Dancing Children

As I have stated before, I did not spend much of my career teaching children, perhaps a total of 4 years out of 25. Not my forte as I did not have the patience or boundless energy required! And I wanted them to “UNDERSTAND” things they could not have cared less about!

But as a university professor, I completely appreciated the well-taught student…and sometimes cried over the pain of a poorly-taught one. Every student who crossed my path had something to work out, to understand. Some were easy to help, some took much time, some resisted and then relented, only 2 ever walked away because they felt what I was asking was too hard. If a student was willing to understand and work to make change, they were better dancers when they left.

My favorite success story was Megan. She came into our performing arts department as a graduate student in Arts Management. Her undergraduate degree was in dance from Point Park University in Pittsburgh. She showed up in my classes because she did not want to stop dancing, but the poor thing was a mess and had decided that pursuing dance as a career was not in the cards. She had already had knee surgery before she came to school and she was scheduled for another 3 weeks after I met her. When she was moving, she was gorgeous…when she was standing still, she scared the hell out of me. She was so determined to turn out her feet that her feet were rolling way over, collapsing her arch, her knees were never straight so she could use what rotation there is in the knee when it is bent, and her hips were flexed as her pelvis was tipped so she could try to get a bit more rotation out of them in that bent poition.

At the end of the first class, I asked her to stay so we could talk. I found out about her knee surgeries, how her teachers as a child had insisted on “Feet to the side!” no matter what, and how her teachers at Point Park had also demanded this of her. No one, NO ONE, had ever taken the time to evaluate her actual range of motion in the hip. So we did, right then.

I had her lie on her back, legs together, feet flexed/toes pointing to the ceiling. I asked her to rotate her legs in the hip socket, to only think about that rotation, not about where her toes were pointing. She did this by clenching her butt (which was very overdeveloped for so many reasons). Not much happened…the angle between her feet was not quite 45 degrees. I asked her to relax and let her feet just flop out. Her feet hit the floor as if she had 180 degree turn-out! Did she? No! She had developed rather amazing, albeit dangerous, flexibility in her knees and tarsus (foot) so her “rotation” was happening in those 2 places. Her thighs, however, were not rotating. So, from this relaxed position, I asked her to NOT clench her butt, but to just gently straighten her knees and flex her feet. The angle between her feet was 45 degrees. I explained to her that this was her range of motion in the hip socket when standing. Period. She was shocked.

Then, still laying on the ground, I asked her to draw her feet up so that she was in a frog position or a prone butterfly which is knees in this position but flat on your back:
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I fully expected Megan’s knees to end up way up off of the ground. Instead, her knees were flat on the floor!!! Now I was surprised! This dancer had the wackiest set of hip sockets I had ever run across! In an extended straight leg position, her hip rotation was extremely limited, but in a flexed position, this dancer had 180 degree turn-out! No wonder her teachers were confused!

Long story short, over the next 2 years, Megan finally learned how to deal with her own unique body…her pain disappeared and she went on to dance. Though her particular hip rotation issues were extreme, it was actually a rare student who came to me who correctly understood rotation.

Another rather common story were the dancers who showed up with chronic hip pain and/or chronic shin pain and/or chronic heel pain and/or chronic knee pain and/or chronic back pain. These dancers always told me about how, as children, dancing was easy and so fun! They were the stars at their schools…most went to some high powered dance camps. They were sure to go on to spectacular careers. At that time, each of these dancers was petite. And then they hit puberty and they grew…fast. Each story told of dancing that became very difficult as they could not make their bodies do what they had always done. Their teachers pushed them to stay on top of their game, but things became worse and the injuries started. They were no longer the stars.

So what happened? Simple…they GREW! Like they are supposed to! It is called the adolescent growth spurt. These poor dancers did not fail, their teachers failed. MISERABLY!!!

As human beings, we grow the most and the fastest as babies. Our second fastest growth spurt occurs when we hit puberty. The gawkiness, the uncoordination, the clumsiness are caused by the fact that bones grow first and then muscles catch up. Muscles that were once long and flexible are now short and tight as they are pulled taut by longer bones. This time of fast growth should be a time of understanding and care by teachers and coaches, not a time of pushing harder. Read this link: http://www.teengrowth.com/index.cfm?action=info_advice&ID_Advice=51791&category=health&catdesc=Health&subdesc=Pain

Training a growing adolescent body now needs to include more stretching so that the tendons that are pulling so hard on the bones do not do more damage. The pain that growing dancers and athletes feel at the site of tendon attachments can develop into apophysitis which is inflammation of the apophysis, the bony protuberance on the bones to which the tendons attach.

Potential growth related injuries

…Traction injuries are another type of injury associated with bone growth. They are caused by repetitive loading while the tendon is sensitive to stress as the bones and tendons are fusing. Traction injuries occur at different sites at different stages of growth.

10 to 13 years of age – at the heel (Sever’s disease)

12 to 16 years of age – at the knee (Osgood Schlatter’s disease)

late adolescence – lower back and iliac pain

The only cure for these traction injuries is rest.
http://www.brianmac.co.uk/children.htm

Our dancing girls are also at risk for knee injuries simply because of the width of the pelvis.

Potential growth related injuries
The change in female body shape during the growth spurt has its particular injury risks. The hips widen, placing the femur at a greater inward angle. During running or walking, this increased femur angle leads to greater inward rotation at the knee and foot. This rotation can result in an injury called chrondomalacia patella, which occurs when the knee-cap does not run smoothly over the knee joint and pain is caused at the front of the knee. Appropriate preventive training to avoid chrondomalacia patella would be to strengthen the vastus medialis muscle, the lower abdominals, obliques (side of stomach), hip abductor and hip external rotator muscles.
http://www.brianmac.co.uk/children.htm

Ali wrote left a comment telling another interesting story:
You know, I sincerely hope that any of my children, should they exist and choose to dance, not have my flexibility. I’m hypermobile and wasn’t noted as such until repeated injuries took me out of dance (probably permanently) at the ripe old age of 20. When getting my knees looked at (chondromalacia patella, both sides), the orthopedic surgeon was astounded by the range of motion I have. No one expects the slightly chubby kid to be hyperflexible.

Turning out has never been a problem for me. I did baby ballet as a small child (until I was 7 or so), and Irish from 16 to 20. When I was little, I do remember being corrected not to turn out so much (which is kind of reassuring in retrospect); in Irish my TC was so pleased I could dance turned out that she never checked to see I was doing it properly. Worse, I don’t hit any pain until I’m nearing 200+ degrees. My maximum safe turnout is the much-desired 170-185 degrees, depending on if I’ve stretched or not. Because of my very classic hypermobility, I can turn my knees, ankles, and feet without feeling pain, even though I know now how bad it is for me. So I often danced turned out only partially from the hip, and mostly with my lower legs, because it was easier for me to control my beats (in hardshoe) and have more powerful jumps (in soft). I knew it wasn’t stable after a couple spectacular falls (second feis ever, beginner jig, I sprained my ankle–and got a pity 4th place!) but wasn’t sure how to fix it until long after I was ordered to quit dancing.

I do find it interesting that my mother, an x-ray tech and everything-but-radiologist-because-she-didn’t-go-to-med-school failed to notice this tendency in me. I walk turned out and often crossed over and have as long as I can remember. My brother is also hypermobile (to a lesser extent, being male and a golfer–though he has the same strain issues in his arms that I did in my legs from overbending), and we’re pretty sure it comes from our dad. Remind me, if we ever meet, to show off my party tricks.

There’s a whole group of kids out there who are hypermobile and many TCs assume this is a good thing. Okay, so I can have great turnout and be very high on my toes, but if I’m not doing it in a way that is healthy for my body, it’s still going to be very bad in the long run–just as bad as forcing a child with less natural turnout into the same position I’m in. I’d love to see a post comparing extreme flexbibility and inflexibility.

Sorry this turned into a mini-essay! Can you tell I’m avoiding doing schoolwork?

Unfortunately, Ali was not taken care of either. Too much flexibility is just as much a liablity as too little. She should have been taught to strengthen her muscles to support and even limit her extreme range of motion. It is a matter of mechanics…the more mobile something is, the less stable it is; the more stable, the less mobile. Finding the balance between flexibility/mobility and stability is a never-ending quest!!!!

As I was researching sources for this post, I was astounded to find that there is very little information out there about the effects of a child’s growth rate on their movement performance. One article I finally found even stated: Unfortunately, there are few well-controlled studies concerning the prevention of injuries to children participating in sports.
http://links.jstor.org/sici?sici=0013-5984(199105)91%3A5%3C429%3ASIIC%3E2.0.CO%3B2-K

The info that there is is not always easily accessed, but here is what I found:
http://www.medical-library.org/journals5a/sports_and_overuse_inj.htm

http://www.acsm-msse.org/pt/re/msse/abstract.00005768-200110000-00014.htm;jsessionid=GJrGFQ7CBPyrJBMcbQt87x4F27gJDbxyNbwLd5VvnDm0bncQS38N!-79285651!181195629!8091!-1

http://orthodoc.aaos.org/davidsweiss/when_can_I_start_pointe.pdf

https://vic.pvhs.org/pls/portal/docs/PAGE/PVHS/PVHS_DOCUMENT_MGMT2/DOC_HEALTH_WELLNESS/FINDING%20THE%20BALANCE%20WITH%20KIDS%20AND%20SPORTS.PDF

http://www.medterms.com/script/main/art.asp?articlekey=7460

http://www.polyphonic.org/article.php?id=49

Click for more kinesiology info: Dance Kinesiology

4 Comments (+add yours?)

  1. Ali
    Aug 28, 2007 @ 11:15:00

    Thank you, that was very interesting! I was never told what caused my knees to degenerate the way they have specifically. The ortho had me demonstrate a few dance moves and said right away they were the likely cause, along with a lack of general strength to hold myself stable, but that was as much as I knew. It’s neat to at least understand the mechanics of my knee pain. You’re terribly helpful that way, Ann.

    On the plus side, I’ve worked on (some–I wasn’t ever aware working on my obliques and core would help, so I suppose I’ll have to start trying) of the helpful muscle groups, and am mostly pain-free now, nearly 2 years after dianosis. I’m lucky that it was caught when it was, and that I’ve got another 15-20 years before the cartiledge is worn enough to need surgery. Had I kept dancing the way I was, it would be a lot sooner, if I hadn’t done more acute damage.

  2. Ann
    Aug 28, 2007 @ 11:21:00

    I was diagnosed with cp too when in college, though then they did not know as much as they know now. I found that as I learned more about alignment and kinesiology, the knee pain disappeared and there has been no need for surgery for it. You may never need it, Ali!

  3. GailV
    Aug 28, 2007 @ 20:35:00

    Thanks for another timely post. My 11 year old has grown so much in the past few months. Just last week I mentioned to her that I supposed she felt less flexible because her bones have grown so much and the rest of her has yet to catch up. She nearly gasped when I said this, since she had wondered why she didn’t have the flexibility she had a couple of years ago.

    It’s reassuring to her to learn that this is normal development.

    The articles you’ve linked have given me more insight into this issue, so I have a little more of an idea how to answer other questions she might have.

  4. Trackback: Dance Kinesiology posts « Taoknitter

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