Physiotherapy for Dancers.

Dance injuries are mostly overused injuries which means something that is done repetitively, often enough can create damage to the soft tissues including muscle joint and ligament. In order to prevent these sorts of injuries we need to:

1. Ensure our training schedule is appropriate in terms of how often, how intense, what sort of area you train in. For example training after a period of rest or holidays may differ from training after an injury which may differ again from training coming into performance.

2. Make sure you have sufficient strength and range of motion ( ROM) in your joints to perform the correct manoeuvre but also appreciate what your limitations are and work within those

3. Correct technique issues that may give rise to unnecessary load through joints or muscles

4. Correctly fitting shoes whether they be ballet flats, pointe shoesm character shoes or alike are instrumental in keeping you comfortable but also supporting you properly when you dance. An ill fiting shoe can make something more difficult to do and inadvertently cause overuse injuries.

5. Nutrition provides your body with sufficient energy to keep active and develop muscle strength. Without the appropriate fuel in your body you will limit your strength and endurance which can lead to fatgue and subsequent injury.

The most common injuries to a female dancer occur around the ankle and foot. For a male dancer it is more shoulders and neck becuase of the differing requirements in dance choreography.

The injuries are typically overuse injuries which affect the soft tissues eg. achilles tendinopathy, ,osgood sclatters, severs

Stress fractures are common in dancers particularly in the foot or shin. Again usually due to overload on the dancer where bone depositon cannot up keep up with the load requriements.

Biomechanical imbalances cause common problems such as snapping hips, plantar fasciitis.

Becuase dancers are typically hypermobile, the injuries from having hyperextending knees (fat pad compolression, patellofemoral pain, SIJ instability are also common in this population.

Impingement pain in joints is fairly common due to the need for joints to go into end of range on a repetitive nature eg. Ankle impingement or hip impingement, labral tears. Traumatic injuries can also occur to a lesser extent but typically lis franc strain which is a ligament strain of the mid foot joints, dislocated shoulders more so in males due to lifting requirements.

This is a physical assessment of all the relevant joints in your body prior to going en pointe. It measures the ROM and strength of these areas in your body such as ankles knees hips back and neck and shoulders. It looks at your typical posture and checks for scoliosis. Most interestingly it compares your measurements to what is considered normal or expected in dancers of this age. It will assess your technical ability to do some movements so as to give an idea of technical ability. This together with how you perform in class and take on choreography is what your dance teacher considers when deciding if and when you are ready for pointe.

A pre pointe assessment may be required by your dance teacher in order to assist a decision of pointe readiness. Also it can be used to identify any areas of your body that may need attention in order to enhance your experience on pointe and furthermore to prevent serious injuries that may eventuate from shortcomings that can easily be identified.

Dance attire with footless or open toe stockings so we can check your feet. Also to bring your ballet flats and pointe shoes where appropriate.

There are better ways to gain your pointe range than sitting passively in a position that will no doubt be stretching ligaments as well as muscle tissue. Ligaments provide stability for our joints and if they are too loose, it makes it more difficult to use the joint properly. Hence we don’t really want to stretch ligaments and anything more than about 30 sec is moving into that range.

Foot stretchers also don’t provide any strengthening effect that ranging exercises will do.

However, if someone has particularly limited ankle range of movement they may help provide a continual movement into that position and provided it is backed up by strength exercises it may be ok. Best to seek advice from your physio prior to using one.