Guest Post: Dancer Injuries — What You Need to Know

My col­league Deb­o­rah Vogel has more than 30 years expe­ri­ence in dance med­i­cine, train­ing dancers and oth­er per­form­ing artists in self-care, align­ment and injury pre­ven­tion.

She pro­vides exten­sive resources and “how-to” videos on her blog The Body Series.

She’s gra­cious­ly allowed me to repub­lish one of her arti­cles — Dance Injury Pre­ven­tion Infor­ma­tion — which can help you (even if you’re not a dancer) under­stand when an injury is poten­tial­ly seri­ous or when it’s just a “nor­mal” part of being a phys­i­cal­ly active per­son.

Dance Injury Prevention Information — Deborah Vogel

How do we dis­tin­guish between an injury and the nor­mal “wear and tear” of being a dancer? This is a ques­tion that dancers and dance teach­ers face on a dai­ly basis. We have to con­stant­ly eval­u­ate the body’s mes­sages and thus make choic­es either to rest or to keep going.

When in doubt, seek the advice of a qual­i­fied med­ical prac­ti­tion­er. You’ll want to err on the side of cau­tion if you have any ques­tions regard­ing the treat­ment of a poten­tial injury. We must teach our dancers to trust the body’s mes­sages. This takes time and expe­ri­ence.

Here are some guide­lines that you can use to help eval­u­ate whether you are deal­ing with an injury.

Four Warning Signs of an Injury

  • Pain that gets pro­gres­sive­ly worse dur­ing class, rehearsal, work out, etc.
  • Pain that comes after your class, rehearsal, or work out and comes back the next day after less move­ment is done.
  • Pain that appears when exe­cut­ing cer­tain move­ments (e.g. dur­ing arabesque or land­ing a jump).
  • No real sense of “pain” but a def­i­nite restric­tion of move­ment.

Handling an Injury

If the injury is acute and you can pin­point the event that trig­gered it (e.g. you land­ed on a sick­led foot, you fell out of a leap, your part­ner elbowed your ribcage, you felt some­thing snap, or you have instant dis­col­oration) apply ice, stop mov­ing, and get to a doc­tor. If your injury doesn’t fall into an acute cat­e­go­ry, the fol­low­ing infor­ma­tion applies to you.

How an injury feels when mov­ing can tell you a lot. If going back to class helps the injury feel a lit­tle bet­ter or less sore, great. Just remem­ber to respect your body’s lim­its dur­ing class until you are feel­ing 100 %. If mov­ing irri­tates the injury or makes it feel worse, get smart. Most injuries can be short cir­cuit­ed in the ear­ly stages. Dancers, in gen­er­al, have a high pain tol­er­ance and need to be giv­en per­mis­sion to take care of them­selves either by tak­ing off from class, sleep­ing, get­ting a mas­sage, or by answer­ing any oth­er of the body’s requests.

Some­times a dancer will begin to feel chron­ic pain in either the mus­cles or a joint. Typ­i­cal­ly, chron­ic pain in the mus­cles is caused by exces­sive ten­sion. In turn, this ten­sion is gen­er­al­ly caused by skele­tal dis­place­ment (poor align­ment). As a result, the mus­cles must work con­stant­ly to both move and sup­port the dancer. Chron­ic pain in the joint is often due to con­stant irri­ta­tion caused by mus­cu­lar ten­sion or a mechan­i­cal mis­align­ment with­in the joints (again, poor align­ment). As all dancers know, align­ment com­plete­ly under­lies one’s abil­i­ty to move effi­cient­ly and “injury free”.

Dance injuries often start in small ways. They sneak up on you. Most dancers with chron­ic injuries are not the ones who sprained their ankles while being low­ered from a lift. The cause of their injuries is more dif­fi­cult to deci­pher. Their com­plaints (as fol­lows) are less clear: “My arabesque is not as high as it used to be”; “My hip is click­ing when I low­er from a front devel­oppe’”; “My low­er back is aching. I’m not sure when it start­ed, but now I can’t do my port de bras back­wards”. These are the more nor­mal, chron­ic “overuse” injuries described in the four ear­li­er sce­nar­ios. These injuries need to be respect­ed before they spi­ral into more debil­i­tat­ing prob­lems.

Chron­ic injuries are more chal­leng­ing and frus­trat­ing to work with, espe­cial­ly if you are in a per­for­mance sit­u­a­tion that demands a cer­tain work­load or in a demand­ing sched­ule that is hard to change. This is when hav­ing indi­vid­u­al­ized guid­ance from a dance med­i­cine spe­cial­ist is impor­tant. Over time you will begin to see pat­terns in how your body feels, and you will be bet­ter able to pre­vent chron­ic strains and injuries.

The first step is to lis­ten care­ful­ly and hon­est­ly to your body (not in a hypochon­dri­ac fash­ion). This will both help you become a bet­ter dancer and/or a bet­ter teacher. If you notice recur­rent pat­terns of strain or if you feel the same type of pain in an area while doing dif­fer­ent types of move­ment, write them down. Keep a note­book handy to jot down which move­ments pro­voke a painful response. See if you can find any sim­i­lar­i­ties among the move­ments in order to deter­mine a cause.

  • Are you con­sis­tent­ly get­ting injured dur­ing the per­for­mance sea­son?
  • Is the chore­og­ra­phy you are danc­ing repeat­ing the same or sim­i­lar move­ments on one side of your body?
  • Are you demon­strat­ing the same side all the time when teach­ing?

Ask your teacher or anoth­er pro­fes­sion­al to watch you exe­cute these move­ments in order to see if you are mak­ing a com­pen­sa­tion that could cause pain. If you can’t find a pain free adjust­ment to the move­ment on your own, see a dance med­i­cine spe­cial­ist and bring your notes with you. If you pro­vide a com­plete pic­ture, the eval­u­a­tion will be more ben­e­fi­cial.

Don’t deny your body’s expe­ri­ence. The goal is to learn how to eval­u­ate and work with your own unique set of kines­thet­ic feed­back. Your teach­ers can pro­vide guid­ance, but ulti­mate­ly, it is the dancer that is in charge of cre­at­ing the nec­es­sary changes in order to dance effort­less­ly and grace­ful­ly, with­out cre­at­ing pain or dam­ag­ing the phys­i­cal struc­tures of the body.

It can be chal­leng­ing for dancers to admit that chron­ic prob­lems can eas­i­ly turn into acute ones. Gen­er­al­ly, acute injuries are obvi­ous ones. For exam­ple, if you rup­ture your achilles ten­don, you are not going to get up off the floor and dance. How­ev­er, if you have achilles ten­donitis, you may still be able to dance (although prob­a­bly not at 100% capac­i­ty). Fur­ther­more, if you aren’t care­ful with your rehab, you run the risk of rup­tur­ing the ten­don.

Oth­er exam­ples of acute injuries might be ten­don rup­tures, dis­lo­ca­tions (patel­la and shoul­ders gen­er­al­ly), lig­a­ment sprains, and inflamed bur­sae. Some­times acute injuries devel­op from “overuse” injuries that have not been reha­bil­i­tat­ed appro­pri­ate­ly. For exam­ple, a stress frac­ture is con­sid­ered an “overuse” injury because it can take a peri­od of time to devel­op. How­ev­er, a stress frac­ture should be con­sid­ered an acute injury that needs imme­di­ate atten­tion once it has been diag­nosed by a med­ical prac­ti­tion­er. I have seen cas­es of achilles ten­donitis become shin splints, which in turn become a chron­ic knee or hip prob­lem because the orig­i­nal ten­donitis was not cared for prop­er­ly.

The bot­tom line is both the acute and “overuse” injuries are injuries and should be treat­ed as such! Pay atten­tion to the warn­ing signs of an injury, and you will pre­vent the more seri­ous reper­cus­sions of an acute injury. Get­ting to know the body’s pat­terns and mus­cu­lar imbal­ances and then address­ing those imbal­ances is the best way to pre­vent injuries.

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Deepen Your Body of Knowledge

The Body Series by Deb­o­rah Vogel

Self-Care Secrets for Mus­cle and Joint Pain

Dancers Know Best — Opti­mum Rehab for the Hip, Knee, Ankle or Foot

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About Ronald Lavine, D.C.

Dr. Lavine has more than thirty years' experience helping patients alleviate pain and restore health using diverse, scientifically-based manual therapy and therapeutic exercise and alignment methods.

His website, askdrlavine.com, provides more information about his approach.

Please contact him at drlavine@yourbodyofknowledge.com or at 212-400-9663.

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