Knees aren’t aligned
[quote style=”boxed”]I have a 13 year old student who has the types of knees that even when facing forward parallel, are not aligned with the foot. They are facing inward. We have been very careful about alignment, but she attended an intensive this past summer and injured one of her knees and is not recovering very well. She has seen a chiropractor who has recommended she not dance for 2 weeks. He gave her strengthening exercises to do. Would you have any other suggestions? Thank you so much, Barbara[/quote]
I suspect that she has tibial torsion, Barbara. I’m curious what strengthening exercises she was given. Most likely non weight bearing strengthening of the quadriceps and while that is good, especially if the medial quad is weak – I would have you pay very close attention to the weight on her feet when she stands and how well she is using her turnout. It is quite common that when going to intensives students have a way of overdoing their first positions to make it look good and can easily strain the area of the knee since this is where they create turnout when they aren’t using it from the hip. Sometimes they also pronate the foot to create a better first position.
The 3 minute clip below describes tibial torsion. I was fortunate when filming this to find a young dancer who demonstrated the pattern that I find so often of more tibial torsion on the leg that has less turnout. The challenge for this dancer is her turnout was less than average. She actually had a greater range of turn in than turnout at her hip so that created even more tension and stress in her legs when she was in ballet class. Eventually, around 13 years old she opted out of ballet and continued being physically active through sports.
So how to work with it? Taking time off from class is called for especially when there may be swelling and inflamed tissue around the knee. When she comes back into class she is going to have to monitor the weight on her feet – it must be equal between the heel, pads of the big toe and little toe. She’ll probably need to bring her turnout in some in first position in order to make sure she can maintain working her turnout from the hips. In modern or contemporary class her parallel will not be parallel. I have my students have their knees directed forward and allow the foot to turn outwards as little as possible, but enough that the weight stays equal on the 3 points.
Lastly, you’ll want to check and make sure her pelvis is placed correctly over her legs as tightness in the hip flexors or some other challenge to the pelvis will certainly influence how the weight of the body falls through her legs.