8.11: Injury Prevention

For the purposes of this chapter, let us assume that an injury is not a simple ache or pain. An injury is an occurrence that is severe enough to cause a dancer to be unable to dance for one or more days after the date of the event. Dance teachers (and health professionals) should use injury surveillance to measure exposure to injury related movements. Best practices have been developed, these are a set of guidelines that a clinician can follow to provide the best possible care and rehabilitation. Sometimes, dancers are reluctant to talk about pain, injuries or other personal factors.

Definition: Injury

A physical occurrence of the body that is severe enough to causes the inability to perform similar or related body movements for one or more days after the date of the event.

Until use of dynamic alignment such as use of turnout is muscle memory, and is habitual, dancers in classical western techniques such as ballet must attend to consciously placing focus on turn out or risk injury. When dancers push off for a jump, the muscles creating the movement shorten. This action is called concentric contraction of the muscles. When you land from a jump, your muscles need to elongate, while still at work. This is called eccentric contraction. Eccentric contraction is the most difficult to obtain muscle memory, but its also what protects you from jump landing injury. In dance, it is more important that turnout be maintained for landing a jump then held at a position at the barre.

Avoid Soft Tissue Injuries with Turn Out & Contraction of Muscles

Figure 8.22. Physical therapy can remedy inflammation, provide corrective treatment, strengthen and stretch, and help heal injuries.

(https://commons.wikimedia.org/wiki/File:Physical_therapy_150408-F-XP707-029.jpg)

Functional Movement Screening (FMS)

Functional movement screening (FMS) can assist in the evaluation of human body movement patterns. Looking for asymmetries and places of weakness, FMS can provide insight into the way the individual body functions, where there might be mechanical restrictions as well as potential risk for injury. FMS employs seven fundamental movement patterns that require both stability and mobility assessment exercises. Screening the functionality of your body can indicate areas of weakness. A screening can reveal a dancer’s need more sleep, nutrition, adjustment of dance technique, or even a need for physical therapy. Use the data to prevent injuries. Outcomes can teach us how to implement strategies toward improvement and greater success. Follow-up screenings are used to compare analysis, and… Evaluate your progress, and make adjustments as needed.

Functional Movement Screening requires that you find a partner, and during the FMS Screening, each partner group gets 10 minutes per station (5 minutes per person). Reflections: At each station, discuss with your partner each FMS screen & any injuries (or strains) you’ve experienced related to that area.

Screening

• Like all athletes, dancers want to be successful in their movement activities.
• Needed: above average strength, flexibility, coordination, endurance, concentration, and discipline.
• Dancers are subject to rigorous physical training and aesthetic demands.
• Needed: extreme joint mobility, powerful jumping, and supernormal balance.

The Purpose of Screening

• As many as 97% of dancers get injured each year.
• #1: The purpose of screening can assist dancers in identifying factors (strengths and weaknesses) in their physical and psychological make-up that can be improved upon for better performance.
• #2: Screening is also important to teach the dance community the boundaries and limitations of functional capacity for the human body in order to perform within safety and wellness.

Variables

• Age
• Rest
• Muscle Strength
• Years of Training
• General Health Habits
• Past Injuries
• Coping Style
• Muscular Flexibility
• Environment (Floors, Barre height, Mirrors, Dance Shoes, Room Temp)

Success in Dance and Life

• Success in any sport does not rely on only one variable.
• Rather, a combination of many skills and habits forms the talent and success of any mover.
• What one dancer excels at, another may not.
• Identifying what weaknesses and concerns exist is the first step toward improvement.
• Screenings help you identify weaknesses and areas of concern.
• Screening data provides guidance on how to progress toward being a more successful dancer.

Objective Scoring

The variables are obtained through tests that yield objective scores. For example, a dancers external hip-rotation (turnout) can be quantified in standing or prone (laying down) positions.

Example: Functional Movement Screening

Functional Movement Screening requires that you find a partner. Classroom should be set up in stations, normally aim for 10 stations and 10 pairs. Now, let’s do an FMS!

Items Needed:

1. FMS Screen Form printed
2. Pen
3. Movement Partner
4. Broom stick (without the broom head) or long pole
5. Blue painter’s tape
6. 2 chairs
7. Tape measure or yard stick

Please consult the image below and utilize the internet to set up the Functional Movement Screen stations. Station Rotation! Feel free to consult the internet for videos for any additional advice on how to perform the FMS tests.

1. Select a station to start
2. FMS: Each partner group gets 10 minutes per station (5 minutes per person)
3. 3 attempts for each station per person.
4. Reflections: At each station, discuss with your partner each FMS screen & any injuries (or strains) you’ve experienced related to that area.
5. Write down in a journal your reflections, and areas for improvement. Be sure to notate any physical limitations, surprises, or areas where you excelled. And why.

Figure 8.23. Functional movement screening (FMS) can assist in the evaluation of human body movement patterns

Station #1: Deep Squat

• Stand tall with feet approximately shoulder width apart parallel.
• Grasp dowel in both hands in both hands and hold it horizontally on top of your head, elbows at 90 degrees.
• Press dowel up, directly above your head.
• While maintaining upright torso, keeping heels and dowel in place, descend as deep as possible.
• Hold for a count of one, then return to starting position.

Station #2: Hurdle Step

• Stand tall with feet approximately shoulder width apart parallel.
• Grasp dowel in both hands in both hands and hold it horizontally on top of your shoulders, elbows at 90 degrees.
• While maintaining an upright posture, raise the leg and step over the hurdle.
• Touch floor in front of hurdle with heel and return to starting position maintaining foot/knee/hip alignment.

Station #3: Inline Lunge

• Grasp dowel in both hands and hold it vertically along the spine, so it touches your head, back and coccyx.
• RIGHT hand should be against the back of your neck, left against lower back.
• Feet parallel, maintaining foot/knee/hip alignment and dowel connecting to three points, LEF step forward, until right knee touches floor.
• Left leg remains perpendicular to the floor.
• Return to starting position.

Station #4: Shoulder Mobility

• Stand tall with feet approximately shoulder width apart parallel, arms hanging comfortably.
• Make a fist so your fingers are around your thumbs.
• In one motion, place the right fist over head and down your back as far as possible while simultaneously taking your left fist up the back as far as possible.
• Do not “creep” your hands closer after their initial placement.
• Reverse.

Station #5: Impingement Clearing Test

• Stand tall with feet approximately shoulder width apart parallel, arms hanging comfortably.
• Place right palm on the front of your left shoulder.
• While maintaining palm placement, raise your right elbow as high as possible.
• Do you feel any pain?
• Reverse.

Station #6: Straight Leg Raise

• Lay flat with the back of your knees on floor, toes pointing up (parallel).
• Place both arms next to your body with palms facing up.
• Flex right foot.
• With the right leg remaining straight and left calf muscle remaining on floor, raise right leg as high as possible.
• Reverse.

Station #7: Trunk Stability Pushup

• Lie face down with your arms extended overhead, hands shoulder width apart.
• Pull your thumbs down in line with _____ (Men=forehead / Women=chin)
• With legs together, pull toes toward shins and lift knees and elbows off the floor.
• While maintaining a rigid torso, push your body into a pushup position.

Station #8: Press Up (Spinal Extension) Clearing Test

• Lie face down with hands shoulder width apart under shoulders.
• With no lower body movement, press your chest off the surface as much as possible by straightening your elbows.
• Do you feel any pain?

Station #9: Rotary Stability

• Get on your hands and knees so hands are under your shoulders, knees are under hips.
• The thumbs, knees and toes must be centered.
• At the same time, reach your right hand forward, left leg backward like your are flying.
• Then, without touching down, connect your right elbow to your right knee.
• Return to extended position.
• Return to start position.
• Reverse.

Station #8: Press Up (Spinal Flexion) Clearing Test

• Get on all fours, descend hip toward heels.
• Lower your chest to your knees.
• Reach your hands out in front of your body as far as possible.
• Do you feel any pain?

Station #10: Posterior Rocking Clearing

• Get on all fours, hands under shoulders.
• Rock gently back and forth – posterior toward heels, weight in shoulders back over alignment with hands.
• Do you feel any pain?