Rehabilitation for Dancers

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By Alison Preston
Dancer, Yoga Instructor

As a dancer for the past 25 years, I have experienced my share of injuries. It can be difficult to decide what track of recovery to follow, especially when you need to be back in the studio or on stage as soon as possible. Recovery can be hard when you can’t find a professional who understands your needs and abilities as a dancer, especially if it is you first injury.

Below are some professionals in the Twin Cities Metro area who have worked with dancers and athletes to prevent and recover from injuries.For those of you living outside the Twin Cities, I’ve also included a search engine to locate doctors in your area.

(Listed in no particular order)
Shawn Douglass, CMT*
Specialty: deep tissue massage
763-213-5505
sdouglassmassage@hotmail.com

Jennifer Armitage, PT**
MN Medical Rehabilitative Services LLC
952-381-3434

Dave Wieber, MTC***
Body Balance
2070 W. 96th Street
Bloomington, MN 55431
952-703-3480

Raul Centeno, CMT*
Specialty – massage for injury prevention
651-263-5574
raulcenteno@cs.com

Click here for a search engine to find doctors across the U.S.
(Click on Doctor Locator, not the Doctor Search.)

*CMT – Certified Massage Therapist
**PT – Physical Therapist
***MTC – Certified Manual Trainer

Note: I am in no way a medical professional. My opinions are based solely on my experience as a dancer in recovery. Please consult with a physician and check insurance coverage before taking on any recovery programs. Good luck on your path to healing!


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Striving or Starving? Dancers and Body Issues

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By Madeline Nyvold

There’s no doubt that many dancers are under constant pressure—the pressure to perform well, the pressure to devote themselves to dance and the pressure to keep their bodies in peak physical condition. These pressures, combined with the scrutiny of coaches, peers and audiences, often make dancers vulnerable to a number of body image issues and eating disorders. According to The National Institute of Mental Health, five to ten percent of girls and women suffer from eating disorders. This is a very real and serious issue, and awareness is the key to prevention.

While no age, race or gender is exempt from eating disorders; adolescent girls tend to be a high-risk group. Ascending Star Dance Team member and high school dance coach Thera Witte agrees.

“In my experience, I have seen more body issue images with dancers as they enter high school. At that age, they are very focused on the physical changes that their bodies are going through and how society says they should look.”

When considering the physical standards set by the media and their peers, along with the pressures of dance, it is no wonder that adolescent dancers are susceptible to eating disorders.

Though all forms of dance have physical demands, none are as rigorous or precise as those of ballet. A study published in the International Journal of Eating Disorders that examined the incidence of eating disorders in members of several North American ballet companies found that fifteen percent of the dancers questioned had anorexia, while nineteen percent of the dancers questioned had bulimia. The physical requisites of ballet have not changed much; however, there is a growing awareness and efforts are being made to recognize and prevent eating disorders. For example, the National Ballet School in Toronto started a program in which its students met in small groups to discuss body image and health issues. After this program was instituted, the incidence of new cases of anorexia and bulimia dropped from approximately 1.6 per 100 girls per year to only one case of anorexia and one case of bulimia during an eight-year period.

The results of the National Ballet School in Toronto’s program demonstrate the important role awareness plays in the prevention and recognition of eating disorders. It is imperative that friends, relatives and coaches of dancers familiarize themselves with the indicators of eating disorders. According to the National Mental Health Information Center, symptoms of eating disorders include unusual or drastically changed eating habits, obsessive exercising or calorie counting, avoiding food or meals or consistently visiting the restroom immediately after eating. Behaviors unrelated to food can be indicators as well.

“A common sign of serious body image issues in a dancer may be always looking in the mirror to check her body,” Ascending Star Dance Team member Trish Gubson said.

Awareness and recognition of eating disorders is very important, but knowing what to do when confronted with them is equally so. Coaches are inoften in a position to intervene, and Witte details the best way to do so.

“Coaches can approach a dancer they think might have an eating disorder by being open and honest with the dancer. It is important to validate and listen to their feelings and not blame or accuse. Coaches should be mindful of all the different body types of their dancers and choose uniforms that all of them feel comfortable wearing,” Gubson said.

Other dancers are often able to recognize behaviors indicative of eating disorders as well and can help intervene. “ [They can do this by] being aware of their peers’ changes in weight, behavior and attitude, and being open and honest and able to talk about body image issues,” Witte said.

In addition, there are resources for those suffering from eating disorders and those who want to learn more about them. The National Eating Disorders Association’s website has information about preventing and treating eating disorders. By cultivating awareness among dancers and coaches, we can all take a step towards eliminating body image issues and promoting healthy minds and lifestyles.


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Nutrition

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By Kate Smith

When one thinks of a dancer and all of the things they need to do to continue to improve their craft, many things come to mind – stretching, taking technique classes and practicing frequently are a few. But one thing that is not as obvious from the outside is nutrition. Improving nutrition can help dancers gain more endurance, strength and improve their overall health and dance performance.

Hydration
The first thing to keep in mind is hydration. Dancers must always stay hydrated, and it can be difficult during an intense practice and performance schedule. However, the importance of fluid intake is not to be overlooked. According to Suzanne Martin’s Dance Magazine April 2003 article, “ Health and fitness for life,” “ a loss of as little as 2 percent of body fluid can imbalance a dancer’s brain chemistry to the point of creating mental confusion and loss of coordination and balance.” Martin suggests drinking an eight-ounce glass of water at the beginning of each day to help maintain hydration.

Diet
When it comes to diet, eating foods that maintain the dancer’s energy level are crucial. The Dance Today! June 2004 article, “Getting through the Day: A Dancer’s Guide to Eating on the Move,” recommends eating carbohydrates such as grains and pasta in addition to breakfast each day.

“I always recommend a sensible diet, including lots of carbohydrates and avoiding too much fat. Dancers don’t need different fuel from other people — they just need more of it because they use more energy,” former Royal Ballet dancer Deborah Bull states in the article.

Bally Total Fitness personal trainer and fitness director Matt Ledbetter also stresses the importance of carbohydrates in a dancer’s diet.

“Carbohydrate is stored as glycogen in the body, and the amount of glycogen stored in the body affects stamina and endurance,” he explains. “ Training and eating properly, with particular attention to carbohydrates, can increase and maintain glycogen stores, which is particularly important for endurance athletes, like dancers!”

Ledbetter says that protein and fat are also important for keeping up energy.

“When fats are eaten as part of healthful foods, they provide an important energy source for athletes in training. Good choices include the fats from nuts, seeds, vegetable oils and avocados.”

So taking in lots of fluids and energy-providing foods are important for a dancer’s everyday nutrition. What about performance season? Eating several small meals each day can be the trick to keeping the dancer’s energy level up during a busy performance season, according to the Dance Magazine March 2006 article, “ Eating and drinking for energy: what–and when–to eat and drink before performing.”

The article states that dance nutritionists advise dancers to eat six small meals a day during performance season, including one two hours before performing and one right after performing. Suggested foods to keep one’s body fueled include protein shakes, sandwiches, bananas, and bagels.

Peak Performance Pasta
For a tasty energizing meal, try Dance Magazine’s “Peak Performance Pasta”

1/2 pound whole-wheat pasta
Olive oil
1 small onion, chopped
1/8 teaspoon hot red pepper flakes to taste
2-3 cups bite-size pre-washed spinach and/or any combination of fresh or frozen vegetables
1 15-oz. can white, black, or red beans drained, or 1 7-.oz. can white tuna in water, drained
Fresh or dried herbs to taste
Salt and pepper to taste
Lemon juice or Parmesan cheese (optional)

Prepare pasta according to package directions. While pasta is boiling, pour enough oil into large skillet to make a thin film on bottom. Heat over medium-high heat. Add onions and stir until just soft. Add hot pepper flakes and toss. Add spinach and cook until slightly wilted (cook other vegetables until barely soft). Stir in beans or tuna and herbs. Toss until heated. Mix into drained pasta. Season, squeeze in a touch of lemon juice, and add cheese if desired. Makes 2-3 servings.

For an Asian variation, use a mixture of peanut and sesame oil. Instead of herbs, add a pinch of ginger. Sprinkle with sesame seeds instead of Parmesan cheese.


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Health and Fitness for Dancers

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By Mario Raspanti

The rhythm that a consistent dance regimen provides for a dancer helps build and maintain the muscles that are used in dance. For both aspiring professionals and recreational dancers, maintaining a daily, let alone a weekly or monthly dance practice regimen can be a real challenge. This is especially true for those that are too busy studying or making ends meet to devote a lot of time to dance.

Caroline Holden, dance teacher and Pilates instructor at the Stoughton Center for Performing Arts, took a few minutes to answer some common questions dancers face regarding dance practice and maintaining fitness.

Q: What should professionals, students, and recreational dancers do to maintain health and fitness during down time?
A: Resting is paramount for any athlete. Muscles need to recover. That being said, keeping the body stretched and strengthened is important. Pilates and yoga are good examples of regiments that keep the body stretched and strengthened. As most dance is anaerobic, an aerobic exercise regimen is also recommended for overall health.

Q: What do competitive dancers and aspiring professionals lose during extended breaks from dance training and practice, and what can dancers do to maintain muscle strength during extended breaks between practices and/or performances?
A: Muscle length and strength are easily lost. However, keep in mind that it takes two times as long to lose muscle as it takes to gain it. Eat lean proteins and stretch and strengthen.

Q: What exercises do you recommend for those that have very little time to dance regularly?
A: Every dancer will have exercises that suit them best. Ask your dance teacher, “If I only have five minutes, what exercises would be best for my body?”

Q: What muscles benefit from dance? What muscles get the most work/stress put on them during dance? What dances are the most physically taxing?
A: Ballet required turn-out which is not a natural position for the body to hold. If ballet positions are done incorrectly they can and will damage the joints of the leg as well as the hips. That said, dancers tend to overtax their hip flexors and
glutes. The entire body benefits from dance training –especially the muscles of the leg.

Q: What dances, exercises, and stretches are good and necessary for warm-up?
A: Pilates, footwork (tondires etc.), developés, are all part of a traditional warm up for ballet, jazz, and modern dancers. Many teachers expect a dancer to be slightly warm and stretched before they begin class in order for class to be most beneficial.

Q: What foods should dancers avoid during periods of extended rest?
A: Dancers are fueling their instrument. You get out what you put in. Be mindful. Lean proteins are always recommended.


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Prevention is Key at the Harkness Center for Dance Injuries

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By Jill Swenby

One of the biggest concerns for professional dancers is injury. For this reason, it is vital that professional dancers take as much care as possible to prevent injury. The Harkness Center for Dance Injuries at the NYU Medical Center, founded in 1989, is aimed at helping dancers do just that. With its innovative Injury Prevention Assessment program, Harkness is utilized by several dance companies and Broadway shows in New York.

Alison Deleget, MS, ATC is a certified athletic trainer for Harkness. (Visit www.nata.org for more information on athletic trainers.) Ms. Deleget works individually with dancers and also travels to studios around New York giving lectures on how to prevent injuries, the common causes of injury, and basic nutritional information. We recently talked to Ms Deleget about the Harkness Center and recommendations for dancers to prevent injury.

How does the Harkness Center for Dance Injuries work?
The Harkness Center has a one-of-a-kind Injury Prevention Assessment program, which is a free service offered to dancers. They can be seen by me for a one-hour, one-on-one assessment of their bodies to identify any muscle imbalances, weakness, tightness, alignment problems, etc. that may put them at an increased risk for injury, and are given a home exercise program to address these issues and ideally prevent injury occurrence. We also discuss nutrition, social habits, survival jobs, warm-up and cool-down practices, etc. to help the dancer get an understanding of how issues outside of their bodies may contribute to dance injuries as well.

What are some of the most common injuries for dancers?
Chronic injuries (the “itis” injuries: tendinitis, bursitis, etc) are by far the most common type of injury seen in dance. Approximately 65% of all dance injuries fall into this category.

How can these injuries be prevented?
Since dance injuries are such a multi-factorial problem, meaning there are lots of different factors that can cause injury, it is hard to say briefly how to prevent them. For chronic injuries, some of the most important things that can be done are to eat a healthy diet, get enough sleep, cross-train with exercise like Pilates or Yoga to keep the body balanced, and try to work as correctly as possible with dance technique. Also, no matter what the dance technique, it is important for dancers to know their own bodies, and accept the limitations they may have as well as the assets they have. Anyone can learn to work with their body, but they have to know and acknowledge what their body can do before they can learn to work with it.

What other tips can you give dancers for staying healthy?
One additional piece of advice would be to get help for an injury BEFORE it turns into a chronic problem that can take months or years to correct. It is important to seek out medical professionals that are familiar with dance and can provide the specific treatments and advice dancers need to recover from injury.

About what percentage of dancers are able to recover? How long does recovery take on average?
Dancers can recover from almost any injury sustained, but some more severe injuries may take a year or more to recover; whereas less severe injuries may only take a few days or weeks to recover. Also, the nature of the injury plays a huge role in the length of recovery. A dancer who has suffered from chronic tendinitis for years may take longer to recover than a dancer who is just beginning to feel the symptoms and seeks early treatment for the problem. The most time consuming injuries are typically traumatic injuries such as an ankle sprain, meniscal tear, or ACL tear. These injuries may need surgery to repair the damage sustained in the injury, and rehabilitation can last for several months. The most important thing for any dancer to know is that with proper care, they can come back from almost any injury.

Do you see many injuries recurring in the same dancer?
We see dancers who have recurring ankle sprains more often if they did not get adequate treatment after the initial injury. With chronic injuries, dancers can sometimes suffer from the same “injury” for months or years, but the severity of the pain flares up and diminishes over time. Injuries like this will flare up when the dancer comes back from an extended break, or when they begin rehearsing extremely taxing choreography that is new to their body. With proper management, these flare ups can be minimized, and ideally, eliminated.

Are there any other major factors in injury prevention?
The most important message dancers should hear about injury prevention is that it involves every aspect of their lives, not just what they do in the studio. Nutrition, rest, psychological support, cross training, survival jobs, etc. all impact dance injury occurrence. In the studio, it is important to have a set routine of warm-up exercises to target the muscles needed for dance, and a cool-down program to stretch out tight, tired muscles and allow the body to recover from dance.

For more expensive health care needs, such as surgery, physical therapy, or diagnostic tests such as an MRI, dancers can apply for the Special Assistance Fund to help cover costs. For more information visit the Harkness website at http://www.med.nyu.edu/hjd/harkness/patients/finance.html.


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Acupuncture for Dancers

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By Laila Hussain

A show of hands, who has ever thought of trying acupuncture? If you have your hand in the air, then perhaps you feel a little sheepish. You don’t really need to raise your hand, but maybe you do need to act on your curiosity and try some alternative therapy. There are many benefits to acupuncture, some recognized by traditional health organizations, and some not. Contrary to common belief, it is actually pretty painless and can even be deeply relaxing. The needles used in this process are not at all like syringes or sewing needles; they are very thin and flexible, gently gliding between the body’s tissues instead of tearing through them. The feeling is most often compared to that of a pinch, or a mosquito bite.

You may wonder how having a number of tiny, flexible needles stuck in you helps to treat anything. Chinese medicine is based upon the relationship of the individual, both physical tissue and spirit, function in relation to each other. In terms of the human body, mind, and spirit, the connective force that runs through it is called“qi,” or chi, as we Westerners spell it. This chi is an energy force that flows through the body along specific pathways, called meridians. When this all important chi flow is blocked by injury, stress, or disease, pain and dysfunction emerge.

Acupuncture, though still relatively new to western culture, is already being applied to various forms of sports-related injuries and is fast becoming a big part of performance medicine. For those of you who don’t know what that is, it’s much like sports medicine, except that it is used to treat conditions specific to performing artists instead of athletes. As a part of this performance medicine trend, acupuncture is helping performers of all kinds live healthier, happier, and more productive lives.

So what does this mean for you dancers out there? It means that if you’re suffering from chronic pain or injury – in any area of the body – acupuncture can quite possibly soothe your pain completely, help your body heal itself naturally, and shorten overall recovery time, without the use of drugs. Dancers can overcome relief from injuries such as sprains, strains, sciatica, and arthritis. It has also been known to treat many different kinds of digestive, psychological, and skin disorders. However, it is important to note that Chinese medicine heavily emphasizes the prevention of injury and illness, as opposed to solely treating an already injured and suffering body. The many artists and athletes who have experienced the benefits of acupuncture see it not only as a life-saver and secret weapon against sudden injury, illness, or pain, but as part of a complete health maintenance program. Many of the testimonials of acupuncture patients claim that it has even cured their insomnia and depression. The National Institute of Health recognizes it as effective in treating headaches, menstrual cramps, low back pain, carpal tunnel syndrome, asthma, addiction, nausea, and various other physical, emotional, and mental problems.

If you or someone you know is a performer who fears that their career will be delayed or cut short due to chronic pain, illness, or serious injury, acupuncture is a viable and recognized form of treatment. Whenever you are choosing a physician of any kind, whether traditional or alternative, it is important to research their training, credentials, and past track record with their patients.


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