Your Body

You spend your days jumping, leaping, bending, twisting and generally putting a ton of stress on your knees. But be kind to them—they’re two of your most important body parts! One of the best ways to avoid knee pain is to strengthen the muscles surrounding your kneecaps. “These exercises will help improve your alignment, which is essential for knee health,” says DS fitness consultant Michelle Rodriguez, who is the founder of Manhattan Physio Group in NYC. “Many knee injuries can be avoided if you pay careful attention to always keeping the knee over the middle of the foot, regardless of whether you’re in parallel or turned out.”

Bridge with Pillow Squeeze 

 

 

Lie on your back with your knees bent and your feet flat on the ground, hip-width apart. Place a folded pillow between your knees.

 

 

 

 

Press into your heels to lift your pelvis off the ground until it’s level with your knees. Don’t let the pillow drop! Keep the sides of your pelvis level and your belly button pulled into your spine as you lower your hips to the ground. Repeat 10 times.

 

Make It Harder!

With your hips lifted in the bridge position, straighten one knee. Keep the rest of your body level and stable.

Keeping your hips elevated, bend your knee, and slowly lower your foot to the floor. Repeat on the other side. Repeat five times on each side.

 

Double Leg Squat (that’s “chair pose” for you yoga buffs!)

 

Stand with your feet hip-width apart.

Begin to squat by reaching your sit bones back past your heels and bending your knees to 100 degrees. Keep your weight in your heels and reach your arms forward to counter-balance your weight. Make sure your kneecaps don’t pass beyond your second and third toes. Press into your heels and activate your glute muscles to return to standing, bringing your hips in line with your shoulders and lowering your arms to your sides. Repeat 10–15 times.

Parallel Pliés with Heel Taps

 

 

Stand on your right leg with your left leg extended in front of you, a few inches off the ground. Hold your left arm out to the side for balance.

 

 

 

 

 

 

 

 

 

 

Bend your right knee—be sure to align your kneecap directly over your second and third toes—as you reach your left foot to the ground in front of you, lightly tapping your heel to the floor.

 

 

 

 

 

 

 

 

Straighten your right knee as you lift your left leg, reaching your left foot out to the side.

 

 

 

 

 

 

 

 

Plié your right leg as you tap your left heel to the floor. Your right leg should be doing all the work.

Repeat to the front and side, completing 10 reps each and then switching to the opposite side. Pay attention to proper alignment throughout the exercise. Your working knee should bend directly over your toes.

 

 

Michelle Rodriguez, MPT, OCS, CMPT, is the founder and director of Manhattan Physio Group. She is a physical therapist specializing in orthopedic manual therapy and dance rehabilitation.

Photography by Sibté Hassan. Hair and makeup by Chuck Jensen for Mark Edward Inc. modeled by nikeva stapleton.

Nikeva Stapleton is a graduate of the Ailey/Fordham BFA Program. She is currently a freelance dancer and model in NYC.

Dance News

Dance Spirit receives tons of letters from readers, and we love it! You tell us about your struggles with and accomplishments in dance and about the dancers on our magazine's pages who inspire you. And often, those letters inspire us. Recently, we got an email from 14-year-old Kayla, whose story of her battle with a devastating knee condition was so heartfelt and brave. I've posted it here, so we can all learn something from her strength.

Dear DS,

Dance is my life. I’ve danced since the age of 3, but this year I lost it.

Since grade five I've suffered from knee pain. At first, doctors said I had too much cartilage, so I had to do a lot of physical activity to wear it down. But they were wrong, and that actually made it worse. That didn’t stop me, and I continued to dance.

In early October 2011 I saw a new doctor who diagnosed me with osteochondritis of the knee. This means my cartilage was cracked, and fluid was pushing my bone out from behind my knee. Basically, my bone was about to break off. The disease has four stages (four being the worst), and I was at stage three. I was rushed into surgery on November 22 and had three screws put in my knee to push the fluid out. I was on crutches for 11 weeks, and I was told that I couldn’t dance for an entire year. I go into surgery again on March 22 to take out the screws. That’s when I will find out if my knee is healed and if I will be able to dance again.

For Christmas I got a subscription to Dance Spirit, and it's how I keep up with dance. I love receiving a new magazine every month, and I spend as long as possible reading it because it's the closest I can get to dancing.

One day soon, I hope to attend dance camps and conventions and improve my dancing enough to try out for "So You Think You Can Dance." I’m excited to see what my future brings!

Sincerely,

Kayla G, 14, Saskatoon, Saskatchewan, Canada

Thanks for sharing, Kayla! Your positive attitude and genuine love for dancing is contagious. DS wishes you all the best for a full recovery and a future filled with dance.

Want to get in touch with DS? Click here to send us an email.

Your Body

A knee injury may seem like the end of your career, but with time and proper care, many dancers return—often in better shape than before: Proper rehab corrects the muscle imbalances that may have contributed to the injury. We’ve put together tips to beat a few knee injuries common to dancers. Always see a physician at the first painful twinge in order to prevent further damage. In the meantime, follow RICE (rest, ice, compress, elevate).

Sprained and Torn Medial Collateral Ligament

Two vertical ligaments act as side supports to the knee:  The lateral collateral ligament, or LCL, which connects the femur to the fibula, and the medial collateral ligament, or MCL, which connects the femur (thigh bone) to the tibia (shin bone), and is injured more often.

Causes: Most often, a blow or force to the outside of the knee, such as a collision with your fellow dancer.

Symptoms: You may hear or feel a pop, after which the knee buckles inward. Swelling will occur immediately.

Recovery: 2-3 weeks for a mild sprain; 6 weeks or more for a tear. Generally, surgery isn’t required.

Prevention: This injury is difficult to prevent, because it usually happens unintentionally, whether by slipping or by colliding with someone or something. Using proper technique and strengthening legs can speed up recovery time and lower the severity of such an injury.

Sprained and Torn Anterior Cruciate Ligament

Two ligaments run through the middle of the knee: the anterior cruciate ligament, or ACL, and the posterior cruciate ligament, or PCL. “Cruciate” means “cross,” and that is what these two ligaments do as they pass through the joint. They also keep the femur from sliding off the tibia. When torn, surgery is sometimes needed.

Causes: Typically, the ACL, which is injured more often than the PCL, is torn as the result of a sudden twisting or hyperextension of the knee, such as landing improperly in consecutive tour jetés.

Symptoms: Usually, a pop will be heard and felt at the knee before it gives way. The knee will swell immediately and you won’t be able to continue moving. Ligament injuries are graded from first-degree sprain, where there may be some tearing of the fibers and mild pain without joint instability, to a fourth-degree sprain—a complete rupture of the ligament and the joint is totally unstable.

Recovery: 6-9 months after surgery.

Prevention: Align knees over your toes, and watch out for planting your right foot, and then sharply turning your body without rotating the right leg; or landing from a jump and pressing the leg into hyperextension.

Tendon Ruptures

Causes: The quadriceps tendon that encases the kneecap may rupture from a trauma such as a fall, but often from long-term tendonitis, which weakens the tendon and makes it vulnerable to tears. A rupture is rare.

Symptoms: A ruptured tendon will cause considerable pain and you won’t be able to straighten your knee. Immediate medical attention is imperative.

Recovery: About one year to heal after surgery.

Prevention: Don’t allow tendonitis to go untreated—and watch where you’re going!

Meniscus Injuries

The menisci are crescent-shaped pieces of cartilage on top of the tibia that create a bowl shape for the rounded end of the femur to sit in. They absorb shock when you run or land jumps.

Causes: A weight-bearing abrupt rotation of the knee, such as turning your body to shift directions but leaving your foot planted.

Symptoms: If the meniscal injury is mild, you may have some pain and a feeling of a catch inside the joint. When a larger piece of the meniscus tears away, the knee may lock painfully. You may or may not have visible swelling.

Recovery: Minor tears of the meniscus can be treated with RICE. More significant tears require surgery. If surgery is necessary, recovery may take 1-6 months.

Prevention: Like the other knee injuries, the best prevention is to train knees always to align. Be especially aware when dancing fast combinations.

Dislocated Kneecap

Causes: An abrupt change in direction while running or dancing and/or from a direct blow. Dancers with knock-knees will be more susceptible.

Symptoms: You’ll be able to see that the patella is out of place; it will be painful to bend or straighten your knee.

Recovery: A few weeks to a few months, to allow the tissues that were strained by the dislocation to heal and for swelling to reduce. It’s possible that the patella will spontaneously pop back into place by itself, but you should still see a doctor to figure out why the dislocation occurred and what you can do to prevent it from happening again.

Prevention: Practicing proper alignment is key—and not just when jumping. When landing in fourth position from a pirouette, for instance, the front knee should be equally turned out as the foot.

Bony Fractures

Causes: Usually falling on the kneecap.

Symptoms: Pain, inability to move the knee, bone abnormalities, swelling and bruising.

Recovery: 6-8 weeks; surgery may be required.

Prevention: Take precautions when learning choreography that involves a lot of landing or sliding on your knees. Use kneepads until you learn how to fall correctly.

Neuromuscular specialist Deborah Vogel directs the Institute for Performance Studies in Ohio and is the author of Tune Up Your Turnout.

Your Body

When you run and jump, your legs absorb a force approximately three times your body weight. That force travels through the knee, which is the body’s largest joint—and one of the most easily injured through overuse. Here’s what you need to know about four knee injuries that are common to dancers.

Patellofemoral Syndrome (Moviegoer’s Knee)

  • Definition: A condition that involves pain in the area of the patella and the edges of the bottom of the femur.

  • Symptoms: Pain is primarily felt in the front of the knee during movements when the knee is bent and the quadriceps are working strongly, such as landing from a jump or walking down stairs. Long periods of sitting may exacerbate this condition, which is why it’s also known as moviegoer’s knee. Symptoms develop gradually and, in early stages, may lessen as you warm up leg muscles. As this overuse syndrome progresses, pain may become more constant with activity, and increase with kneeling and during movements such as grand pliés.

  • Causes: Poor alignment of the legs in turnout is a major contributing factor. While the patella should move in a vertical up and down direction or tilt slightly, unequal pull from the quadriceps can add a lateral side-to-side motion. Most often in dancers, the patella is pulled toward the outside of the knee due to excessive external rotation of the knee joint, which wears down the cartilage on the underside of the patella.

  • Rehabilitation:  Initially, reduce activity, and ice frequently. Strengthen quadriceps, along with stretching to lengthen the hamstring, calf and iliotibial band. Also, be sure that your knees are always aligned properly in turned out positions. Instead of forcing turnout, stand in parallel first position, rock back on heels, flex toes off the floor, open legs outward (rotating from the hip) as far as possible and then place toes back on floor. This is your natural turnout from which you should work.

Patellar Tendonitis (Jumper’s Knee)

  • Definition: Inflammation of the patellar tendon that connects the kneecap to the tibia.

  • Symptoms: Pain at the bottom of the kneecap that increases with repeated jumping and running. It starts as a dull ache during activity, but can progress into more severe and continuous pain.

  • Causes: Misalignment of the feet such as pronation (rolling in) will put strain on the muscles surrounding knees. Structural variations at the knee, including bowlegs and knock knees, can do the same. Having weakness in the quadriceps and/or excessive tightness in the hamstrings will put stress on the patellar tendon.

  • Rehabilitation: Improve quadriceps strength and hamstring flexibility, remembering that muscle balance around joints is essential. With any tendonitis, the first task is to reduce inflammation through rest, ice, compression and elevation (RICE). If you take action right away, the prognosis is good, but ignoring symptoms can lead to chronic tendonitis, increasing risk of tearing and degeneration of the tendon.

Osgood-Schlatter Disease

  • Definition: Swelling, pain and tenderness just below the knee, where a bump forms on the top of the tibia.

  • Symptoms: Pain at the top of the shin, which increases during running and jumping. Kneeling will be uncomfortable because of the developing bump on the tibia.

  • Causes: Bone grows faster than muscle, so when a dancer is in the midst of a growth spurt, the quadriceps muscle pulls at its tendon. This strain causes the tendon to pull away from the bone, causing pain and swelling. If left untreated a visible bump will appear, as new bone is formed.

  • Rehabilitation: When pain develops, apply ice to decrease swelling. Cease leaping and jumping in dance class, use kneepads during floorwork and focus on building quadriceps flexibility. Osgood-Schlatter usually goes away when growth spurts stop and muscle tightness releases; however, dancing in spite of the pain lengthens the time needed for rehabilitation and increases the risk of a permanent large boney bump beneath your knee.

Iliotibial Band Syndrome

  • Definition: Inflammation at the bottom of the iliotibial band where it crosses the outside of the knee.

  • Symptoms: Pain and tenderness on the outside of the knee, especially after dancing.

  • Causes: Weak lateral hip muscles make the iliotibial band overwork. Pre-existing iliotibial band tightness along with uneven leg length and pronation can contribute to this problem. A tendency to stand with feet wider than hips is often a clue that the iliotibial band is tight.

  • Rehabilitation: Reduce inflammation through icing. Then, stretch and release muscular tension of the iliotibial band, followed by strengthening lateral hip muscles. Try this stabilizing/strengthening exercise for the lateral hip muscles: Stand on right leg, with the knee neutral and the pelvis square. Left leg is in a low parallel passé and hands are on hips. Slowly turn your head from side to side four to six times as you maintain balance. Repeat on the other leg. To release tension in the lateral hip and iliotibial band, stand on a straight right leg with the left foot crossed in front for balance. Shift hips to the right as you lean left, feeling a stretch on the outside of the right hip. Repeat on the other side.

Neuromuscular specialist Deborah Vogel is the co-founder of the Performance Institute in NYC and author of Tune Up Your Turnout.

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