ACL Injury Risks

Whether you are a conditioned athlete, fitness enthusiast or weekend warrior, the last injury you would like to be diagnosed with is a torn ACL (Anterior Cruciate Ligament). It is one of four major ligaments of the knee and its main purpose is to prevent forward translation of the tibia (leg) on the femur (thigh).

Recovery from this surgery is a long and arduous task, which can be as mentally taxing as well as physical. The process can take 6-12 months depending on your activity of choice post-surgery.

There are multiple ways that the ACL can be compromised. Most ACL injuries are common in sports that require a sudden change in direction. An underlying issue that could predispose an individual to an ACL injury is alignment and deconditioned hips. Hip strength and mobility is crucial to the health of your lower body. Hips and ankles are two of the most mobile joints in the body, the knee is not. So, being that the knee is in between the two it can be stressed at different times especially if the hip and ankles are misaligned.

ACL injuries

ACL tears are more likely in female athletes versus male athletes. There are many reasons for this—hormonal changes, wider pelvis, increased Q angle (angle of pelvis to knee), and a greater discrepancy in strength.

Valgus knee alignment upon landing (knees closer together than hips and feet) is another circumstance that can result in an ACL tear. This can be tested by having the athlete perform a simple squat (no weight). If the knees collapse inward as the depth increases this would be a red flag. Also, twisting motions can result in injury.

So, make sure to incorporate hip strengthening and mobility into your workouts to reduce the risk.


by Rocco Ferraiolo PTA, USAW-L1SP, NASM-CPT,PES


5 Warm Up Stretches for Golfers

Here are 5 warm up stretches to help with your golf game and prevent injury. As with any stretch, it should be comfortable to hold for at least 20 seconds and not cause pain! Should you have any questions ask a health professional.

Wrist Extensor and Flexor Stretch

  • Start by keeping your elbow straight. Then pull your hand down towards the ground to feel a pulling sensation in the back of your forearm. Apply some over pressure from your other hand. Hold 20 seconds and repeat 5 times on each arm.
  • Start by keeping your elbow straight. Then pull your hand up towards the sky to feel a pulling sensation underneath your forearm. Apply some over pressure under your knuckles and pull towards you using the other hand. Hold 20 seconds and repeat 5 times on each arm.

Wrist Extensor

Hamstring and Shoulder Stretch

  • Grab the longest club in your bag. Take the end of your grip and put it against the ground. Holding onto the club head with both hands, slowly walk backwards and lean forward. A pulling sensation should be felt in the back of the shoulders and in the back of your legs. Hold 20 seconds and repeat up to 5 times.

Hamstring Stretch

Trunk Rotational Stretch

  • Take an iron and place it on the back of your shoulders. Grab the club with both hands and turn all the way to the left. Use your hands to give you leverage and hold a stretch for 20 seconds. Repeat 5 times to the right and left.

Trunk Rotational

Trunk Side Bending Stretch

  • Take a golf club and hold it slightly wider than shoulder width apart. Raise the club overhead as far as comfortable and then tilt your body to the left. Hold for 20 seconds and repeat 5 times to the left and right.

Trunk Side

Calf and Achilles Stretch

  • Place your palms on the golf cart. Stand with 1 foot back keeping your knee straight and heel on the ground. Bend your front knee and lean forward onto the cart until a stretch is felt in the calf. Hold 20 seconds and repeat 5 times on each leg.

Calf Stretch



Written by Chris Athos MPT, COMT

Preferred Orthopedics of the Palm Beaches

Surviving Your Summer Program

Summer Dance Program

Even though school and studio classes are still in full swing, it’s never too early to start preparing for the summer dance season. Many dancers have already chosen a dance program for the summer. Summer dance programs come in many shapes and sizes in terms of intensity, duration, location (close to home vs. out of state), style(s) of dance, hours, and teachers. However, every summer program has one thing in common – it’s a change from your normal routine.

Whenever you have a change in your routine, your body is always at an increased risk for injury. The body adapts amazingly well, but when there is change there is also opportunity for injury. Not to discourage summer program participation, on the contrary. Summer programs can be valuable in so many ways, in meeting new people, trying new styles of dance, advancing technique, promoting your career, and so much more. There are many reasons to participate in a program this summer. However while you are dancing at a summer program, stay aware of your body and do your best to decrease your risk of injury.

The most important part of surviving your summer program is to warm up appropriately. Make sure to avoid the extremes of warm up – either not warming enough, or overdoing your warm up. This is important for both the dancers and the teachers in summer programs. Warm up is essential in dancing and is even more important when you’re asking your body to perform new movements. You might need to tailor your warm up for each different style, but it is also good to remind your body of some basics. Also, we all have a tendency to want to “show off,” especially around a new group. Make sure you’re not pushing your extension or movement too far before you are really warm.

While cross training is essential for longevity in dance, it needs to be tailored for your summer program. If your summer program is more intense, or more hours, than you usually dance, choose a few cross training items (planks, pushups, therapy exercises, etc) and focus on those. Alternatively, if your summer program is shorter in duration, or at a more relaxed pace, then it might be the best time to try some new cross training activities (swimming, elliptical, Pilates, barre work out, etc). Of course, if you are taking the summer off of dancing, this is the perfect time to try out some new movements and activities. However, just because you are a good dancer, doesn’t mean your body automatically knows how to do Pilates (or any other new activity). Be patient and enjoy learning a new movement pattern. Planning ahead is key for surviving a summer program, so know your summer dance schedule and plan your cross training ahead of time.

Don’t forget to get enough sleep! Summer is almost always a time where your sleep changes schedule. Whether you are participating in a summer program near home or far away, it’s important to get enough sleep at night. Sometimes getting enough sleep is easier over the summer without some of the school demands, but often it can be harder because you are in a different routine. Injuries are much more common when you are fatigued. This can happen at the end of a long day of dancing and/or because of lack of sleep. Balance pushing yourself with attending to your body’s fatigue level.

Most of all, have fun! Dance is supposed to be fun, and your summer program should challenge you as well as give you a new perspective on your art.

Summer Program Do’s and Don’ts:

  • DO push yourself / DON’T forget to rest your body
  • DO cross-training / DON’T over-extend your body before you are warmed up
  • DO drink plenty of water / DON’T eat too much junk food
  • DO make new friends / DON’T hurt someone’s feelings
  • DO try new things / DON’T neglect your technique
  • DO have fun!


by: Dr. Kathleen L. Davenport, M.D.

The “F” Word


I am writing this issue about a topic we have all struggled with. How do we talk about size? My title refers to the three letter “F” word, “Fat.” This is a challenging topic because most of us (or perhaps all of us) feel unsure about our size at times. If we are unsure about our own bodies, how do we even begin talking about this issue with someone else?

When I think about bodies, I think about health. A healthy body is a balanced body. We need to take in enough fuel and nutrition to get through the day, but not so much that we begin to feel tired and slow. Likewise, we need enough exercise and activity to keep our bodies strong, but not so much that our bodies start getting injured and breaking down.

Nutrition is about balance and performance. Your body needs fuel to make it through the day, and particularly through dance classes and dance rehearsals. Most dancers need to refuel multiple times through the day to keep up with the demands of dancing. The amount of fuel your body needs changes as your dancing schedule fluctuates. For example, you may need to add more healthy snacks during a show week or over an intense summer camp. If your body does not have adequate fuel, it cannot keep up with your dancing.

Likewise, keeping up with your fitness is important in order to keep up in dance class. This is the “F” word I prefer when talking about bodies. Like most things in life, fitness is about balance, which is different for every dancer. Most dancers need to do some sort of cross training, but it is also important not to overdo. Rest and recovery are an important part of any activity. If your fitness is not balanced with recovery, you may be at for risk overuse injuries.

Sometimes dance can be seen as focusing on the external lines or images of our art. While dance is beautiful, it is the internal beauty that matters, not only the external picture. We connect most deeply with dancers who dance from their hearts, not just their muscles. Your body is your tool to express your soul. So you have to tune and tone your body, but, in the end, it is your soul that will ignite the audience.

Choose your words! Words can be very hurtful, whether they are on social media, or said behind someone’s back. Often times, we don’t even think about our words and a simple comment can be taken the wrong way. Most people feel unsure about their size at some point (or many points!), no matter what size they are. Dance teachers and parents should also be careful about their words and avoid comments about dieting, or “feeling fat.”

Finally, ask for help. If you are being teased about your size or weight, let that person know your feelings are hurt. Then, talk to someone you trust about your concerns. If you are concerned about an eating disorder in yourself, or someone else, The Alliance for Eating Disorders is a great resource and is a good place to start.


by: Dr. Kathleen L. Davenport, M.D.


Why Does Technique Matter?

Dance Technique

Sometimes technique can seem a little boring, or maybe even pointless. Why spend more than half a class at barre or warm up before getting to the “interesting” combinations? Why do some studios require ballet technique classes in order to participate in competition, jazz, or other “unrelated” teams/companies? What is the number one way to prevent dance injuries? The answer to all these questions lies in the basics of dance technique and its importance to all dancers.

Technique does not refer to having a “perfect” or 180 – degree turn out. It does not mean that each bâtiment à la seconde grazes your ear. While good technique may lead to these attributes, it is not the goal of good technique. Having good technique involves learning and working with your body’s unique capabilities to maximize your full potential as a dancer.

Turnout is one of the primary areas where technique plays a large role. Each dancer has a certain amount of turnout, and learning to use that turnout appropriately is the key to both longevity and quality of movement. There are many professional dancers who never achieve 180-degrees of turnout, or anywhere near that level, yet lead highly successful dance careers. The most important aspect is working hard to maximize each dancer’s turnout out, but without “cranking” or forcing their turnout beyond their body’s unique anatomical abilities. Most teachers use a “knees over toes” (knees over the 1st and 2nd toe) rule of thumb to ensure their dancers are not over working their turnout. Forcing turnout leads to dance injuries in the foot, ankle, knee, hip, and back, which, in turn, have the potential to shorten a dance career.

Another area of technique is core control. This is not always the term used in dance class, but you’ve heard it in different ways. Dancers are told to “pull up” or “not sink” into their hips. These terms refer to controlling the core, or the area encompassing your hip, stomach, and back muscles. Many dance teachers refer to this as your “center” – and for good reason! This area is the center of your body, your turning focus, and your balancing point. Without strength and control of your core, or center, your dance movements will lose a mature and grounded quality. Additionally, it will be more difficult to perform higher level choreography that requires increased strength. Of course, lack of core strength can also lead to dance injuries and create a longer recovery time from an injury.

Breathing may not inherently seem like an aspect of technique, but working with your breath in dance brings your technique together. Many health practitioners include the breathing muscles with the core. This is because the primary muscles that control your breath are located in your stomach and chest. Once you have pulled up, turned out, stomach and chest in, shoulders down, arms out, head turned, somehow you are now supposed to dance! Breath control can help release some of this tension and allow the muscles to move through the space, rather than gripping or forcing the movement. Dance is a balance between strength and elegance, control and release, power and grace. Learning, controlling, releasing, and using your breath helps bridge these dynamics in your movement.

Dancers who use proper technique will find themselves not only advancing in classes, companies, and roles, but will also decrease their risk of dance injury. As many dancers train with new teachers and studios for summer intensives, it is crucial to remember your technique basics and expand your training horizons. But above all, technique is about giving you the building blocks to enjoy your art form, so work hard and have fun!


by: Dr. Kathleen L. Davenport, M.D.

The Price of Pointe

The Price of Pointe

I am writing this article at the request of one of my “dance moms.” She mentioned that she did not have a clear idea of everything involved with her daughter starting pointe. Like many dance parents, she learned how to navigate this step in her daughter’s dancing through other parents, teachers, dance stores, and blogs. While all these resources are essential to the dance community, she asked if I could write an article from my experience, while including her insight from a parent perspective. My dance parents are some of the most generous people with sharing their insights, tips, and struggles, so it is with a special thanks to them that I write this article.

[As an aside, I have written this article using “she” to refer to the dancer en pointe with continuing the gender trend that women and girls are frequently placed en pointe, whereas this is not as common for male dancers. However, male dancers do participate in pointe work, as it builds balance and strength, and this article is equally applicable to their pointe process.]

Know before you go

Before you make your shoe fitting appointment, make sure the teacher and/or studio has cleared your daughter to advance en pointe. Each studio/teacher has different requirements for advancement, so just because a dancer was en pointe at one studio, does not necessarily mean she will be placed en pointe at another studio. Additionally, there may be many steps, such as a doctor’s evaluation, prior to your studio allowing her to progress to pointe.

Also, studios have different ideas about specific pointe shoes. Some teachers prefer certain brands, shank hardness, etc. Other teachers have no preference as long as the shoe fits well. Make sure you have asked ahead of time, as some stores will not allow you to return the shoe if the teacher does not approve.

If the shoe fits…

A pointe shoe fitting takes about an hour. This may be longer or shorter depending on the dancer’s foot shape, experience, and strength. A pointe shoe fitting is often made by appointment only, so call the dance store and plan ahead accordingly. Pointe shoes should be re-fitted a minimum of every 6 months while the dancer is still growing and every 2 years after growth has completed.

A pair of pointe shoes typically costs around $60-$100 per pair, not including the ribbons, toe pads, etc. New shoes need to be purchased whenever the old pair has worn out (known as “dead” as in, “Dad, I need new shoes because these are dead!”). The timing on new shoes is entirely dependent on how much she is dancing, the strength of her foot, and how well she cares for her shoes (see below). If she is just starting en pointe, the shoes may last several months since her foot is not as strong yet and she is likely not en pointe for much time. However, as she advances, new pointe shoes will need to be purchased more often. Some professional dancers will require a new pair of shoes for each performance. I cannot stress how important it is to avoid dancing on a dead pair of pointe shoes. Injuries, such as stress fractures, are more common while dancing in an unsupportive shoe, and can take a long time for recovery.

Shoe Care

Now that you have the shoe, how do you care for it? Dancers should be responsible for sewing their own ribbons. It should be the dancer’s expectation that if she is mature enough to be placed en pointe, that she is also ready for the responsibility of sewing her own ribbons. Most dancers sew ribbons on in a square with an “X” through the square to avoid the ribbons fraying, but there are many ways to sew ribbons on. Many dancers either place an anti-fraying material on the end of the ribbon or burn the ends (obviously, with parent supervision) to prevent fraying.

After dancing, it is normal for the feet to sweat and the shoe to become sweaty as well. It is important to allow the shoe to dry completely before wearing again. This will help the shoe last longer and remain strong to support the foot. In the Florida humidity, drying can take longer. Therefore, dancers may have two pairs of the same shoe and alternate pairs between days.

Similarly, pointe shoes should not be left in the Florida heat for any length of time. The Florida heat can wear them out more quickly and cause them to be less supportive, so pay attention to the dance bag being left in the car.

Final Thoughts

Pointe work can be rewarding and fun, but it’s not for every dancer. The price of pointe can be high, and it is important to remember that a dancer can advance her career, including as a professional, without ever going en pointe. Follow your dreams, in whatever shoes (or lack thereof!) you need to get there.


by: Dr. Kathleen L. Davenport, M.D.

Keeping Up while Sitting Out

Keeping Up While Sitting Out

I often write about injury prevention because my goal is to keep dancers dancing. However, injuries happen and sometimes even the best-prepared dancers get injured. Dancers are trained to dance, not to sit on the sidelines. So when a dancer gets injured, it is natural to feel a little lost. While I hope you’re never in this situation, here are some tips of how to keep up if you have to sit out.


Even though you are not dancing, now is the best time to address some weakness that may have put you at risk for injury. Assess your other body areas – core (abdominals, back muscles, hip muscles), legs, upper body, and ankles. Is everything as strong as it possibly can be? This is also a time to focus on your whole body strength. Some dance teachers will let you do your cross training or physical therapy exercises on the side during class, but you have to ask each teacher.


Having an injury and being out of dance can take its toll on your mood. It is normal to feel left out, sad, or down when you have an injury. Many dancers worry they will be left behind with class or technique. They worry they may not get large roles, or may not be moved up a level. These worries are generally just that – worries. Most dancers get back to dancing at their same level, or higher, after an injury. Staying positive can be hard, but it is key. Keeping a good attitude helps healing and can help you return earlier and stronger. Focus on this time as a rebuilding period where you are becoming stronger and taking the time to improve your technique. Then, you will be back stronger than before.

Staying involved

For many dancers, their lives are at the studio. Being out of dancing does not necessarily mean being out of the studio. Each dancer is different, but many dancers need time in the studio to keep up with the choreography, technique, and friends. Every studio and teacher has different rules; so make sure to ask permission before trying out any suggestions. Some dancers video or film rehearsals so they can learn the choreography later. There are teachers who include sideline dancers in assistive teaching, but not every class works well with this method. If you are not able to attend your studio, take the time to read about dance history or watch historical dances or dancers.


Journaling or answering questions about a class can help you improve your own technique in new ways. It may not be appropriate to share the answers, but the most important part of the exercise is improving your dance and artistry. Here are some suggestions:

  • Write 3 corrections you would make if you were the teacher. How would those apply to you and your dancing?
  • Write 3 positives the dancers should continue doing well. What are things you are doing well for your dancing and your health from the sidelines?
  • Choose one dancer and watch her/him. What do you see? Make sure you are looking critically for both positives and areas for improvement.
  • Who in this class inspires you? Why?
  • Listen to the music playing. How does this influence the dancers? Comment about musicality.
  • What do you see in this class that you are planning to apply to yourself in future classes?


Even if you are not sitting out of class for an injury, these are tips that can improve your dancing and your artistry. Dance happy, dance healthy!


by: Dr. Kathleen L. Davenport, M.D.