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Dance Injury Prevention
- 1. Dance Injury PreventionBy Patricia Boakye, Jeannine Dion and Jessica Whittemore With special thanks to PSU Dance Corps, and Artistic Director Drew Roublick
- 2. About PSU DanceCorps A new dance group on PSU Campus ~30 girls ranging in age from 18-23 Varying levels of technical training ~10 hours/week rehearsal time, about how much time per week you would study for a 3 credit class
- 3. Overview Dance Corpshas dancers at all technical levels The risk of injury is greatest for dancers without technical training The goal of this program is to provide an effective educational strategy to prevent dance related injury.
- 4. Goals By theend of this presentation: Clients will demonstrate proper stretching technique Clients will explain the importance of adequate nutrition Clients will demonstrate knowledge of how equipment, environment, and awareness contribute to injury prevention.
- 5. Anatomy of thefoot and ankle The foot consists of twenty-six bones, twenty-nine joints, thirty-one muscles, and many ligaments, tendons, nerves, arteries and veins. The bones of the foot are divided into three groups; seven tarsal bones, five metatarsal bones and fourteen phalange bones.
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- 7. The Ankle Anotherimportant joint for dancers is the Ankle joint. The ankle joint is held together by ligaments. The lateral ligament is the one that you damage when you sprain your ankle and if it becomes completely torn, the ankle becomes very unstable. The only movement that can occur in the ankle joint is pointing and flexing of the foot
- 8. Common injuries Foot/AnkleMuscular Knee Hip Different disciplines pose different risks In a study of 61 sports done by Dr. Jim Nichols, Ballet proved most demanding.
- 9. Common Injuries Dancerswho continually dance on a hard floor will sometimes develop pain above the calcaneus in the area of the Achilles tendon; this condition, commonly referred to a dancer’s heel. Most injuries occurs during jumps. The most common injuries are to the 5 th metatarsal, the bone on the outside of the foot. Metatarsalgia is commonly caused by instability in the joints of the smaller toes.
- 10. Prevention Proper stretchingStrengthening the muscles that control toe flexion can be helpful. Stretching of the tissues in the back of the heel (calf and Achilles) is also important to reduce the stress placed on those structures. Proper equipment Attention to technique Attention to self
- 11. More Prevention Attentionto surroundings Cross training Adequate nutrition and hydration Women should take in 1200 mg of Ca/day to reduce the risk of fracture Adequate intake of calories is vital to peak performance and healing
- 12. Interventions Correct techniquesIncrease rest time Activity modification Portable dance floors
- 13. Results Clients participatedin a survey after the presentation and of the 8 girls who were able to attend, 6 had at least 6 years of training. Clients expressed interest in nutrition and an additional discussion was held. Clients were able to demonstrate proper stretching technique, and able to modify movements to their comfort level.
- 14. Sources Benson, J.E.,Geiger, C.J., Eiserman, P.A., & Wardlaw, G.M.(1989). Relationship between nutrient intake, body mass index, menstrual function, and ballet injury. Journal of the American Dietetic Association , 89 (1), 58. Berardi, G. (2006). In It for the Long Haul 8 Dancers Share Their Injury Prevention Tips. Retrieved March 11, from Dance Magazine website: http://findarticles.com/p/articles/mi_m1083/is_7_80/ai_n16533603/print Goldstein, S.(2007) Increasing your team's flexibility. Retrieved April 1, 2008, from Varsity.com Web site: http:// www.varsity.com/index.asp?article =1372 Karpen, M. (2001). Ballet the most Demanding Sport for Joints, Muscles. Medical Post. Nov 27, 2001. Vol. 37, iss. 40, p. 36 Jones, J. (2007).On the surface. Dance Teacher . 29(4) , 56-58.
- 15. Sources (2004). Stretchingand its importance in dance.. Retrieved April 1, 2008, from Dance Info Web site: http:// www.geocities.com/catdanse/stretchpositions.html (2006). Dancing - preventing injury. Retrieved April 1, 2008, from Better Health Channel Web site: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Dancing_preventing_injury?Open (2004). Dancers and MSI: Prevention and treatment. Retrieved April 1, 2008, Web site: http://www.shape.bc.ca/resources/pdf/MSIDancePrevention.pdf (2001). Dancers Bone Up in Injury Prevention. Retrieved March 11,2008, web site: Http://www.encyclopedia.com/doc/1g1-70926831.html (2005). Harkness Dance Center Spring Newsletter. Retrieved March 11, 2008, website http:// /www.med.nyu.edu/hjd/harkness/assets/newsletter_spring05_%20complete.pdf
Editor's Notes
- #3 Specializing in tap, jazz, ballet, hip hop, lyrical and modern Clients have varying educational backgrounds but all have some college education Some girls have been dancing all their lives, i.e. kristen but others like me or danielle are just learning. Dance Corps supports a community environment of shared dance instruction and cooperative learning. Dances are choreographed and performed by the company Before a performance practice time increases to 15-20 hours per week, often late at night from 9-11
- #4 The white strap that can be seen above the ribbons of the shoe helps to stabilize Danielle’s ankle.
- #8 located between the talus and the inferior ends of the tibia and fibula bones
- #9 Lack of shock absorption and poor floor quality are two of the leading causes of injury. Floors not made for dance can cause dancers to become prematurely fatigued injury. Common injuries: Sprains and strains – muscles and ligaments overstretched (knee and ankle). Muscle strains and pulls are common among any athlete and can be resolved with NSAID’s and rest. Stress fractures – dance moves that require force and repetition (jumping) can cause small breaks in bones of foot and ankle. When dancing, individuals can experience a stress (hairline) fracture to the metatarsal bone if they continually dance on hard surfaces. Tendonitis – inflammation of tendon (achilles tendon) Blisters – d/t ill-fitting shoes Toenail injuries ingrown toenails Impact injuries – falling over, bumping, tripping Different disciplines use different muscle groups and different actions. For example Modern has lots of lifts and partnering as does ballet which poses unique risks such as strains, and damage to many major joints like the knee, hip, and shoulder. Tap has repetitive percussive motions which can contribute to shin splints or stress fractures. It is important to be aware of the risks posed by your discipline . Ballet dancers must maintain an exceptionally thin, sylph-like body but also maintain a high standard of technical proficiency and strength that is demanded of all high-performance athletes.
- #10 It is caused by inflammation secondary to trauma in the joint between the calcaneus and the talus. Pointing the foot brings about the pain. Posterior impingement syndrome, commonly known as dancer’s heel, involves compression of soft tissues at the back of the ankle. Ankle sprains are usually sustained upon landing jumps, either improperly or landing on an objector another dancers foot. Metatarsalgia means pain along the metatarsal
- #11 Proper stretching means stretching warm muscles, and stretching to the point of “good pain” You should never stretch through sharp pain and a good stretching routine will start with general calisthenics and move into more related motions like straddle stretches, ankle rolls, and isolations. Stretching increases temp. of muscle and connective tissue which is associated with a decreased risk of soft tissue injury. DON’T ever stretch cold muscles. There is some debate about how long you should be stretching for, a good goal is 10-30 seconds. Lack of flexibility can inhibit the ability to perform some dance leaps and turns. The inability to stretch to the needed length causes the stressed muscle to pull on adjoining tendons and muscles and can result in a pulled muscle. Stimulates the CV system to adjust blood flow to go to those tissues that need oxygen most. Stimulates joint lubrication and prepares joints for full ROM. Proper equipment Have multiple types of footwear available so more able to adjust to flooring (ie. sneakers rather than slip on jazz shoes for grip on cement and as cement can cause wear and tear on dance shoes). If you are not a technical dancer attention to technique as you learn it is vital, and more seasoned dancers would do well to remember that too. Continually check your alignment before you move and be aware of how proper technique feels so that you can check yourself every time you dance. Inexperience – don’t have skills or technique needed to meet the physical demands of the chosen dance style. Make sure to follow directions of instructor. Know when you are getting tired, dancers who are fatigued are more likely to hurt themselves, also pay attention to your body and be smart, if you are injured don’t dance because if you rest and heal you will be back on the floor more quickly than if you push through and take the risk of injuring yourself further. Know your limits, if you know that you need more warm up time before advanced movements take it. Rest between workouts – with rest muscles become stronger and are able to sustain more force and therefore able to do more work. Deal with injury immediately to prevent further damage. RICE treatment. Do NOT use alternate methods of icing b/c only reach 1 st layers of skin and not the injured area. Returning to dance before an existing injury has healed can aggravate the condition. Learn to recognize signs of MSI such as discomfort, pain, tingling, or numbness while dancing; weakness or difficulty with fine control of movement; stiffness or limited ROM; postural changes; local swelling or redness. Poor fitness – weak muscles are more likely to tear when challenged or stretched. Poor posture – weak muscles in back and abdomen increase risk of injury to all areas of the body including spine and legs. Fatigue – sloppy technique
- #12 Attention to surroundings Flooring – sprung floors absorb some of the force and decrease the impact on the body. Talk to representatives about the type of rehearsal and performance floors, the size and height of the stage, if it has an incline and whether it is in or outside. Mark choreography while on unforgiving surfaces (ie. concrete). A NYCB study showed that dancers who took a pilates, yoga or even other dance classes between class, or dancers who went to the gym and did cardio were less prone to injury. This is probably so because if you work the same muscles too much, they become overdeveloped and surrounding muscles will become weak and you will be more prone to injury. Adequated nutrition and hydration In a survey done by Druss, ballet dancers listed weight and diet as their chief concerns and stated that they consume less than 1000kcal/day eating disorders. Nutrient deficiencies: Zinc, folate, calcium, and vit. B6 are involved in protein synthesis and in the maintenance of bone and cellular integrity, and aids in injury healing impaired tissue growth and regeneration slow healing process danger of starting again too soon. Vit B6 deficiency interferes with amino acid synthesis and RBC production. Folate plays important role in the formation of DNA rapidly dividing cells needed to proliferate. Inadequate intake of calcium responsible for high incidence of stress fractures. Nonmenstruating athletes are at a greater rosk for developing osteopenia decrease in bone mass, risk for stress fractures. Requirement for calcium in nonmenstruating is thought to be almost double that recommended for females with regular menses. Iron deficiemcy anemia impairs energy production fatigue musculoskeletal injury. Use of supplements – don’t make up for dietary inadequacies. Drink lots of water before, during and after. With most minor injuries like strains, and sprains rest, ice and elevation are sufficient in addition to time off from class. Should your injury be serious such as a break or a tear requiring surgery seek immediate medical attention and follow your pre and post op instructions to reduce the risk of re-injury.
- #13 Do warm up stretches before beginning dance session. Alternate physical rehearsal with mental rehearsal to balance physical demands with rest while maintaining a focus on performance. Respect your body’s limits. Rosin can be applied to pointe shoes, and traction pads to tap shoes for added resistance on slippery surfaces. Portable dance floors good for competitive dance teams on the go and offer considerable protection.