By Brittany O’Rourke Daniels, PT, DPT, CSCS
Dancers are required to jump and land on one foot while on their toes and with their hips turned out. They then immediately move onto their next move without time to think about all the strain that was just put on their low back, hip, knee, ankle, and foot during that one of many jump landings during one of their many dance routines. Dance injuries are very common due to the repetitive stress on joints and lack of rest, but there are ways to help decrease the risk and occurrence of injuries in dancers.
Some of the most common dance injuries occur in the low back. Issues that can put dancers at risk for low back pain include impaired posture, weakness in the core and gluteal muscles, tightness in muscles that attach to the pelvis and spine, and decreased range of motion in the hip. Other common dance injuries occur in the foot and ankle. Issues that can put dancers at risk for foot and ankle pain include tightness in the calf muscles, decreased range of motion in the big toe, weakness and impaired stability in the foot and ankle, and impaired biomechanics that can contribute to impaired weight distribution in the foot.
Many dancers stand and dance with their pelvis tilted forward, known as an anterior pelvic tilt, and their low back arched excessively, known as hyperlordosis. Unfortunately, this posture stretches the gluteal and core muscles along with the hamstrings, putting them in a disadvantageous position so they are unable to work at their optimal strength. This posture can also cause increased tightness in the hip flexors. Decreased hip external rotation can also contribute to the hyperlordotic posture. When dancers are required to turn out their hips and don’t have enough hip external rotation range of motion, they may arch their low back to compensate. Stretching the hip flexors, strengthening the core and gluteal muscles, maximizing hip external rotation range of motion, and improving postural awareness to help maintain a neutral spine can help correct this abnormal posture. This can help relieve strain on the low back to help decrease the risk of injury.
Decreased hip external rotation can also lead to compensation through the foot and ankle by collapsing the arch of the foot to try to accomplish sufficient turn out, which can lead to injury. Decreased range of motion in the big toe or weakness in the foot can lead to dancers bearing more weight on the outside of their foot. Bearing too much weight on the outside of the foot instead of through the ball of the foot and big toe can put dancers at risk for twisting their ankle. This imbalance can also lead to pain on the outside of the foot and ankle or pain between the toes due to the impaired weight distribution. Strengthening muscles in the foot and ankle to improve stability and maximizing range of motion of the big toe and hip can help distribute forces better and help decrease the risk of these injuries.
Dancers spend a lot of time on their toes. Without sufficient calf stretching to help counteract this imbalance, it can lead to tightness in the calf muscles which can also contribute to injuries. Stretching the calves regularly can help prevent this. Both the gastrocnemius and soleus muscles should be stretched, so make sure to stretch calves with the knees both straight and bent. Also, make sure not to let the arch of the foot collapse while stretching. Turning the toes slightly inward while stretching can help prevent this and help optimize the calf stretch.
Landing jumps on one leg can be straining in itself but add weak gluteal muscles to this, and the risk of injury can increase significantly. The gluteus medius muscle helps stabilize the pelvis while standing one leg. It has to work even harder when landing a jump onto one leg and if it is not strong enough, this can put increased strain on the low back, hip, knee, foot, and ankle. Keeping the gluteus medius muscle strong with side leg lifts, sidestepping, and even balancing on one leg while maintaining an even pelvis can help reduce the risk of these injuries.
Dancing involves complex dynamic movements that require optimal balance, strength, flexibility, and range of motion. To reduce the risk of injury, dancers should regularly stretch, keep core and gluteal muscles strong, and perform single leg balance and stability training focusing on even weight distribution. Dancers should listen to their bodies and avoid pushing through aches or pains. They should address them early by seeing a qualified health care professional to help correct posture, muscle imbalances, and biomechanics. Ice and rest can help pain temporarily, but correcting the root of the issue is extremely important to promote optimal healing and prevent future injury!