn’t know, women are more susceptible to SIJ pain than men. This is because of that thing called child birth. Remember that thing? The ligaments that stabilize the SIJ are more lax in women so that we can do that child birth thing one day. Less stability= more susceptibility to getting hurt.

Women also naturally have a higher degree of anterior pelvic tilt than men, which puts more stress on the SI joint. This is why paying close attention to alignment and doing an appropriate amount of core training is essential for us ladies, and especially dancer ladies.

Why is SI joint pain and dysfunction such a big deal?

Well, it hurts, so that sucks. But our SIJ’s have a pretty important role- To transfer force from the upper extremities to the lower extremities. And the reverse. Force transfer is important for any kind of athlete. Also if you like having fun, playing sports, or tipping cows.

What does SI joint pain/dysfunction usually feel like?

SIJ pain is usually lumped in the broad category of “lower back pain”, and can be characterized by a radiating pain around the lower back and bum area.

Bizz mentions a couple of cool assessments you can do on yourself to determine whether or not your low back pain is coming from the SIJ, so I won’t get too into that. Also, if you have lower back pain, your first move should be to see a professional about it to determine a proper rehabilitation program. That said, one assessment I generally do when working with someone is a little Thai Yoga Massage move called the “hip hop”.

 

This is Albert (Krishna), one of my Thai Massage teachers, teaching at the Sivananda Yoga Center here in Toronto.

Those Thai were trying really hard to mainstream when they named that one… But anyway, this particular Thai Massage stretch not only feels awesome (because it wiggles the SIJ around), but based on how much movement I can get in the person’s  SI joint, I can tell how jammed and unstable it is, and which side is more affected than the other.

In dancers, I’ve noticed that the right side is generally less stable, with less movement and more pain. In my experience, dancers also tend to have more external rotation in their right hip. This is because in dance classes we end up practicing things more on the right side than the left, and so we develop more turnout on the right side, which causes the right piriformis to get super tight, pull on the SIJ, and cause pain.

This leads me to…

What Causes SI Joint Pain?

In Rick’s seminar (who, by the way, knows way too much about every injury), he listed that the SIJ is most commonly injured by:

1)      Trauma

2)      Pregnancy/child birth

3)      Overuse

4)      Repetitive movement

5)      Leg length discrepancy

For dancers, and other super active people, the most probable causes are muscle imbalances created by overuse and repetitive movement. I would also add prolonged poor positioning, or shifty alignment, to that list, but this can be lumped under repetitive movement.

The most common muscles associated with SIJ pain are glute med and max, piriformis, quadratus lumborum and biceps femoris. These muscles stabilize the SIJ. When stability is compromised due to an increase of stress on the joint, they tighten up to try to add more stability.

What Can You do About Your SI Joint Pain?

First, stop doing the things that make it hurt, go see a specialist, and get some rest. And then you can start doing some of these things:

1)      Find neutral spine. Find it and start walking around in it all day every day. I cannot stress how important alignment is if you like not being in pain all the time! Being in the proper alignment will take stress off the SI joint and strengthen the muscles which stabilize it. Start now. Find neutral spine and use it as often as you can. How?

I like to find neutral spine by using a little trick I stole from Dr. Stuart McGIll: Bend forward about 45 degrees and put your fingers on your low back erectors. They should feel hard and activated*. Begin to bring your back into an upright position, but stop when you feel your lower back muscles first relax. This is neutral for YOUR spine. Now hold onto that position with your pelvis and bring your ribcage back over it if you feel like you’re leaning way forward.

Sam is so awesome for always being my “exercise model”.

I tend to always be in too much anterior pelvic tilt (sway back posture), so being in a neutral pelvic alignment is important for me if I want to be pain-free and happy. Which I do. This trick worked wonders for me and taught me how to properly engage my core, glutes and hammies.

 After you’ve mastered finding neutral spine (read, have become obsessive compulsive about using it all freakin’ time), strengthen it! Learn to deadlift with perfect form, and start deadlifing everything from now on.

There is no more “pick up from the ground”. There is only deadlift.

2)      Get some core stability. Specifically, learn to activate the transverse abdominus and the deep pelvic floor muscles. Not only do you need strength and endurance in your core, but a little fine motor control don’t hurt either. Your core muscles stabilize your SIJ. More stability is good!

Stable joint=no pain

Unstable joint= pain

Mike Robertson, from Indiana Fitness and Sports Training,  wrote an article called Core Training For Smart Folks, which you should now go check out. If you’re smart…

3)      Learn proper hip extension. Get a friend to check  out your hip extension skillz by doing a simple single leg hip bridge. If you notice that there is significant arching in your lower back, and your chest is rising to your chin, and your bum is still squishy, then you are doing hip extension from all the wrong places.

4)      Self Massage. Most of us can’t afford to get weekly massage therapy. Luckily, you can still get a good amount of benefit from self massage You may need to do some self-massage on your problem areas 3 times a day at first, and then reduce the frequency until you’re just maintaining whenever you feel a flare up.

I forget who I heard it from first, but I like the saying, “Doing self massage between massage appointments is like brushing your teeth between seeing the dentist.”

My favourite items to self-massage with**:

Lacrosse ball:

Great for hitting the piriformis, glute med and max, lower back, and QL area. If that’s too intense, use a tennis ball, or a less dense rubber ball from the dollar store.

Foam roller:

Use it for the above if using a lacrosse ball is too intense. Also for your IT bands and upper back. I’ve never tried it, but I hear you make your own roller out of various other hard objects wrapped in other various softer coverings. Try wrapping an unopened soda bottle, one of those Nalgene bottles, filled with water and frozen, or some PVC piping wrapped with bubble wrap or that non-stick rubbery stuff you put under tablecloths.***

5)      Static and dynamic stretches. Perform dynamic stretches for the culprit muscle(s) before you do any kind of moving for the day, and static stretches after you’re done your day’s work.

Dancers be careful with your hamstring stretching! Many people have tight hamstrings as a result of SI joint pain, but dancers actually have pretty darn flexible hamstrings, and seem to be obsessed with stretching them. In my experience, dancers can benefit a lot more from strengthening the hamstrings than stretching them more, as they are one of the more common dance injuries. One that is close to my heart, so to speak.

6)      Improve thoracic mobility. If you only move from one point in your spine (probably the lower part), then all the stress will accumulate at that point. If you can learn to move from multiple points on your spine, the stress will be more evenly distributed.

And that’s all she wrote.

For more on exercises and strategies for developing strength and changing the way you move, check out my resource, Dance Stronger. 

*Yes I realize I just used the words ‘hard’ and ‘erectors’, almost in the same sentence. Sue me.

**Sue me, again…

*** If anyone tries to make their own foam roller, I want to see a picture of it! Success or fail.

 

Conditioning With Imagery: A Chat With Donna Krasnow

Conditioning With Imagery: A Chat With Donna Krasnow

One of the most important things you can do to better yourself is to talk to a lot of people that are way smarter than you. Be the stupidest one in the room every once in a while (but not all the time…).

That’s exactly what I set out to do when I contacted Donna Krasnow. We sat down in her hotel room discussed things to do with training dancers. It was great.

Donna Krasnow is a former professional dancer, full professor at
York University’s Dance Department, choreographer, and creator of C-I Training
(Conditioning With Imagery for Dancers). She is the co-author of the new book
Conditioning with Imagery for Dancers, with professional dancer Jordana Deveau. Visit her website here for more info.

Krasnow specializes in dance science research, concentrating on injury prevention, conditioning for dancers, and motor learning and motor control. Her most recent research focus has been the adolescent dancer, psychological issues surrounding injury and dance training, and motor control in elite dancers. She received her M.S. degree in Dance Science in 1994 from the University of Oregon and is a Level I Certified GYROTONIC® Trainer . Her articles have been published in Medical Problems of Performing Artists; Journal of Dance Medicine & Science; Impulse: the International Journal of Dance Science, Medicine, and EducationJournal of Dance Education; Bulletin of Osaka University of Health and Sport Sciences; Medecine des Arts; and Dance Research Journal.

If you haven’t gathered, Donna is way smarter than me, and chances are way smarter than  the majority of you reading this too.

She was in Toronto this week teaching the Conditioning With Imagery teacher training course. This course teaches other dance science enthusiasts and teachers her training method, which she has used to help countless dancers improve their technique and understanding of the moving body, as well as to prevent unnecessary injuries. Though I only had an hour to speak with her, it was enlightening, to say the least.

Here now is a summary of our chat:

What caused her to first become interested in the physiology and science of dancing?

Donna told me that her reason was actually kind of selfish- She, like many dancers, was tired of getting injured! She has a list of injuries that could go on and on, but her back was a big issue for her in the past.

Sound familiar?

This led her to start reading and learning about new methods of training the body to make it more resilient. She studied in yoga, pilates, floor-barre classes, Qi Gong and somatic practices, among other things, and eventually began to put it all together which created the foundations of what is now her Conditioning with Imagery philosophy.

So what is “Conditioning with Imagery”?

Donna explained that conditioning with imagery is a blending of science with somatics. It borrows from the best of several techniques.

She retold to me the story of being in Philadelphia for a convention and having the opportunity to experience presentations of many different training methods, one of which was by Sally Fitt (author of Dance Kinesiology) and was all about the science side of training, and another was an Alexander technique presentation, which is all about using imagery to reprogram the body.

This got her to thinking, why must the two- science and imagery- be separate? Hence the creation of conditioning with imagery

For those of you who don’t care much for the science side of dance, the rest of this article may not be for you, so skim at your leisure, as I press forward into more specific aspects of training dancers.

I asked Donna what she thought of  training hip drive and posterior chain power. Did she think it was useful, as it often is for other athletes? Olympic style lifting or plyometric training in particular.

“Yes. If the dancer has a need for it.”

She explained to me that many dancers are naturally good jumpers and it would not be a productive use of their time to work on something they are already good at. Hip drive power does help with vertical jump height, which is of importance to dancers, but if they don’t need much extra help in that regard, it is not necessary.

She states that the training must be specific to dancing. For this very reason, she is not in favour of ballet dancers doing much plyometric training. Her experience is that it will not transfer over to a dance setting as one would like it to, for the feet are in a parallel position which is not very helpful for dancers who work in turn-out.

I asked about doing plyometric work in a turned out position, and we both agreed that it would probably not be safe for the knees.

Olympic lifting could however be quite beneficial for dancers needing help with their jumps.

There is still much research to do in this area. Perhaps I’ll do some more reading of my own and see what I can find. Stay tuned for that.

Can you guess what Donna thinks about dancers developing upper body strength?

She’s all for it! Donna points out that dancers often need arm strength for lifts and to fall safely to the floor, among other choreographic elements.

However, she explained how the traditional methods of upper body training are not appropriate for dancers. That is to say, the traditional method is aimed towards male trainees who want to build muscle (hypertrophy) without any kind of functional end-goal.

Dancers do not need to hypertrophy their upper body muscles, but rather need endurance and strength. She pointed out the common misconception that women dancers shy from strength training in the fear of becoming bulky, but this is only because they look at male bodybuilders who follow a set and rep scheme with the aim of getting bigger muscles.

Donna suggests that for dancers it is optimal to use a rep range geared toward muscle endurance (12-15 reps), with a lower weight, and to do 2 sets.

The arms need strength, endurance and control. To avoid upper body training is a common mistake.

Other imbalances that are prominent in dancers, and which Donna stresses should be addressed include:

  • The spine and core
  • Lateral quads dominant over medial quads
  • Excessive foot pronation
  • Weak adductors and gluteus medius

I then selfishly asked:

What is your favourite core strengthening/motor control exercise?

Her reply: “I don’t have a single favourite!” (rats…)

She explained that she is in her third day of teaching the CI Training course (and intensive course which runs for 6 days), and she’s aleady gone through about 7 core exercises. She states there has to be versatility, because that is the nature of dance. You must have a range of movements.

Not only that, but “core training” has to be always happening. Even if it is not a “core” exercise, the core must be cued to work. A good core exercise is one that transfers over to the dance setting.

So what about Crunches? Crunches are fine if done correctly, but by themselves are not sufficient for dancers’ needs. They need a variety of exercises that deal with core support, trunk stabilization, and balance control. Perhaps not the most efficient use of your time.

We got to talking more about core conditioning, and Stuart McGill’s name came up (to whom she refers fondly as Stu. They’ve met, and I’m a little jealous). McGill is a big name in the athletic performance training, and lower back pain prevention and rehabilitation game.

I have dabbled  in implementing his method of “abdominal bracing” to prevent lower back injuries while training training my own dancers.

I asked her what she thought of the idea of abdominal bracing, and if it was effective for dancers.

In her mind, bracing the abdominals is actually counterproductive for dancers early in their training, and they should rather be instructed to lengthen. This simple use of imagining the spine elongating, and the narrowing of the waist, she states, has been much more effective in her experience.

She explains that you must look at the function of the spine for the dance population: The spine does a lot of moving through all planes, and this motion often needs to be fluid. It makes sense that bracing the abdominals without understanding how to control it segmentally would hinder a dancer’s ability to control his/her body effectively.

Donna talked about how many of the athletes McGill is training do not require the fluidity of the spine that dancers do, and so for a shot-putter, for example, bracing the spine would be highly effective.

There is a place for bracing the abdominals in dance training, however it should be learned after the dancer first understands how to control the spine’s individual segments. She refers to the work of Australian, Paul Hodges, which focuses on deep segmental stability and “hollowing” of the abdominals, rather than bracing them.

Her method is to start by training the deep muscles that control and stabilize the spine as it curves and arches, and then do more McGill type things, like planks and birddogs.

Thanks for that tip, Donna!

At the gym I work at, they have one of those full body vibration plates that supposedly give faster results by exercising on a vibrating surface. I asked Donna if she knew anything of the science behind these contraptions.

To which she replied: “I have no comment until I see the research.”

Donna is the kind of person who needs to see concrete evidence before she jumps on a bandwagon. This is a good quality to have in order to avoid a lot of the bull-shit that marketed to us these days. Remember when we thought this was a good idea?

I mentioned to Donna that I had read the abstract of a study which used the vibration plate in a training protocol for dancers and found that they were able to increase their ankle stability to a higher degree than a group of dancers who did conventional exercises, not vibrating. She replied to this that she could see how it may have some benefits in terms of proprioceptive issues, as the vibrations create a more unstable surface.

Here’s another study that found dancers could improve their vertical jump height by using the vibrating plate in their training…

Perhaps I will read more on this topic, seeing as I have access to one of these (expensive) machines. Are they worth it? Who knows. I’m still sceptical, and my opinion is that this machine was created by people who are lazy and don’t like hard work. But who knows!

Like Donna said, “I don’t know until I see the research”.

I asked Donna if she could describe a particular “a-ha!” moment on her journey to understanding movement.

She exhaled deeply and replied that there were too many to even mention. One in particular that she shared with me was the realization of the “neuromuscular”, and just how important motor control was.

It is not simply enough to strengthen the weak muscle, or stretch the tight ones. That’s only part of the picture. Donna expressed that it is equally important to make changes to habitual movement patterns. Retrain the way you move in everyday life, as well as in a dance setting.

As she put it, in class, you work hard to do good for your body for 3 hours a day. But if for the rest of the day you’re slumped over, in awkward positions, walking strangely and adopting a generally poor posture, you’re not helping yourself, and you’re undoing any of the positive work you did in class.

In recent months, I’ve discovered how much the mind needs to make changes as well as the body. Many dancers are in a less than optimal emotional and psychological state which does not allow them to perform physically at their highest potential. I asked Donna what role she thought psychology and emotional health played in dance training, and if she felt it deserved more attention.

She agreed, but said that the emotional health of a dancer must be approached indirectly. It’s in how you relate to your dancers or clients that will affect them psychologically.

Donna expressed how she felt that many dance teachers do a bad job of this. The learning environment is created through the language used by the teacher, and often this language is one that is critical, and negative. For example, she told me story of how a young girl she was coaching had quite a pronounced pelvic tilt that caused her stomach to protrude slightly. What did her previous teachers tell her? Push your stomach in! Push your bum in!

According to Donna, the language you use should not ask the dancer to hide any part of them. Don’t ask the dancer to hold in their stomach, this is counterproductive not only physically, but it will foster a negative emotional environment. Instead, she suggested the image of lengthening the body.

She also explained that many dancers have “issues of beauty”. What this means is that they are so stuck to notions that for a position, such as a perfectly turned out 5th, to be beautiful, they need to crank their bodies in unnatural ways, and this is more important than being safe and protecting their bodies. This notion needs to be retaught. As I mentioned earlier in this post,  you mustn’t be stuck to the idea that you need 180 degree turnout, most of us can never obtain this safely and it’s just not worth it.

Donna stated that many postural dysfunctions are in fact rooted in emotional trauma, and that she found many were able to change emotionally by changing the way their bodies move. This rang 100% true to me. If you want to test this theory, try walking around all week with absolutely perfect posture. Really focus on it. I challenge you to tell me you don’t feel like a  whole new person by the end of the week.

Donna also stressed the importance of the spiritual aspect of dance. Many of us have lost this. Dance began as a spiritual practice, and it should always have that same importance. Again, we have issues with beauty. Actually expressing the spirit through dance will always be more moving that a perfectly executed triple pirouette.

What Donna felt was most lacking in dancers, and what could be considered their biggest issue, is that they lack education on the things that really matter. They have tons of skill acquisition, but very little knowledge. I asked her to share what she felt were the 3 best pieces of advice she could give dancers wishing for longevity in their careers, and here  they are, just for you:

  1. Be vigilant about warm-up and conditioning.
  2. Work only with people who honour the body.
  3. Never put aesthetics and fashion above health.

Amazing.

This post is once again becoming lengthy, and so I want to wind things down by sharing with you what Donna said to be the most rewarding part of her career so far (and she’s done a lot, from choreography, to performance, to teaching, to conditioning, to research, creating her own training method, writing a book, and more…)

For her, it was not the material accomplishments that were most rewarding, but the giving and the receiving, in both directions, that has taken place throughout her career. The science aspect of things combined with the beauty of performing and choreographing was what she felt was the most fulfilling.

I will close with what I think is a recurring theme of this blog, and which Donna stresses as extremely important: The art of dance is just as important as the science.

If you want to learn more about Donna,  her teacher training course, or read her book, head to her website for more information.

I want to thank Donna graciously for taking time out of her busy schedule to speak with me. It was fantastic.

I urge you all strongly now to check out Julien Smith’s blog . Take cold showers daily, talk to strangers, do things that scare the crap out of you, and hang out with people that are way smarter than you.

Oh, and like me on facebook .

 

 

 

 

 

 

 

 

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:

http://fitnessblackbook.com/interval-training/are-you-in-good-shape-or-do-you-just-have-a-high-pain-tolerance/
References:

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.