If it’s one thing dancers are always thinking about it’s their feet, and with the many hours spent in class and rehearsal, it can help to have a little something that freshens them up a bit.
This 4 oz all-natural foot spray by Aurorae makes for a great addition to your dance bag. Whether you are trying to revitalize some old technique shoes, or you want to deodorize your feet a bit before slipping on some sandals, this little product is a good choice. Made with essential oils such as peppermint, tea tree, eucalyptus and thyme, it has a delightful scent, and because of its size, it is super portable.
The thing I was most impressed with was the pump for this product. Instead of a harsh stream of liquid or a heavy spray, it delivered a light mist which keeps your feet from getting soaked with it. Also, a little bit goes a long way, so you can use a light hand when applying.
All in all, this foot spray makes a nice addition to any dancer’s bag.
New dance medicine book to share! “Safe Dance Practice” is written by three British colleagues of mine in the dance medicine world, Edel Quin / Sonia Rafferty / Charlotte Tomlinson. All three are involved with IADMS (International Association for Dance Medicine and Science), Safe in Dance International (SIDI), and are all MSc graduates of the Dance Science program at Trinity Laban Conservatoire of Music and Dance (London UK). They have been long-involved in dance medicine and science, aka Dance Wellness, aka Safe Dance Practice (a British term), and have put together their invaluable knowledge and experience in writing this book – giving teachers and dancers a solid grounding for training healthy dancers who will be better equipped to dance many long years, in the best possible condition. The book is a great addition to your dance medicine and science library – Please pass it on!
by Sonia Rafferty, Charlotte Tomlinson and Edel Quin
What It Isn’t!
The term “safe dance practice” often conjures up the vision of a checklist of boring, restrictive, and often unnecessary health and safety regulations. As dancers, choreographers, and teachers, we certainly don’t want to be held back in our artistic endeavours by recommendations that we think will limit our creative risk-taking capacity.
Fortunately, the upsurge of interest and increasing knowledge in safe dance practice will help us to do exactly the opposite. We can support artistic challenge by helping dancers to train and work at their best, but also heed the potential reasons for the high injury rate that has been observed in a wide variety of different dance styles.
Who Is It For?
Safe dance practice is important for dancers of any age and any ability. It is not simply for the elite “racehorse” of a dancer, at risk because of high-level demands, or the dancer who perhaps could be seen to be more prone to injury because of lack of technicality or physical ability.
Knowing how to work safely and effectively is relevant for everyone – for dancers themselves who can take responsibility for protecting and maintaining their readiness to dance, and for teachers who are trusted with instructing the dancing bodies. Add to that list the choreographers who use the expertise and abilities of dancers to create innovative and challenging works, and the artistic directors and managers who rehearse those dancers and organise their schedules.
by Selina Shah, MD, FACP
Our bones are important because they serve as the foundation on which we are built. Bone is living tissue that contains blood vessels; proteins, including collagen; and cells that are actively maintaining healthy bone. Bone also contains many minerals, the most important of which is calcium.
Building Strong Bones
We have the best chance of building our strongest bones when we are young — because the rate at which we form bone is higher than that of losing bone up until about the age of 30, when peak bone mass is reached. After peak bone mass is reached, we starting losing bone at a higher rate than we form it. The majority of the mass of our bones forms between the ages of 11 – 14 in girls and 13 – 17 in boys. The more bone mass you have by the time you reach peak bone mass, the less of a chance of you have of breaking your bones, especially later in life as bone loss occurs.
Bone Health And Your Diet
As dancers, we place a lot of stress on our bones. This stress can lead to damage of bone tissue. However, luckily our body is designed to repair itself, so bones maintain their healthy structure by containing cells that remove damaged bone and replace it with healthy bone, also known as bone turnover.
In order to achieve the highest bone mass possible and to ensure healthy bone turnover, it is important for our bones to have the right ingredients. Dancers need have enough nutritional intake based on activity level, adequate calcium, and adequate Vitamin D. Without these, a decrease in bone density can occur, making a dancer susceptible to fractures and stress fractures.
Dance is a form of exercise which uses energy. This energy needs to be replaced by consuming enough healthy carbohydrates and fats so that your body can continue to function normally. Having adequate fuel is especially important for girls to ensure normal, regular menstruation. The hormones that regulate menstruation directly affect bone mass. If a dancer does not consume enough calories and fats to adequately re-fuel the body, then the hormone balance gets thrown off – which can result in a decrease in bone density.
It is not unusual to experience irregular periods (meaning periods that do not come monthly) during the first year of menstruation. However, missing your periods for months at a time or getting your period too late, may also be a sign that you are not consuming enough calories. Genetics and other medical issues could also be playing a role in abnormal menstrual cycles or later onset of menstruation. It is best to consult a physician if you do miss your period for more than 2 months, especially if this occurs on a regular basis, or if you are 15 years old and have not gotten your period. Males are also susceptible to bone loss due to inadequate energy consumption. All dancers need to consume enough calories to re-fuel the body.
The human body is designed to always have normal calcium levels – so if you do not consume enough calcium, it will take it from bone which again will lead to decreased bone density. The Institute of Medicine currently recommends consuming the amount of calcium based on age shown in Table 1 below. It is best not to exceed the amount of calcium shown at the upper limit column because this can increase the risk of forming kidney stones. It is best to get calcium from dietary sources such as dairy, almonds, broccoli, Brussels sprouts, and dark leafy greens, to name a few. Check your food labels and calculate how much calcium you get in a day. If you do not reach the level recommended in Table 1, then buy a supplement. Do not take more than 500mg at a time to maximize effective absorption.
Table 1: Institute of Medicine Daily Adequate Intake of Calcium
|Age||Calcium (mg/day)||Calcium (mg/day) Upper Level Intake|
|4 – 8||1000||2500|
|9 – 18||1300||3000|
|19 – 50||1000||2500|
|51 – 70||1200||2000|
Bone Health And Vitamin D
In order for your body to absorb dietary calcium, you need to have an adequate amount of Vitamin D. The best source for Vitamin D is from the sun. Vitamin D is formed by cells in the skin layer. Sun exposure to form Vitamin D in the skin is inhibited by sunblock and decreased by clouds and pollution. Additionally, the darker the skin color, the longer daily exposure time to sun is needed for the cells in your skin layers to form adequate vitamin D. Generally speaking safe sun exposure (no sunblock for the time allotted as long as there is no risk of skin cancer by family or personal history of skin cancer) is best obtained between the hours of 10am – 3pm on the arms and legs for a minimum of 20 minutes per day depending on skin color and the latitude in which you live.
The further you are from the equator, the less Vitamin D is formed during winter months. It is difficult to adequately consume Vitamin D from foods fortified with Vitamin D. A few foods such as Cod Liver Oil, egg yolks, salmon, sardines, mackerel, and canned Tuna are natural sources of Vitamin D. One study found that more than 95% of dancers are deficient in Vitamin D. If you cannot get enough sun exposure, the Institute of Medicine recommends the supplementing Vitamin D at the levels based on age shown in Table 2 below. Your doctor may check a blood level and recommend a higher dosage of Vitamin D to boost your levels quickly. It is difficult to become toxic with Vitamin D supplementation. Follow your doctor’s advice.
Table 2: 2010 Institute of Medicine Daily Adequate Intake of Vitamin D
|Age||Vitamin D (IU)|
|0 – 1||600|
|1 – 70||600|
In summary, it is best to ensure adequate Vitamin D levels, calcium intake, and food intake to develop and maintain strong bones. The younger you begin, the better off you will be in the future.
Selina Shah, MD, FACP is a board certified sports medicine and internal medicine physician and the Director of Dance Medicine at the Center for Sports Medicine in San Francisco, CA and Walnut Creek, CA. She has lectured nationally and internationally on various dance medicine topics and has published papers in medical journals and books including her original research on dance injuries in contemporary professional dancers. She is the dance company physician for the San Francisco Ballet School, Liss Fain Dance Company and Diablo Ballet. She is a physician for Berkeley Repertory Theater, Mill’s College, St. Mary’s College, and Northgate High School. She takes care of the performers for Cirque du Soleil and various Broadway productions when they come to the San Francisco Bay Area. She has taken care of several Broadway performers (i.e. American Idiot, South Pacific, Lion King, Book of Mormon, MoTown, and Billy Elliot). She is a team physician for USA Synchronized Swimming, USA Weightlifting, USA Figure Skating and travels with the athletes internationally and nationally. She is also a member of the USA Gymnastics Referral Network. As a former professional Bollywood and salsa dancer,
Dr. Shah is passionate about caring for dancers. She continues taking ballet classes weekly and also enjoys running, yoga, Pilates, weightlifting, and plyometric exercise.0
Aloha! Nancy Wozny, our Somatics specialist on the 4dancers Dance Wellness Panel recently gave us Part I of “Flash Feldenkrais for the Busy Dancer” – here is Part II. This one is focused on what to do after a trauma, like a fall, or a disorienting movement experience (like a hectic, packed rehearsal day!). Thanks again to Nancy, and Happy Holidays to All! – Jan Dunn, Dance Wellness Editor
by Nancy Wozny
I scampered to the edge of my seat to watch Cassandre Joseph fall from a great height as part of the kinetic pyrotechnics of STREB FORCES. She falls (or flies) and crash lands unharmed, as all of the STREB’s super action heroes do during their recent show at Miller Outdoor Theatre in Houston. Part of Elizabeth Streb’s brilliance is her meticulous methodology of falling, flying and crash landing in a way that we feel the visceral excitement of the motion.
Falling, jumping, unusual landings and the like, are all part of the contemporary dance landscape now, as dancers need to be fluid movers on the ground and in the air. Even partnering has evolved to include fabulous eye candy lifts and maneuvers. But there are times when dancers take a tumble when it wasn’t in the choreography. Most often, you stand up without any apparent injury, just feeling little stunned. Whether one sustains injury or not, unintentional forces have entered our systems, and we may feel discombobulated for a while. We’ve taken a blow, and that has an impact whether or not there are any visible scars.
All of this leads us to the continuation of my Flash Feldenkrais for the Busy Dancer. During Part I, we focused on coming back to neutral in the joints. This next lesson addresses how we organize ourselves for action, and is especially aimed to help us regain a neutral organization after a tumble or trauma. Even a minor trip can have somatic repercussions and lead to unnecessary holding patterns. The lesson is also great at just calming us down, and who doesn’t need a little bit of that now and then in the dance biz?
Flash Feldenkrais Lesson #2: Organizing the Spine in Side Lying
When to do this lesson: After any form of trauma or disorientating movement experience.
Why do this lesson: The lesson will help you return to a more neutral organization, calm down, and improve well being, if you feel a bit shaken up from a minor fall or a hectic day of rehearsal. If post injury, check with your doctor first.
What you need to do this lesson: You will need about 20 minutes of uninterrupted time, a soft mat or blanket and a towel to support your head during this lesson.
Remember: Rest between each step and before you fatigue. Do each instruction just a few times. Make the movement as easy as possible.
Rest on your back and notice your contact. Determine your favorite side. You will be lying on that side during the lesson. Turn to the preferred side so that your arms and legs are at a right angle to your torso. Your knees are bent at right angles but your arms will be straight and not bent at the elbows. Your palms rest on top of each other.
Move your top arm forward in the direction of your fingers passed the lower hand and then back to your starting place, remembering to keep the top arm straight. Notice the shape of your back changing and your head rolling toward the floor in front of you. Rest on your side.
Now move your top shoulder backwards in the direction of the floor behind you. Your top hand will glide toward the elbow of your lower arm. Your top shoulder blade moves behind you toward the floor. Turn your head toward the ceiling as you roll backward. Rest on your side.
Combine both movements, so that your top hand is moving forward and back. Feel the movement go through your spine. Your head will also be rolling toward the floor in front of you and toward the ceiling. Rest on your back and notice the contact of the working side.
Return to your preferred side. Move your top knee further forward, so that it passes the lower knee. You should feel the top ribs articulating. It’s a small movement. Make sure to move the knee directly forward in the direction it is already pointing. Think of your knee as a headlight so keep the light going the same direction as you glide the knee forward in space. Rest.
Now move the knee backwards so that the top hip moves toward the floor behind you. Put both of these movements together so that the knee moves forward and backward in space. Rest on your back. Notice how the contact of the working side.
Return to your side. Move the hand and hip forward and backward. Notice the movement of your head. Make the movement as fluid as possible. Rest on your back and notice the difference between your sides.
Repeat the entire lesson on the other side.
Rest on your back and notice your contact. Come to standing and notice your posture.
Remember you can do these lessons any time, whether you’ve taken a tumble or just want to come back to a calm place. Enjoy the lesson and stay tuned for Flash Feldenkrais Part III.
Nancy Wozny is editor in chief of Arts + Culture Texas, reviews editor at Dance Source Houston and a contributor to Pointe Magazine, Dance Teacher and Dance Magazine, where she is also an contributing editor. She has taught and written about Feldenkrais and somatics in dance for two decades.
The web and social media can be wonderful places to get information – facts and news are able to be shared shared quickly and easily. Unfortunately, the same things that make these areas great for spreading information can also have a drawback. Too often something can get passed along without context, which can change the entire meaning…or information can be widely shared that may not have a solid foundation underneath it.
In the coming months our Dance Wellness team will be putting together some solid guidelines for readers on how to go about evaluating dance medicine and dance wellness information on the Internet. They will share specifics on what to look for when searching for, and reading dance wellness info on the web.
We’ll also be compiling and sharing a list of reputable sites that you can go to for information in this field.
In the meantime, our Dance Wellness editor, Jan Dunn, wanted to address some recent information that has been circulating around on social media about the use of ice for dance injuries to make sure that dancers know that indeed, the ice pack is still a useful tool!
This post is in response to discussions I recently became aware of online (primarily on Facebook) regarding the use of ice in treating injuries. Respected dance educators were advocating throwing away the ice pack, despite the many years where RICE (Rest / Ice / Compression / Elevation) has been advised, or more recently PRICE (Protection / Rest / Ice / Compression / Elevation).
I was not aware of any discussions, presentations, or articles on this topic in the dance wellness field – and so was cautious / skeptical, since some of what is seen or posted online is not necessarily true – or is not in line with current scientific / medical protocols. I started doing some research, and checking with various experts in dance medicine – including members of the 4dancers.org Dance Wellness Panel: James Garrick, MD; Moira McCormack, PT; Selina Shah, MD; Matt Wyon, PhD; Janice Plastino, PhD; Robin Kish, MA; Gigi Berardi, PhD; Emma Redding, PhD; Erin Sanchez, MS; and Nancy Wozny.
And what I learned is — well, please don’t jump on this particular bandwagon and throw away your ice packs!
Ice can clearly be overused, and when it is, it’s not good. It can damage the tissue it’s meant to be helping if it’s kept on too long. It is usually advised the first 48-72 hours after an acute injury (like an ankle sprain). Some of the sites online are advising not using ice at all are saying that because inflammation is the body’s way of healing, and they imply that to use ice is to stop inflammation. But ice treats the symptoms of inflammation, it doesn’t get rid of it. Ice and compression (more on that in a moment) can reduce the amount of initial swelling –which speeds the healing process– and this is the whole point of post-injury care.
Why Ice Can Be Helpful
Ice is also very useful for helping decrease pain levels –another major symptom of inflammation. So another good reason not to throw away that ice pack.
There is also the issue of “secondary hypoxic injury” – this refers to tissue not damaged by the primary injury (such as the ligaments directly affected by an ankle sprain), but nearby, which can become damaged as a direct consequence of the physiologic response to the primary injury. Ice can slow down these metabolic processes and therefore save some tissue.
How to Use Ice
When you do use ice, go for at least 10 – 15 min. on a new injury (or until the area is numb, which vary slightly depending on how muscular or bony the area is), allowing at least 20 min. before re-applying. Try to go for at least 5 min. minimum on not-so-new areas, if you can’t do the full 10-15.* You have to also always be sure you have something between you and the ice itself – most icepacks come with a fabric covering, and that works fine. You just don’t want to put ice directly on the skin, without something to protect it (think “freezer burn”!). Never use heat on a new injury.
Now, let’s briefly go over Compression. Most people interpret this as (for example) wrapping an Ace bandage around a sprained ankle. Yes, all well and good – but, as Dr. James Garrick, MD (one of the founders of both the sports medicine and dance medicine fields) points out:
“The ‘hollowed out’ areas posterior (behind) the malleoli (ankle bones, on both inside and outside of the joint) and anterior (in front of) will have NO compression at all (with an Ace bandage), and those structures (the ligaments that were actually injured) will actually be encouraged to swell more.”
What is needed instead is focal compression (directly on those “hollowed out” areas)—which moves the bleeding away from the areas injured. Dr. Garrick gave the example of a dancer whose sprained ankle was treated with this protocol, and “the ankle actually looks like an ankle, not the polish sausage one sees if just an elastic wrap is used.” He noted that this dancer was able to walk with nearly full ankle motion 24 hours after the injury.
Some of the dance medicine medical and scientific colleagues (and non-dance as well) whom I contacted on this Ice / No Ice question, gave some pertinent thoughts that are worth passing on:
“There is no research that counters the practice of using ice to reduce swelling. On the contrary, there are studies that do show the benefits of ice as well as NSAIDS. Not using ice is not standard of care in sports medicine, and I don’t know of any research in dance medicine.” (orthopedic MD who specializes in sports and dance medicine).
“The articles being referenced (in some online sites advocating no ice) need to be referenced to determine their quality – most research in this area is pretty poor. I am also a great believer in using our years of clinical experience (on the beneficial aspects of using ice)”. ( PhD researcher in Sports Physiotherapy).
“Until I see some really solid physiological studies, over time, that ice is detrimental and actually damages the tissues, I will continue to use it as part of my treatment protocols.” (long-time sports medicine physical therapist).
So in conclusion – I hope this article / advice from dance (and sports) medicine experts (who keep up with the latest research) will help clarify this for you, and as I said at beginning – please don’t throw away your ice packs!
Happy Nutcracker and Holiday Season! – Jan Dunn, MS, Dance Wellness Editor
*Please note that this time has been adjusted from the recommendation of 5 minutes, along with a clarification to make it more applicable to a variety of injuries
Editor Jan Dunn is a dance medicine specialist currently based on the island of Kauai, Hawaii, where she is owner of Pilates Plus Kauai Wellness Center and co-founder of Kauai Dance Medicine. She is also a Pilates rehabilitation specialist and Franklin Educator. A lifelong dancer / choreographer, she spent many years as university dance faculty, most recently as Adjunct Faculty, University of Colorado Dept. of Theatre and Dance. Her 28 year background in dance medicine includes 23 years with the International Association of Dance Medicine and Science (IADMS) – as Board member / President / Executive Director – founding Denver Dance Medicine Associates, and establishing two university Dance Wellness Programs
Jan served as organizer and Co-Chair, International Dance Medicine Conference, Taiwan 2004, and was founding chair of the National Dance Association’s (USA) Committee on Dance Science and Medicine, 1989-1993. She originated The Dance Medicine/Science Resource Guide; and was co-founder of the Journal of Dance Medicine & Science. She has taught dance medicine, Pilates, and Franklin workshops for medical / dance and academic institutions in the USA / Europe / Middle East / and Asia, authored numerous articles in the field, and presented at many national and international conferences.
Ms. Dunn writes about dance wellness for 4dancers and also brings in voices from the dance wellness/dance medicine field to share their expertise with readers.4
Aloha! I would like to share with you a new book in the Dance Wellness field, “Dance Science: Anatomy, Movement Analysis, Conditioning” by Gayanne Grossman, PT. Specific Information on the book is below.
Gayanne has a long background in dance medicine and science, working with injured dancers and teaching anatomy / kinesiology at Muhlenberg College in Allentown, PA, as well as heading up the Performing Arts Wellness Program for Lehigh Valley Health Network. The book is aimed at high school / college-level dancers, and is a terrific resource for those looking to dig deep into the scientific arena, and to stretch their knowledge about the body and safe dance training / technique. It can also serve as an excellent scientific reference manual to keep on hand. Please pass it on! Take care – Jan Dunn, MS, Dance Wellness Editor
For students of human movement, kinesiology, dance science, and dancers, Dance Science takes a positive approach to what a dancer can do to dance better through an understanding of anatomy and an analysis of movement which, in turn, will decrease injury rates. It presents anatomy and motion in a dance-specific way that teaches readers to appreciate and take ownership of their bodies through hands-on experiential activities.The book concludes with an approach to exercise design for enhanced performance integrating the principles of dance science. Accompanied by 90 anatomical illustrations, 30 photographs, and 3 graphs.
320 pages, 7″ x 10″, Paperbound, ISBN 978-087127-388-8 $49.95
Hardbound ISBN 978–087127-387-1 $39.95
Order from: Princeton Book Company, Publishers
Here is an excerpt from the text:
Training Efficiently and Safely for Needed Stability
Start strength training using isometrics. Use varied positions and joint angles. They will facilitate motor learning in many positions.
For example, your hip joint hyperextends; the femoral head abuts the Y ligament well past normal hip extension. You do not gain stability from it soon enough. Your pelvis may be in posterior tilt before your femoral head stops moving forward. Compare with a dancer whose femoral head stops at the Y ligament with minimal hip hyperextension: this dancer feels stable because the lumbopelvic and hip alignment are closer to neutral at end range hip extension. The hypermobile dancer needs extra training to know how to feel where that position is located. Begin with isometric holds, focusing on femoral head placement. (See Stork Stand and Weight Shift exercises later in this chapter.)
Strength train hypermobile dancers with isotonics, too. Use in the inner ranges (smaller movements) at first then increase the range of motion. Here is an example:
Begin standing at the barre and resist the first few inches of hip flex–ion, then repeat for hip abduction, adduction, and extension. When improvement is noted, increase the range of motion another inch or two. Tie one end of a light-weight exercise band to the barre and the other end to your ankle. Because hypermobile people may gain strength at a slower rate, increase the resistance when you are able to.
Include proprioception training in standing, sitting, or pushing up on stable, then unstable, surfaces to increase the awareness of joint position. Include slower combinations to facilitate correct postural control. Should hypermobile dancers stretch? Not too much. Dancers love to stretch so this behavioral change can be a challenge. Hypermobile people have a lot of stretch and they have decreased proprioception. They have to stretch quite far to feel end-range motion, sometimes into an extreme range of motion that may not be safe. These dancers are looking for feedback from the joint receptors and an enormous ROM may be necessary to stimulate these receptors in a hypermobile person.0