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DANCE "PREHAB": Proactivity, Preparation, and Opportunity

Presentation/article information compiled by Moira Docherty, PT, DPT & Robert Tsai, PT, DPT
Posted 4/22/2020

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Pursuing a dance career inevitably means managing injuries, as you continue to challenge the boundaries of what it means to be an artist.

Injury and the recovery process means lost time, lost training, and time away from a deeply personal, as well as communal, experience.

So how can "prehab" help? What exactly is "prehab" and what does "prehab" entail? , where does one even start?

Prehab is assisting dancers and performers to take active steps to address known injury-risk factors by building awareness, staying a step ahead, and preparing the dancer to minimize dance injury risk.

If you are a young dancer, dance parent, or dance studio owner, you know first hand that dance is a physically and mentally demanding experience - no matter what age, who, or where you are.

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When talking about dance injuries and decreasing risk of injury, we must recognize the dancer as an artist-athlete.

Just like an athlete, the dancer places themselves under immense amounts of physical and mental stress.
Just like an athlete, the dancer requires copious amounts of preparation.
Just like an athlete, injuries and managing injuries will be part of the career.
Like athletes, dancers must train to dance, and not just rely on dancing alone to train.

Dance-related injuries commonly occur during high cardiovascular activity and often are related to periods of fatigue. Most injuries in dancers occur in the lower extremities (primarily in the ankle and knee) which is not surprising, as dancers may perform upwards of 200 jumps per 90 minute class.

Common factors related to dance-injury include:

- Lack of warm-up
- Poor alignment of body weight
- Poor core strength
- Weak eccentric strength of leg muscles

These factors, including many others, can be successfully addressed with proper guidance and comprehensive, individually designed prehab programs.

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Frequently, dancers experience increased intensity in dance training during periods of growth, exposing them to increased injury risk.

Periods of rapid growth bring changes to the young dancer. Muscular imbalances or decreased coordination and balance are not uncommon.

Many myths associated with weight/resistance training continue to permeate our community, such as fear of developing bulky muscles and damage to growth plates. These myths have been repeatedly disproved through extensive studies in the youth population, and young dancers stand to benefit from resistance training methods to establish strong physical foundations during periods of growth to assist in their artistic development.

**For in-depth information and recommendations, see our article Resistance Training and the Young Dancer

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Due to earlier dance specialization, many dancers are entering professional life at a much younger age than in previous years.

Social media and popular culture have also propelled many dancers into the media spotlight, exposing them to the physical and mental stressors early on.

Preparation and education are now more important than ever to ensure that young dancers:

1) know how to appropriately prepare themselves,
2) are aware of their limits, and
3) at the same time aware of their potentials and how to maximize their performances without sacrificing their health, safety, or longevity as a movement artist.

As dancers seek to prolong their careers, it is important for dancers to realize that health and wellness is not a trend, but an active choice to make in order to dance as long as possible.

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Prehab for the dancer ultimately must be specific to them and their dance activity.

Prehab for a ballet dancer, is going to look significant different than prehab for a bboy or bgirl.

Prehab for the dancer can take the form of:
- Education through workshops/lectures.
- Individualized or group prehab programs to address dance-related risk factors
- Consistency and accountability during and after physical therapy for a past injury.

Additionally, "Working on your core" or "building core strength" is something often heard in the dance community, but "core" activation will be different for jumping, landing a jump, turning, and performing floor work.

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For any dance artist, there are a myriad of factors when it comes finding their personal place in the dance world.

Through DANCE|PREHAB, perhaps we can help you to develop a greater sense of purposeful preparation to eliminate a little bit of the uncertainty that comes with such a mentally and physically demanding artform. Move through your artistic endeavors with trust and faith in your preparation and capabilities.

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References:
  1. Koutedakis, Yiannis, and Athanasios Jamurtas. "The Dancer As A Performing Athlete". Sports Medicine, vol 34, no. 10, 2004, pp. 651-661.
  2. Schmit, Jennifer M. et al. "Dynamic Patterns Of Postural Sway In Ballet Dancers And Track Athletes". Experimental Brain Research, vol 163, no. 3, 2005, pp. 370-378.
  3. Liederbach, Marijeanne et al. "Comparison Of Landing Biomechanics Between Male And Female Dancers And Athletes, Part 2". The American Journal Of Sports Medicine, vol 42, no. 5, 2014, pp. 1089-1095.
  4. Wyon, Matthew. “Preparing to Perform: Periodization and Dance. Journal of Dance Medicine & Science, Volume 14, Number 2, June 2010, pp. 67-72(6)
  5. Campbell, Ryan S. et al. "Intrinsic Modifiable Risk Factors In Ballet Dancers: Applying Evidence Based Practice Principles To Enhance Clinical Applications". Physical Therapy In Sport, vol 38, 2019, pp. 106-114.
  6. Liederbach, Marijeanne et al. "What Is Known About The Effect Of Fatigue On Injury Occurrence Among Dancers?". Journal Of Dance Medicine & Science, vol 17, no. 3, 2013, pp. 101-108.
  7. Ekegren, C.L, et al. Injuries in pre professional ballet dancers: Incidence, characteristics and consequences. J Sci Med Sport. 2014 May;17(3):271-5
  8. Gamboa, Jennifer M. "Injury Patterns In Elite Pre-Professional Ballet Dancers And The Utility Of Screening Programs To Identify Risk Characteristics". Journal Of Orthopaedic And Sports Physical Therapy, 2008.
  9. Russell JA. Preventing dance injuries: current perspectives. J Sports Med. 2013;4:199-210.
  10. Stracciolini A, et al. Resistance Training for Female Pediatric Dancers. Journal of Dance Medicine & Science. 2016;20(2):64-71
  11. MItchell, Siobhan. The Growing Dancer: Physiological Challenges. 2018, https://www.onedanceuk.org/wp-content/uploads/2018/03/One-Dance-UK-The-growing-dancer-Physiological-challenges-by-Siobhan-Mitchell.pdf. Accessed 2 Apr 2020
  12. Kinney, S. et al. (2018) The Effect of Physical Therapist Involvement in the Diagnosis and Treatment of Youth and Adolescent Dancers’ Injuries. Journal of Dance Medicine and Science, 22(2), 81-83