En Pointe Readiness and Injury Prevention for Dancers

Lynn Batalden, DPT, OCS, is back on point helping dancers avoid injury en pointe (dancing on their toes). Back in May, Lynn did a survey of research to discover the answer to the question “When are young ballet dancers ready to dance en pointe?” While no clear answer was discovered in the research, she found four tests that correlated with ballet teachers’ determination for when dancers are ready. In October, Lynn connected with a dance studio in Elburn to put these tests to the test. Lynn visited the studio along with her videographer, Mark Mattson. Lynn measured the dancers’ available ankle mobility, and used the saute test, which entails jumping up and down repetitively in a leg position typically seen in ballet; the airplane test, featured in a recent post and similar to yoga’s “warrior III” position ; the tilt test, which is a ballet pirouette or turn; and a heel rise test that measures ability to raise up on your toes repetitively. An app called Coach’s Eye allowed Lynn to film the dancers’ movements in slow motion and draw basic lines on the image to measure angles on the body. These tools gave her the ability to show the dancers where excess stress is on the body during certain movements.

Dancers, like other young female athletes, need to know about the best ways to jump and land. Females are particularly subject to stress on the inner knee due to having a wider pelvis, often greater flexibility than males, and hormonal influences.

Dancers need the most extreme flexibility in the foot compared to other athletes. They need to point the foot 40-50 more degrees than the average population. Without this flexibility, they become predisposed to foot injury. Ankle control is also closely related to hip strength and control and several of the tests performed take this relationship into account.

During testing, Lynn observed many of the movement problems she tends to see in the clinic in all ages and populations. People tend to think that if a person exercises a lot or is athletic that they don’t have weakness in specific muscles. Clinically we find that our body strives for efficiency and if a neighboring muscle is stronger or better at doing a task, it takes over. This is especially true if muscles are fatigued. So, we have athletes getting stronger in groups they are already strong in or using tightness in certain areas to act like a brace or splint to avoid controlling and coordinating multiple muscle groups. The weak areas stay weak unless these patterns are identified and form corrections and specific exercises targeting the groups are implemented.

The dancers Lynn tested were between 9-16 years of age. An adolescent in this age group should be able to raise up on their toes on one foot 27 times. (Adults should be able to do 20 times and 5-8-year-old should be able to do 15 times). For the dancers tested, the average for the right leg was 9.5 and the left was 8.9 times. Improving just this one area for these dancers will likely improve the quality of their dancing and help them avoid injury.

Lynn credits her interest in physical therapy in part to her own dance training growing up and she loves to see dance performances. Her favorite recent performances include choreography by Jerome Robbins to Philip Glass music, Glass Pieces, performed by the Joffrey Ballet (part of their recent “Modern Masters” program; as well as their performance of A Midsummer’s Night Dream.

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