Speak up about any pain you might be feeling and get it checked by a professional.
Photo by Nanette Grebe/Thinkstock

Do you ever wonder if you are getting enough calcium? What about enough sleep? Did you know it's possible overstretch your legs to the point of injury?

Those were just a few of the topics addressed at last night's Injury Prevention Workshop, part of the Complete Dancer Series at the School at Steps in NYC. During the event, we heard from a professor of orthopedic surgery, a representative from the Harkness Center for Dance Injuries, a Pilates instructor and New York City Ballet principal Sara Mearns about what dancers can do to prevent injuries and enjoy long, strong and healthy careers. Dance Spirit was there to get the lowdown:

  • Women accrue more than half of their skeletal mass during puberty. What does this mean? We need to increase our calcium intake as much as possible since it can help prevent stress fractures now, and osteoporosis later. We also need lots of protein. Now, this doesn't mean you need to scarf down a hamburger and seven glasses of milk with dinner each night. Green leafy veggies are a better source of calcium than milk. Try adding some kale to your morning smoothies—you won't even know it's in there.

  • According to The Harkness Center, 60 percent of all dance injuries are chronic—caused by overuse (or misuse) over a long period of time—like tendonitis, bursitis, or stress fractures. (Compare that to 35 percent of acute injuries—one-and-done-type injuries, like ankle sprains.) So this means three things:

  1. Robin Powell leads a Pilates demonstration.
    Photo by A. Greenwald, courtesy The School at Steps.

    Working correctly with proper technique and alignment, plus dancing on good flooring, can help prevent chronic injuries caused by misuse. Think about this: One dancer does 200 jumps in one class. Umm...that's a lot of stress on your joints!

  2. Taking class all the time without any other activity is not healthy. Work in parallel, too—not only turnout. Play sports. Go to yoga class. If you do the same motions over and over again, you're creating muscular imbalances which can lead to injury. Strengthen your whole body—not just a few select muscles.
  3. Fatigue is a HUGE cause of injury. You get injured when you're tired—when your muscles and joints are tired and when YOU are tired. So...

  • Get lots of sleep. Teen dancers need 9.25 hours every night. It may seem like a lot, but it can help.

  • From left: Dr. Andrew Price, Leigh Heflin, Robin Powell, Sara Mearns and Kate Thomas.
    Photo by A. Greenwald, courtesy of The School at Steps.

    As dancers, we are often "Type A" people—and perfectionists. Stress can be a healthy motivator for us. But stress also makes us tired. So remember that our parents and our teachers are our allies, not our enemies. If you feel extremely tired in class one day—maybe you woke up four times the night before and then didn't get to eat breakfast—tell someone! If you try to push through a hard class and you're not all "there," you could be putting yourself at risk for injury.

  • Think of your muscles like Play Dough. When it's cold and right out of the tub, the dough breaks easily when stretched. You have to mush it and mold it before it becomes pliable and stretchable. So after a long day of class and rehearsal, don't go home and stretch more—you'll be too cold. Plus, your body needs time to repair so you can be at your best the next day. Eat, do your homework and chill out. Save the stretching for the studio.

  • If you feel something, say something. If something hurts, speak up and tell your teacher. Overuse injuries are often easier to fix if they're caught early on. Of course, lots of times dancers are just sore. So how do you know when "sore" is really an injury? A good rule of thumb is that if it hurts for more than five days, see a doctor or medical professional. Chronic injuries are hard to detect, but if the soreness keeps happening, or it goes away and comes back more intense, there's cause for concern. Make an appointment ASAP—sometimes you won't be able to be seen for a few more days—and tell your teachers.

  • Take time off. It's suggested that all athletes need three months off to perform at their highest level. This doesn't mean you have to suddenly become a couch potato for three months each summer. But schedule a week here or there when you don't dance. Take Pilates, do yoga, go bike riding. Stay active, but stay out of the dance studio. It may sound blasphemous, but it can really help in the long run.

Sara Mearns spoke about her injury prevention regimen: a full-body massage using foam rollers and balls every morning following a hot shower.
Photo by A. Greenwald, courtesy The School at Steps.

Want to find out more? The Harkness Center for Dance Injuries (in NYC) offers one-on-one injury prevention assessments. They're free! You can make an appointment to look at your flexibility, strength, mobility or hypermobility and discuss what you need to stay healthy. Check their website for more info and details.

Take care of your body so you can stay in the studio—and not on the sidelines.(iStock)

Every dancer, at some point, is faced with physical pain. Fractured bones, inflamed tendons and muscle strains seem to come with the territory. They might even force you to take an unwanted break.

But injuries, particularly overuse injuries, can be prevented. DS talked to medical experts about the most common problems dancers face. Take their advice to stay ahead of the pain—and off the injured list.

Stress Fractures

What they are: Stress fractures are small cracks in the bone that occur when too much force goes through the bone. They’re commonly seen in the second and third metatarsals, but shin splints can also turn into stress fractures if you’re not careful. “The muscle pulls on the outside lining of the bone and becomes inflamed,” says Michelle Rodriguez, physical therapist and owner of Manhattan Physio Group. “If you keep jumping and pushing through it, you can end up with a stress fracture.”

How to prevent them: When your workload or class schedule increases over a short amount of time, you’re at risk for a stress fracture. Try not to do too much too soon. Slowly build up the number of classes you take, and limit the number of big jumps you do in one day.

It’s important to get plenty of calcium and magnesium in your diet, since they keep your bones strong. Foods like spinach, broccoli and dairy products will give you a boost. It’s also crucial that you get your period, since estrogen plays an important role in bone density. “Many young dancers don’t get their periods within the average age range because of the pressure to be thin. They’ve got all this physical demand on an immature skeletal system,” Rodriguez says. If you don’t have your period by age 15 or 16, talk to your doctor.

How to treat them: Rest for 4 to 10 weeks. Your doctor might put you in a walking boot to protect the injury. If you start having tenderness in the middle of your shin or feel a bump on that bone, see a doctor right away. Tibia fractures will keep you from jumping for several weeks.

Not nearly as pretty as pointe shoes... (iStock)

Tendinitis

What it is: Inflammation of the sheath around the tendon, or tendinitis, is another overuse injury. “I see the condition most in the Achilles and the FHL (flexor hallucis longus) tendon, which points the big toe,” says Dr. Kevin Varner, an orthopedic surgeon who works with dancers at Houston Ballet. “It happens when dancers overwork their bodies and get muscle fatigue, like during a long run of Nutcracker shows.” Also common is patellar tendinitis, or jumper’s knee. As your quadricep muscles get tighter and tighter, they put tension on your kneecaps and pull the patella up toward the thigh.

How to prevent it: One of the most important ways to prevent tendinitis in the ankles is to practice good alignment. “Be sure to relevé over the middle of your foot and ankle,” Rodriguez says. “The more you wing your big toe, the more you overuse your FHL.” Since the FHL muscle is deep in your calf, you can use a ball to massage it and release its pull on the tendon. For jumper’s knee, get into the quadriceps with a foam roller or a dense rubber ball—and then stretch.

How to treat it: “When you have recurring tendinitis, make sure you find the underlying cause,” Varner says. “Forcing your turnout and rolling in on your ankles will make your Achilles tendons tight, for example.” Physical therapy, ice and anti-inflammatories can help reduce pain and swelling.

Ankle Sprain

Protect, rest, ice, compress and elevate—then say goodby to that pesky sprain. (iStock)

What it is: Ankle sprains catch you by surprise. One minute you’re fine, and the next you’ve twisted your foot and overstretched or torn ligaments around your ankle. “The typical ankle sprain is in someone with a high arch, because they tend to roll the ankle to the outside more,” Varner says. Varner sees more ankle sprains in younger dancers, usually because of poor technique. “They don’t land from a jump the way they should and end up twisting their ankles.”

How to prevent it: Strengthen the peroneal tendons on the outer sides of the ankles to provide more stability. Do Thera-Band exercises to practice winging and sickling the foot and multiple series of relevés with proper alignment.

How to treat it: Protect, rest, ice, compress, elevate (PRICE). “Make sure you’ve recovered fully before returning to the studio,” Varner says. “Injuries that aren’t rehabbed all the way tend to recur.”

Lower Back Strain

What it is: Many dancers experience lower back strains and tightness. “Sometimes they try to attain a certain line, like arabesque, and compress their lower backs in an attempt to get their legs up higher,” Rodriguez says.

How to prevent it: Lower back strains can be prevented by strengthening the core muscles. If your midsection is strong, you’ll engage your core muscles when you’re working instead of your back muscles.

How to treat it: “Get a massage,” Varner says, “and try alternative medicine like acupuncture. Dancers find that it decreases swelling and lessens pain.”

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