All dancers get tired—eventually an intense rehearsal or class schedule can take its toll. But some of us experience something greater than periodic tiredness: chronic fatigue syndrome, which is persistent or never fully goes away. Here's how to address and reverse the effects of chronic fatigue and get back to your fully energized self.

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Nathan Sayers

Are stiff, swollen Achilles tendons making pointe class painful? You could be suffering from Achilles tendinitis. James Gallegro—MSPT, CMPT with the Manhattan Physio Group, who works with many professional dancers and companies—spoke to Dance Spirit about how to handle the all-too-common problem.

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OK, so going to the gynecologist isn't exactly fun. But the good thing about your annual visit is that it's a one-stop, totally confidential way to get your most sensitive questions answered. And it's essential that you ask them! After all, there's nothing more important than keeping your dancer body—every part of your dancer body—in tip-top shape. If you're feeling shy or embarrassed, just remember: Gynecologists have heard it all. Here are the answers to some of the questions they get asked the most.

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Courtesy AQUA Studio NY

As a dancer, cross-training is a non-negotiable aspect of staying healthy. But sometimes the prospect of another dreary gym session is…less than inspiring. Banish boredom and take a cue from these three pros—a ballet dancer, a modern dancer and a Broadway performer—who shake up their cross-training with unusual activities. We asked Kendall Alway, DPT, a physical therapist who runs SF Performing Arts Physical Therapy and is the associate director of the ODC Healthy Dancers' Clinic in San Francisco, CA, to weigh in on the effectiveness of each method. Look no further for exciting cross-training regimens that can keep your dancer body challenged, balanced and injury-free.

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Podiatrist Thomas Novella remembers one of his first interactions with dancer feet. Fresh out of podiatry school, he saw a patient from The Joffrey Ballet and assumed he knew the clear way to help her out. “I thought I was doing her a favor by trimming her calluses off, just like I'd been trained to do," Novella says. “She called me every day for the next two weeks screaming at me until the calluses started to come back. I immediately learned my lesson!" Now more than 30 years into his career, Novella works with dancers from New York City Ballet, American Ballet Theatre and other dance companies at his practice in NYC, so he's not only learned the importance of calluses to protect delicate skin, but also things like the risks of an ill-fitted shoe, and the toll that Nutcracker season can put on a body. But not every dancer is lucky enough to have a doctor who knows the ins and outs of the dance world. Dance Spirit asked the experts to break down four common scenarios in which your doctor will be better able to help you if you can give a dance-specific description of your needs.

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University of Massachusetts, Amherst, dancers performing at a choreography show (Jim Coleman, courtesy Five College Dance Department)

College is all about investing in your education, but it's also the perfect time to meet a ton of people. The intense nature of a college dance program means you might have the chance to collaborate with anyone from visiting choreographers to MFA candidates to alumni—and those people can help lay the groundwork for your professional career. Dance Spirit asked two pros how they built lasting professional relationships that started in college.

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The worst has happened: You landed a jump and felt an oh-so-terrifying pop in your ankle. As your friend rushes over with an ice pack, your entire dance career flashes before your eyes. All you really want to know is how bad it is—and how long you’ll have to stay off your toes.

Dancers endure a lot of physical stress on a daily basis, making injuries like sprains, strains, fractures and stress fractures fairly common throughout the body. Here, Dance Spirit breaks down the differences between the four diagnoses—so you’ll know what to expect when your doctor gives you the news.

The diagnosis: a strain

Strains usually build up gradually over time but can also happen suddenly. They occur when muscles or tendons (tissues that connect muscle to bone)—frequently in the lower back or hamstrings—are stressed by prolonged repetitive motion. Strains often come with pain, swelling, limited mobility or muscle spasms. “I usually see strains in dancers who are trying to get a muscle to stretch or contract more than their body can tolerate,” says Katie Lemmon, an athletic trainer with Athletico Physical Therapy in Chicago, IL.

Treatment strategy for strains depends on their severity. You may make significant recovery with a few days off, but you may also need up to six weeks working with a physical therapist, or even surgery. Lemmon recommends turning to a dance-friendly physical therapist as soon as possible, since they can often help correct anything in your technique that might increase your risk for re-injury. “It could be an imbalance in your muscles,” she says. “For example, if the pulling feeling is in your hamstring, you might need to stretch out the front of your thigh. We always recommend a technique assessment to look at how all the parts of your body are working together.”

The diagnosis: a sprain

A sprain is usually accompanied by pain, swelling, bruising and limited mobility. It indicates a stretching or tearing of ligaments, the bands of tissue in your joints that connect two bones. In addition to the classic sprained ankle, you can also sprain ligaments in your knee with an unexpected twist, or in your wrist during acro or partnering. Sprains usually happen suddenly, and they’re more likely if you’re tired or haven’t warmed up properly.

While a mild strain may only require a few days of rest, ice and wrapping, most ankle sprains will require some time in a brace or a boot. Podiatrist Ronald Werter, who works with professional dancers in NYC, says moderate sprains may only require two weeks in a boot followed by two weeks in an ankle brace. The more intense the tear, the longer you’ll have to stay off the foot. If the ligament is completely severed, it could take six months or more to heal. In that scenario, many dancers opt for surgery to repair the ligament, since it typically won’t reconnect on its own.

It’s important not to return to dancing too soon after a sprain. “If the ligament is still overstretched, you may be at risk of making the injury worse or tearing it completely,” Lemmon says. “Even when your doctor says you can go back to dancing, start gradually with movements that don’t require twisting, turning or jumping.” Working with a physical therapist can help you regain balance, strength and range of motion. And your doctor may recommend taping the affected area to add support when you first return to the studio.

(Photo by Lucas Chilczuk)

The diagnosis: a fracture

A fracture, or broken bone, happens suddenly, usually from landing a jump wrong, falling or being dropped while partnering. You’ll often feel and hear a snap, followed by throbbing pain, swelling, bruising and sometimes noticeable deformity. Werter says he commonly sees broken toes in dancers, which, at best, heal with taping and a couple days of rest.

However, a broken metatarsal may require surgery to insert a pin or screw in the bone. “After surgery and six weeks in a boot, it should be stable enough to dance on carefully, but you’ll likely need about another three months to be completely healed,” Werter says.

To avoid fractures, Lemmon suggests checking in with a nutritionist to be sure you’re eating a bone-healthy diet. Often, dancers with poor nutrition or amenorrhea (lack of periods) will have weaker bones, which can make them more susceptible to fractures. The good news is that once your bone completely heals, the chance of breaking it again doesn’t increase in healthy dancers. In fact, Lemmon says, the bone may actually heal stronger.

The diagnosis: a stress fracture

A stress fracture happens when a bone begins to develop thin cracks due to prolonged stress. Dancers usually get them in the bones of the foot (metatarsals or sesamoids) or in the bones of the lower leg (tibia and fibula), and they may not be easily spotted with an X-ray. They’re usually caused by overuse or repetitive pressure on the bone—jumping repeatedly on a hard floor, for example, or even wearing pointe shoes that don’t fit correctly.

“For foot fractures, I start by immobilizing it in a walking boot for just a week,” Werter says. “After a week, if there’s no pain, I’ll wrap it and ask the dancer to take it easy. If treated properly, a stress fracture should be OK to dance on after about three to six weeks.”

Lemmon adds that being diagnosed with a stress fracture, much like being diagnosed with a strain, is a sign that you may be fatigued or need to reevaluate your technique. “A stress fracture in the foot, for example, could actually be caused by an imbalance in your hips or core,” she says. “Taking time off to heal is an opportunity to figure out what caused the injury in the first place.”

You work hard in dance class to perfect your technique and perform at your best. But what you do outside of class counts, too. The truth is, little everyday habits—like carrying an overstuffed dance bag or texting nonstop—could be negatively affecting your body and, ultimately, your dancing. Dance Spirit investigates seven bad health habits that have repercussions in the studio.

The Habit: Crossing your legs.

The Risk: “Doing it once or twice isn’t a big deal, but habitually sitting with your legs crossed can lead to real changes in your body,” says Alison Deleget, a certified athletic trainer at the Harkness Center for Dance Injuries at NYU Langone Medical Center. “Since you’re not sitting evenly on your pelvis, you’re forcing your spine to curve to one side.” Over time, you may develop back or hip pain, and overstretched back muscles on one side of your body may leave you feeling uneven in class. Want to look ladylike without throwing your body off balance? Try sitting squarely on both hips and crossing your feet at the ankles.

(Photo by Ammentorp Photography/Thinkstock)

The Habit: Constantly texting.

The Risk: Typical texting posture—head bent forward and shoulders slumped—puts the equivalent of 60 pounds of pressure on your upper spine, which can lead to wear and tear on the supportive tissues between your vertebrae. “It shortens the muscles in the front of your upper body and neck while overstretching and weakening the muscles in the back, which may make maintaining correct épaulement more difficult,” Deleget says. In the short term, spending hours hunched over your phone could cause headaches or a sore neck and shoulders; in the long term, it could mean herniated disks or nerve impingements. The next time you get a text, try bringing your phone up to your face to respond, or ask Siri to type for you.

The Habit: Cracking your neck, back or toes.

The Risk: You may have heard rumors that popping your joints will eventually lead to arthritis. The good news is there’s no research supporting that theory, and feeling a hip pop during class is perfectly fine. The problem comes when dancers start forcing their joints to pop instead of letting it happen naturally. This can stress the joints’ connective tissues and cause them to overstretch and become unstable. “It’s like dancing on a slinky when you should be dancing on a bed spring,” Deleget says. “That slinky gives much less support.”

The Habit: Walking like a duck.

The Risk: All the older dancers are doing it, but that doesn’t mean you should. “The joints of the knees and ankles work like hinges, designed to move straight forward. Walking turned-out means putting excessive stress on the insides of your knees, ankles and toes,” Deleget says. It won’t lead to better turnout, but it can lead to anterior hip pain—a common and sometimes debilitating injury for dancers.

The Habit: Carrying your dance bag on one shoulder.

The Risk: When only one side of your body carries a heavy load day after day, you’re likely to develop muscle imbalances that can lead to overwork- and stress-related injuries—from your shoulders all the way to your pelvis. “If one side of your upper trapezius muscles becomes more developed than the other, your shoulders may also look uneven when you’re dancing,” Deleget says. “Opt for a backpack, and wear it the proper, ‘geeky’ way—straps secure and chest strap fastened, not thrown over one shoulder or hanging down over your butt.”

(Photo by Bonnin Studio/Thinkstock)

The Habit: Typing in bed.

The Risk: It’s been a long day, you’re exhausted and you have a paper due tomorrow. You may be tempted to snuggle up in bed to write that essay—but resist the urge. “If

you plan on working for an extended period of time, always sit up with your spine in a neutral position. Don’t slouch and definitely don’t lie down,” Deleget says. Making bad homework posture a habit strains the connective tissues in your spine, which can cause pain and stiffness in your lower back when you dance. Sitting up straight improves your core strength and posture for class.

The Habit: Wearing flimsy shoes.

The Risk: Your feet are two of the most important parts of your dancer body, so it’s crucial to shoe them with care. Podiatrist Ronald Werter, who works with professional dancers in NYC, says the worst options for your precious feet are paper-thin flip-flops or super-squishy boots. “They’re worse than walking around barefoot,” he says.“Unsupportive shoes force you to put more pressure on the inside of your foot, which causes the tendons that support the arch and ligaments in the ankles to stretch.” Without proper tension, foot and ankle strength will be much harder to retain.

Werter recommends testing shoes before you buy them by squeezing both the arch and where the big toe hits with your thumb and forefinger. If you can compress them to half the thickness they were before, save your money. Instead, look for a shoe with a hard rubber or leather arch built in.

As for your favorite heels, Werter says they’re OK as long as they’re not higher than two inches. Just make sure that the middle of the shoe, where the shank would be on a pointe shoe, can’t fold easily, so you have strong support.

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