I am delighted to introduce you to Moira McCormack, the chief Physiotherapist (that’s the UK word for Physical Therapist) for the Royal Ballet Company in London, England. Moira is a former dancer who became a PT, and has been working with dancers for over 20 years.
Several months ago we had an article on stretching, and I promised you a follow-up; a piece specifically on hypermobility — so here it is! We are indebted to Moira for writing this for 4dancers, as she is one the leading experts in this area of dance medicine.
- Jan Dunn, Dance Wellness Editor
Everyone knows that dancers need to be flexible. You can work hard to achieve flexibility but while this is not easy or comfortable it is achievable to a certain extent. However, there are those dancers who do not have to work for flexibility – they can already do the splits every which way, often have swayback knees, a very flexible spine and ‘amazing’ feet. These dancers have an inherited joint flexibility. This means the connective tissue, at cellular level, which binds the body together – joint capsule, fascia, ligaments, tendon, and skin – is not as tightly or evenly knit together compared to other bodies.
Just before you wish you were one of those, you need to know the drawbacks. If you have inherited a global hypermobility (hyper=more than normal) there may be some far reaching consequences.
These dancers also have flexibility where they do not need it – the joints of the fingers which bend backwards to an alarming degree, the shoulders that are extremely flexible and the swayback elbows which look distorted. Also the skin is over stretchy, especially at the elbows and knees and over the back of the hand.
Those dancers find it hard to build strength, control and stability. If joint capsule and ligament allow more excursion (movement), this can lead to early wear and tear or even injury if dislocation takes place.
Good stability around joints is a result of joint capsule and ligament restriction and deep muscle activation during dynamic movement. All dancers need this, but the hypermobile dancer needs it even more, to counteract the lack in ligamentous restriction and protection.
There is a whole range in flexibility of the human body – from a global tightness which we do not find in dance to a global hypermobility which we do see, but it is not necessarily recognised as a condition to be handled with care.
The hypermobile dancer can make beautiful shapes but the coordination required to achieve a speedy petit allegro can be elusive. Balance and correct alignment can also be compromised in the dancer who is struggling with joints that are more mobile than stable. Overuse injuries and trauma can occur and it is the accumulation of injuries that progress the unfortunate dancer into what we call the Hypermobility Syndrome.
The hypermobile dancer who understands the particular requirements of her / his body will find training more logical and encouraging.
As with all dancers, stability and control starts with the pelvis and spine. The deep abdominal muscles and deep spinal muscles targeted in Pilates exercises are isolated and activated (editor note: In Pilates this is called “core control”, and in dance as often referred to as “center”).
The hip joint needs a balance of muscle around the ball and socket joint to stabilize and protect it. Placement and control should not be compromised by height of legs and ballistic (quick bouncy) movements.
The shoulders also require stabilizing, with exercises targeting the rotator cuff muscles to avoid subluxation (where the joint slips out of place just slightly) or dislocation (where it comes completely out of the socket) – especially in young male dancers who are starting lifting work.
The hyperextended knee needs to gain control throughout range, not just in the locked back position, to allow a global control of posture.
The foot requires correct alignment in order to cope with all dance techniques and needs specific foot exercises to develop the strength required for jumping, landing and pointe work. The very flexible foot, although attractive, is harder to control.
The hypermobile dancer finds it hard to gain and maintain strength – the ability to generate force within contractile muscle tissue. For this, high resistance exercises are necessary in the gym using equipment. This ‘cross training’ really is necessary for this particular body type.
This is the term used to describe the body’s position sense…i.e, knowing where you are in space. Good proprioception of the pelvis develops with core stability exercises, which educate correct spinal position. Good proprioception of the knee is developed with balance and resistance exercises and attention to perfect alignment in class. Take care not to rely on mirrors in studios. Instead try to develop better sense of position by improving alignment through careful repetition. Dancers describe this as ‘getting on your leg’.
Balance mechanisms are challenged in the more flexible dancer. Balance and proprioception are a result of accurate sensory information from joints and muscles via the nervous system. There is some evidence that these mechanisms are slower in the hypermobile body, which has to work harder than others to improve. Balance exercises in conditioning classes, the use of a wobble board and trying simple movements with the eyes closed can improve this.
Good coordination is the integration of all the above. The hypermobile dancer may struggle with speed and complex technique but repetition and determination produce rewards. (Slower work is their forte which can make the most of their exceptional lines.)
Posture and Alignment
The characteristic hypermobile posture – the rounded shoulders on the tucked under pelvis resting over the locked, swayback knees – is not to be recommended. So much time spent locking into the front of the hips and the back of the knees is weakening. Developing good postural habits – taking posture from class outside the studio with you (without the turn out) – can help with stability and control.
Fatigue can occur earlier in the hypermobile dancer simply because dancing can be more challenging for this type of body. Some aerobic exercise should be part of every dancer’s regime – swimming, brisk walking or using gym equipment.
The hypermobile dancer enjoys stretching because it is easy and feels good. However, stretching for long periods at the end of range can simply encourage instability. Sitting in box splits for too long is not good for hip joints and is unnecessary for already flexible muscles. We all prefer to practise what we are good at, while we should work at what does not come naturally. Instead, concentrate on stability exercises.
Frustratingly, sprains and strains can take longer to recover as hypermobile tissues heal more slowly. You may notice that your skin bruises and scars easily. That is because it is thinner and more delicate than normal. Injuries do heal however, but need patience and following all the same rules.
To conclude, the hypermobile body has a number of challenges but also some valuable advantages. Line and flexibility can be truly displayed once strength, stability and coordination have been acquired. In dance, different body types will require a different emphasis in training. Understanding the hypermobile body means you can train with realistic aims.
BIO: Moira McCormack MSc is Head of Physiotherapy at The Royal Ballet Company in London, UK.
After a professional dance career in classical ballet she retrained as a Physical Therapist and has worked with dancers for the last 20 years. She teaches anatomy, dance technique and injury prevention internationally, with a main interest in the management of the hypermobile dancer.
Today we’d like to welcome Lauren Herfindahl to 4dancers. Lauren is a dancer with Boston Ballet, and she was kind enough to talk with us about preparing for her roles in the company’s upcoming engagement at Lincoln Center.
Can you tell readers a little about your background in dance and how you wound up dancing at Boston Ballet? I started ballet at a very young age after my mother noticed my strong interest and desire to move and express myself to music. I loved putting on mini dance performances for friends and family members, so you could say I always had an innate passion to be a performer. My family and I moved to the Boston area from the West Coast when I was eight and my mother enrolled me in Boston Ballet School. I studied at the school for 7 years before getting an offer to join Boston Ballet II. I grew up watching Boston Ballet and performed many children’s roles in large productions, including six years of children’s roles in The Nutcracker, so it was a dream come true to be offered a job with my home company. It is now only a week away from the end of my first season as a Corps de Ballet member!
This is Boston Ballet’s 50th season and it will be the first time they have performed at New York’s Lincoln Center. What is it like to be a part of this historic event?
It is truly an honor to be able to be a part of such an amazing company. Even from my ten years of watching and now dancing with the company, I have seen it grow into a sensational organization filled with so many amazing artists! To be able to bring this to a new audience is a great opportunity, especially to perform at Lincoln Center. I have learned a lot about the history of Boston Ballet this year, and without George Balanchine and the Ford Foundation, Boston Ballet might not be what it is today, so it seems fitting that we are now closing such a historic season in New York City.
Would you talk a bit about this performance series and the role(s) you will be dancing in New York? What has been the biggest challenge for you personally in preparing for it?
by Andrea Thompson
On Friday, June 6, I had the unique pleasure of performing a work’s world premiere and closing show within a nine-hour span. These were vastly different experiences — and that was the point.
For the past two months, my fellow Hubbard Street 2 dancers and I had been knee-deep in creation, collaborating with the Citizen Musician Fellows of the Civic Orchestra of Chicago. The focus was “In C,” a piece by composer Terry Riley that celebrates its 50th anniversary this year. It’s an unusual work to learn, requiring both its sheet music and a set of instructions for playing — and I mean “play” quite literally. Its structure is improvisatory in nature: Each musician is allowed to play the 53 musical phrases or “cells” of “In C” as many times as he or she pleases, dropping out and reentering the score at will. Riley’s instructions contain goals and guidelines, but outside of these each musician has freedom to decide in the moment what and when to play.
In the spirit of game-playing, listening, and the ephemeral nature of performance, we created — with the help of choreographer and Hubbard Street 2 director Terence Marling — our own approach to this ever-changing music. From early on, we knew we would perform an outdoor show to a recording of “In C” prior to an evening show accompanied live by the Citizen Musician Fellows.
In other words: One show would have a predetermined length, while the other could last anywhere from 30 to 90 minutes. Gulp.
We embarked on our choreographic journey by studying the cells, picking out landmarks we could identify regardless of how the score was interpreted. Cells of whole notes became our best, most recognizable friends. After familiarizing ourselves with the score, we had to figure out what the nature of our choreographic content would be. Games and improvisation seemed a natural fit given the structure of this music, so we set to work brainstorming new and favorite improv tasks, sharing visual images we wanted to achieve, and developing movement phrases inspired by the music.
Sequencing all that material was like putting a puzzle together. Certain ideas fell naturally in line with specific cells and became markers — assuming we’d be able to hear them in live performance — and then it was a matter of filling in the blanks with tasks that linked together logically. Like the musicians, we could stretch ideas out longer to challenge each other, or speed through them when it felt right. We developed a long string of cues and signals to indicate to each other when it was time to progress. We ended up with around 43 tasks, which spanned Riley’s 53 cells as a kind of roadmap. Our director Terry used a giant chronometer to denote each change of cell he heard in the music, so we would always know approximately where we were.
Of course, with our piece tied to spontaneity, every time we practiced our structure we landed somewhat differently on the recorded music. Terry rehearsed us to several different recordings of the piece in the week leading up to our shows, so that we wouldn’t be thrown off by unpredictable variations in the live music. And although we rehearsed a few times at Symphony Center’s Buntrock Hall with the musicians as well as every day in our West Loop studios, taking our piece outside meant encountering a whole new set of elements we could do nothing to prepare for indoors.
Our debut of “In C” kicked off the inaugural Living Loop Festival (produced by Chicago Loop Alliance and High Concept Laboratories). It was a gorgeous morning downtown when we arrived, with blue skies and warm temperatures. Our stage was in the shade at first, but by noon the sun was beaming down, warming our bodies and our marley as we adjusted to all the sights and sounds around Federal Plaza. Some people sat with their lunches just a few feet away from us, while others stayed further back and watched from a distance. Many stopped to catch just a few minutes of the piece; I even saw people across the street stopping to take in the scene.
All the outdoor elements lent themselves beautifully to the nature of the music and the choreographic structure we created to it. “In C” is about paying attention to your surroundings, and deciding to either counter them or let them inform you. Each spectator of our performance became a part of “In C” as they strolled by. The dancers tuned into each other, the music, the clock — and simultaneously took cues from passersby, the Alexander Calder sculpture sharing our plaza, buildings, and the perfectly blue sky above. All told, the performance was an exhilarating experience I won’t soon forget.
The evening performance was an equally memorable, though entirely different occasion. Buntrock Hall was set with a marley in the center of the space, while audience seating and musicians surrounded it on all sides. The piece began with a xylophone — the only constant element involved — setting the tempo, after which the musicians walked to their places and one by one, began playing the first cell. A few seconds later we followed to the edges of the space to enter one at a time as well.
Musician and dancer alike shared a palpable sense of anticipation. Everyone was open to informing and being informed by what we heard and saw — the backbone and the beauty of our collaboration — and I could sense that cooperative atmosphere as soon as I entered the room. Though we’d rehearsed together before, I was never more cognizant of the musicians’ eyes than during the show. In performance I was acutely aware that how I danced could have an impact on the upright bass, or the trumpet, or the viola — which could in turn affect how other musicians made their sounds. The unpredictable nature of “In C” became even more exciting knowing that I was part dancer, part listener and part co-conductor. Performing the piece with brilliant, enthusiastic live musicians brought it to life in a way completely different from performing outside earlier that day, yet equally fascinating.
It’s hard to believe the project we spent nearly two months on is now over, but the experience has certainly impacted me for the long term. Every member of HS2 contributed to the creation of our structure in a significant way, and I think we all came to realize the value of “just throwing ideas out there.” As a group, we tried every single proposal and held each other to refining what was unclear. We tried to create a work true to Terry Riley’s musical guidelines and appropriate to the playful, unpredictable nature of his piece. I think we not only succeeded in that, but also succeeded in opening ourselves up to new possibilities of how to choreograph, how to work together and how to collaborate with artists of other genres. Our “In C” may be over, but it has left an eternal eighth note–playing xylophone in my head and with it, an eagerness to enter the next cell.
Andrea Thompson enters her second year with Hubbard Street 2 at the start of the company’s 2014–15 season. During Hubbard Street’s satellite Summer Intensive Program at the University of Iowa, Thompson will teach ballet technique and HS2 repertoire to pre-professional dancers ages 14–17 from across the country. For a complete HS2 touring schedule, artist profiles and more, visit hubbardstreetdance.com.
Contributor Andrea Thompson (Maplewood, NJ) trained at the New Jersey School of Ballet, American Ballet Theatre’s Jacqueline Kennedy Onassis School and the Ailey School in New York City. Thompson has also studied at the Juilliard School, Northwest Professional Dance Project, Springboard Danse Montréal, Nederlands Dans Theater and Batsheva Dance Company, which brought opportunities to perform choreography by Gregory Dolbashian, William Forsythe, Natalia Horecna, Jessica Lang, Marina Mascarell, Idan Sharabi, Robyn Mineko Williams, Paul Lightfoot and Sol León. At the San Francisco Conservatory of Dance, under the direction of Summer Lee Rhatigan, she trained with and performed works by Christian Burns, Alex Ketley, Thomas McManus, Robert Moses, Ohad Naharin, Alessio Silvestrin and Bobbi Jene Smith. Thompson joined Hubbard Street 2 in August 2013, following work in San Francisco and New York with Zhukov Dance Theatre, Chang Yong Sung, LoudHoundMovement, Backwoods Dance Project and the Foundry.
by Emily Kate Long
Summer is my favorite time to dance. The warm weather makes my joints feel looser and my muscles freer. The more humid air gives the floor just the right amount of tack and traction. Pouring sweat halfway through bare feels like my soul is being washed clean. What could be better?
Unfortunately, all that dampness is prime breeding ground for bacteria, and the added friction inside my shoes causes extra blisters to form where I normally don’t get them. It also makes my shoe bag and my locker smell pretty unpleasant!
Maybe you share a barre with a ripe-footed neighbor, or maybe you’re the one with the stinky shoes. Maybe you’ve put on a costume and wondered if its last wearer forgot to put on deodorant. Keeping dance clothing and footwear fresh is important all year long, but especially in summer when the air gets thicker and the sweat runs faster.
My fix for smelly shoes and costumes is an antiseptic spray* I make at home. Here’s my recipe:
- Rinse a perfume or hairspray bottle in hot water a few times to get the residue out. Running it through the dishwasher does the job pretty well.
- Fill the bottle with one part alcohol and two parts distilled water. You can use rubbing alcohol, Everclear, or vodka (note from the editor: dancers 21 or over for the Everclear and vodka please!)
- Add 30 to 50 drops (two to three teaspoons) of lavender essential oil or tea tree oil. Both of these have antiseptic properties and smell awesome.
- Close the bottle up tight and shake to combine the ingredients. You’ll probably notice that the solution gets warmer when everything is mixed together.
- Spray away!
A few cautions with this stuff:
Always shake the bottle to re-mix before you spray. The oil will separate to the top of the solution.
Essential oils cause some kinds of plastic to deteriorate. I’ve melted more than one of those all-purpose travel size spray bottles by accident. A bottle that already held something like perfume, hairspray, or cleaner will probably hold up fine.
If you plan to use this on fabric, only spray the inside, or test an area to make sure the spray won’t cause any damage.
For feet and shoes, spray after dancing and on the insides of your shoes only. Let the shoes dry out before you put them away. For that matter, let your feet dry out and cool off before you put them away, too!
This spray can also be used safely in pointe shoes. Again, I’ll emphasize letting them dry out for a few minutes before storing. I also use it to sanitize my foot rollers, Yoga mat, and sometimes even my whole locker.
Smelly feet—or just body odor in general—can become a touchy subject in the studio. Having a community bottle of foot spray has become a good way to make light of the subject of stinky shoes. I’ve gotten into the habit of keeping a big bottle of it in my locker that everybody dips into whenever we need it for footwear or dancewear.
With that, I’ll wish all our 4dancers readers a happy, sweaty, fresh-smelling summer.
Here’s to the heat!
*This antiseptic spray is not intended to be used as a treatment for any type of injury or physical problem–it’s just a freshener!
Assistant Editor Emily Kate Long began her dance education in South Bend, Indiana, with Kimmary Williams and Jacob Rice, and graduated in 2007 from Pittsburgh Ballet Theatre School’s Schenley Program. She has spent summers studying at Ballet Chicago, Pittsburgh Youth Ballet, Pittsburgh Ballet Theatre School, Miami City Ballet, and Saratoga Summer Dance Intensive/Vail Valley Dance Intensive, where she served as Program Assistant. Ms Long attended Milwaukee Ballet School’s Summer Intensive on scholarship before being invited to join Milwaukee Ballet II in 2007.
Ms Long has been a member of Ballet Quad Cities since 2009. She has danced featured roles in Deanna Carter’s Ash to Glass and Dracula, participated in the company’s 2010 tour to New York City, and most recently performed principal roles in Courtney Lyon’s Sleeping Beauty, The Nutcracker, and Cinderella. She is also on the faculty of Ballet Quad Cities School of Dance, where she teaches ballet, pointe, and repertoire classes.1
Integrating Best Practices From Dance Medicine And Science To The Faculty Of A Professional Dance Conservatoire
I am so pleased to introduce our guest contributor, Rachel Rist, M.A., Director of Dance at Tring Park School for the Performing Arts, an hour outside of London. The Tring Park School is one of only 21 schools in the UK selected to receive government funded Dance and Drama Awards. Graduates go on to prestigious careers in all the arts, dance included. I have known Rachel for 20+ years, and it has been a pleasure to watch her emerge as one of the titans of dance medicine worldwide. She is a wonderful role model for teachers and school directors who want to integrate dance medicine knowledge into their training programs, and that is the topic I asked her write about, for this first article (we hope she will do more!!). – Jan Dunn, MS, Dance Wellness Editor
by Rachel Rist, MA
Twenty five years ago, when Dance Medicine was relatively unknown, as a newly appointed Director of Dance at an elite school in the UK, with a faculty of about 35 dance teachers of varying genres, I had a strong vision of the healthy dance training that I planned for the school. Unfortunately, at that time, nearly all of the faculty had been trained in the ‘old school’ system of ‘dance till you drop’ and ignore injuries, because; ‘that is how we did it in my day…’ This perpetuated the myth of over-reverence for a traditional system of training that was at best brutally strict and, at worst, produced a tremendous drop out rate of injured dancers and damaged performers. The faculty were luckily open to change as many of them had in fact, been injured out of the profession themselves still relatively young in their careers as professional dancers.
Key to encouraging dance teachers to reassess their own practices and looking for ways to implement new ideas, was to find a physiotherapist (PT) whom the teachers liked and respected - and to then establish weekly team meetings with that therapist and encourage frequent dialogue, have training sessions with them, and ask them to watch classes and rehearsals. The teachers found themselves also asking the PT questions on an informal basis around the coffee machine, or at lunch break, so when he came to lead them in an introductory session in Core Stability, they were already on board.
The next development was to introduce a screening process for the students. This is an increasingly common tool for schools and companies to use with their dancers (Editors note: See our recent article on this topic.). It involves looking at the dancer’s body / overall health / technique, and providing feedback for them — in terms of potential areas of weakness that might cause future problems.—i.e, it is a preventative tool.
The first step in this effort was to encourage any teachers who wanted to have a screen, free, for themselves. They came away from their personal screen understanding that the more we understand our own bodies, the better able we are to look after and maintain them. Teachers were fascinated and soon even the more skeptical ones were asking for a screen and were very keen to encourage their students to attend one. The students gained much from the screenings and importantly, came away with an individually designed training plan for their own physique. Alongside this was the In-Service training sessions for the teachers every 6 weeks, often led by myself or invited experts. (All sessions were during lunch times and providing baked goodies was an integral part of ensuring good attendance!)
Implementing Pilates and supplementary training was a natural progression from the screening process, and the faculty could see how valuable this could be for an injured dancer, to maintain range of movement and strength whilst still protecting an injury. The Pilates teacher was also a natural link between the Physiotherapist and the teacher (and importantly, was also an ex- professional dancer herself). At every development, good communication was vital, as was leading by example.
Implementing fitness training, however, was a lot more challenging. In a school that delivers academic work in addition to elite dance training, finding the time to do this in the packed curriculum was a real challenge. If something new goes into it, something has to come out of the timetable, or we have to work the students harder during their breaks. A compromise was to give a little lunch break time and a little class time to create a slot for the supplementary fitness training. It was 6 weeks before any benefit was revealed, and there was barely a day went by that a teacher, student or parent did not protest at the additional training. However, the outstanding results in improved fitness and condition of the dancers in the annual school show was all the validation it needed.
While working from a solid foundation of committed teachers, maintaining an open dialogue and always encouraging teachers to ask, challenge and find out more, we still needed to ensure that our training systems were in harmony with outstanding quality training of the adolescent dancer. This continues to be done by lesson observations, staff development and training, team teaching, regular training sessions and an ethos of constant evolution and growth. However, the most convincing and exciting outcome was seeing our dancers graduate into national and international level dance companies, go on to have long careers and indeed second careers as Artistic Directors. Longevity of a professional career at a high level was always the goal.
As new teachers joined the dance faculty, they were chosen not only for their experience and professional skills, but also for their interest or knowledge or passion for learning about the body. Gradually, teachers (and importantly, prospective students) gravitated towards the school precisely because the school had a reputation for providing outstanding training within a safe and healthy dance environment.
Now, with an incredible faculty of nearly 45 staff of highly experienced and skilled teachers, our school remains at the forefront of providing healthy dancers who are sought after by leading companies.
Personally, I was inspired by Dr. James Garrick, MD of Saint Francis Memorial Hospital Dance Medicine Division (in San Francisco), who, when I asked how he had become interested in Dance Medicine, replied; ‘it was a bloody-minded ballet teacher…..’
My mission was clear.
BIO: Rachel Rist, M.A. is the Director of Dance at Tring Park School for Performing Arts in Hertfordshire, UK. She has a Master’s Degree in Performing Arts, and is a published author of a first book, ‘The Injured Dancer’ (1986) and a second book ‘Anatomy and Kinesiology for Ballet Teachers’ (1996) and regular feature writer of many articles for dance magazines. She was President of the International Association for Dance Medicine and Science, (2003 – 2005) and later, Chair of its’ Education Committee. She has twice hosted the annual IADMS conference in 1997 and 1999. She is still a board member of IADMS. Rachel was the Chair of the Faculty of Education for the Royal Academy of Dance, and a member of the Executive Committee. She has worked extensively with Dance U.K, as a member of the Editorial Board for the ‘Fit to Dance?’ reports, 1 and 2 and on the editorial board for the ‘Dance Teaching Essentials’ book, is on the editorial board of the magazine ‘Dancing Times’.
Rachel was on the Steering Committee for the Music and Dance Scheme’s ‘Excellent’ projects, Steering committee for Foundations4Excellence, and Vice Chair of the Council for Professional Dance Schools. Rachel was also a founder developer of a qualification with Trinity International Examinations board on Safe and Effective Dance Practice.
She was external examiner for the dance degree course at Middlesex University and also external examiner for the MSc in Dance Science at Trinity Laban. She lectures extensively nationally and internationally on Dance Medicine and Training.