Posts

Adult tibial torsion?

I recently viewed your video “tibial torsion audio” on youtube and was directed to your website thebodyseries.com; I was amazed to realize that the dancer in the video seemed to have the same problem as me, where she did not stand evenly on her legs, and in a demi pliet the knee turned inward in relation to the foot. I believe that my right leg has tibial torsion which is negatively impacting my ability to dance or workout. I was wondering if you knew of any doctor who specializes in diagnosing or treating adult tibial torsion, or could provide exercises to help correct this condition. I am a bit clueless, because this is the first time I have heard of someone with knowledge of the asymetry which affects others and me. Any help or direction you could provide would be invaluable and greatly appreciated.

Sincerely,
Josh

Unfortunately, Josh, you can’t undue the tibial torsion once you have it – but it doesn’t have to stop you from dancing. You do, however, need to focus first and foremost on keeping the weight even between the 3 points of the foot, the pads of the big toe, little toe, and heel. The knees will not be over the middle of the foot as we so often hear in dance class. For the dancer with tibial torsion if they pull the knees out to get them over the middle of the foot they are doing it by supinating the foot or overly using the sartorious muscle to pull the knees out to the side. Then you’ll have more problems than just pulling the knees out to the side!

The treatment? To simply balance out any muscular imbalances and keep the weight on the feet properly placed while working the turnout as well as you can from the hip – not the knees and feet.

Turnout and 5th position

Today’s blog entry is in podcast form. Here’s the question and then you can click on the highlighted link to hear my verbal response.

Hi! I have always have struggled with my turnout due to my bone structure. I have a few questions regarding my turnout and would LOVE to hear your advice. First, I have pretty good turnout when my legs are in the air especially in passe where I can have an 180 degree passe and still maintain good turnout on my standing leg. I do not have this turnout when my legs are in contact with the floor, such as in fifth position. Why? Second, I have always had to really work on my fifth position. I feel that my bum is sticking out and that I have too big of a curve in my lower spine. I do not tuck my pelvis only lengthen it downwards and I also pull my front up in addition to strengthening my lower abs. Why is my alignment not straighter? Lastly, when I stand in fifth position my hips always seem to twist into the barre even though I am holding my turnout in both legs. I know I will never have perfect turnout but would like to use what I have the best that I can. Thank you so much for your time. I bought “Tune Up Your Turnout” and thoroughly enjoyed reading it. Thank you so much!!! Katherine

click below for my response. Be patient – it’s a 7 minute response and might take a moment or two to load.

Click here

Enjoy!

Analyzing a turnout exercise

I’ve embedded a brief video on analyzing an excellent and effective turnout exercise. It looks deceptively simple, but isn’t. I encourage all of you to try it yourself and with your students! After you click the link below it will need a moment or two to load – if you click play before it is fully loaded the movement is jerky or stopped. It should take between 30 seconds to a minute to load. The movie clip will open in a new window.

I’ve got a few more slots open for Analyze This! workshop. They are going quickly, so do email me if you are interested.

Enjoy!

Deborah

turnout-exercise-copy2

50% off on select DVD’s until midnight, January 4th!

Happy New Year!

I was sitting at my desk this morning reflecting upon the past year and setting new intentions for 2009. I am so grateful to have my dance community. As teachers, nothing makes us feel better than to share our knowledge with others, it is a win/win situation.

I thought about how wonderful the past week was with having my 3 children at home (plus a few of their special friends☺ I scaled back like many of you have, and yet this holiday season was one of the nicest ones in years because I wasn’t so stressed about doing it right. Fewer gifts and more laughing…

The kids and I had some good home-cooked meals (the African curry turned out super!) and played Cranium and Mad Gab, and my all time favorite card game ‘May I’. (It’s a Vogel tradition – I’ve played it since childhood – a type of rummy)

As a thank you to you, my appreciative dance community, my DVD’s are now half price – 50% off – until midnight PST, January 4th. My intent is to help you start the new years off right – with affordable and to the point (no pun intended) information to help you become even more amazing dancers and teachers than you already are.

When you go to the http://www.thebodyseries.com to order your DVD’s, the sale price will be reflected accurately in your shopping cart. There are 5 DVD’s being offered at half price

* Analyzing Turnout
* Analyzing Arabesque
* The Standing Leg
* Ballwork: Releasing Muscular Tension
* Strengthening the Lower Extremity

Perhaps you can round out your collection or give a gift to a special dancer.

When you are at the website, check out December’s Dancing Smart blog postings in case you didn’t catch one of the 7 posts! Make sure to listen to The Science of Dance Training podcast that Lisa Howell and I did together just before Christmas.

Most of all, please accept my warmest wishes for a peaceful, abundant, healthy and dance-filled 2009!

Deborah

“Education is the key to injury prevention”

Utilizing Turnout without tucking under

Greetings, everyone, and Happy New Year! May 2009 be the best year ever!

I’m wondering if you can help me with turnout. I understand the concept of turning out using the small rotator muscles underneath the buttocks, however every time I engage them, I can’t help but to engage my gluteus maximus also – which doesn’t benefit turnout. If I let go of my core I can relax these bigger muscles while maintaining turnout, so I’m wondering if this is an issue with how I hold my center more than turnout?
Thanks!
Emily

Congratulations for knowing that the turnout muscles are smaller and deeper – underneath the bigger gluteal muscles!

Whether or not the gluteal muscles contract depends on what the movement you are doing. The gluteus maximus is a powerful hip extensor – it takes the leg backwards and stabilizes the pelvis on the legs. They actually assist your turnout when you take the leg behind in a back tendu. If you are standing in first position and do a cambre forward and backwards, the gluteals will contract strongly when you cambre back.

When you are doing a demi plie, though, the gluteal muscle should not be contracting strongly because you are flexing the hip. If you contract the gluteal muscles when you are doing a demi plie, you will tend to tuck the pelvis under – not a desirable action.

So turning on the gluteals is almost automatic when you take the leg behind you – but how do you turn them off when you are moving your leg to the front or during the descent of a demi or grande plié?

One of my favorite exercises for teaching dancers where their turnout muscles are is to have them lie on their side with their legs bent with their knees forward and feet in alignment with their hips. Placing one hand on the top buttock area, slowly open your top knee like a clamshell keeping your feet together. If you do a set of 20 lifts (remembering to slowly close the knees together) you’ll definitely feel the deeper rotator muscles working, while being able to monitor whether or not the gluteal muscles are contracting.

Another good way to practice this patterning between the gluteals and the rotator muscles is to start by standing in parallel with one foot in coupe. You’ll then stay standing in parallel and slowly turn out and open the gesture leg to the side.

It is very easy to monitor whether or not you are keeping your pelvis square through the weight on your standing foot. Keep the 3 points of the feet firmly planted on the ground and don’t let your foot ‘roll in’ or pronate!

In time, you will have changed the pattern of always gripping the gluteals – and – your range of motion and ease of movement will be better!

Until next time,

Deborah

“Education is the key to injury prevention”

Announcing The Science of Dance Training Podcasts!

We’re almost at the end of the year and Lisa Howell and I have been planning
some very special joint projects for next year. We are both passionate and
committed to educating dancers and teachers on how to get the most out of
your dancing. We’ve created a blog at TheScienceofDanceTraining.wordpress.com

We decided that we wanted to end this year on a very special note and are
going to be doing a free podcast that will be available online. We hope to
record the podcast before Christmas – and we need your help. We want you to
email possible questions that we can discuss in the podcast.

To celebrate our collaboration and to make it more fun – the six people who
get chosen to have their question answered in the podcast will get to
choose..

one of Lisa Howell’s dance education manuals, which include…

  • The Perfect Pointe Book and AV Course
  • The Front Splits Fast Flexibility Manual
  • The Advanced Foot Control Course
  • Core Stability for Dancers Manual

And you’ll be able to pick one of my products from The Body Series…

  • Tune Up Your Turnout book
  • Train Your Brain: A Teen’s Guide to Well Being Analyzing Arabesque DVD
  • Analyzing Turnout DVD The Standing Leg DVD
  • Ballwork: Releasing Muscular Tension DVD.

If you are interested in being one of our 6 winners this is what you’ll need
to do.

Go to thescienceofdancetraining.wordpress.com and submit your question.

You can also submit your question by sending an email to
thescienceofdancetraining@gmail.com

Send in more than one question, if you like, to increase your chances of
winning. Lisa and I hope to do a monthly free podcast as a way of saying –
thank you for being a part of our dance community.

Send your questions in quickly – we’ll be choosing the winning questions
this weekend – watch for another announcement saying the podcast is ready
for your listening pleasure!

Deborah

“Education is the key to injury prevention”

Hamstrings & Sore Sits-bones

Greetings!
I haven’t gotten to answer any questions over the past few weeks as I’ve had some special events such as spending time with Lisa Howell, the wonderful Australian dance physiotherapist who authored the Perfect Pointe Book and the Perfect Pointe System! Lisa and I then went off to the IADMS Conference (International Association for Dance Medicine and Science) where I got to meet – some of you!

I so appreciate learning and being inspired by all the good work that is happening in dance medicine from around the world. Thanks to all who stopped to introduce themselves to me!

Onto the questions of the week….

My question concerns soreness around the sits bones during lunges and straddle split stretches (both the kind where you face a wall and push yourself closer and where you lie on your back perpendicular to the wall with your legs dropped open). I’m used to feeling sore there when working on hamstring flexibility, but never before with other stretches. It’s especially odd with the lunges, because the soreness is in the buttock of the BACK leg. Rotating the leg inward seems to help a little. Do you have any ideas what may be going on here?

Your turnout muscles also attach in the area of the sits bone. You gave a good clue that rotating the leg inward helps relieve the soreness some. Why don’t you try putting a pinkie ball or a tennis ball underneath your pelvis and rolling lightly around. Pay special attention to the sitting bone area. After gently massaging that area do your stretching and see if there is any difference in your response. Let me know if that helps!

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Another dancer writes….

If the hamstrings are tight where might a dancer feel discomfort?

We talked about this in class this morning. It seems logical that if the hamstrings are tight you would feel that tightness at one of the ends of the muscle. Either around the sits bone like the above question – or at the knee. But interestingly, often hamstring tightness and problems show up as lower back aches, and lower back problems will be felt in the hamstrings.

seated_hamstring_nThink about a dancer who has tight hamstrings and is sitting on the floor with one or both of the legs in front of them. As you can see from this picture, the hamstrings aren’t being targeted very effectively – rather the back is taking the brunt of the stretch.

Try using the pinkie ball on your back and pelvis. I really should buy stock in a pinkie ball company! – just teasing!

Sometimes releasing muscular tension above or below the hamstrings will help. I have students spend about a minute rolling a pinkie ball underneath one foot. They are massaging the plantar fascia of the foot. Then they go to touch their hands towards the floor and generally at least 50% of them will feel the hamstring loosened up on the side they used the pinkie ball. They didn’t stretch the hamstring directly – and it still benefited!

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I promise I’ll get back on track with the newsletter. I’m working on updating the website and along with that bringing some new information to you! Stay tune for more info in future newsletters!

Warm regards,
Deborah

Painful Knees

Question of the week…
I am 13 yrs. old and i have been having problems with my knee. I have pain under my knee cap and sometimes it get to the point where it hurts to walk. (It also hurts to walk up and down stairs and especially if I go into a deep plié or a grand plié) I am a very very active dancer and I would like to know what is wrong with my knee. I just went to the doctor two days ago and they said I should stay take about 5 days off of dance and take the anti-inflammatory medicine they prescribed for me, but as the days go on it doesn’t seem to be getting any better. I really hope you can tell me a way to help heal my knee so I can start dancing again. Thank you so much for all your help.
MARIAH

Dear Mariah,
I would first say to follow your doctor’s advice, and take the time off from dance – and take the medication to reduce any swelling. If you are having pain while walking or climbing stairs, you certainly shouldn’t be in dance class until you can do daily movements without pain.

That being said, once your pain is better you’ve got to figure out why it started hurting. Have you gone through a recent growth spurt? Bones grow faster than muscles, and knees are often a place that feel those ‘growing pains’.

Was their a change in activity prior to your knee hurting? Did you start a new technique class, or start with a new teacher, or just come off summer vacation? It can be a real shock to the body when you are off from dance for a while, and then jump in and start taking daily classes.

What’s your turnout like? Is the knee that hurts on the side that has less turnout? Often our turnout is unequal and we compensate by rotating the foot out farther on the side that has less turnout at the hip, and then we put a twist at the knee.

It’s also possible that a piece of cartilage got irritated for some reason that will remain unknown – and – by taking care of it, you will be back to dancing in no time at all. Best wishes for a speedy recovery. Continue to ice, rest it, and follow your doctor’s suggestions. It’s possible that he will put you in physical therapy next so you will be guided in correcting any imbalances of muscle strength and flexibility.

Arabesque

question of the week….

I’ve got a question about arabesque. Many of my students open their hips more than is necessary as they approach 90 degrees, which makes squaring their shoulders a problem, as well as turning out their base leg and aligning their ribs over their hips, leading to a lack of balance. This year, one of my goals with them is to instill a better sense of squareness. However, as soon as they start to really try to square their hips, their working leg turns in, drops, and the back of the knee softens. Grrr! I understand the meaning of turning out within the hip joint as much as possible, and we do work that, of course, but how exactly do you square your hips and still get any height on a back extension? I’m starting to think I need to concentrate more on the base leg turnout, because they’ll be less able to open that working hip if the standing leg is rotated more, right? Sigh……..Thanks for any reply……..
Jennifer

Delicious question, Jennifer! You have discovered one of the ‘myths’ of ballet – that you can keep your hips square as you do an arabesque. It’s why I created the DVD Analyzing Arabesque!

When you are taking a leg into a back tendu, you can keep your hips square for a short period of time. How long you can keep your hips square has to do with the range of motion of the hip flexors and your own personal boney hip structure. A few dancers can stay totally square for the whole back tendu – more often than not – most dancers have already opened the working hip by the time they reach the end of the tendu.

For an arabesque – I have never seen a dancer stay totally square in an arabesque. It is anatomically impossible. That being said the concept of squareness is one that we should strive for. But how?

You have hit the most important nail on the head and it has to do with the standing leg. The better a dancer gets at maintaining the turnout of the standing leg while doing a back tendu or arabesque, the squarer the hips will appear.

As you know the spine will rotate and spiral away from the leg in arabesque (right leg in arabesque, the spine spirals to the left) in order to keep the upper body focused forward. This also helps to keep the dancer on her standing leg.

The most important areas to work on if your students aren’t staying square are
1. flexibility of the hip flexors, especially the iliopsoas (this will help to give them a higher arabesque and an easier time staying up on their standing leg)
2. flexibility and strength of the rotators (this will help them rotate both legs more evenly – instead of focusing on one of the legs more than the other)
3. ability of the standing leg to maintain turnout (to keep the hips square)
4. range of motion of the spine to allow that easy spiral and to keep the upper spine upright (which makes the leg look higher)

Bottom line – the hips will open some – and the pelvis will rotate – effectively ‘turning in’ the standing leg. And – by focusing on countering that tendency by keeping the weight balanced on the standing foot (not dropping back into the heels as is so common) and thinking stabilizing and rotating the standing leg – you’ve got your best chance for that elegant line of the arabesque.

Your thinking is on the right track!

Warm regards,
Deborah

“Education is the key to injury prevention”

Toeing – In

Happy Labor Day weekend! Many of you have already started back into the fall semester and others will start on Tuesday. I hope your fall is getting off to a splendid start!

Onto the question of the week….

I had the great fortune of attending your classes at the DTSC again this year. I was returning after having taken your class 5 years ago – after which I ran right out and purchased some pinky balls. Since that time, my father has taken up working out and has had many successes with that. He has had the occasional ache and pain however, to which I have recommended some of your ball-work. Although he listened, it wasn’t until the PT suggested something similar that he gave my suggestions some validity! I’m trying to get him to borrow my ballwork video that I purchased. 🙂

My question today is in regards to my daughter’s feet. At an early age, watching her on the sidelines and even in her own early dance classes – I took notice of something funky going on with her feet. Now, age 6, I have concern still. As she has taken some ballet technique and gymnastics classes – it has become more apparent that her feet appear to turn in while in action. She can stand in first, draw her leg up to passé and keep the knee back, heel forward as long as I remind her. When her movement is stationary or sustained she understands and tries to make corrections… yet when she is dancing her feet turn in..quite a bit. A simple leap – toes turn in, a small arabesque – turned in, on the uneven bars her teacher called me over before coming to the conference because when she circles the barre – her foot turns in. I’m beginning to notice it might be in her right foot more then the left. The pediatrician looked at her feet at the 5 yr. and 6 yr. visit and has determined she is turned in slightly – but it is mild. Although she may never be a professional dancer – it is difficult for me as a dance teacher to see her little feet so turned in when she dances. Should I be concerned or not? Is there anything I can have her do at home to help? What type of orthopedist should I be looking for to look at her feet? If her feet are mildly turned in – is there any concern I should have other then dance related?

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Lovely question! Turning in of the feet or pigeon-toed can come from three different areas – at the feet, the shin bone, or the hips. Let’s take a look at each one individually.

9052When the feet turn in at the feet it is called metatarsus adductus . This is where the bones of the feet turn in. Typically, this is caught before the child even begins walking and the doctor would have suggested massaging and stretching the feet as she grew. Since it was not caught when she was really young, I would rule out this cause for your daughter’s turning in of her feet.

We have talked about tibial torsion in other newsletters, more often we talk about external tibial torsion – but there is internal tibial torsion. In dancers I see more external tibial torsion which describes an outward rotation of the shin bone. I often find this in dancers who aren’t using their turnout from the hips, but rather are turning out from the knee down. Over time, that stress from standing in too much turnout creates a rotation at the bone that one might think is a good thing – but actually, it means that your knees and the feet won’t be lined up and leaves the dancer vulnerable to knee and ankle injuries.

202b.Par.0001.ImageInternal tibial torsion, which your daughter might have is where the shinbone rotates in making for a pigeon-toed walk. This isn’t unusual in toddlers and preschoolers, and often corrects itself as they become more active in running and walking – the 5-6 year old stage. Sometimes toeing in lasts into the school years, but usually isn’t a problem. In fact there are some sports that favor internal rotation, such as martial arts, soccer, and sometimes basketball.

If the toeing in was happening just from the shin you could sit your daughter on the edge of a table with her knees facing forward and you would see a clear inward rotation of the shin bone – as in the picture to the right.

When the turning in is coming from the hip it is called anteversion. The normal range of turnout and turn in at the hip is 45 degrees for both. When you have more turnout it is called retroversion, when you have more turn in it is called anteversion. This is a structural situation where it describes the angle of the neck of the femur to the shaft or long body of the femur or thigh bone. If you test your daughter’s range of motion at the hip by lying her on her stomach that might give you an idea if she has some natural anteversion.

W Sitting1A child with anteversion easily W sits – as shown in this picture. It will be interesting to find out what the relationship is between the two hips – are they even as far as their range, or is one more turned out or more turned in. This is very common, and while it isn’t a significant issue, you would want a young dancer to create her first position based on the lesser turned out leg, rather than the more turned out leg.

Watching the recent Olympics and especially the gymnastics competition, I was struck by how many of the gymnasts had a slight tendency to turn in their feet on the balance beam as well as on the floor routines. No one would ever say that their line wasn’t beautiful and elongated – even if it wasn’t as turned out as what the dance world would like.

All in all, I think I would take a look at these 3 areas on your daughter, see if you can get a better idea where her toeing in is coming from – and then encourage her to be as well-rounded and active in all ways as possible. At 5-6 years of age, I’m prone to suggest going light on the amount of turnout emphasis and focus on the alignment of the hip, knee and foot – which is what you are already doing. Since she can do that when she thinks about it – my intuition says she will improve her ability to automatically line her legs up as she gets older and better able to maintain that specific focus during class. Now you have a way to periodically assess her range of motion and know better where to focus her attention.

Below are pictures of what normal turnout would look like, a retroverted hip (excessive turnout) and an anteverted hip (more turn in than turnout)

Normal ext RotNormal amt. of turnout – 45 degrees

 

 

 

Retroversion t-oRetroversion – more than normal turnout (leg is resting on other thigh)
Anteversion: more than normal amt. of turn inOLYMPUS DIGITAL CAMERA

Until next time,

Be well,

Deborah

“Education is the key to injury prevention”