Recovering from injury

I am a 15 year old ballet student who hopes to pursue a career in dance. Right now I have an achilles tendon injury that requires passive healing, a lot of physical therapy and may take many months to heal. I have been off of dance for about 2 months now, and I’m having a very hard time coping with this rest period. Going from 15 hours of ballet a week to none has put me in a kind of “dance withdrawal.”. I am trying to keep in shape, but there is really no physical activity that compares to ballet for me, and I have a hard time finding the motivation to go to the gym. Do you have any reconmendations for keeping in physical shape (flexibility, strength, balance, core work, etc.) and also in a good mental state during periods of injury rehabilitation?

Thank you so much, your blog is a wonderful resource.

-Jackie B.

I’m so sorry to hear about your Achilles tendon injury. It is especially rough for someone like you who is used to being so active. I know your ankle is being taken care of with going to physical therapy, so we’ll focus on the right of your body ‘s well being.

I’d like you to first focus on the perspective that this is a good cross training opportunity for you. How is your cardiovascular strength? What about your upper body? That is an area that many women could improve – especially in these days of extreme athleticism and using your arms for support in contemporary choreography.

Those 2 areas along with core work with theraband or foam roller could easily be focused on during your rehab – even without going to the gym☺ (I don’t like the gym atmosphere and also prefer working out at home) I like using the kettle bell for my cardio. It’s amazing how much you work within just a minute. It’s a weight that has a handle on top and you swing it for between a minute and 2 minutes (I started at 30 secs) and then rest, walking around for a few minutes in between. You are doing interval training with this. Cardiovascular health is about the ability of your body to recover from stress.

I found a kettle bell demo on youtube that is better than most – although I will say that I do not ‘snap’ my knees or suggest that my dancers do as she is showing on this video. Bring them to straight, using the gluts and engaging the abdominals as you straighten your legs – but do it without snapping. Here’s the youtube link so you know what I’m talking about.

This time off from dance is a great time to be focusing on virtual rehearsals – using visualization to set new pathways from the brain to the muscles.

I’d like to tell you a fascinating story about Marilyn King, who was a two-time Olympic athlete and later a coach at the University of California. Her story beautifully demonstrates the power of mental rehearsing. She made the 1972 pentathlon team and placed 13th in the 1976 Olympics. She was determined to do even better at the 1980 Olympics and gave herself all of 1979 to train for the trials that would happen in the spring of 1980.

In November 1979, she was in a head-on car accident and suffered a severe back injury. Her friends and physicians felt her chances for competing in the Olympics had come to an end. She spent four months in bed, a daunting setback for anyone training for a physical competition. During those long months, Marilyn was determined to continue training and working in the only way she could, which was in her head. She went through every event in her minds eye and watched endless hours of the world’s best pentathlon athletes competing. Sometimes she watched them frame-by-frame.

When she was able to walk again, she went to the track and continued to train by envisioning herself going through each event successfully.

When it came time for the trials, she was better enough to compete and put herself through five grueling events—without having months of physical preparation, as the rest of the athletes had. She described moving almost as if in a dream, as she had rehearsed it so many times in her head during the past months. She placed second in the trials and went to the Olympics that summer.

Inspiring story, yes? She had a strong desire, focused only on what she wanted – cultivated by an emotional attitude that supported success—and took the actions she knew would optimize her performance, physically training when she was able and mentally training when she was not.

Elite athletes have long known about the power of mental rehearsing. Musicians and dancers are beginning to be more aware of the body/brain connection to their performance.

Watch the videos of your favorite dancers, put music on and go through barre, or other warm-ups… in your mind’s eye – not in real time. Imagine how good you are going to feel when you are back in class – and feel that way now!

What I know about healing is those who are able to maintain a positive attitude, imagining the best coming out of the situation, rather than the worst, are often the ones who heal the quickest as well.

Hope that helps – and best wishes for a speedy recovery!

Bone Bruise

Last week during an over enthusiastic assemblé I managed to slip, flip into the air, and fall on my back. My doctor said I bruised a bone; my sacroiliac joint. It has been nearly 2 weeks, and I have been resting it. However, it still hurts to développé do the left side, left passe, and land on the left side (it’s my left sacroiliac joint). I am supposed to start intense ballet classes next week. What should I do? Will dancing with the bone bruise make it worse, even though nothing is touching it? Is it ok to dance through this pain? Is the pain that I experience during passe due to damaged ligaments or something? I am really nervous about this.

Thanks, Miriam

Ouch! Bone bruises can take a long time to heal. You were right to make sure there was no fracture in the area – and then I’m imagining the doctor told you to ice the area to help decrease inflammation. With bone bruises you won’t see a lot of visible swelling, but rest assured, it’s there – so icing can help.

My concern is that you fell on the sacroiliac area so you may have created a small torque at that joint which isn’t helping your rehabilitation. Remember there is a small amount of movement that is possible at the sacroiliac joint, and it’s possible that landing so heavily on one side could have created a small shift.

Do you notice a difference in your discomfort between standing in parallel and doing a passé and doing it in turnout? If standing in parallel is better than in turnout you may have strained the deep external rotators – which are the turnout muscles)

Gentle stretching is the key.

Try sitting on a chair and cross your left ankle over your right thigh. Lace your hands underneath your left knee and gently press your left knee into your hands. This turns on the deep gluteal muscles. Now keep a gentle pressure down into your hands as you slightly tilt forward with a straight back. Think of the sits bones reaching back into space. You’ll feel a stretch somewhere in the left buttock area. If it is too strong – don’t tilt forward so much. You are in control of how much effort and how much pull – and it should be comfortable, not painful.

After doing this 1 – 3 times on each side – stand back up and try first position passé. Is there a difference? Any easier?

After a fall like you took you need to be aware and watchful for muscular imbalances and possible strains as after all – it wasn’t just the pelvis that took the hit. You have lots of muscles in that area that also were impacted and that is where I would have you focus your attention. The hip flexors might also be involved, and doing extra stretches may be useful.

As always…. listening to your body’s messages is key. If doing a specific movement increases your discomfort pull back. Think about what is different about that movement from movements that don’t hurt. Then you can begin to investigate more specifically what muscle area you need to attend to. It is often hard to figure out what is muscle and what might be ligament in an area such as the sacroiliac joint, but with gentle exploration you can begin to tease out more specifics as to what makes it worse and what makes it better. If you don’t feel that you are making a fast enough recovery I would encourage you to see a good physical therapist to check out the range of motion of both hips and the muscular balance around the pelvis.

Sending you positive intentions for a speedy recovery!



“Education is the key to injury prevention”

Slow recovery…

Someone recommended I e-mail you, because we have been unable to get answers from doctors and physical therapists who know enough about ballet.

My daughter, stepped on a pencil a year ago. She is 14 and loves ballet. The pencil graphite lodged deep in the bottom of her foot. She was operated on by a good podiatrist. He had to cut through 3 layers of muscle and the plantar fascia was repaired. She seemed fine. She went back to ballet and was still doing fine. After a few months, she went slowly on pointe. She was fine until she started doing pointe for longer periods. At that point, her progress went way backwards to the point where it hurt to walk. We went to a great physical therapist and she got much better. She massaged it, iced it, put on ultra sound, had Ashley do exercises..etc.She is just getting back to ballet this month, but her foot is hurting again. It isn’t hurting as much as before, but it began to hurt after she was doing ballet classes again. She danced the first few classes for only 15 minutes. She was fine at that point. When she went up to 30 minutes, she began to have trouble. She is not on pointe. Ashley is still doing massage on the foot, putting ice on it, and doing stretches based on the physical therapist’s orders.

Her physical therapist and podiatrist are very good, but really don’t know about ballet. Any ideas on how to get her better and back to ballet? Your input would be greatly appreciated.

A concerned mom,

Joan – you’ve been very fortunate to have a good podiatrist and physical therapist. It is encouraging that she does respond very well with the physical therapy. I suspect that there was a compensation that occurred after surgery that hasn’t been fully addressed. When we injure something on one of our legs, whether that is a foot injury like your daughter had or a knee or hip issue – our body automatically compensates. It is quite amazing in that respect – we start to stand with more weight on the other leg, potentially start having a muscular imbalance between the two sides, and so on. It is so automatic that we don’t realize going back to class that there still may be some compensatory movement happening.

I would also question if there has been some fascial restriction above the level of the plantar fascia. I wrote a post about flexibility and fascia that you’ll want to read. I wonder if there is some fascial pull in the torso or pelvis that has not been dealt with yet. If there is a pelvic/torso shift or a rotation that is occurring it could be changing her muscle usage and ballet technique. While it is hard to assess these shifts yourself, have your daughter face a mirror and stand in a neutral position with her arms just hanging by her sides.

When you look at the figure below you can see she has a pelvic shift right, torso shift left (you always describe the direction from their point of view) Notice how she makes her shoulders look square, but when you look at the arms and how they hang there is more space between her left arm and pelvis, while her right arm touches her pelvis. She is not standing with equal weight on the two legs. If she turns out into first position she most likely will continue this imbalanced pattern.

There may be something like this that is going on with your daughter. Perhaps her dance teacher could meet with the two of you before or after class to look at her alignment markers. Is the middle of the ear over the middle of the shoulder, hip, knee and ankle from the side? From the front if you drop a plumb line from her nose does it fall evenly between the 2 feet? Are her hips, knees and ankles in alignment?

While everyone is asymmetrical, and I would expect to find some shifts, rotations, etc., it could be that her shifts are causing enough of an imbalance in class where she is not working evenly on her two feet. It might also be very useful to find a massage therapist that will look at your daughter’s standing alignment and based on what she sees, work to release the myofascial tensions. This will be different from a regular massage. He/she will slowly stretch and lengthen the fascia – not always a comfortable technique, but the results are well worth it.

Hope this gives her a few more suggestions for a speedy recovery. I’m rooting for her!



“Education is the key to injury prevention”

What Are The Goals For Conditioning Programs?

The goal for conditioning is to prepare our bodies to do the unusual and unique movements that separates dance from pedestrian movement. There are three principles that need to be addressed in strength training for dancers in order to maximize your efforts. The three principles are overload, specificity and reversibility. We’ll start with the principle of overload.

The overload principle states that strength of a muscle cannot be increased unless the muscles are stressed or worked beyond their normal workload. You can do this in a variety of ways. You can increase the frequency of the exercise program, the duration, or the intensity. Let’s say you want to strengthen your ability to jump. You might do single leg relevés, a set of 10, 3 times a day (increasing the frequency by increasing the times you repeat it during the day). You could do one set, working your way up to more reps (allowing the fatigue of the calf muscles to determine how many you do — increasing the duration). You could also do a set of relevés, and then take that into jumping (increasing the intensity).

The principle of specificity states that the way you strengthen a muscle group should be as similar as possible to the dance movements you do in class or on stage. The example that I use most often for specificity training is abdominal exercises. Most dancers and athletes know how to do ‘crunches’ —
which do strengthen the abdominal muscles, but not in the same coordination that they would be used for standing up straight, or keeping the torso tall and long while doing a developpe’, for example. The abdominal muscles in a crunch are doing an concentric contraction which means the length between
the ends of the muscle are shortening, while the abdominals work more generally in an eccentric and isometric contractions when you are standing and walking. (Isometric contraction means the length of the muscle stays the same, eccentric contraction means the muscle lengthens as it contracts)

The last principle, reversibility, describes the loss of strength that happens when you stop training. This loss of strength can occur rapidly unless there is some other form of cross training to take its place. Generally speaking, a muscle needs to be conditioned at least two times a week in order to maintain its level of strength. What does this mean in practical terms? A common example would be the dancers that take the summer off from dance classes. They are going to have a longer time getting back in shape come fall than someone who danced even occasionally or twice a week, during the summer. If they didn’t dance, but worked out at the gym on a regular basis, focusing on their overall health, combining cardiovascular with weight training, they will have a far easier time coming back into classes in the fall as their general muscle tone will have been maintained but without the specificity of dance movement. (I do encourage dancers to cross train for optimal health.)

There are two factors that influence the strength of a muscle. The first is the size of the muscle and the second is the nervous system’s ability to control the muscle. Each muscle has many muscle fibers — often up into the hundreds of thousands. When these fibers receive a message or signal from the nervous system they contract, or shorten. If the movement requires little strength, then fewer fibers will be directed to contract. As more strength is required, then more muscle fibers are called into action. Through strength training the nervous system is learning to better coordinate the contraction of muscle fibers — this increases their strength without increasing their size. It will do this naturally when the body is in good anatomical alignment — AND — the dancer is not overworking their musculature. What do I mean by that?

I often see dancers standing in first position, with their gluteal muscles contracted and tucked under, their quadriceps contracted to ‘pull up’ their knees, their arches ‘lifted’, shoulders ‘pulled back’, necks ‘lifted’. Get the picture? They have incredible muscle contraction going on and they aren’t even moving! Now when they try to move from that posture they are going to have to work even harder, which has the potential to create muscle strain. They will have to disengage from all the holding and then re-engage to move. This is an example of very inefficient muscle usage, although it does make you ‘feel’ that you are working very hard.

Before I get sidetracked into talking about the myth of no pain no gain let’s get back to muscles and conditioning. You want to create a muscle that will be adaptable, or in other words, a well-toned muscle which is one that is strong and flexible. An example of this is that the hip flexors need to be strong to lift the leg up into a battement front, but also needs to be flexible to help lengthen into an arabesque.

There are times that cross training is a very good way to help a muscle develop the strength it needs for specific dance movements. For example, if you are trying to develop more strength for développés , doing some typical knee extensions or leg lifts would give the quads a better foundation of strength. The leg lifts would increase the frequency of repetition, and if you put a weight on your leg while doing knee extension, it would increase the intensity of the exercise. Then you can get back to specificity and practice your développés while lying on your back, to keep your pelvis and torso aligned, before returning to try them in the standing position.

Sometimes dance classes cannot give you everything that you need to develop as a dancer and that is when the educated dancer does training, whether it be for strength or flexibility or coordination, outside of class. Hopefully this information will be useful when you are helping a student gain more strength in their dancing. Dancers need lean and strong muscles. Pilates and yoga are both wonderful modalities that focus on both strength and flexibility of the body, and are good adjuncts to the dance class. Going to the gym or health club can help to increase strength and improve your overall level of conditioning. Ultimately, though, dancers improve their dancing by being in the studio with a good teacher — that’s you!

Have a great day!


“Education is the key to injury prevention”

Flat spine and back pain

Announcement: Anneliese Burns Wilson has a great offer of a free download for a modern lesson. Check it out at She also has a free download to a ballet lesson. Anneliese is my co-author for the Functional Anatomy for Dancers series and is a fantastic resource for us all!

Secondly – I have a few spaces left in my Analyze This! Train Your Eye for Dance. It’s going to be a fantastic opportunity to hone your analysis skills. I’ve never offered this information before – and – I’m not sure I will again. Click Here for more details

I have a student who has experienced back pain. Here is her mother’s description of what the doctor said about her x-rays: “She has a reverse curve shape of the bone structure in her neck. There is definitely a narrowing of the spaces between the vertebrae at the base of the neck. There might be bone fusion that has already occurred. She has been having lower back pain and may have some narrowed spaces in the lower lumbar also.”

What does this mean for her dancing? What may I be doing as her teacher to help warm up her body before ballet? What do I need to be careful of? She is doing Cecchetti level 6 work.

Thanks! Carroll

I’m always so appreciative of teachers who ask questions – and wonder why? It’s those questions that started me on my own path – having students come up and say, my right knee bothers me when I’m doing plié in 5th – why? My left arabesque is higher than my right – why?

We know the spine is composed of 3 curves. At the neck and lower back areas the curve goes forward towards the front of the body, and in the chest area it curves towards the back of the body. These curves are essential for shock absorption.

I have seen young ballerinas work hard to make their neck absolutely flat. The center of their ear is just behind the middle of their shoulder. Flattening the neck creates a flattening response in the rest of the spine – similarly – flattening the lower back will often create flattening of the curves above it.

All bodies, including the prepubescent ballet body, should have curves to it. The buttocks should round slightly behind the lower back. As the x-ray report states, decreasing the curves of the spine will decrease the spaces between the vertebrae. This isn’t good.

Okay – we’ve established the fact that you need to have curves in your spine. Now how do you help her as her teacher? I would begin by putting her on the floor or mat and having her feel how there is space between her neck and her lower back and the floor. Her first impulse will be to flatten those areas. Then I would bring her up to standing and place her against the wall with her buttocks lightly touching and nothing else – so she again can have some feedback of what it feels like to have a natural curve in those areas. (decreased curve)

Warming up before class would focus on releasing tension. Watch her carefully for straining and pushing to put her body ‘in alignment’. Easy spinal swings, relaxing over a physioball (on her back as well as on her stomach) will feel good. I’m assuming that her physician has put her in physical therapy and she has exercises to do to help redevelop the natural curves to the spine.

Most of all – be aware of her standing stiffly, pulling her head back and up. The other pattern will be tucking under the pelvis. I’m not sure which end of the spine is more the culprit for her – but I imagine you have some ideas from being her teacher!

Having her discomfort decrease will be postive indicators that you are on the right track!

Warm regards,


“Education is the key to injury prevention”

Shin Splints

If you haven’t had a chance to listen to the mp3 file that was posted in the last newsletter, it’s still up.

Secondly, I wanted to let you know about another wonderful dance website called Dance Advantage. ( It’s written by Nichelle Strzepek and is filled with valuable information. Check it out! (I’m hoping soon to get a page on my website for links)

Lastly, I want to firm up the rest of 2009’s schedule and so if you are interested in having me come to your area to do an all day workshop, now is the time to email me at! I realize if you are interested in a workshop before summer, most likely it would have to be on a Sunday. I’ll be in Chicago in July at CDMA, and am working on details to come to Denver, Colorado.

With finances the way they are with everyone, I wanted to figure out a way to make the very important info about the science of dance training available and affordable to everyone. So here is my outline.

We’ll meet from 9 – noon and then 1:30 – 4:30 with an open Q & A from 4:30 – 5pm.
The whole day would be $150, a half day $90. Generally, I gear my information towards the older dancer or teacher, but I would consider doing a workshop geared towards the 10 – 16 year old. There would need to be 20 participants so that I could make my minimum fee of $3000 – and I will take care of my housing and travel expenses. (of course the person setting it up wouldn’t be charged as they are offering space) I wouldn’t want more than 30 participants in any one workshop. Participants will walk away with valuable resource material to support what they have learned. (Sorry if talking about finances is tacky in a newsletter – but I always appreciate someone being honest and clear when they are proposing something, so that’s why I’m telling you the details before you indicate your interest.)

If you are in an area where the dance community is willing to drive up to a few hours to attend such an event – and there are enough interested dancers and dance teachers to make it happen – please let me know! (email me at I will help with advertising the event and location on my website and announcing it in my newsletters. (I’d also consider traveling to Europe – but you’d need to let me know asap you’re interested!)

Onto the question of the week from Hetty…

I am fifteen years old; I have been dancing for the past 10 years or so. I started with Ballet and I am now doing jazz and Modern. I dance about 8.25 hours per week plus 1.25 hr additional coaching on Saturdays for Grade seven ballet exam due in March.

Problem: My right shin hurts a lot. I Rest, Ice, Elevate and Compress and it goes away and comes back when I dance again. If I rub the calf muscle with sports balm the pain goes away.

Will massage help in this situation? I already checked with a sports doctor who recommended the RICE method.

This is a great question that is pertinent to all dancers and physical movers, such as cheerleaders & runners. Shin splints is often given as the diagnosis when you feel pain at the front of the lower leg. As we have mentioned before pain is always a cause for concern, and you would want to seek out appropriate medical attention if the pain is not getting better with your self treatment program. The doctor needs to rule out more serious problems such as stress fractures, which can occur from shin splints that go untreated. So words to the wise, shin splints do not need to be a rite of passage for dancers!

There are several theories on what shin splints really are. A common definition is inflammation of the periostium, which is the sheath that surrounds the tibia (which is the shin bone.) You can also have small tears and/or inflammation in the anterior tibialis muscle, which is the muscle in the front/outside of the calf, which flexes the foot towards the shin. You may have a combination of both problems.

Typically in shin splints you feel pain from the ankle to about half way up the shin. The area may feel swollen and tender. A warning sign of a stress fracture is when the pain becomes sharper and more specific to one spot on the tibia. Please go get an x-ray, Hetty, if this is what your pain feels like.

There are multiple reasons why you might get shin splints. The easiest one to figure out is dancing on too hard of a surface. Sometimes shin splints come on with a sudden increase in training – for example, all of a sudden doing twice the number of jumps and leaps in each class. (I’ve seen a lot of girls get shin splints in December when they start increasing rehearsals for Nutcracker and their muscles and feet aren’t conditioned and ready for the increase in time spent in pointe shoes)

Another common reason for shin splints is from an imbalance between the muscles in the front and back of the leg. More often I see dancers who are tight in their posterior calf muscles (the gastrocnemius, soleus) and end up loading the front calf muscle, which tries to help deepen the flexion as we described prior. It is also possible to have some weakness in those same muscles that can create a strain situation when you do multiple jumps and leaps. The key is balance, always.

I want to mention one other common issue with shin splints and that is poor foot mechanics. If you have a tendency to pronate, or roll in on the arches of your feet, you will be at greater risk for developing shin splints. This is another very good reason to make sure turnout is being created at the hip, not at the ankle/foot. If the shin splints have this biomechanical basis an insert or orthotic in your shoe wear can be helpful in keeping you out of pronation.

So what can you do to if you think you have shin splints? First, pull back from your jumping and leaping until you don’t feel pain in your shin area. It’s very hard to stretch the anterior tibialis muscle, especially for dancers, who have a good point. Instead, take your pinkie ball and kneel on the ground placing the pinkie ball under the front of one calf. You are going to gently massage the muscle by rolling on the ball or pressing down onto the ball. This will help decrease the tension in the anterior tibialis, and often make an immediate difference in how your calf feels when you stand back up. Many dancers will also use the ball to massage the back of the calf, and then stretch afterwards.

You can stretch the back of the calf by doing the typical lunge stretches with your back leg straight, and then with a tiny bend at your knee, bringing the feeling of stretch down into the Achilles tendon. You could also stand with the ball of your feet on the bottom step, or a couple of books, and allow your heels to drop down keeping your knees straight, and then with your knees slightly bent.

Generally, physicians and physical therapists initial will suggest using ice on the painful areas, and at a later time go between icing and applying moist heat to the area. Of course it goes without saying that dancing without having your leg muscles properly warmed up will increase your potential for shin splints (as well as other injuries:)

Since you have been doing the RICE treatment, lets try more massage, perhaps with the pinkie ball, along with pulling back on jumping and leaping, and increasing your stretching. You want the synergy of all of those things at the same time for shin splints. If this helps decrease the soreness or pain, that’s wonderful! You’re on the right track! If it doesn’t seem to help, or if the pain is getting worse, then stop dancing and get yourself to the doctors. You need to rule out the possibility of a stress fracture.

Best wishes for a speedy recovery!


“Education is the key to injury prevention”

Pain… should you work through it?

Check back often for new questions! Thanks to all the people who wrote in with appreciation for the podcast. I loved reading all your kind words!

I have a question about dancing while in pain. I hear such different opinions from different people. My daughter’s dance teachers will absolutely not let them dance if in any pain at all. She has them sit out. Yet, my daughters friend who has a different teacher is told to push through the pain, toughen up and keep going. I say this could cause further damage and they could be out for longer. I have seen other dancers dance at shows when they could barely walk due to muscle pulls. I think my daughters teachers are right and I’d personally never allow my daughter to dance in pain, but what is your professional opinion?
Thanks, Eileen

I agree with you Eileen. When we get young dancers believing that pain is just a part of dancing – we are doing them a huge disservice and setting them up for injuries. You may want to read my article posted on the website (under articles, a new section for me) on ‘Soreness versus Pain’.

Let’s take a closer look at what pain really is. When a dancer injures strains a muscle, breaks a bone, etc. that is called nociceptive pain. The International Association for the Study of Pain defines nociceptive pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.” There is also neuropathic pain which is pain that results from an injury or problem in the nervous system. We aren’t going to talk about that type of pain – most dancer’s nervous systems are working just fine – and for that we need to be grateful!

When dancers hurt or injure themselves the nerves send a message to the brain. They are doing their job by informing command central that there has been some damage to the tissues. Some times the brain sends back a messages such as ‘get out of there fast!’, for example, when we accidentally get too close to a hot stove, our hand’s response is to jump away from the danger.

Pain can be dull or aching rather than sharp. The pain is still a message from our brain that we need to be careful – it keeps us from injuring the muscle or joint further. When we appropriately attend to the pain through a variety of methods, ice, changing our technique, rest, etc. the pain lessens because the tissues are healing. When a dancer keeps going in spite of the pain they run a very real risk of creating a chronic injury that may ultimately take them out of dancing for a much longer period of time.

I know how challenging it can be to translate our body’s messages – from dancing and doing gymnastics myself, and teaching for the past (gulp) 30 years! It takes time and awareness to learn what is the soreness of a newly activated muscle is compared to the strain of tendonitis. This is part of the dancer’s education if they continue dance for any length of time.

And – there are always ways to work with pain besides ‘ignoring’ it! Sometimes an adjustment in alignment or turnout can immediately take the painful stress away. That would be good information, yes?

Sometimes resting for a day while stretching and icing can do wonders. Sometimes it takes a physician or physical therapist to help decipher what the pain message is.

My message to dancers? Learn to listen. To your body’s physical messages, as well as to your emotional responses and intuitions. Don’t freak out when you start to feel discomfort – but instead ask yourself with real curiousity – hmmm.. I wonder what this means? Do I need more sleep? Need to eat better? Stretch more? And so on..

Happy holidays to you all!


“Education is the key to injury prevention”

Painful Ankles, Cramping Arches, Strained Hamstring

If you are interested in creating extra income for yourself, please check out last week’s newsletter to get the scoop on the affiliate program!

Recitals are around the corner, please remember to take care of yourself!

Onto the questions of the week:

Hi. The top of my left ankle is continually painful, in an aching sort of way. It must be some sort of tendon thing. I also have arthritis in the big toe on that foot. Any helpful suggestions?

My first suggestion is to do some daily work to release any muscle tightness from the front of the calf by kneeling on a pinkie ball and massaging the anterior Tibialis muscle which is on the outside of the shin bone.

Next, I would check out your alignment of that foot. Do you have a tendency to pronate? The reason why I ask is that when you pronate the big toe takes a hit, and often a bunion begins creating an ideal arthritic situation. If this is true, try taping your foot for pronation which will lift and support the bones in the arch of your foot. If it feels better to be in a running shoe with good support I would suggest not going barefoot and teaching in a shoe with an arch or taping your feet.

If the dull ache continues you’ll want to go to the physicians and get an x-ray to rule out a stress fracture or other boney problems, such as a spur. I just took my daughter in for this exact reason – and fortunately – it got ruled out temporarily – which gives me permission to work in these other ways. Although, that being said, if the ache doesn’t improve within a couple of more weeks I will have more x-rays done, because stress fractures are tricky and sometimes don’t show up right away.

Hoping it is an easy fix!


First of all, thank you so much for the Amazing Turnout and Arabesque DVDs. They have been extremely useful!

My question for you is: I sometimes get cramps in the foot or both feet during class. The cramps concern the 2nd to 5th toes, making them completely frozen. Can you tell me if this is because of tight extensor digitorum longus or could it be more due to tight intrinsic foot muscles? I do proper warm-up and even use a golf ball to massage the tight spots on my soles before each class. I wonder what I am missing. Can you recommend a good stretch for that?
Thanks! Louisa

You are doing the right actions to release the plantar fascia and the intrinsic muscles of the foot. The act of cramping usually happens when there isn’t enough strength in the intrinsic muscles, they fatigue, and then cramp. (I’m making an assumption here that you eat well and do not have a chemical/nutritional imbalance in your body)

Sit in a chair or on the ground with your leg and foot straight and in front of you. You are going to watch your toes as you slowly lengthen through the ankle keeping the toes flexed and separated, before slowly continue to lengthen the toes while keeping them separated. At first this can be hard! Only pointe your foot as far as you can keep the toes lengthened. Once you have reached that point, gently wave your toes in the air. If you cramp during this exercise you know that you have to strengthen the foot muscles and that should cut down on the in class cramping. Of course, keep using the pinkie ball or golf ball to release any tension in the foot and calf. You can use the golf ball for the foot, but when working on the calf I would only use the pinkie ball.


I’m 34 and I’ve been dancing (ballet) since I was young. I currently take 5-6 intensive ballet classes a week. Last July I pulled my right hamstring when a guest teacher pushed my leg into a higher penché. My hamstring in my supporting leg gave out. It was very painful for several weeks, but I danced through it, taking anti-inflammatories and going easy on my extensions. My physio gave me stretches and strengthening exercises and I had some massage work done.

Nearly 10 months later and I’m still having issues with it. I’m only now getting some flexibility back, but I don’t have nearly the same flexibility in that leg. Stretching after class or at home only seems to make things worse — I’m usually quite sore the next day.

The routine seems to go like this: My hamstring starts to feel better (ie. it doesn’t hurt); I take my extensions and splits a little further; I get sore; I back off until it feels better, etc. etc. It seems to be a chronic problem now.

I guess my question is: is stretching making things worse, or am I just stretching too much?? I’ve been told that inactivity will result in scar tissue (I sit all day at a computer at work) so I try to stretch for at least 15 minutes every day.

Thanks so much for your help!

My heart goes out to you. I have seen 2 other dancers whose hamstrings were torn by well-meaning but anatomy-ignorant teachers. Sometimes the damage is done before the dancer thinks to say ‘stop’! It is never appropriate to increase a dancer’s extension in this way. One of the other dancers was taken out for a full year from her professional career in Europe! She was lying on the ground stretching, and had a teacher lift the leg up into a hamstring stretch and press it towards her body. This dancer was very flexible, but her body did not have the time to adapt to someone else’s force and tore her hamstring. Enough said – never – stretch out someone’s hamstrings unless you are a physical therapist who has been trained to listen, feel and watch for the subtle cues from the muscles.

There are 2 suggestions I have for you. The first would be to have someone who is trained either by Tom Meyers ( or a massage therapist that does myofascial release work. Rolfing is another name for another type of myofascial release work. They will work slowly, deeply, and along the entire posterior muscular line, as well as any other fascial lines they see are off. The whole body adjusts to trauma, and your hamstring tear was certainly a traumatic event. By releasing corresponding areas that tie into the fascia of the hamstrings you are treating the whole body rather than just the hamstrings. (An aside, Tom Meyers book, Anatomy Trains is wonderful!)

The second suggestion may seem a little more off the beaten track. It seems like common sense to acknowledge that our emotions have an influence on our physical body just as our thoughts do. Our thoughts and our emotions are integrally connected as thoughts create the chemicals of emotions.

I’m not going to go into a deep conversation about the field psychoneurophysiology, but I am going to suggest that you try working on the issue of this injury with EFT. EFT is a tapping technique that has been described as emotional acupuncture. If you go to you can first watch a very short video introduction to EFT, read the online manual, and search in the thousands of case reports where athletes and others have used EFT for performance enhancement as well as relief from physical ailments. Just typing in injuries in the search box will bring up 171 cases of where EFT was used for injuries.

I use EFT and while I don’t totally understand how and why it works I am all for any and all techniques that empower us to create change in our own lives.

Please send me an update on how you are doing.

To your good health!


“Education is the key to injury prevention”