Tibial Torsion
Dancing Smart Newsletter
February 4, 2005
Greetings!
I want to thank all of you who sent questions and comments for the Tune Up Your Turnout book. It's coming along quite wonderfully, and I'm at the point of working on the illustrations and diagrams, although I will admit to periodic overwhelm. I am including some Q&A's from my newsletter over the past year into the book. I was going write each reader to ask permission, but found that I did not have email addresses for many. In the book I put the name only at the end of the question in the same way that I do in the newsletters. Since I do not have the affiliations for most question askers (hmm. is that a word?) I have not included any affiliations. I apologize for not thinking to create a data base for the questions when I started the newsletter. It is something I will ponder for the future. In the meantime, I am sending this newsletter as a public notice that your question could be a part of the book!
Onto the question of the week:
I would like some information on the best way to manage tibial torsion, particularly for the dancer that is not working incorrectly, but has been "duck footed" from birth. I mention this because you were the first source I found that really suggested not trying to align knees and ankles for someone like this. For years teachers told me I needed to strengthen my lower leg muscles to make them align. To me it seemed that this just forced my feet to roll to the outside or put excess pressure on knees.
When you have tibial torsion you need to monitor the weight placement on your feet to determine if you are placed correctly. I understand that many teachers will say to put your knees over your feet, but for the person with true tibial torsion they can only do that by supinating or sickling their foot which is the opposite of pronation, which is rolling in.
This does place tremendous pressure on the knees, and it shifts your weight backwards, making it hard to keep your pelvis placed correctly over your feet.
Now we have multiple compensations occurring and an unstable dancer who is going to have trouble balancing.
As teachers, we need to constantly remind our students that the weight needs to be divided equally between the pads of the big toe, little toe and heel. Period. If you are working on lifting your instep to stay out of pronation – you lift until the three points of the foot have equal weight. Period. It's that simple.
Remember how to check for tibial torsion. Have a dancer sit on a chair or table with their leg hanging down. The knee should be facing forward. Note where the foot is facing. With external tibial torsion the foot will be turned towards first position without any muscular effort.
In my turnout video there is a great shot of a young dancer who has tibial torsion only on her right side. She is sitting on the floor with her legs extended in front of her. Both kneecaps are facing the ceiling and the left foot is in a relaxed point, and the right foot is off on a 35-degree angle. This young dancer had an anteverted hip structure, meaning she tested with more turn in than turnout. Her right hip had more turn in than the left, and it was her right shin-bone (tibia bone) that had the external tibial torsion. Is that coincidental? I think not. She had been taking ballet for 5 years, and was standing in a first position that was more than 90 degrees total. She has since then dropped out of ballet for a variety of reasons but one of them was that her knees were giving her problems. When her Mom asked me my opinion I thought her changing to another style would be useful, like jazz or hip hop where there wasn't as much focus on maintaining a turned out position.
In some ways, having tibial torsion gives you a better looking first position that what you truly have in your hips. It's more at the barre that dancers with tibial torsion can get into trouble because of the slower movements and the greater focus on the joints of the lower leg. When the dancer with tibial torsion is moving across the floor it probably feels like less of a problem because your body will automatically compensate to keep you balanced.
As a side note, I was looking through Dance Spirit Magazine. I was perusing the audition guide and noticed that in the majority of the stunning pictures of dancers they had throughout the guide, if you analyze the turnout on the two legs in an arabesque, the standing leg was barely turned out. These gorgeous dancers in those beautiful poses are paid professional dancers. What gives?
That question is the reason behind my "Tune-up your Turnout" book that will be out this spring. We want to encourage our dancers to work with their turnout as well as they can and at the same time demystify turnout and acknowledge we need to be adaptable in how we use our turnout depending on the particulars of the movement. Let's give our dancers the tools to work their muscles correctly and within anatomical principles. Help them to understand the realities of THEIR body – so they can bring all that joy and passion to their dancing without feeling like a failure if their body isn't perfect.
On with the dance!
Deborah