Dancer Health

SAFE DANCE: Preventing Injury in Winter

By Rain Francis of Dance Informa.

Brrrr… it’s COLD out there! Winter has well and truly set in and we are more at risk of injury than we were in summer. Dance Informa consulted leading dance physio Lisa Howell, of Perfect Form Physiotherapy, to find out the best ways to stay healthy and strong during the cold months.

What is the best way to warm up for class?

This really depends on what type of class you are doing. Your warm-up should always be class-specific and take into account what state your body is in on that particular day. If you have just been sitting in school classes for the last couple of hours, you’ll need to do a lot more mobilising exercises in your warm up than you would if you have just come straight from another dance class, or walked half an hour to the studio.

First, focus on getting your heart rate up. One example might be to go for a light jog around the studio, to pump fresh blood through to your muscles. You can then work on mobilising your joints, fascia and muscles into the ranges that you need for the particular class you are doing. This is not the time to be trying to improve your range. Flexibility work needs to be done separately; it should not be the focus of your warm-up. You should only be warming up into your currently available range.

It’s really important to “wake up” the muscles you will be using, to increase the neural firing to each particular set of muscles. Make sure you do some specific isolated core work, activate the turnout muscles, get the small muscles in your feet going, and whatever else you are going to need to use in the class. A lot of people forget to wake up their proprioception before class, but including this step can make a huge difference to your class work. You can do this by doing some balance work; doing various exercises on a wobble board or just trying some balances on demi-pointe will make you a lot more stable in your turns and adage.

REMEMBER: Warming up is definitely not just about sitting in second position or doing big, long sustained stretches to try and get more flexible. It is about preparing your mind, your body and the specific muscles you need for class. For more information about warming up, visit perfectformphysio.com.au/dance-warm-up.

What is the safest way to stretch?

There are several different styles of stretching and each has its merits.

Static stretches, such as sitting in second, should only be done at the end of the day, after your training has finished. If you are stretching one particular muscle for anything longer than about 30 seconds, it will not be able to fire at it’s full capacity for about half an hour afterwards. That means that long stretches before class actually hinder your progress.

If you are doing a session to work specifically on your flexibility, working just ‘at the edge’ of a stretch is helpful. Focus on learning how to internally relax so you can go deeper into the stretch, without pain or pulling. Stretching should never be forced or painful. Muscular resistance when moving into a stretch is your body’s way of protecting you from injury, when it feels that a movement is unsafe. You need to work gently and consistently with your body so that it feels progressively more comfortable with more extended positions.

Dynamic stretches, moving through different ranges with control, such as a fluid Vinyasa Yoga Sun Salutation, can be used throughout the day, to both warm up and cool down, as they encourage blood flow and increased fascial mobility throughout the entire body.

Fascial mobilisers are a helpful tool to incorporate into your warm-up. They focus on getting the layers of fascia in between the muscles to slide over each other, and are far more beneficial than simply yanking on a muscle. You can find out more about fascia and fascial tension here

REMEMBER: Save your long stretches and flexibility work for the very end of your training session, and never force a stretch.

Is it safe for students to push each other into stretches?

When it comes to young dancers, pushing each other into stretches is a very dangerous practice. There are several main reasons why.

The first reason is that in young dancers, the joints are not fully developed yet, so if force is applied (for example, students using their feet to push each other into second splits) serious damage can occur to the head of the hip, changing the shape of the joint, and causing long term damage.

Secondly, young dancers don’t necessarily have a good feeling of how hard is too hard to push. Stretches that are unsafe may not actually feel painful, and they will think that the stretch is fine, unaware of what is going on internally.

Additionally, young students can often not discern between “good pain” of a muscle working or being stretched, and the “bad pain” of a muscle tearing. This is something that comes with age and experience so it is advisable to not engage in partnered stretching under the ages of 15.

Many of the larger muscle groups in the body have an attachment point into the bone that is very close to, or directly on, a growth plate. During active phases of growth (usually between 11 and 15) strong stretches of these muscles can actually cause an Avulsion fracture, where a piece of bone is pulled away from the main bone. These fractures are difficult to heal, and can be career ending.

REMEMBER: Being pushed into stretches is very dangerous. Be patient and work on your flexibility gradually, to increase it safely over time.

Do we need to do anything differently in the cold months as opposed to when it’s warmer?

Definitely, yes. What works fine as a warm-up in the summer might need adjusting in the winter. Start by thinking about your environment. For instance, a big factor is how warm the studio is. If you are walking or taking public transport to class, your core temperature may drop down significantly during your commute, so it will take longer to bring your internal temperature up in the winter months. If you have more than one class in a row, make sure you stay warm during your break time; you can cool down a lot in between classes if you’re not in a very warm environment.

Another very important thing to consider is hydration. In winter, dancers often do not drink enough water. It is really important to stay hydrated, as you are still working and sweating, even if sometimes you don’t feel like it. A lot of people get dehydrated in winter, so always keep your water bottle handy, and remember to replace the salts that you lose with sweating by adding in an electrolyte replacement, but be careful that it does not have added sugar, colouring or artificial flavours. Coconut water, for example, is a great, natural electrolyte. 

REMEMBER: Consider how warm your class environment is, and don’t forget to stay hydrated.

Can Pilates or other strengthening programmes help to prevent injury?

Absolutely. Pilates, Gyrotonics, Yoga, and working with a Swiss ball are all good ways of strengthening the body for dance. Any form of detailed, specific training to balance your body is going to be good for you, as long as it is done well. Aim to identify any weaknesses or asymmetry, and focus on exercises that specifically target these areas. A lot of people focus on mobility but do not have the strength to control it.

Pay special attention to the very small muscles that stabilise the joints. There should be a focus on the very fine control of the deepest, small muscles in your spine, the pelvic floor and the deep abdominals. Find a physio who has a visual ultrasound (Real Time) machine, which lets you see which muscles are firing. This way, you can practice your abdominal work while looking at the muscles on a screen to make sure the correct muscles are being used. This is a really helpful tool that is very much under-used. Many dancers are doing loads of abdominal exercises but are in fact only training the external muscles, even if they have been doing Pilates for years. True core stability is often very misunderstood and if you can learn how to fire the correct muscles, your technique will greatly improve. For more information about this, visit perfectformphysio.com.au/visual-ultrasound.

REMEMBER: Focus on the fine control of deep spine, pelvic floor and abdominal muscles by doing some functional training on a regular basis.

Are there any forms of exercise that are particularly helpful or unhelpful to dancers? Is there anything we should avoid?

Each form of exercise has its place depending on what you’re doing. With any type of exercise think of why you are doing it, i.e., the outcome from it, and weigh this against any potential risks.

Unhelpful activities include excessive extension of the spine and working on flexibility when you don’t have the strength to control your current range. Fine coordination around the joints is of the utmost importance for preventing injury and developing good technique. If you are struggling with your flexibility, don’t just push into the restriction. Often there is a reason for it, so find a physio or other practitioner who can assess the restriction, and work on improving it in isolation, before attempting to go back into the movement. You will have much faster, safer and long-lasting improvements doing it this way.

REMEMBER: Anything that teaches you how to refine your technique is good. Anything that forces a movement or gives you pain is generally not so good. If something is not working for you, or you feel uncomfortable, you may need to try a new approach.

We often have ‘niggles’ that go away by themselves. How do you know when it’s time to see a physio?

If a ‘niggle’ has been hanging around for three days and it’s not changing or it’s getting worse, definitely go and see someone. If you have any neural pain – any numbness or pins and needles – you definitely want to get that seen to straight away. Likewise for any excruciating, sudden pain with unexplained cause. Acute injuries, such as sprained ankles, should be seen to as soon as possible.

If your muscles are sore from working, or if there’s a little strain that drops down in a few days, it’s usually not necessary to book an appointment. But take any strains as a sign: What could you have done to have brought the pain on? Is there a weakness on one side, have you started a new routine which includes a movement you don’t normally do? Take any niggles as a lesson on how you’re working your body. They don’t just happen for no reason, so it’s better to take them as warning signs and take action before they turn into major injuries.

REMEMBER: Listen to your body, and if you’re unsure, get it checked out. It’s better to be safe than to end up having months off down the track with a serious injury.

What is the benefit of a cool-down?

When you are training, you create micro-tears in your muscles, which then get rebuilt with new muscle fibres so you are training the muscle fibres to get stronger. A good cool-down should get new blood circulating around the body to help heal any micro trauma, and remove the by-products of muscle contraction (often known as Lactic Acid), making sure you’re not sore the next day. Gentle dynamic stretches help unravel any remaining muscle contraction from your session and helps the muscles to relax back to their normal level.

REMEMBER: Your cool-down is an essential part of your training routine, helping to make you a better dancer and avoid injury. A cool-down should be fluid, and controlled, starting to slow you down, and be focused on bringing your body back to ‘factory settings.’

Is stretching sufficient for a cool-down, and if so, what kind of stretching?

Static stretching is not a sufficient cool-down. You need to focus on getting new blood into your muscles and other tissues. Again, a yoga sun salutation is ideal, as it lengthens and moves the muscles in different ways. We often focus too much on stretching the muscles in one direction. There are very few muscles in the body that are a flat sheet; most are rounded, going in several different directions. Aim to mobilise each muscle in several different positions rather than holding a static stretch. 

REMEMBER: Cool-downs should be fluid and focused on moving the muscles in more than one direction.

What are your top tips for preventing injury during the cold months?

Learn about your body. If you know about your own anatomy, you can be much more aware of what is safe and what’s not. The way your body works is very different to the way your best friend’s works, so don’t feel pressured to force movements just because your classmates can do them.

Be safe. Work closely with a physiotherapist, osteopath, or a Pilates instructor who knows a lot about dance. The key to preventing injury and having a long career in dance is knowing your body intimately and respecting it, yet still challenging your own boundaries. It’s all about how to improve safely over time rather than expecting instant results.

REMEMBER: Safety first! Every body is different; learn what works best for you!

Photo (top): © Andriy Petrenko | Dreamstime.com

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