Dance Injury Prevention

Dance Injury Prevention

As a dance medicine specialist, I have treated many dance injuries in Seattle, New York City, and Florida. I have recently moved to Boynton Beach to treat dancers in South Florida and to be one of the company physicians for Miami City Ballet. Preventing serious dance injuries is important to keeping your body ready to meet the demands of your art. Some injuries happen quickly, but most dance injuries have been happening over a longer period of time and are overuse injuries. Therefore, preventing these injuries cannot happen overnight. It is about taking care of your body so it will take care of you in return.

What goes in the body. Nutrition is important in injury prevention. Dancers spend long hours at the studio. Eating calories wherever we can doesn’t always add up. Your energy balance is crucial in keeping healthy and injury free. You burn a lot of calories in your dance training and you need to replace those with good nutrition. Getting out of balance can result in injury to your bones and muscles, not to mention making it harder and taking longer to come back from an injury. Also, not having enough calories can negatively impact your dancing and artistry. Some quick, healthy foods to throw in your dance bag are nuts, dried fruit, and vegetable sticks.

Cross training. Even though you spend many hours a day in dance class; you can still have weakness in some muscles. You need to train like you perform for dance specific physical conditioning. However, core strengthening is also very important to protecting your body from injury and for improving your dancing. Try planks, bridges, and even some push-ups for your cross training. Some teachers add conditioning exercises between barre and center. Many dancers add these exercises to their warm up. Also, dance class does not necessarily build aerobic fitness, cardiovascular health, or endurance. In order to improve their performances, dancers often add swimming or elliptical work outs to build their endurance.

The “R” word. “Rest” can sound like a dirty word to dancers. However, your body needs time to recuperate from the demands of an intensive dance schedule. Sometimes the body is just not ready to keep up with the demands of an intensive dance schedule. Saying “no” to some activities might be necessary to keep you healthy and dancing longer. Dropping a class or reexamining the schedule can help prevent fatigue, burnout, and injury. While these choices may be difficult, it can keep you dancing healthier for longer, which is the ultimate goal. Dancing is supposed to be fun!

Warm up. Get your blood and body moving. Sometimes this means walking around in the studio or doing some gentle jumps or leg swings. Start slowly and gently and give yourself appropriate time for warm up before class, rehearsal, performances, and auditions. Some dancers need stretching in their warm up, but others need more strengthening. If you are naturally very flexible, you may not need extra stretching in your warm up. Once you are a little warmer, active stretching, like battements and lunges, can be helpful. Additionally, make sure to warm up your plié (starting in demi-plié), and feet (rolling through the feet and progressing towards gentle small jumps).

Technique. Proper technique is essential to prevent dance injuries. Of course, using proper technique also helps advance your dancing. Sometimes dancers feel they are in a class that is too easy for them and they want to be promoted. If this happens, focus on perfecting your technique. Dancers can learn from any teacher in any class, so make the most of whichever class you are in. If you do have a dance injury, reexamining your technique and focusing on improving it can also bring you back stronger from your injury. Dance is about discovering how your body fits with movement. Your body is unique and is not like anyone else’s, so focus on your own body and your strengths instead of comparing your dancing (especially turnout or extension) to someone else.

Injuries happen. Dance is demanding and even if you do everything possible, you may still get injured. If that happens, be sure to take care of the injury. There are some aches and pains that you can keep dancing through, but a real injury needs to be discussed with a health provider who understands dance or sports injuries. A good rule of thumb is any injury where you cannot participate in dance class, or you have to modify a lot of class, should probably be seen by a health care provider. This doesn’t always mean you have to stop dancing, but you do need to make a rehabilitation plan with your dance medicine specialist. An untreated injury can become a chronic problem and can prevent you from dancing to your full potential and even lead to further injury. Make sure you are giving your body the best opportunity to keep you dancing for your entire life. Dance healthy, dance happy!


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


Technology is Affecting Your Spine

The era of technology has changed the way we communicate with each other. Text messaging on cell phones is a common way that people are communicating. What we don’t realize is how detrimental this could be to our neck, shoulders and back. Whether you are spending time on your phone text messaging or even reading on your tablet you are assuming the forward head posture.

The average head weighs approximately 10 pounds when it is in neutral position (ears over shoulders) and every inch that your bring your head forward you are changing the alignment and increasing the pressure on your spine.

Prolonged forward head posture can lead to neck strain which can include muscle imbalance, muscle tightness, headaches, muscle spasms, and nerve irritation. Also, staying in a slumped over position is not favorable for your lungs or internal organs. Test yourself try taking a deep breath while hunched over and then when sitting up straight. How do you feel?

Here are tips to help avoid forward head position:

  1. Make a conscious effort to know where your head is in space, your ears should always be in line with your shoulders.
  2. Squeeze your shoulder blades together
  3. Use a docking station
  4. Sit with your feet flat
  5. Take frequent breaks from your phone or tablet, if you have to set a timer to reminder yourself.

Some things you can do to alleviate symptoms in your neck, upper back, and shoulders.

  1. Chin tucks or Cervical Retraction (try making a double chin)
  2. Cervical Rotations (looking from side to side)
  3. Shoulder Shrugs
  4. Shoulder Blades Squeezes
  5. Chest stretches
  6. Going for a 15-20 minute walk without your phone or tablet.

Technology will continue to evolve which will keep us more connected, but in the mean time it can cause us to have more negative affects from over use. Try to be mindful and take a break for your cell phones, tablets, and other hand held devices in order to protect your spine.

by: Rita Zimmermann, LPTA/CLT

Back to Health

Chiropractic PainSpine Health: Making sure your back bend is not a back break

A healthy body is essential for healthy dancing. Spine health is not only important for injury prevention, but also important for improving your technique, strength, endurance, and quality of dance.



Your core protects the spine and keeps your back healthy. Many dancers think of the core as the abdominal muscles (“abs”). The abs are one part of the core. The core also includes the back muscles, the abdominal muscles that wrap around the side of your waist, your hip muscles, and your buttock muscles. All of these muscles contribute to your core. Importantly, strengthening these muscles helps with your control. This means your extensions are able to be held higher and longer, your balance is better, your turns increase, and your artistry improves.


Outer Hip Leg Lift

One of my favorite core exercises focuses on the outside hip muscles. No matter what physical activity you do, you will tend to have muscle imbalances. Dancers work their turnout, so often times the other hip muscles are under-trained. You lie on your side, controlling your waist so you are not arching or tucking. Then, lift the top leg. It is best if you can bring the leg behind you in extension a few inches and turn it in just a little. I think of touching the toes of the moving leg to the arch or heel of the grounded leg. You should feel this working the muscles in the outside of your buttock/hip. You should not feel it working the muscles in your groin or hip flexor area – that means your leg is coming too far in front. Make sure to do both sides evenly.



Another favorite core exercise is planks. This is essentially a push up position that is held in place. It can be held either on the hands or the elbows/arms. Keeping a straight spine without arching or tucking under and not allowing your pelvis to move upward (which makes it easier) is important. Your body should be in a straight line. Ninety seconds is a good goal for a plank. Once you feel confident with your plank, add a side plank. Again, make sure your body is in a straight line and exercise both sides evenly.



A bridge (also known as a half bridge) can also help strengthen your core muscles. Lie on your back with your feet on the ground and your knees bent up, arms by your side. Press your feet into the floor or exercise matt, lifting the hips upward so your weight is on your feet and shoulders. You are now in the bridge position. You then roll down from that position as you exhale and contract.



A strong core leads to a healthy spine. A healthy spine also comes from correct technique. At a young age, when they have less core development, dancers often arch their backs. This is for many reasons, but it can lead to injury. Teachers help their dancers correct this technique error, but sometimes dancers over correct an arching issue and end up tucking. Similar to a contraction, the dancer tilts the pelvis forward, often at the bottom of a demi or grand plié.

The correct alignment is to keep the spine neutral through a plié without arching or tucking. A correct plié influences a neutral spine just as the converse is true: a properly aligned spine produces a quality plié. Teachers at auditions may look for spine alignment and correct use of the core muscles. This is because how dancers use their spine can reveal potential information about their level of control, movement quality, and core strength.



Core cross training helps protect the spine, but it also helps your quality of dance. It is difficult, if not impossible, to maintain the positions required in dance technique without strength. While dance technique alone builds strength, it also builds imbalances, like any other physical activity. Adding a few core exercises can improve your health and your artistry. Happy, healthy dancing!


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

Specialization in Young Athletes May Not be a Good Idea

Assorted sports equipment on blackAll of our athletic families, or those that show an interest in sports, would like our youth to become the next LeBron James, Aaron Rodgers, Derek Jeter or for the young women they could perform like Britney Griner, Kerrie Walsh, or Lindsey Vonn. The reality is this…DO NOT over do one sport early in their development. Specialization or sport specific training too soon can hinder their growth not only in sports but general health.

Sports all contain their own set of movement patterns which can lead to overuse injuries to their under-developed structures and soft tissue, not to mention one sport does not fully engage the young athlete’s nervous system. By letting them participate in multiple sports or activities, this will help prevent wear and tear at an early age and stimulate their nervous system, thus helping to prevent injuries. Having your child participate in a training program is a great idea but it does not, and should not be too specific to one sport. It should be to develop an overall athletic base, and prevent injury.

Finally, LET KIDS BE KIDS! Do not let them focus on one sport or activity. Let them explore their boundaries and let’s face it, if sports are your kid’s thing, playing multiple sports will benefit them when they decide on the one they enjoy most.


By: Rocco Ferraiolo PTA, NASM certified, USA-L1SP

Which Brace Is Best for My Knee?

ID-100120677Braces can be prescribed for many reasons, depending on a patient’s symptoms or recovery point after injury. The following is a summary of braces prescribed, and ways that braces can assist the knee in performing regular activity.

  1. Sleeve or Wrap-Around Braces: These usually slide up the leg like a sock or wrap around the leg with Velcro. They fit snuggly around the lower thigh to the mid-calf. They are used to provide minimal stability and are mainly used to control swelling at the knee. These are usually sold in drug stores and do not require a physician prescription.
  2. Hinged Knee Brace: These braces usually have 2 types of fasteners. It can be held on by strong Velcro or with plastic buckles. They provide a moderate amount of support and help prevent with knee buckling. They will all have a metal support hinge on the inside and outside of the knee. They can be administered by a physician, or found at medical supply stores.
  3. Arthritis Brace: These braces are made of a rigid tough plastic and are held in place with straps. They are used to “unload” an arthritic area of the knee that may have significant more wear and tear than the other side. This may be beneficial in prolonging the need for surgery while increasing stability, and allowing more weight bearing with less pain. These braces are prescribed by a physician, and a trained professional will come to fit a custom brace for your knee.
  4. Stability Braces: These braces are used to protect the knee after ligament or tendon repairs. They are also made of a hard plastic, and fit snugly to the leg with straps. They are mainly used in the return to sporting and high level activity after surgery. They need to be custom fitted to an individual, and require a physician prescription.

If you feel that you need one of the following knee braces or have questions, make an appointment with one of our physicians, or ask your physical therapist.


Written by Chris Athos MPT, COMT

Preferred Orthopedics of the Palm Beaches


Image courtesy of Ambro


ID-10065153Hyperthermia is a dangerous condition that occurs when the body becomes overheated. This can lead to heat exhaustion, and ultimately heat stroke. The body core temperature can rise up to 104 degrees Fahrenheit or more. Hyperthermia can lead to brain damage, organ failure, and death.

It is important that you are aware of the symptoms of hyperthermia.

Fatigue, Dizziness, Cramps, Headaches, Vomiting, Nausea, and Weakness are some of the symptoms. The heart rate may become elevated, and skin may be reddened. The skin may be moist if you are still sweating, or it may be dry if sweating has stopped. Mental confusion or seizures may occur, and ultimately coma or death.

Heat exhaustion is a less severe form of hyperthermia. People can have similar symptoms like weakness, muscle cramps, headaches, nausea, and also profuse sweating.

There are things you can do to help prevent hyperthermia:

  • Drink plenty of water.
  • Wear light clothing that is breathable and nonrestrictive.
  • Know your limits-if you are feeling short of breath or too hot, take a rest.
  • Start off your exercises slowly, and gradually build up.
  • Avoid alcohol since it predisposed you to dehydration.
  • Provide yourself with shade.
  • If possible, increase air flow with fans.

Image courtesy of ponsulak/ 

Get That Stability Ball Out of the Closet

Too many people tell me that they have an exercise ball and never use it or don’t know what to do with it. Here are five core exercises to put that ball to good use. These are general exercises, and should only be performed without causing back pain. Should you have any questions, please consult a physician or health professional.

Exercise #1: Oblique/Latissimus Dorsi Ball Isometric
Lay on your back with the exercise ball on your stomach. Tighten abdominal muscles and raise 1 knee to make contact with the ball. Take the opposite forearm and push through the ball towards your knee. Push for 10 seconds for a total of 10 repetitions. Repeat this on the opposite side.

Exercise #2: Bridge Exercise
Sit on the ball. Walk your feet forward rolling your body down the ball until your buttock is on the ground and the ball is in contact with you upper shoulders and head. From this position, push through your feet trying to keep the pelvis level. Repeat 10 times and perform 2-3 sets working on control in a pain free range.

Exercise #3: Ball Roll Planks
Start on your hands and knees with the ball in front of you. Place your forearms on the ball and tighten your abdominals. Walk the ball forward with your forearms as far as you feel comfortable that you can hold for 20 seconds. Focus should be on your abdominal contraction and after your 20 second hold, roll the ball back towards you. Repeat 3-5 times and increase your hold time as you improve your core strength.

Exercise #4: Quadruped Arm and Leg Raises
With the ball on the ground, place your stomach on the ball in an all 4’s position. From this position you should focus on keeping your back flat and hips on the ball. Lift one arm upwards and kick the opposite leg backwards keeping your balance on the ball. Repeat 10 times alternating each arm and opposite leg.

Exercise #5: Torso Twist
Sit on the ball. Walk your feet outward so that the ball is in contact with your mid back. Keep your torso flat and your butt up in the air away from the floor. Raise your arms to point straight up towards the ceiling and interlock your fingers. Bring your arms to the right as far as you can without rotating your hips and pelvis. The idea is to try and keep flat your torso flat using your core musculature as the arms move from right to left in front of the body. Rotate hands each direction 5 times slowly and repeat for 3 sets. Add a weight between your hands as you build core strength.

Chris Athos MPT, COMT