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We all know that scene in Center Stage: Juliette (Donna Murphy) finds Eva (Zoe Saldana) working alone in the studio late at night. She starts to coach her, and then comes that iconic line; she cups the barre with one hand and says, “It’s here.” She’s reminding her student that it all comes back to the work.

In researching for this series on a rise in dance injuries (anecdotally, rather than empirically seen at this point), Dance Informa heard a similar sentiment from dance medicine and dance science professionals: it all goes back to consistent work on technique and artistry. That work requires patience (it can feel slow), intentionality and working in alignment with one’s own body.

In this second installment of the series, we’ll deep dive into aspects of training, anatomy/kinesiology and dance medicine research with respect to injury prevention. As we look closely at if dancers are getting injured at a higher rate in this post-COVID lockdowns world, and why that might be, those are all important pieces of the puzzle. We’ll hear from the same accomplished experts. Stay tuned for Part III, where we’ll look at how we push back against this trend. Check out Part I here, if you haven’t yet!

Balanced conditioning for optimum dancer wellness

Sue Mayes, principal physiotherapist of The Australian Ballet, believes that basic knowledge on anatomy and kinesiology can go a long way toward dancers working in safer ways. She advocates for increased dance anatomy education and research. To get a keener idea of your dancing body and how it’s working, “look at the muscles that control the movement,” she advises dancers.

For many dancers, part of that learning is coming to understand the importance of strengthening — for technique, for artistry, for career longevity and much more. Mayes explains how consistent stretching without strengthening can detract from one’s technique and artistry. “If the structures that give stretch and recoil [to your muscles] can’t do that, then those muscles have to work harder – and they’ll fatigue faster. You won’t have that spring in your dance.”

She’s also quite clear that she’s “not saying ‘don’t go to end ranges [of flexibility]’ – just do it safely by also strengthening and engaging musculature.” That’s “mobilizing rather than stretching,” Mayes says – with “muscles engaged at all times and control at end range. That optimizes technique.”

Following all of that, Mayes reinforces for young dancers that if they want to dance professionally for a sustained period, they have to develop a hip strengthening program. That guidance comes from her research on dancers’ hips, which found that strengthening exercises help prevent hip injuries. Also as a result of from that research, Mayes and her team teach dancers “a toolbox of exercises to dancers that they can choose from.”

The result? “We’ve markedly reduced injuries, and also increased the longevity of [dancers’] careers,” she notes. Further, she adds, such strengthening work has also helped dancers finish their careers safer and heathier – versus hobbling out with a slate of injuries. Such dancers “have listened to the education and found out what works for them,” Mayes believes.

What works for dancers often “doesn’t need to be difficult.” She recommends a few fairly simple exercises: sets of rising to relevé and lowering with control, stair running (“fantastic for strengthening feet and ankles,” Mayes says), weight lifting with control at end ranges of motion. Arguably, with the potential to help dancers do what they love stronger and longer, the only real question is “why not?”

Joshua Honrado, Doctor of Athletic Training with NYU Langone’s Harkness Center for Dance Injuries, reminds us of key principles for safe, informed pedagogy – principles to inform that conditioning work. Some of this might feel like a refresher for many well-informed readers – but that never hurts! It’s important for dancers to strive for “neutral alignment,” and for teaching artists to guide them in that direction, for one. For two, observe and respect the limitations of anatomical structure. “We know, from dance science literature, that safely increasing flexibility/range of motion is a long-term goal,” Honrado affirms.

He also underscores the importance of proper, consistent warm-up and cool-down. Time your deep stretching more toward the cool-down end of things, and even better toward the end of the day, he recommends – because static stretching actually fatigues muscles. Muscles need energy for executing technique exercises and choreography in a fully supported, safe way. “Fatigue closely correlates with injury; it can make it all too easy to lose [sound] alignment and support,” Honrado notes.

He also encourages dancers to get sufficient and periodic rest and recovery. At the same, “active downtime” is most beneficial, he notes: with continuing to set and reframe goals, as well as (along with rest) working towards them. There’s actually dance science research demonstrating the benefits of not completely resting during times off from dance (or at least with time in the studio significantly reduced), Honrado shares.

Learning technique and learning to question

Some could laugh off that aforementioned Center Stage moment as a little cheesy, yet for Zac Jones of Heal Yourself and Move, everything really does go back to technique. As he’s working with clients, he immediately has them apply their kinetic learning to their technique. He asks them to “test everything they’re doing [for conditioning] against their dancing…is it improving it?” Evidently enough, if the answer there is “no,” then there’s not much point to doing whatever exercises they’re doing.

That question could be meaningful for dancers following less-than-sound conditioning guidance from social media; if they recognize that something they’re doing isn’t helping them, they may very well stop doing it before they get hurt. In a larger sense, this is also building a “value system” – as Jones defines it — of critical thinking, investigation and balanced rigor. Those are values that can truly serve dancers on their artistic path.

He also encourages dancers to feel what’s going on in their body on a deeper level as they go through exercises and technique – to key into their interoception (inner feeling) and their own body’s wisdom. All of that can help them see the advantages of the quieter independent work, without the “fanfare of class,” Jones says — focused, quiet time and space that can bring a good deal of that meaningful learning of one’s own body.

From there, dancers can start to connect what’s happening in class with all of the work they do outside of class; it all gives dancers that patterning that makes technique feel as natural as breathing, as Jones puts it. As such, establishing that patterning gives you a sincere advantage toward accelerating your technique and artistry, he adds.

At minimum, those skills and mindsets can guide dancers to know enough about their own body to recognize how attempting an oversplit might not be the best idea for them – even if it wowed them when they saw a favorite Instagram influencer do it. Jones reinforces a key truth that we discussed in the first part of this series: when we see things on social media, we don’t know the context.

With dance-based images and shapes, that context includes that person’s innate skeletal system, how that person prepared for it and how they got into it. Without taking that context into consideration, dancers often “want to push through an obstacle,” Jones describes. That doesn’t work, he notes – rather, it “just magnifies the obstacle…because the body says, ‘What are you doing?! Stop!’ It’s our evolution as humans.”

A more useful process – Jones details, echoing Honrado – is learning to “to respect the obstacle,” and then investigate it. “Find the resistance point, and over time work around it and dissolve it.” From there, it goes back to the technique and the vocabulary, Jones reiterates. It all becomes connected, the technique and somatics inextricably linked in supporting dancers toward being the strongest artists that they can be.

All in all, pursuing something that might not be right for your body could be “shape-chasing,” as Jones calls it. In contrast, integrating the shapes of dance technique and choreography into your own physicality is true learning, he notes. Then, it becomes “as easy as breathing.” Our body is beautifully complex, more than any one step or phrase of movement vocabulary could be. “Start to tap into that!” he advises.

Getting “buy in”: Engaging students in their own wellness 

You can lead a horse to water…you know the saying. We can educate dancers and encourage a certain way of working, but they’re the ones who have to keep doing the work: consistently, patiently and mindfully. How can we get “buy in” from them, as Mayes puts it, that this kind of approach will truly get them to where they want to be as dancers?

Both Mayes and Jones point to “the proof in the pudding” — the great results that a more informed, safer approach can bring. Dancers notice that strengthening can actually increase range of motion, for one, Mayes says. Dancers Jones has worked with “have come back [from injuries] stronger technically,” he notes. “With the right information, they can go into their bodies more – really focus and find more possibilities.”

Tracking progress also helps dancers concretely see how they’re improving, week to week – which only helps that “buy in,” Jones affirms. Essentially, if dancers can see that it’s helping them become stronger technically, they’ll most likely do it.

Jones also believes that how he works with dancers helps engage them. He says that the simple question of “how do you feel?”, while they execute a certain exercise, helps a dancer feel “seen and heard.” Feeling like that helps them “really respond…and it becomes more of a dialogue – a circular dialogue between teacher and student.” Reflective questions for students, to be pondered and answered after class, can enhance such a dialogue, Jones adds.

The idea of “it’s the journey, not the destination” can feel like the most cliche Instagram inspiration – yet cliches become cliches because they contain truth. As another time-tested aphorism, there are many paths up the mountain. “There are so many ways to get to the technique [aims that dancers want],” Jones reminds us. Those ways are as numerous and diverse as we are. Perhaps the investigation of all of those paths, to find what will help us reach our dance goals, is its own kind of reward. Enjoy the exploration, dancers. “Put the feel before the ideal,” Jones quips.

By Kathryn Boland of Dance Informa.

The post Are dancers getting injured more? Part II: It all goes back to technique  appeared first on Dance Informa Magazine.

A big leap, a multiple turn, an intricate phrase of choreography – and, pop. There goes an injury. Alternatively, other dancer injuries are quieter, yet no less debilitating — building up over time from misalignments or simply the physical demands of a certain style. Injuries have always been an unfortunate phenomenon in the dance field. Dancers are athletes, after all (and more!).

Post-COVID lockdowns, however, teaching artists and dance medicine specialists are (anecdotally speaking) seeing a concerning rise in injuries. Why might this be? One factor could be more and more dancers looking to social media and other internet sources (with no guarantee of expertise, or of working from evidence-based guidelines) for guidance on stretching, conditioning and more.

Environmental factors such as dancing in small spaces, on non-sprung floors – also due to COVID-inflected factors – seem to have not helped there. Additionally, also due to COVID, dancers have come back to packed seasons when they may very well not have been able to stay in the kind of shape necessary to meet the demands of dancing full-out through program after program.

In the first installment of a three-part series on this phenomenon, we’ll explore those factors – what we know about them, at least (before we can say that we really know for sure, dance medicine researchers need to validate what we’re seeing with empirical data). Next, we’ll investigate some technical and anatomy/physiology principles that can help reduce the risk of injury (not to mention enhance dancers’ artistry!). Finally, we’ll lay out some more overarching principles for pushing back against this (seeming) current trend of an increase in dancer injuries.

Dance medicine specialists will lead the way. For this series, Dance Informa speaks with Sue Mayes, Principal Physiotherapist of The Australian Ballet; Zac Jones of Heal Yourself and Move; and Joshua Honrado, Doctor of Athletic Training with NYU Langone’s Harkness Center for Dance Injuries. Without further ado, let’s explore.

Information from questionable sources: Stretching guided by ‘influencers‘

Mayes works mostly with professional dancers, who do tend to rely on trained, reputable sources for conditioning and stretching guidance (and of course, there are exceptions there). Yet, she does see images on social media that concern her, of dancers going to extreme end ranges of flexibility. Considering the actual, ultimate goal of dance artistry, “why do we need that [sort of] range of motion if we can’t control it?” she asks.

She’s firm that there are much safer ways to achieve that end range of motion – those which also ensure that the flexibility is supported by musculature and the necessary anatomical structures (such as ligaments). Indeed, flexibility without the necessary anatomical support can have dangerous outcomes – and not only those that are immediate (for example, dysplasia of acetabulum of the hip joint, which can occur down the line as a result of continuous and extreme passive stretching, Mayes notes).

Jones, on the other hand, does work with young dancers. From what he’s observing there, he’s also concerned. He sees certain social media accounts sharing exercises and tips on stretching that are “detrimental to technique.” He’s also seen what’s shared on these accounts influence the actions, priorities and perspectives of various individuals involved in a young dancer’s training — from teaching artists to parents to the dancers themselves.

One might wonder how all of this has happened. As Jones sees it, during COVID lockdowns, dancers wanted to continue working on goals for flexibility, technique and conditioning, various things that matter to dancers when it comes to their craft. When studios were closed (apart from sometimes sporadic online class offerings), the internet was where they had to go for that information on all of that. Sadly, “a line was cut between the teacher and student. That daily discipline and close guidance were no longer there,” Jones explains.

Moreover, “social media has made it even more attractive to find information online” – as noted, not all of it being scientifically sound (shout out to dance health professionals who are sharing great information online – you are very much out there and doing great, important work!). For as advantageous and enjoyable as it can be, social media is not exactly built for context, deep-dives of good information, or nuance (tune in to Part II for lots of anatomy/physiology information – we will proudly go there!).

Mayes reiterates a key problem with that lack of context when it comes to images of dancers at extreme end ranges of motion. “Can they really support themselves in their technique, in a way that makes you want to watch them on stage?” She notes that “when you’re looking at pictures on Instagram, it’s a static picture and not movement.” The latter could be a whole different story. Also lacking in these images, Mayes and Jones both agree, is context around dancers’ skeletal structures – in other words, the skeleton you were born with being the one that you have to work with.

For example, we can’t change the length of our limbs to alter the look of our lines or our hip structure in order to safely increase our turnout. Jones notes that it is possible to work with some of these skeletal limitations in order to make technique and aesthetic adjustments. That needs to be done in an anatomically-informed, careful and intentional way, however. That’s most often not going to come through exercises from Instagram. It takes careful one-on-one work.

On the other hand, there are things that we can look for in images of dancers to get a better idea of supported, stable technique (or lack thereof) – are they aligned, for one. “There’s a lot of cheating going on,” and that cheating can be obvious in some images, Mayes notes bluntly. That can further sharpen concerns about dancers taking stretching/conditioning instruction from social media.

Space, flooring, navigating layoffs: Dancing with the right supports 

Dancing in small spaces, with the potential to knock into furniture or other objects – not to mention dancing on floors with less-than-adequate support to dancers’ joints – can’t have helped things when it comes to this seeming rise in dancer injury rates. Toward the latter, Honrado notes that research on dance flooring makes it fairly clear that the right kind does make a difference.

He shares that at Harkness, they’re seeing many dancers with low back and knee discomfort – which may very well be linked with more-than-occasional dancing on non-sprung floors. Yes, COVID lockdown-era virtual classes could be harder to find than in-person classes prior to it (and now, one could argue). Yet, dancers still did dance – at home and at other spaces available to them. Not all of those spaces could offer them the safest, most supportive features for their moving body.

Honrado notes that there (unfortunately) aren’t a plethora of studies focusing on the effects of COVID lockdowns on dancers. Yet, there have been a couple, those that speak to best practices when it comes to dancer layoffs. One, out of Portugal, looked at the effect of physical preparation classes offered to dancers during COVID lockdowns. The study found that dancers came back to the studio, when it was safe to do so, with even more flexibility and mobility (in other words, muscle-supported flexibility – for instance, the height at which a leg can lift itself versus being assisted by an outside force).

Honrado believes that these results indicate “dancers shouldn’t completely rest” during layoffs or other times away from the studio. “We know that flexibility is the first to go, so dancers should keep working on that” – in a safe, evidenced-based manner, he’s clear to add. However, another study out of China found that when dancers returned from a layoff – without physical preparation classes – they had fewer injuries and decreased fatigue. Honrado explains that those outcomes could be from dancers having time for their body to rest and recover, but it’s not quite clear.

(Stay tuned for Part III to learn more from Honrado, and all our experts here, about how dancers can be more informed consumers of online information on stretching and conditioning – such as how to spot “red flags” for information that’s not reputable or empirical.)

A better focus: Technique, strength, artistry 

Yes, there’s anecdotal evidence that we’re seeing an unfortunate, concerning rise in dancer injuries post-COVID lockdowns. There’s also hope that we don’t have to get stuck there. Jones points to bringing everything back to technique and artistry (more on that in Part II, from pedagogical best practices to cross-training principles for injury prevention). The flashy Instagram images of dancers stretching at extreme ranges of motion – that, in the end, aren’t really what the art form of dance is about – can then begin falling out of focus.

When all is said and done, the dancers who we see on social media aren’t us. We don’t have their body, and they don’t have ours. We don’t have their unique artistic gifts, and they don’t have ours. “Rather than copying someone else, you have to figure out your own body and how you can access” the technique and movement at hand, Mayes reminds us.

By Kathryn Boland of Dance Informa.

The post Are dancers getting injured more? Part I appeared first on Dance Informa Magazine.