Hamstring Strain?

Dancing Smart Newsletter
November 10, 2006

Let's start with one more email about pointe shoes before we go onto the new question of the week.

I (finally) had time to sit down and read through some of the latest newsletters and since I am definitely a worshipper at the "altar of pink satin "... I have worn and fit and sold many different types of pointe shoes. By now, I'm sure you've heard from the entire global village on this but I thought I'd add my two cents.

I don't care much for Gaynor Minden for dancers in the beginning stages and anyone who particularly needs to build strength. The shoe does (my opinion) too much of the work for the dancer. It's very difficult to roll through those last few centimeters to full pointe because the shoe doesn't really bend there.

However, for difficult to fit feet the Pietra Merlet Kaliste model is great. It breaks fairly low (but not so much as to create a pre-tendonitis situation), has a stretch back/heel area and since the arch is polycarbonate it molds enough to sit on the foot correctly, but holds up longer than the redboard shanked shoes. It has a lower vamp which may be address some of the concern's about the 13 year old from the newsletter, is sturdy and very appropriate for a beginning or intermediate dancer. The shoe is somewhat tapered and many dancers (especially those new to pointe) may think it looks weird, but if the toes are not square it performs very well.

I thought I'd mention this because I too have the Pointe Book and the Merlet brand is not mentioned. I used to be a sales rep for them after I had tried and really liked their products. It is not available through any of the discount houses except for Back Bay Dancewear (www.backbaydancewear.com). They have been running ads in Pointe Magazine -- you can call the 800 number (you'll usually get PJ or Violette) and ask who locally sells them.

I adore pointe shoes and love solving the puzzle of the best shoe for the foot I'm working with. I'm always interested in pointe insights.
Another great pointe shoe is Suffolk Solo Pointe. They have a squarer box, low vamp and are a workhorse although light. The vamp was too low for me but I loved the shoe. Suffolk was started by a couple of makers who left Freed's of London.

So, here was a lot of info that was completely unsolicited!
Boleyn

Thank you, Boleyn!

Onto the question for this week:

Question of the Week

Deb's Answer

I can understand your concerns, Emilie, and am glad that you are getting some manual work. I want to reassure you that you are not falling apart! Everyone,dancers and non- dancers have to deal with changing bodies. The challenge comesin developing good listening skills to the messages our body is giving. We reallyneed to get beyond the collective myth that as dancers – we are going tohurt – and that's normal. Poppycock!

I want to go over some warning signs of an injury in just a moment. First, though, let's talk about some strategies for you. After a muscle has been strained ortorn, adhesions develop to help knit the torn tissue back together. This is good – becausethat is what we want our body to do. Having the deep tissue work is helpful afterthe injury has healed, because it helps to break up the adhesions and keep themuscle fibers working smoothly. The fact it has not after this amount of time,makes me suspect (similar to your mother – aren't mom's smart?) that theproblem may be coming from somewhere else. Does your massage therapist find reallysore areas deep in your buttocks, around the turnout muscles? If so, the sciaticnerve may be unhappy and inflamed and needs to be attended to. Try doing ibuprofenor a similar anti-inflammatory for 3 days, and then stop cold turkey. When youwere on ibuprofen, did it make your leg feel better? (If it does feel better,please do not take it as permission to do everything full out and push yourself)If the pain is neurological rather than muscular it may calm down with an anti-inflammatory.

If you do have some nerve inflammation, then a careful evaluation of your pelvic alignment is in order. Do you have a tight iliopsoas muscle and hip flexors?Sometimes they go hand in hand with an inflamed sciatic nerve. If the discomfortcontinues, I am going to suggest that you see a sports physician. You need tohave an accurate diagnosis of what is going on so your recovery efforts are morespecific. Don't worry about falling behind in class right now. Your first focusis to get your self back to 100%. The more you try to push through the pain withoutknowing why you are having pain, the longer your rehabilitation will take.

Here is some dancing smart info for recognizing injuries. The following is from the very first newsletter I wrote back in 2003. Enjoy!

PAIN IS ALWAYS A CAUSE FOR CONCERN

Didn’t catch that the first time? Let me repeat it!

PAIN IS ALWAYS A CAUSE FOR CONCERN

I make a big deal out of that sentence because I run into so many dancers who have come to believe that pain and being a dancer go hand in hand. I’dlike to challenge that belief and have you consider that your body can be yourbest ally in pursuing an active dance career — not your enemy.

How do you do that? By recognizing early warning signs of injury and handling them before they get so bad that they take you away from dance class or rehearsal.So how do you recognize a potential injury? Here are 4 possible scenarios.

1. Pain that gets progressively worse during working out.
2. Pain that comes after you work out and the next day comes back after less working.
3. Pain that is accompanied by a certain movement (e.g. arabesque).
4. No real sense of "pain" but a definite restriction of movement.

Dancers often will feel temporary muscle soreness after a class that has been particularly challenging, or when new choreography or movement styles are beingintroduced. This soreness can be caused by an accumulation of waste productsproduced after overworking the muscles without the proper warm-up for that movementpatterning. Combinations in center and across the floor typically use differentsequencing and patterns of movements than a barre warm-up or our modern dancewarm-ups. Depending on your individual body type and structure there are movementsthat suit you better — other’s that challenge your physicality. Thistype of soreness generally goes away after a few days. Moving and stretchingeasily helps to absorb the lactic acid. Being properly hydrated is essential.(A general rule for hydration is one quart of water for every 50 pounds of weighta day) This means water…not soda, not juice, not coffee or tea…water.Of course having proper nutrition for your body type is also essential for thebody to repair itself easily and quickly, even from small muscle tears.

Often you won’t feel this muscle strain until the day after a class, usually upon awakening the next morning. What happens is that overly forceful stretchingor movements that are outside of your normal vocabulary can cause small tearsin the muscle and connective tissue. While it is true that the way a muscle getsstronger is through overloading it, which means gently stressing the muscle beyondits normal workload, when you overload the muscle too aggressively in a class — thenyou are potentially going to create the stiff and sore body the next day. Thismay take several days to disappear, depending on how well you are taking careof it in ways that we just described before - by hydrating, de-inflaming, gentlystretching.

How an injury feels when moving can tell you a lot. If going back to class helps it feel a little bit better, and you feel less sore, great. If moving irritatesit or makes it worse, get smart. Most injuries can be short circuited in theearly stages if respected. I generally find that dancers have a high pain toleranceand need to be given permission to take care of themselves by sometimes (gasp,gasp) taking off from class, sleeping, getting a massage, or one of the manyother requests that your body may be asking of you.

Sometimes a dancer will begin to feel chronic pain in either the muscles or a joint. Typically when chronic pain is felt in the muscles it is caused by excessivetension. This tension is caused by skeletal displacement and making muscles workconstantly to both move you and support you. In the joint, chronic pain oftenhappens because of a constant irritation that can be caused by muscular tension,or a mechanical misalignment within the joints.

Dance injuries often start in small ways. They sneak up on you. The dancers whocome to see me aren’t the ones who sprained their ankle as they were loweredfrom a lift. The complaints are less clear…"My arabesque is not ashigh as it used to be, and my hip is clicking when I lower from a front develop" or "mylow back is aching, I’m not sure when it started, but now I can’tdo my port de bras backwards" These are the more normal, chronic overuseinjuries that I described in the 4 earlier scenarios. These scenarios need tobe honored for their potential to spiral into more debilitating problems.

Chronic injuries are more challenging and sometimes frustrating to work with, especially if you are in a performance situation that demands a certain workloador a demanding schedule that is hard to change. This is when having guidancefrom a dance medicine specialist is important.
Over time you will begin to see patterns in how your body feels and be able tomore quickly head off strains and injuries. The first step, one of listeningcarefully to your body, honestly and with compassion, (not in a paranoid or hypochondriacfashion), will both help you become a better dancer and a better teacher. Don’tdeny what your body’s experience is. Line 10 dancers up and have them describegrand plié in first position and you will get 10 different descriptions.The goal is to learn how to evaluate and work with your own unique set of kinestheticfeedback. Your teachers can provide guidance, but ultimately, it is the dancerthat is in charge of creating the necessary changes to dance effortlessly andgracefully, without creating pain or damaging the physical structures of thebody.

Warmest regards,

Deborah

"Education is the key to injury prevention"

Copyright ©2003-2006 The Body Series. All Rights Reserved.

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.