Injuries Impacting Professional Dancers

Injury-Prevention Tips from Joffrey Dancers Help Recreational Athletes

Injury-Prevention Tips from Joffrey Dancers Help Recreational Athletes

Professional dancers, like professional athletes, are subject to injury because of the constant stress they put on their bodies. And while these dancers and athletes have dedicated medical teams to attend to their needs, recreational athletes can learn from their experience.

“Dancers in a lot of ways are similar to everyday athletes who want to stay in shape and have fun,” says Simon Lee, MD, foot and ankle orthopedic surgeon at Midwest Orthopaedics at Rush and medical director for The Joffrey Ballet.

Just like dancers, recreational athletes can experience stress fractures, sprained ankles, tendinitis and knee issues. To prevent such injuries, it’s important to start with a good warm-up.

“I don’t think people realize how much time dancers spend warming up and stretching,” Lee says. “Recreational athletes are pressed for time and want to compress their athletic activity, but that’s the way injuries occur. The older we get the more important it is to get warmed up and stretch.”

Joanna Wozniak, a full member of the Joffrey since 2003, can rattle off a list of aches, pains and injuries she has suffered because of her physically demanding profession. To prevent injuries, Wozniak, like the other Joffrey dancers, starts with a daily 90-minute class of classical ballet exercises to warm up the body.

“Every movement is important to work every different muscle system, just like every brick is important for the foundation in a house,” she says. The class is followed by six hours of rehearsal, during which dancers learn the movements of new choreography and eventually start running through the whole dance.

In addition to dancing, Wozniak is on the move in other ways. She goes for walks, rides her bike, runs to build stamina, takes Pilates classes to strengthen her core muscles and practices Bikram yoga and other forms of yoga for stretching.

“It’s good to practice different forms of exercise because they use different muscles,” Wozniak says. “It’s like rotating the tires on a car because it slows down wear and tear.”

Cross-training with other sports and strengthening core muscles is critically important for recreational athletes, Lee says. He recommends adding cycling or swimming to help maintain body balance, strength and flexibility.

“Running is probably one of the worst activities to do consistently every day,” Lee says, “because it only works certain parts of your lower body in one direction — straight — and causes a lot of issues, such as overuse in the ankles and knees that are mainly strengthened on the anterior and posterior sides.”

“So many of us are constantly getting hurt and in pain that it becomes difficult to differentiate between what is a normal ache or pain and what needs more care and attention,” Wozniak says.

Wozniak takes care of some problems on her own by stretching, staying hydrated and using hot compresses or ice. But when her arm started turning purple and swelling, it was time to consult with Rush doctors. She was quickly diagnosed with thoracic outlet syndrome, which restricts normal blood flow to the arm. In her case, the condition was caused by overuse of her arms. She had surgery to have a rib removed in order to alleviate the problem.

Whether you’re a professional dancer or a recreational athlete, ongoing aches and pains are worth a consultation with a medical professional. “We have a knowledge of physiology and anatomy so we know what can be problematic and what can be ignored or pushed through,” Lee says.

Wozniak, who is 33 and has been dancing since age 7, is so passionate about dancing that she is motivated to do what it takes to maintain and improve the quality of her performance, but recreational athletes may not always be predisposed to work out consistently.

To improve the fun factor of staying fit, Lee suggests recreational athletes participate in a group sport such as flag football or a pick-up basketball league. “When you work out together there is the camaraderie of teammates working to achieve a goal,” he says.

Wozniak finds that camaraderie at the Joffrey. “We all care a lot about each other and support each other,” she says. “We’re like a family.”

Wozniak recently performed in a dance called “Body of Your Dreams” that spoofed the notion that quick fixes can help you effortlessly achieve the ideal physique. “I think people can get caught up in the trap of the importance of the perfect body image,” she says, “but you have to put things in perspective and find happiness and fulfillment in other ways.” And working out safely and preventing injury can help achieve that goal.

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When Turf Toe Strikes, You’ll Know What To Do

Turf toe is not a term you want to use when talking to a ballerina before her diva debut or a head football coach about his star running back.

“Turf toe” is the common term used to describe a sprain of the ligaments around the big toe joint. Although associated with athletes who play sports on artificial turf or hard surfaces, such as soccer, basketball, wrestling, gymnastics, and dance, it can happen to anyone! It’s a condition that’s caused by jamming the big toe or repeatedly pushing off the big toe forcefully as in running and jumping.

What Causes Turf Toe?

Turf toe is a sprain to the ligaments around the big toe joint, which works primarily as a hinge to permit up and down motion.

Just behind the big toe joint in the ball of your foot are two pea-shaped bones embedded in the tendon that moves your big toe called sesamoids. These bones work like a pulley for the tendon and provide leverage when you walk or run. They also absorb the weight that presses on the ball of the foot.

When you are walking or running, you start each subsequent step by raising your heel and letting your body weight come forward onto the ball of your foot. At a certain point you propel yourself forward by “pushing off” of your big toe and allowing your weight to shift to the other foot. If the toe for some reason stays flat on the ground and doesn’t lift to push off, you run the risk of suddenly injuring the area around the joint. Or if you are tackled or fall forward and the toe stays flat, the effect is the same as if you were sitting and bending your big toe back by hand beyond its normal limit, causing hyperextension of the toe. That hyperextension, repeated over time or with enough sudden force, can — cause a sprain in the ligaments that surround the joint.

What Are the Symptoms of Turf Toe?

The most common symptoms of turf toe include pain, swelling, and limited joint movement at the base of one big toe. The symptoms develop slowly and gradually get worse over time if it’s caused by repetitive injury. If it’s caused by a sudden forceful motion, the injury can be painful immediately and worsen within 24 hours. Sometimes when the injury occurs, a “pop” can be felt. Usually the entire joint is involved, and toe movement is limited.

How Is Turf Toe Diagnosed?

To diagnose turf toe, the doctor will ask you to explain as much as you can about how you injured your foot and may ask you about your occupation, your participation in sports, the type of shoes you wear, and your history of foot problems.

The doctor will then examine your foot, noting the pattern and location of any swelling and comparing the injured foot to the uninjured one. The doctor will likely ask for an X-ray to rule out any other damage or fracture. In certain circumstances, the doctor may ask for other imaging tests such as a bone scanCT scan, or MRI.

How Is Turf Toe Treated?

The basic treatment for treating turf toe, initially, is a combination of rest, ice, compression, and elevation (remember the acronym R.I.C.E).This basic treatment approach is to give the injury ample time to heal, which means the foot will need to be rested and the joint protected from further injury. The doctor may recommend an over-the-counter oral medication such as ibuprofen to control pain and reduce inflammation. To rest the toe, the doctor may tape or strap it to the toe next to it to relieve the stress on it. Another way to protect the joint is to immobilize the foot in a cast or special walking boot that keeps it from moving. The doctor may also ask you to use crutches so that no weight is placed on the injured joint. In severe cases, an orthopaedic surgeon may suggest a surgical intervention.

It typically takes two to three weeks for the pain to subside. After the immobilization of the joint ends, some patients require physical therapy in order to re-establish range of motion, strength, and conditioning of the injured toe.

Can Turf Toe Be Prevented?

One goal of treatment should be to evaluate why the injury occurred and to take steps to keep it from reoccurring. One way to prevent turf toe is to wear shoes with better support to help keep the toe joint from excessive bending and force with pushing off. You may also want to consider using specially designed inserts that your doctor or physical therapist can prescribe for you.

A physical therapist or a specialist in sports medicine can also work with you on correcting any problems in your gait that can lead to injury and on developing training techniques to help reduce the chance of injury.

 Contributed by Aetrex

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Back to Basics: 3 Injury Prevention Tips for Dancers

By Athletico Physical Therapy

As summer starts winding down, dancers are getting ready to transition to the fall program season. Preparing for the season’s big shows means long hours spent at rehearsals on top of other responsibilities, such as academics, work and household duties.

During this time of year, it can be easy to overlook some of the fundamentals of injury prevention when trying to fit in a rehearsal into a busy schedule. However, this is the time when the basics like proper warm up and nutrition matter the most. To help dancers minimize the risk of injury and stay ready for their big shows, we are highlighting three basic injury prevention tips below:

1. Warm Up

To minimize the risk of injury during practices and performances, dancers should incorporate dynamic warm-ups into their training routine. Dynamic warm-ups increase heart rate and get the blood flowing so that the muscles become more pliable and able to stretch. This helps prime the body for physical exertion and minimizes the risk of injury to muscles or joints. A few examples of dynamic warm-ups include body weight squats, jumping jacks, and forward and backward lunges.

Learn more about dynamic warm-ups, as well as cooling down after activity, by reading “Warming Up vs Cooling Down: Things to Know.

2. Cross Train

Although technique training is important, dancers should also consider adding cross training into their routine to improve endurance, strength and flexibility. Swimming or biking are activities that can help improve endurance, while strength training can improve muscular fitness. Additionally, incorporating exercises like Pilates into training can help dancers improve flexibility, balance and core stability.

3. Maintain Healthy Habits

In order to be in peak condition, dancers should focus on their general health in addition to their training. This includes maintaining a healthy diet, staying hydrated and getting enough sleep. Since dancers don’t typically have an off-season, they are more likely to experience altered sleep-wake rhythms, which can increase the risk of illness and musculoskeletal injuries. For tips on how to get better sleep, read “Eat, Sleep, Dance, Repeat: The Importance of Sleep for Dancers.

These three tips can help both experienced and novice dancers keep their bodies healthy to minimize the risk of injury during practices and performances. Should an injury occur, make sure to schedule an appointment at a nearby Athletico location so our team can help you heal.

If you are a dancer who would like to learn more about our Performing Arts Rehabilitation program, please email performingarts@athletico.com.

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The Power of the Mind-Body Connection: Make Mental Health a Priority

By: Erica Hornthal, CEO of Chicago Dance Therapy

Image result for mind body connectionAs a dance/movement therapist, I have always known that the mind and body are connected. I see it in my clients who carry scars of physical abuse, emotional abuse, tragic loss, debilitating illnesses and crippling anxiety. This tip is a reminder to pay attention to your body and know that there is a psychological component to your movement or even lack thereof. Whether or not you consider yourself an athlete, it is beneficial to move everyday and pay attention to what your body is saying.  So what can we do to be more present to the psychological impact that our bodies endure?

  • Never underestimate the power of your breath. Not only taking time to breathe, but notice how deeply you are breathing. The bodies ability to breathe can become compromised due to stress. Allowing for “breath breaks” throughout the day actually alleviates the buildup of stress and calms the nervous system.
  • Check in with your physical health every day. Make sure to move your body throughout the day to see what feels good and what doesn’t. Notice aches and pains that weren’t there before. Pain is your body’s way of telling you that something is not right.
  • Mental health is physical health.  There is a connection between mind and body even if you are not aware of it.  Everything you encounter emotionally, your body feels.  Take time to recognize that connections.
  • Make an appointment for a mental health checkup. Make your mental health a priority. Don’t wait for a reason to see a mental health provider. Be proactive!  Call Chicago Dance Therapy for a mental health check today!

Erica Hornthal is a licensed professional clinical counselor and board certified dance/movement therapist. She received her MA in Dance/Movement Therapy and Counseling from Columbia College Chicago and her BS in psychology from University of Illinois Champaign-Urbana.  Erica is the founder and president of North Shore Dance Therapy and Chicago Dance Therapy.  As a psychotherapist in private practice, Erica specializes in working with older adults who are diagnosed with dementia and movement disorders.  Her work has been highlighted nationally in Social Work Magazine, Natural Awakenings, and locally in the Chicago Tribune as well as on WCIU and WGN.

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