Hyperextended Knees, Hamstrings & Turnout

Dancing Smart Newsletter
February 16, 2007

Greetings!

Here's your winter dancer's tip! Anyone's back sore from shoveling snow? Mine was – and I needed to increase my iliopsoas stretching (because of the constant bending and straightening) and upper back pinkie ball work. It also told me since I had slacked off on my upper body strengthening that I need to get back on the program!

Right to the questions of the week…

First Question

I'm delighted to read that her teachers are aware that working in hyperextension is a problem. Often I find teachers who promote the look of hyperextension. When your daughter went through her significant growth spurt, it is quite possible that she lost a bit of strength in the quadriceps and hamstrings. The hyperextended dancer often is quite flexible, and needs to develop the strength to maintain a straight line in the legs. This will make her feel as if her knees are bent – but she needs to persevere – until she is able to break the pattern of the hyperextension.

Have her become more aware of her standing position outside of class. Note how often she sinks into her knees. As far as a time frame for this problem it will depend more on her ability to self-correct her standing alignment. She cannot expect a fast turnout around time with this pattern if she only works on it in class. She needs to change this pattern of standing – period – no matter whether she is in class or standing talking to friends.

Once she begins to stand in a more anatomically correct position, her strength will also improve – although it wouldn't hurt to encourage her to do some one on one training with the Pilates or Gyrotonic equipment. Being in NYC, it should be easy to find a studio. As she is able to have her pelvis in line with her legs, and develops the strength to maintain that position, her pointe work will definitely improve!

Next Question

Let's take your first question first. The problem is almost always in the hamstring length. Let's think about it. The hamstrings attach at the sits bone and below the knee. In order to sit at a 90-degree angle with your legs in front you need flexible hamstrings. If your hamstrings are pulling, they will pull on the pelvis and you will roll onto the back of the pelvis. You can have flexible hamstrings and a tight lower back and be able to sit up straight in this position, but not be able to round forward. No amount of core strength is going to bring your pelvis upright if the hamstrings are tight.

You might try checking your hamstrings in a different way. Lie on your back at the opening of the door. Your pelvis is close to the doorframe, let's say you put your right leg up on the wall with a straight leg, just to the right of the opening, and your left leg is sticking through the door. Got the visual?

In this position your pelvis should be resting comfortably on the floor, your lower back has its small arch. Pay close attention to whether the pelvis is tipping (tucking under). You need to keep the sits bone resting on the floor. If you have the hamstring flexibility to sit in a 90-degree position with legs straight in front, you'll be able to do this. You have taken the lower back muscles out of the picture as well as the abdominals need to keep your pelvis upright.

Note how far away from the wall your pelvis needs to be in order to keep the pelvis in a neutral position. This is a rough measurement of your hamstring flexibility. This is also a way to stretch your hamstrings, but as I have mentioned in earlier newsletters, I prefer stretching the hamstrings in a standing position, with one leg on a chair, flexing forward at the hip with a straight back. Most students don't have to bend very far forward with the pelvis before they feel a good stretch at the hamstrings.

If you are stretching consistently, and still aren't getting anywhere, focus more on release and massage of the whole backside of your body. Pinkie ball work can be effective, as well as myofascial release, which is a specific type of massage addressing the connective tissue of the body.

As far as your second question – the answer is the hamstrings need to have the flexibility to straight the leg from a bent, passé position, to straight. What is happening to you is very common, and the way dancers typically get around this is they hike their hip up to compensate for hamstring tightness.

Be patient, stop thinking of yourself as an inflexible dancer, and tell yourself everyday that you are becoming more flexible! Sounds silly, perhaps, but your mindset truly does influence your muscles ability to change!

Last Question

It's possible that her lordosis is coming from an overly contracted iliopsoas muscle which needs to be released and stretched before she can access the turnout muscles more effectively. I often find the pattern you are describing, swayback and overuse of the gluts. This makes sense because of the iliopsoas is pulling the pelvis forward in an anterior tilt, then the hamstrings and gluteal muscles would try and pull it back down in back.

Encourage your student to work with the pinkie ball, first starting by placing the ball between her and the wall, and rolling all around the gluteal area. Then she can work in the runners lunge or some variation to stretch out the iliopsoas. It might also be very useful if you test her range of motion at the hip. You can do it as follows.

Knowing how to test turnout accurately is very important assessment skill. The average amount of external rotation (turnout) to internal rotation (turn in) is 45 degrees in both directions, adding up to 90 degrees total. Much less than the 180 degrees that is held up as the gold standard for dancers.

The frog position is a highly inaccurate method of testing turnout. The hips are flexed in the frog position, which automatically allows for a greater range of motion. It is much more useful to know what the range of external versus internal rotation is when the dancer is standing. Knowing how much range the hip joints have will help determine where to place the feet in first position, in order to decrease strain on the knees and ankles that come from over-turning out.

You want to test for turnout with the hips in an extended position. Begin by having the dancer lie on their stomach, with their legs stretched straight behind them. Gently bend one knee, monitoring that the front of the hip does not move away from the floor. The lower back should not arch at all during the testing.

Once their knee is bent at 90 degrees, let it fall gently over their other knee. This gauges their turnout. Then allow the knee to gently fall in the opposite direction, which is their turn-in. Generally, the both directions will add up to 90. If the numbers are much less than that focus on releasing tension in the hip area through stretching and massage and retest. The dancer below increased turn in to 45 degrees after releasing turnout muscles. This allowed her to stand with less tension in first position. Remember, good muscle tone means the muscle has the ability to both be long and strong.

If your student tests with way more turn in than turnout, then you know her hip structure is keeping her from utilizing her turnout as well as you'd like. In that case, still encourage the use of the pinkie balls and stretching, as she needs to accurately use whatever amount of turnout she has, and also decrease her first position.

Be well!

Deborah

"Education is the key to injury prevention"

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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.