Beautiful lines. Extreme flexibility. These are some phrases we associate with dancers, along with extraordinary hand-eye coordination. It’s not uncommon to see pictures of dancers stretching in the most nonhuman way possible.
You might think that one way to be a better dancer is to stretch more often. So unsurprisingly, when the Australian Ballet shared that they would stop stretching and focus on strengthening to prevent dance injuries, it caused quite a sensation in the dance world. Yet, the ANB is not wrong in refocusing their techniques to focus on strengthening and cross-training for Ballet. Cross-training is one way of preventing knee and hip pain.
You might be wondering, how else do I lessen my chance of being injured so I can enjoy full mobility and dance?
We have shared some common knee and hip injuries in our previous post and what you should do if you are experiencing pain.
This article will highlight five ways you can prevent knee and hip injuries.
Why do dance injuries happen?
Dancing is physically demanding, and dancers perform repetitive movements for several hours a day. Studies have shown that dancers tend to injure their lower bodies more often. Additionally, as an art form and a sport, dancers do not just dance, they also attend techniques and choreography classes, leaving no ‘offseason’ in between.
Dancers also like to ‘dance through their pain’, further aggravating the injury. Restrictive diets and improper training can also lead to dance injuries.
5 ways to prevent dance injuries
1. Cross-train to build strength and endurance in all parts of your body.
As mentioned earlier, cross-training to strengthen your leg muscles is a good way to prevent injuries.
Cross-training for dancing involves varying your fitness program by combining different types of exercise activities such as cardiovascular exercise, strength training, and flexibility exercises like yoga or Pilates.
When you cross-train, you strengthen your leg muscles. These exercises will help stabilize your knee joint to protect it from injury. Strengthening your muscles can help to prevent meniscus tears. The meniscus is a cartilage that protects the knee joint from impact by absorbing shocks. Meniscal tears, are common injuries in dance. It often occurs after landing a jump or a sudden twist of the knee. Wear and tear from loading the joint and twisting your lower leg to improve turnout can also damage knee cartilage.
Symptoms that have damaged your meniscus include pain and swelling. You might also experience a locking feeling caused by a piece of meniscus coming loose and getting caught in the joint. You may recover from minor meniscal tears when you rest, but serious injuries require surgery.
You should stop immediately if you experience sudden knee pain when bending during a class or rehearsal.
Another way is to wear protective knee gear during sports to support your knee during activities that may increase your risk of injury. If you are on the floor a lot for floorwork, it is a good idea to invest in a knee guard to protect your knee from the hard impact of the floor.
Apart from cross-training, you can try specific exercises to strengthen your lower leg muscles so your meniscus does not absorb the full impact of your landing. See our last section on targeted exercises you can do to improve your leg strength.
2. Warming up properly
Before any physical activity, you must adequately warm up your muscles. Dancers often neglect this step as they want to jump straight into action literally.
This is the first step to prevent injuries. Hip flexor injuries usually occur from a lack of warm-up before a dance class. Since we use our hips in nearly all movements, you should spend time on a proper warm-up that will help reduce hip flexor irritation.
Hip injuries in dancers can happen suddenly or result from gradual overuse. Constant excess rotation on the hip and repetitive extension of the legs put extra stress on the joint.
If you often feel pain in your hips, you might have overused your hip joint and surrounding muscles, resulting in hip flexor tendonitis. This can cause frustrating pain while dancing or sitting for extended periods. Apart from that, a lousy landing or fall can cause a hip flexor injury that, if not tended to, can develop into a lifelong struggle. For immediate steps to take after a hip flexor injury, visit our guide on how to apply first aid to fall victims.
As a dancer, you might yearn for extreme flexibility and stretch your muscles further to reach your flexibility goals. But it is important to remember that stretching and warming up are different. Static stretching involves holding a position for a long time to elongate the muscle, while a dynamic warmup involves stretching through a range of motion.
Dynamic warm-up stretches that involve active movements to stretch the muscles to their full range of movements, such as side-to-side lunges and walking lunges, will help you warm up your hip flexors. Walking lunges can be done as part of a warm-up routine to prepare the muscles for more intensive dance movements or as part of a strength and conditioning program. They effectively improve lower body strength and flexibility, which are critical for dancers.
Additionally, since they mimic natural walking movement but with an added element of balance and control, they are useful for activities like dance that require a strong foundation and body awareness. Warming up helps to prevent hip injury, and it is extremely important. Dancers with hip flexor injuries should consult a doctor or physiotherapist. They may recommend specific hip flexor exercises to warm the joint and prevent further injury.
3. Always wear proper shoes
Your knees and hips are the largest joints in your body and support your weight. The type of shoes you wear impacts your feet and knees’ position and movement. When you wear shoes that properly support your feet, you can move naturally, maintain regular leg and knee alignment, and reduce damaging stress on your knees.
Different dance styles may require other shoes. Always check with your dance teacher what is needed and buy the proper footwear. Below are a few tips on shoe choice based on dance styles to prevent knee injury.
Many dancers like to train barefoot, especially in contemporary dance. It’s easy to injure yourself without shoes to cushion the impact of a bad landing. Wearing flat ballet shoes to offer some level of protection can help to cushion your jumps.
Cardio-intensive dances like hip-hop or K-pop require fast and sharp movements. Wearing shoes that can cushion the impact of a sudden turn and keep your knees aligned will prevent knee injuries.
Ballroom dances require high heels and increased pressure on the front part of your foot. When you put constant pressure on the front part of your foot, the shin muscles and the foot are strained, possibly leading to knee pain. The height of the heels can also cause your calf muscles to shorten, leading to foot and knee pain. If you constantly wear heels, do:
- Vary your footwear if you wear heels often in and out of dance class.
- Choose shoes with firm midsoles and good soles to keep your foot forward and prevent knee pain.
- Look out for wear and tear and change shoes when you need them.
Knee strain can affect the tendons, which contributes to many knee conditions. Any shoe that forces your foot into an unusual position can cause tendon strain.
If your knee hurts or you feel knee pain when bending, consider your shoes first, especially if you lead an active lifestyle or work for long hours on your feet.
4. Practise with proper technique
Dancers often perform hundreds of jumps in a class, which greatly impacts knee pain. Many dancers assume pain and injury are part of the job, but knee problems are neither inevitable nor untreatable.
Symptoms of patellofemoral pain syndrome (runner’s knee) can develop gradually. You might first feel soreness around the edge or underneath the kneecap, which worsens when you dance or sit for long periods.
What happens is that the patella does not track properly as the knee goes through a range of movements. You might also hear popping or cracking under the patella when bending or straightening the knee.
Incorrect technique, muscle imbalance, and a lack of flexibility are all factors that contribute to knee pain.
This is also why so many young dancers get injured they tend to force their turnout, which puts abnormal stress on their joints, particularly the inner knee.
The meaning of turnout in ballet is to rotate the leg at the hips. Then, turn the feet (and knees) outward, away from the body. A turnout is an essential part of classical ballet technique. A 180° turnout where both heels are touching and your feet are in a straight line from the front is considered a “complete turnout” and is impossible without conditioning. Even with exercise, your body places some limitations on your turnout potential.
To prevent injuries, you have to turn out with technique and control. You need strong core muscles, hip abductors, quadriceps, and flexible hamstrings to turn out correctly. If you feel knee pain when bending, it’s time to check in with your doctor rather than to keep forcing your body to perform.
5. Eat well, hydrate regularly
Water and electrolytes are essential to delivering nutrients that help cartilage repair itself when injured. When you stop drinking water, the wear and tear on your cartilage (especially your knees) outpace the body’s ability to generate new cells. Injuries like cartilage tears and meniscus tears can result.
Our joints have cartilage which is made up of 60% water. This cartilage acts like a cushion or a shock absorber that reduces the friction between the bones in the joint with the help of gel-like lubrication called synovial fluids.
When you do not drink enough water, cartilage loses its sponginess. Drinking more water may not heal joint pain directly, but it can keep your joints healthy. Proper hydration improves synovial fluid production, reduces inflammation, and maintains the shock-absorbing properties of cartilage. Adults’ recommended daily water intake is 3.7 litres of fluids daily for men and 2.7 litres for women. Of course, if you perspire more and work out more often, you should increase your water intake.
Enhancing your Dance Routine: targeted exercises and stretches
To further support the health and performance of dancers, it’s essential to focus on specific exercises and stretches that can be incorporated into daily routines. These targeted activities enhance a dancer’s abilities and play a crucial role in preventing injuries. Below, we outline key exercises for both cross-training and warming up, providing dancers with a comprehensive approach to their physical conditioning.
For Cross-Training:
- Strength Training: Incorporating exercises like squats and lunges helps build the muscular strength essential for demanding dance routines.
- Cardiovascular Exercise: Engaging in activities such as swimming or cycling boosts endurance, a vital component for any dancer.
- Flexibility Training: Practices like yoga and Pilates are crucial for improving flexibility and core strength, enhancing a dancer’s range of motion and stability.
For Warming Up:
- Dynamic Leg Swings: This exercise is designed to loosen the hip flexors and hamstrings, preparing them for intense dance movements.
- Walking Lunges: A great way to actively warm up the thighs and calves, ensuring they are ready for the demands of dancing.
- Arm Circles: Essential for upper body movement fluidity, these help loosen the shoulder joints and improve overall arm coordination.
Other ways to prevent knee and hip injuries for dancers
Here are additional strategies, including massage and other methods:
- Regular Massage Therapy: Massage helps relax tight muscles, improves circulation, and reduces stress and tension in the body. This can be particularly beneficial for dancers who often strain their muscles and joints considerably.
- Myofascial Release: This specialised physical therapy focuses on releasing muscular shortness and tightness. It’s beneficial for dancers as it targets the connective tissue (fascia) surrounding the muscles, helping relieve pain and restore motion. Using a foam roller for myofascial release is a popular method for self-massage and to help alleviate muscle tightness, soreness, and inflammation. It also increases your joint range of motion.
- Pilates: While it’s a form of exercise, Pilates deserves special mention for its focus on core strength, flexibility, and balanced muscle development, which can help protect against injuries.
- Regular Health Screenings: Regular health check-ups can identify potential health issues that could increase the risk of injury, such as bone density problems or joint conditions. Visit us at Hip Knee Orthopaedics Singapore for knee and hip evaluations.
- Joint Supplements: Consultation with a healthcare provider about supplements like glucosamine and chondroitin may benefit joint health, although their efficacy can vary.
- Mental Health Support: Mental health is as important as physical health. Stress, anxiety, and depression can all have physical manifestations that might increase the risk of injury.
Conclusion
While it is easy to think ‘mind over matter’ and try to grit your teeth through pain, minor aches can lead to major injuries. If you experience pain around your hip and knees, seek a doctor’s advice before you continue dancing or exercising.
Every patient deserves comprehensive and efficient care for their musculoskeletal conditions to regain mobility independence and enjoy quality time with their loved ones. With a passion for treating hip and knee conditions, Hip and Knee Orthopaedics Singapore aims to provide you with quality care by thoroughly assessing your condition and personalising your treatments to meet your needs and goals.
