Knees & Hips
Dancing Smart Newsletter
February 17, 2006
Announcements
Only 6 more weeks until spring! I want to give you a heads up on a wonderful article Kristin Lewis has written for the April Dance Spirit magazine called "True or False". It was so much fun to be interviewed for it - and it is one you'll want to post on the studio wall as we de-myth some of the old sayings that have been around forever. I won't say anymore than that - you'll have to wait to read it yourself!
Onto a few different questions..
Question #1: Knock-knees
I have a problem. I don't have the turnout I wish I had. I have somewhat knocked-knees and I'm wondering if this is affecting my turnout. My teachers don't say anything about it but it's not pleasing me. I think I have a lot more rotation but I just can't seem to find it. Do my knock-knees have something to do with it? I don't want to "crank" my turnout because one of my teachers injured her knee and had to have surgery because of that. Thanks for listening!
Kayleigh
Dear Kayleigh,
The first thing I want you to do is test your turnout by lying on your stomach with your legs underneath you. Have a friend help by bending one knee and carefully taking the foot over the other knee without your hips moving from the floor. This will test for how much turnout you have.
Being knock-kneed does determine the amount of turnout, but it will influence how easily you can stand in 5 th and 3 rd positions. Both positions are a little bit harder when you have knock knees, and you won't be able to cross over as well.
You are so smart NOT to crank your turnout. Doing so does increase the potential for knee injuries! After determining what your turnout is currently, you can then go to work to strengthen and stretch the turnout muscles to maximize usage and to encourage more range.
Good luck!
Question #2: Hip Flexors
I really value the questions and answers that you send us. It really helps to think through what I'm doing myself, and also how to help my students (I'm an "older" dancer, and also teach adult beginners in the gym at work - yes, we are very lucky to have great exercise facilities at work. And I also teach stretch and Pilates at work). My question is about my hip-flexors. After decades of ballet (and some modern and jazz), I have fairly recently discovered that I have never pulled up my knee-caps, nor engaged either my quadriceps nor the front of my hips, nor actively engaged the turn-out muscles around my hips. My legs are slightly hyper-extended, and I just locked the knees and thought I had "straight legs". I have always been told that my tail-bone tips back, and mostly corrected by being told to "tuck under". I'm sure these problems are all connected in some ways.
Well, I'm now concentrating on both pulling up my knees and pushing down with my calves/weight. I find this helps enormously with balance. My legs have gotten much stronger. I've been doing core strengthening, too, with Pilates and additional crunches, and that has helped too. I'm still struggling to upright my pelvis, though this has become easier with the stronger core muscles. I also stretch my hip flexors (straight leg and bent leg runner's stretch). I have your "turn-out video" and do the exercises you mention in it, too. The problem, though, is that my hip-flexors are often very sore, especially at night. I feel as though they should be stretched, but often they actually feel better if I hug my knees in tightly, which relieves both the front of my hips and my lower back. So, my questions are, (1) what can I do to better engage the turn-out muscles, quadriceps and hip-flexors, so that they function effectively without causing pain afterwards, and (2) what should I do to strengthen these muscles?
Many thanks for sharing your knowledge with us. Best regards, Lesley
It sounds like you are on the right track to making some great changes in your muscle patterning, Lesley. I would caution you, though, to not overwork the hip flexors by pulling up the knees unless you are doing something that requires quadriceps engagement. You don't want to go from a state of under engaging your muscles to over engaging them. Allowing your weight to drop through the calves and feet into the ground is very good. Lengthening the spine and pelvis away from the ground is also very good. Pilates focuses on efficiency of movement, especially when training on the reformer.
I'm curious if your hip flexors would get sore prior to your new focus. If your hip flexors are sore because you are gaining strength, then I would back the intensity of your strengtheners. Being too sore after training or class is a case of 3 steps forward and 2 steps back. Check the amount of springs you are using on the reformer - or if you are only doing Pilates mat class, then you may want to bend the knees some while doing exercises like the hundred series so you are not holding the legs up so long in flexion.
Folding your knees into your chest would feel good as it stretches the lower back, and it takes the pull off the hip flexors. There isn't any problem with doing that, simply follow that position with one that extends and stretches the hip such as any variation of the runners lunge.
I suspect that you are subtlety overworking the hip area - overcompensating from your earlier pattern. Know that when your alignment is correct, and your muscles are well-toned, the hip flexors and turnout muscles will work appropriately to create the movement without having to actively engage them. Perhaps this seems backwards, but continue with all your stretching of the hip flexors and turnout muscles and if you are only doing the Pilates mat, notice if your hip flexor soreness eases off the days you aren't doing mat class. If so, try adapting your leg position so not to strain the hip flexors as much, or use a theraband whenever possible to give support to the legs as if you were on the reformer. This would be my initial suggestion rather than adding on more strengthening.
Question #3: Hyperextended Knees
I have been teaching ballet to private students for almost 30 years. Recently I saw the most extreme case of hyperextension I have ever encountered.
The girl is 16 and has been dancing for 13 years and is now dancing at the advanced level in her school. When she stands in second position, her knees are about 1 inch apart. I asked her what her teachers have said to her about this. She said some of them say just forget it. Others say, "Try not to hyperextend your knees." !!!
Normally, I try to work with a student to at least lessen the hyperextension, by having her stand with her heels together in first position, with the kneecaps lightly pulled up, and to try to recapture that position while standing on one leg. But in this case, I must deal with a background of training (Balanchine/SAB) that has told her it's not important, to forget about it.
I don't know enough facts about this. I have 2 questions: 1. Do you know of any documented cases where hyperextension has clearly shown harm to the dancer, disruption of career, serious injuries, clear physical weakness, inability to achieve steps or movements -- any hard evidence that can be presented to someone of this sort to convince them to change their ways? 2. Is there any clearly documented study showing that the various things teachers do in the effort to prevent hyperextension are successful?
Let me close by saying how much I appreciate your site and newsletters, which I have only recently discovered. You are performing a valuable service to the dance community, which I know will be helpful to many.
Best wishes, Beth
Beth, I have not found specific research on dancers and hyperextension, but I don't doubt that there is some out there. There is an organization called IADMS which stands for the International Association for Dance Medicine & Science. (You can find them on the web at iadms.org) They might be able to help you with finding the actual studies.
There is much information that shows that hyperextension puts strains on the ligaments, most specifically the posterior cruciate ligament, and the anterior cruciate ligaments. In sports like football, the hyperextended knee is not desired, and in tracking knee injuries you will see as a cause for many of them, hyperextension of the knees. Typically they are more traumatic and acute - instead of the chronic injuries that dancers have. I'm not sure that research will impress your dancer, but at least it is out there.
They are the ligaments that cross and run from the front to the back of the joint and keep your femur and tibia over each other. When you go into hyperextension you are wearing down the front of the meniscus, another ligament that serves to deepen the space that the femur rests in, and allowing the femur to shift to the back of the knee joint.
I believe you are giving the correct information to your dancers. Have them bring their heels closer together (not more than an inch or so apart at most), and encourage her to stabilize her alignment through lengthening the legs and using the abdominals to stabilize her pelvis.
Warmest regards,
Deborah
"Education is the key to injury prevention"
Have a Question?
Email your questions to Deb at AskDeb@thebodyseries.com or visit her online at http://www.thebodyseries.com.
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Deborah Vogel is a dancer, author, and master teacher who conducts workshops across the U.S. for both student and professional dancers. Her numerous articles on dance technique and injury prevention have appeared in Dance Spirit and Dance Teacher magazines. She is the Director of the Institute for Performance Studies and a faculty member at Oberlin College and the OC Conservatory of Music. During her years in NYC she co- founded the Center for Dance Medicine. Deborah makes her home in Oberlin, Ohio.
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