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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