Tendinitis

One of the most common injuries suffered by performers of all types is tendinitis. But what exactly is it? Quite simply, the suffix “-itis” means “inflammation of,” so tendinitis is an inflammation of the tendon. To be more precise, tendinitis is an overuse injury affecting a muscle’s tendon and the musculotendinous junction (the part where the muscle fibers join with the tendon fibers). [A side note: tendinitis and tendonitis are both correct spellings.]

Tips for Going to the Doctor's Office

Some dancers don’t like to go see the doctor (even when they really need to) because they feel that (a) they already know what the doctor is going to say [“Stop dancing!”] or (b) they think it will be a waste of time and they won’t actually get any personalized attention or advice. Or both.

If you fit into the first category, choosing the best type of physician for injured dancers may help you feel more comfortable seeing a physician. If you fit into the second category, make sure that you’re giving your doctor the most accurate and complete information to allow him or her to give you the most accurate diagnosis and the best treatment plan. Your diagnosis can only be as good as the information you provide your medical provider.

The following tips are designed to help you get the most out of your doctor’s visit, including an accurate diagnosis and an effective treatment plan.

My 6 Favorite Stretches for Dancers

Stretching can be used to achieve several different goals and at various points in a workout. As you read through the following list, remember to always follow the 10 Rules of Stretching! Here are my 6 favorite stretches for dancers.

My Dance Injury Needs to be Seen by a Doctor. What Type of Doctor should I See?

So, you’ve decided that you need to see a physician for your dance injury (or your injury that’s affecting your ability to dance). Here are some things to keep in mind.  There are a few options for selecting a type of physician to see for your dance-related injury:

• Your family practice physician/primary care provider
• A sports medicine physician
• An orthopedic surgeon (sports medicine and orthopedics may be in the same clinic or department)

Cross-Friction Massage

If you have ever been treated by an athletic trainer, physical therapist, or other manual therapy practitioner for a subacute musculotendinous injury (like chronic tendinitis…which is technically tendinosis…), you may have had cross-friction massage performed on your injury. But you may not know exactly what it is or why your therapy provider chose that particular treatment for you.

Meniscus Injuries

Within the knee, there are two fibrocartilaginous crescents that sit on top of the tibia (the shin bone). These are the menisci. Their outer rims are thicker than their inner borders. They help to create a sort of seat on top of the tibia for the condyles of the femur. The medial meniscus is C-shaped while the lateral meniscus forms more of an “O”.

10 Rules of Stretching

Stretching, both static stretching and dynamic movement, can be very helpful for a variety of reasons, as long as it is done properly. To ensure that you’re correctly performing static stretching to improve overall flexibility in the long-term, here are the 10 rules of stretching.

Landing with Proper Mechanics

If you are a dancer, you have most likely heard at least one of your teachers say, “Roll through your feet!” or “Get your heels down when you land!” These instructions are given to help dancers land with proper mechanics and reduce their risk of injury while maintaining their jump height during a combination of successive jumps.

High Ankle Sprains

In the lower leg, the two bones, the tibia and fibula, meet twice: once near the knee and once just above the ankle joint. The distal tibiofibular joint (the one just above the ankle joint) has ligaments that connect the two bones in the front and back of the joint. These ligaments blend together with the connective tissue that runs between the two bones throughout the lower leg (called the syndesmosis or the syndesmotic ligament). Injuries to the distal tibiofibular ligaments are referred to as “high” ankle sprains due to their location in relationship to the rest of the ankle joint. Syndesmosis sprains often occur with high ankle sprains either at the same time that the high ankle sprain occurs or shortly afterward due to the syndesmosis having to absorb higher forces than usual after the tibiofibular ligaments are sprained.

Cross-Training for Dancers

So far, you’ve read about the myths of working out, the most common misconceptions about exercising for dancers, and why you should stop believing those who say that running is bad for dancers. All of these articles discuss the varied beliefs surrounding cross-training for dancers. But what exactly is cross-training?

Cross-training is a term that has been around since the mid-80s and it simply refers to training in more than one sport or physical activity. The concept of cross-training came about as a way to address the shortcomings of sport-specific training, like muscular imbalances and an increased risk of developing overuse injuries. Cross-training is designed to improve the body’s physical fitness (cardiovascular fitness, muscle strength or endurance, flexibility, etc.) while reducing the negative effects of sport-specific training. Properly-selected cross-training routines can also fill in the gaps in functional ability that sport-specific training can have.

Static Stretching or Dynamic Movement?

You know that you should warm-up before you stretch, but how do you make sense of all of the conflicting information out there about static and dynamic stretching?

For decades, sports medicine practitioners and researchers have debated the effects of static and dynamic stretching. Unfortunately, it seems that every time new stretching-related research is published, its findings contradict the study that was published before it. The most important thing to remember when perusing the findings of all of these studies is that many of them are examining different outcomes: one study will compare static and dynamic stretching for improvement in flexibility while another study compares the two looking for any changes (improvement or decline) in athletic performance immediately after the stretch. Since studies are examining very specific effects from static and dynamic stretching, it is not always a good idea to compare these results to each other. However, the news media often does just that when they are reporting the most recent study’s findings, which leads to confusion.

Please, stop believing (and saying) that running is bad for dancers!

Dancers, especially those who take ballet, often hear that they should NEVER run as a form of exercise because it will do many horrible things to the body from a dance perspective. While injures can happen when you run, they can also happen while swimming, biking, dancing, riding in a car, walking in a shopping mall, getting out of bed, showering, or going up or down the stairs.

Most of the “reasons” why running is bad for you as a dancer have no basis of truth and some of them, quite frankly, just don’t make any sense. The vehemence with which dance teachers and some dancers argue against running is baffling.

Patellofemoral Pain Syndrome: Symptoms and Treatment

Patellofemoral Pain Syndrome (hereafter referred to as PFS) has many causes and can really be a hassle to deal with if you don’t recognize the symptoms early.

Your Guide to Knee Braces

One of the most annoying things about having knee pain (aside from the pain itself, of course) is trying to figure out which of the 9 million kinds of braces you should get. Alright, so maybe it only feels like there are that many types of knee braces. The majority of knee braces fall under one of 4 categories: knee sleeves, lateral stabilizers, hinged braces, and patellar tendon straps. Learn what distinguishes these categories from each other, why you’d want to use any of these types of braces, and how to ensure that you’re wearing the brace correctly.

Warm-up Before You Stretch

Most people know that you should warm-up before physical activity. But what you might not know is why. Keeping in mind that using a heating pad is not a substitute for warming up, a proper warm-up does not have to take very long or use much space or equipment for most performers, especially dancers. Dance classes are designed to start out with a warm-up-like component and gradually increase in difficulty as the class progresses. However, time and space are often limited in dance class, so dancers may not be able to perform a complete warm-up solely by taking class. Taking yourself through your own personal warm-up routine allows you to make sure that you’re ready to start physical activity, regardless of what that activity is and where you are.

Causes of Patellofemoral Pain Syndrome

The knee joint is actually a combination of two joints: the tibiofemoral joint (the hinge joint that most people think of when talking about the knee joint) and the patellofemoral joint (which isn’t so much a joint as it is a place where bones slide past each other). This article is going to focus only on the patellofemoral joint. This term describes the gliding articulation of the patella (kneecap) with the trochlear groove of the femur (thigh bone).

The patella glides up and down in the groove in the femur during knee flexion and extension. This groove helps facilitate keeping the patella lined up with the midline of the leg.

Yes, dancers, you actually can (and should) exercise outside of dance!

The most common misconceptions about exercise for dancers and why they’re wrong

Dancers – raise your hand if you’ve heard someone say that exercising outside of dance is bad for you as a dancer. (Ok, now put your hand down because everyone who can see you right now is trying to figure out what you’re doing.)

No single article can cover all of the misconceptions and flat-out lies that surround exercising for dancers, but this article will attempt to debunk the most heinous ones that rear their ugly heads most often.

Ice vs. Heat

Now that you know the effects of cold and heat on the human body, here is the answer to the ever-popular question, “Should I ice it or use heat?”

How Cold and Heat Affect the Body

You strain your hamstring doing a penche, so you put ice on it. Your muscles are achy when you’re lifting your sousaphone over your head after the first week of band camp, so you use a heating pack to soothe them. You know that ice and heat help, but how do they help?

Cold application (cryotherapy) and heat application (thermotherapy) are often used in athletic medicine at all levels, from weekend warriors to professional athletes. But why? Changes in temperature result in predictable physiological changes within the body. As you would expect, cold temperatures often result in different changes than warm temperatures do, but there are some changes, such as reduction in pain, that can be caused by either cold or heat application.

Lateral Ankle Sprains

The body’s joints get their static and dynamic stability through a combination of bony architecture, tightness and orientation of ligamentous structures (ligaments and the joint capsule), and muscular contractions. The amount of a joint’s stabilizing forces coming from each of these factors at any given time is dependent on the specific joint and the current position of that joint. Joints are most stable when the majority of the joint’s stability comes from the bony architecture, and they are often least stable when the ligamentous structures are left to contribute the most to the joint’s stability.

The ankle joint is most stable in a combined position of dorsiflexion (lift up your toes and front of your feet so you can walk only on your heels) and eversion (try to “aim” the soles of your feet as far away from each other as you can without rotating your legs) and least stable in a combined position of plantarflexion (point your feet and toes) and inversion (soles of the feet turned toward each other).

Is it a Sprain or a Strain? (part 2)

Find out the specifics of sprains and strains in this 2-part article

Part 2: Strains

There is a plethora of information surrounding sprains and strains. As a result, the information presented here has been split into 2 articles. This is part 2 – be sure to check out Part 1: Sprains.

What is a Strain?

When a muscle, tendon (what attaches muscles to bones), or its associated fascia is torn or suffers a stretching-based injury, it is called a strain. A tendon’s collagen fibers, which are what allow the tendon to become taut when its muscle pulls on it, break after a 6%-8% increase in length. However, a tendon is usually twice as strong as its associated muscle, so when a musculotendinous unit is strained, the injury is usually located within the center of the muscle (referred to as the muscle belly) or at the spot where the muscle fibers blend into the tendon (called the musculotendinous junction).

Is it a Sprain or a Strain? (part 1)

Find out the specifics of sprains and strains in this 2-part article

Part 1: Sprains

There is a plethora of information surrounding sprains and strains. As a result, the information presented here has been split into 2 articles. This is part 1 – be sure to check out Part 2: Strains.

The Basics

Sprains and strains are often discussed together and thought of as being essentially the same. This most likely is due to the fact that initial treatment for mild strains and sprains are so similar. However, there are differences between the two injuries, and the full course of treatment and rehabilitation after a severe strain is not the same as it would be for a severe sprain.

Debunking the Myths of Working Out

There are a myriad of myths and half-truths surrounding exercising and you’ve likely heard many of them – possibly even coming out of a friend or family member’s mouth. What follows is a list of the five most persistent misconceptions about exercising. You might be surprised by the physiology that challenges some of these beliefs.

The Healing Process

The inflammatory response, which is responsible for causing swelling right after an injury happens, is the first of three phases (or stages) of the body’s healing process. The amount of swelling and duration of the inflammatory response depends on the severity of the injury and the type of body tissues that are damaged.

The three stages of healing are often discussed separately, but the healing process is more of a continuum than a step-by-step procedure, and the various stages overlap each other without any true beginning or ending points. Because of this, time after injury is usually used to identify the stage of healing that a given injury is in (assuming that the normal healing process is taking place). It’s important to understand that the healing process needs to be uninterrupted in order for the body to heal properly and completely.

Swelling

Swelling is one of the body’s common reactions to injury.

But what is swelling?

It’s a collection of excess fluid that leaks out of the body’s blood vessels into the spaces between cells. It tends to accumulate in internal cavities within the body, like the area just in front of the bone on the side of your ankle when you have an ankle sprain (for you anatomy nerds: it’s called your sinus tarsi and it’s located anterior to your lateral malleolus). Despite the bad rap that swelling often gets, it’s necessary. It can help to protect the injured body part from further injury, and it kick-starts the healing process.

Now, swelling can identified as either acute or chronic.

Using a Heating Pad is not the same thing as Warming Up

Many performers – most often, they’re dancers (sorry, guys, but it’s true) – think that if they use a heating pad for a few minutes before a workout, rehearsal, or a performance they will be properly warmed up and ready for physical activity.  While using a heating pad can help achieve some of the things you need from a proper warm-up, it can’t do all of them.

When sports medicine professionals, like athletic trainers, tell you to warm up before you start a workout or a rehearsal, they don’t mean that they want a part of your body (say, your hamstring) to feel hot to the touch.  What they mean is they want you to go through the process of physiologically warming up.  Basically, they want you to do several minutes’ worth of light exercising that elevates your heart rate.

Why?