Our 'turnout' turns out to be fixed

INTRO

     Ballerinas value their turnout, and many schools that audition children check if they have the "perfect" turnout to determine their potential to become a professional dancer. Some ballet documentaries show teachers sitting on top of the hips of teenagers in attempt to increase their hip mobility, but it is very painful to watch as students cry and scream for help. Is it necessary? Can everyone obtain a perfect turnout?

Svetlana Zakharova with her perfect 180 degrees split

"CORRECT" TURNOUT

     The "correct" turnout is considered a 90 + 90 degrees rotation of the legs combining to form a 180 degrees perfect straight line. However, this anatomically and biomechanically uncommon. The femur cannot turn 90 degrees: usually, the hip rotates 58%, and the knee rotates 42%. As dancers compensate the lack of turnout at the hip by increasing the turnout in the knee, they increase the risk of knee injuries by pulling the ligaments and compressing menisci. 




CHARACTERISTICS OF THE JOINTS

     The factors that determine the joint range of motion are the articulation of joints, ligaments, tendons, areolar tissue, the length of muscle tissue, and the response from stretch receptors. Surprisingly, muscle tissue only accounts for 10% of the joint flexibility. The first four that were listed previously accounts for 85% of the flexibility, and they are hereditary. However, the response from the stretch receptors can be manipulated. When muscles are stretched too quickly or too much, these receptors activate to tell the body to contract the muscles to avoid muscle tear. These receptors can become sensitive. By using PNF stretching techniques, we can suppress the activation to stretch muscles. 

      Most dancers are already flexible in terms of the muscles around the joints. What many dancers want to manipulate is the hereditary aspect of the flexibility, but training to obtain greater flexibility seems to have no effect. A study on elite-level teenagers showed clinically insignificant increase in their turnout. However, they saw slightly greater increase in younger teenagers than the older dancers. Still, there is too little evidence to support flexibility training to increase turnout.




SKELETAL INFLUENCE TO JOINT RANGE OF MOTION

     The hereditary influence to the turnout has 4 factors: orientation and depth of acetabulum, shape of femoral neck, degree of femoral version, and degree of tibial version. 

• Orientation and depth of acetabulum

          Acetabulum is the "socket" in the ball-and-socket joint in the hip. When the socket is deep, they would be able to hold on to the femur tighter, thus more stable. The degree of turnout is increased if this acetabulum is shallow, therefore allowing the head of femur to gain more range of motion. Greater turnout also shows acetabulum that point outward instead of pointing forward. 

• Shape of femoral neck

          Femoral neck is referred to the portion of femur that attaches to the hip. The head of femur directly attaches to acetabulum, and the neck extends to the shaft of the femur. The turnout is increased when the neck of femur is longer. The length of the neck allows the femur to move around without bone-to-bone contact with the hipbone. 

• Degree of femoral version

          The neck of femur sticks out at different angles in everyone's femur. As you can observe in the picture below, when the femur is laid down, the head of the femur on the left points sideways (retroversion), whereas the head on the right side pints upward (anteroversion). This effects he range of motion in the hip joint. Greater turnout means greater retroversion of the femoral neck. 

• Degree of tibial version

          Similar to the femoral version, tibia also attaches at a different angle. Usually, when your knee is extended straight, tibia shifts sideways to "lock" the knee into position. The greater the angle of tibial version, the greater the turnout. 

CLOSING REMARKS

     Although muscles account for only 10% of the joint range of motion, you can lose flexibility very quickly if you do not stretch those muscles. Since 85% of the flexibility is hereditary, you should not stress out about your flexibility. The good thing about not being hyperflexible is that you are less prone to injuries because your limbs are attached to each other quite firmly. Most of my posts have something in common: work with what you've got. As you may know, doing a developpe with straight legs but slightly turned in hips is better than an ugly "turned-out" developpe. You are what you're born with, so instead of comparing yourself to others and hurting yourself, try to find the best way to compensate for the lack of turnout. 

References

Champion, L. M., & Chatfield, S. J. (2008). Measurement of turnout in dance research: A critical review. United States: J Michael Ryan Publishing, Inc.

Deighan, M. A. (2005). Flexibility in dance. Andover: J Michael Ryan Publishing, Inc.

Barre Exercises Are The Best Form Of Warm-Up

INTRO

I used to think barre exercises were so boring. I looked forward to center exercises and plowed through adagio. But if you think about it, those exercises and the order of the exercises have not changed, and remained somewhat identical through hundreds of years. Even professional dancers will not rehearse until they are done with the whole barre routine. 

Photo by Jim Stratford

Ballerinas were probably doing warm-ups right all along. Recent studies showed that what warm-ups in PE classes and athletic practices are not beneficial to the muscular power, body temperature, and many other things that needs to be happening during warm-ups. So let's dissect the routine and see how you can use barre exercises to your benefit.

Static stretching before exercise performance will not enhance power or reduce injury

     Stretching is believed to be an important aspect of warm-up since it increases the range of motion, but static stretching (staying in a stretching pose for an amount of time) in particular is being criticized over the past decade. Studies showed that static stretching would decrease movement explosiveness and speed, and supported the idea that dynamic exercises (involving continuous movements) have better effect on the body. Dynamic movement can raise body temperature, enhance muscle excitation, improve awareness of your body positioning and movement, and maximizes range of motion. 

     Barre exercises require you to move your whole body in a continuous motion, especially because the routine is done to music. Although dancers still incorporate static stretching, research shows that there are no negative consequences from static stretching followed by dynamic movement exercises. So engage yourself to those boring exercises, because it's definitely worth your time. 

The order of barre exercises are actually well-thought-out

     Plie… tendu… jette… leading all the way to grande battement. They didn't just put those sequences together. It's planned out! Starting from plie, we move joints in our legs. This movement squeezes synovial fluids into the joint spaces and makes sure that the joint movement is as smooth as possible. Tendu and degage starts the warm-up from the toes and ankles, leading to frappe and petit battement, which requires lower-leg motion and control. Moving up to the thighs, we do ron de jambe and ron de jambe en l'air. Adagio engages activities in large muscles in the thighs, which acts as a preparation to the dynamic, explosive movements in grande battement. What I just said was only about the legs. Think of what all of it does to the upper body and the core!

     The order of barre exercises are very beneficial for the preparation for other activities. In modern times, health and exercise assessments by personal trainers are done in sequences for similar reasons and objectives. No matter who the instructor is, and wherever you are, you will be warmed up at the end of barre. 

Side-alternating exercises make it easier for injured dancers

     There is an interesting phenomenon called the contralateral strength training effects. If a person does bicep curls on the right side only, a small effect can be observed on the left biceps. This information is important to injured athletes and dancers because being injured shouldn't stop you from reaching your goals. It should also not act as a set back. Post-injury rehabilitation would be necessary, but during the injury, training the uninjured side can help the injured side retain some of the mass and control. 

     Barre exercises switches sides and keeps alternating, which requires one piece of music to be played twice. Even if you are injured, move the uninjured side of the body. BUT, remember that rest is necessary for injury, and you should always listen to your doctor or trainer. If it hurts, stop. If the injury is making you compensate your body to form wrong posture, you can hurt yourself even more. My point is, some times, injuries act as an obstacle when you're preparing for auditions, competitions, and performances. Don't let that stress you. Use the contralateral strength training effects to your advantage during the barre exercises. 

END NOTE

Dancers blindly take barre exercises seriously without thinking the actual benefits of the movements. We are always desperate to find spaces to warm up. Even if there are no barres, we put our hand on a wall or hold on to a chair: we know that it's important. I hope that the information I listed above help you understand the benefits of the exercises we value so much. Keep in mind that this is just the three things that pops into my mind, so if you can think of other benefits, let me know!

REFERENCES

Carroll, T. J., Herbert, R. D., Munn, J., Lee, M., & Gandevia, S. C. (2006). Contralateral effects of unilateral strength training: Evidence and possible mechanisms. Journal of Applied Physiology, 101(5), 1514-1522. doi:10.1152/japplphysiol.00531.2006

Daniel Craig Bishop, & Geoff Middleton. (2013). Effects of static stretching following a dynamic warm-up on speed, agility and power. Journal of Human Sport and Exercise, 8(2), 391-400.

Faigenbaum, A., & McFarland, J. E. (2007). Guidelines for implementing a dynamic warm-up for physical education.Journal of Physical Education, Recreation & Dance, 78(3), 1-1.

The Not-So-Obvious Differences Between Hip-Hop and Ballet

INTRO

     When I was dancing ballet, my teacher had animosity towards hip-hop for its lack of construct. But it was common for ballerinas to quit ballet to dance jazz or hip-hop instead, and ever the other way. It wasn't until college when I met different dancers who taught me how wonderful and exciting other genre of dance are.

Tamara Rojo and Urban Dance School dancers

     Ballet and hip-hop are considered to be on the opposite sides of the dance spectrum. Not many people can dance both genres (unless you're Alex Wong). In my opinion, Step Up was the ONLY movie that succeeded in collaborating both genres. LXD (the Legion of Extraordinary Dancers) is also very good at collaborating different genres on stage. 

     The difference in ballet and hip-hop is very obvious. But WHAT is the difference? In this post, I have listed points that came up during a conversation with a b-boy. (Note that these points are from a ballerina's perspective. Some points may not apply to choreography/commercial hip-hop)


OVERVIEW

     Ballet has a history of more than 300 years. This form of dance was originally for royalties and people of high socio-economic status. On the other hand, hip-hop became popular in the late 1970's, but derived from earlier dance styles. This form of dance started amongst communities of low socio-economic status. Hip-hop dancers experience injuries in both lower and upper extremities (especially breakdancers), as opposed to the majority of lower extremity injuries in ballet. The setting of hip-hop is moving from streets to studios, as the current industry require fast acquisition of choreography for performances. Hip-hop is a growing industry as it is now implemented in communities as a youth-program. Some hip-hop dancers seek to incorporate ballet techniques for individuality and core strength. Ballet is now adapted as exercise (i.e. Pure Barre, Ballet Beautiful, etc.) for weight-loss. 

THE PURPOSE OF DANCE

      Ballet: Dancing is a discipline. Dance is being able to show grace through the formation of lines with one's body, and being able to accomplish highly technical skills without seeming to be working hard. Dancers need to replicate dances as precisely as possible. The importance of playing a role is to research and stay in character. If you stop taking classes, you stopped dancing. 

     Hip-hop: Dancing is a way of expression. Dance shows personality. Replicating dance is "biting," so dancers have to come up with one's own styles and moves. Dancing is about acquiring new skills and taking it to the next level. Once a dancer, always a dancer.



COMPETITION

     Ballet: You will see 10 or less different variations. Competitions rarely incorporate self-choreographed pieces. Results are announced after each round of competition. Individuality is important to highlight whether you're a good jumper or a good turner. 

     Hip-hop: Stereotypically battles. Each dancer is compared to the opponent. Results are announced on spot. Usually improvisation to music of the DJ's choice. Individuality and technicality is important for expression within a given amount of time. 



CLASSES AND PERFORMANCES

     Ballet: Focus on precision. You will stand out if you're doing something wrong, and that's bad because no one will even look at you. Class structure is usually barre-centre-choreography. 

     Hip-hop: Focus on individuality. You will not stand out if you're doing what you're told. Your take on music and cool improvisation will get you attention. Classes are not necessary for street styles. Class structure is usually warm-up, then choreography/practice.



PROFESSIONAL LIFESTYLE

     Ballet: Aspiring dancers hope to join a ballet company. Secured job but low salary, and threat to lose position after every seasons. Many teach on the side. Training can start as early as 3 years old, and some dancers seek for apprenticeship and professional training programs away from home. Retirement can be around mid to late 30's.

     Hip-hop: Aspiring dancers hope to have TV/film appearances, or as background dancers for artists, or as teachers. Less job security, but with the right opportunity, payments of each performances can be adequate or more than adequate. Many teach in studios and guest perform at shows and competitions, or work as full-time in other industry. 



DANCING IS DANCING

     It is interesting to see the differences, but regardless of the dance values and cultures, they are both considered "dance." Personally, the most interesting aspect to realize was how "boring" ballet is considered to be because there is no improvisation. I had always thought ballet was a form of expression, but how do you express yourself without your own choreography? I recently attended to watch dance battles, and it is exciting. I found hip-hop to be like a conversation where dancers express, and the audience replies with reactions to each moves they liked. Ballet will always be in my heart. But I really want every dancer to experience different dance cultures and not shut them down, because they all have a lot to offer.

     Recreationally, it keeps you physically and mentally healthy. So, researchers have been trying to determine the best form of dance to teach in physical education class, but it is important to know that there is no best form of dancing. Art, in general, is a tool for self-expression. Ballet and hip-hop, the two extremities in the dance spectrum, make this form of expression unique and diverse. 


    Did I miss anything? What do you think is the difference between ballet and hip-hop?
REFERENCES

A community-based hip-hop dance program for youth in a disadvantaged community in ottawa: Implementation findings. (2010). Health Promotion Practice, 11(3), 61S-69S. doi:10.1177/1524839909353738

Ojofeitimi, S., Bronner, S., & Woo, H. (2012). Injury incidence in hip hop dance. Scandinavian Journal of Medicine & Science in Sports, 22(3), 347-355. doi:10.1111/j.1600-0838.2010.01173.x

When are adolescent dancers ready for pointe shoes?

…That is probably the ultimate question for every young girls that dance ballet. "When do I get my first point of pointe shoes?"

© 2011 Oliver Endahl 

INTRO

     Personally, I got my first pointe shoes when I was in 3rd grade. Some dancers brag about how early they got to start wearing pointe shoes. Yes, I did get a head start, but now I am permanently injured. When I was in 5th grade, I felt a pain in the middle-side of my foot. To this day, a bone called navicular in my foot is poking out, and I never saw a doctor for this problem. 

Most ballet teachers look at 3 factors to determine if the dancer is ready to be on pointe:

• Chronological age:  The average age is 12, and the range can be between 9 and 15 years old
• Years of training:  Usually around 3-4 years of ballet training prior to acquiring pointe shoes
• Range of motion in the ankle:  Studies showed that ballerinas have 10 degrees larger range of motion than non-ballerinas. Apparently, the narrower the range of motion, the more chance you can get pointe shoes related injury. 

But here's the problem. Chronological age and maturation age are very different. And, between age 12 and 14 is when the growth spurt occurs dramatically. The strength, flexibility, and proprioception (how you know where your limbs are) is distorted, and adolescents have to constantly adjust to the maturing body. In adolescents, parts of bones are weak because the epiphyseal plate (which is a layer of cartilage in a bone for growth) is not calcified (solidified) yet. That is probably why my foot is not in the right form. The rapid changes raise safety concerns for dancing on pointe, and the years of training isn't a good enough way to determine how ready you are. 

THE TESTS

     Some researchers decided to seek for more objective way to determine if a dancer is ready. So what is it to be "ready"? Ready is to have dynamic trunk control, neuromuscular control of the lower extremity (like legs, ankles), and the alignment of the lower extremities. Using already-existing performance tests, researchers worked with ballet teachers to decide what would be a good predictor for readiness. Here are the 3 tests:

• "Topple" test

          In this test, a student has to perform a single pirouette en dehors from 4th position. A passing test is when she is able to perform the pirouette with supporting leg fully extended, the other leg in full retire (aka passé), and maintaining a vertical alignment and a controlled decelerating landing.

• Airplane test

          Trunk pitched forward, other leg extended back, and keeping the pelvis square to the ground, a student has to perform a pile with one leg and touch the floor with fingers. A passing test is when 4 out of 5 plies are done with aligned supporting lower extremities.

• Single-leg sauté test

          Considered the most useful, this test is when a student jumps (or sauté) on one leg while maintaining an upright and stable trunk, neutral lower extremity alignment, proper toe-heel landing, and fully extended knee and pointed toes in the air. A passing test is when 8 out of 16 jumps are properly executed. 

          By using these tests, teachers can easily see if the dancer's body is built for pointe shoes. Keep in mind that flexibility, strength, and control are the necessities for dancing on pointe. 

LOOKING AT THE LONG TERM EFFECTS

      My friend told me that when she went to a doctor to seek treatment for her foot, the doctor replied, "It's hard to treat this, or tell you to stop dancing on pointe. Humans are just not build to be on their toes." And that is true! Since it is definitely not normal, you need to pay close attention to the body and stay attentive to all injuries when dealing with adolescents. I still get some pain in the winter when my foot gets cold. Puberty is such a fragile time for the body, so giving a huge impact on its maturation can cause damages, like my foot. It is important for dance teachers to know how to assess dancers for pre-pointe screening. Long-term health of a dancer is more important than getting a head start on the pointe training. It is also important to acknowledge that everyone's time of readiness  is different. Build your body. Become ready. Then you can start dancing unnaturally, like on pointe. 

REFERENCES

Meck, C., Hess, R. A., Helldobler, R., & Roh, J. (2004). Pre-pointe evaluation components used by dance schools. Journal of Dance Medicine & Science, 8(2), 37-37.

Richardson, M., Liederbach, M., & Sandow, E. (2010). Functional criteria for assessing pointe-readiness. Journal of Dance Medicine & Science : Official Publication of the International Association for Dance Medicine & Science, 14(3), 82-88.

My Experience As A "Fat" Ballet Dancer

INTRO

     I recently read a beautiful and inspiring article on Misty Copeland about her body struggles and how it affected her career as a dancer.  Copeland is an African American ballerina, who has a body figure that is untraditional to the ballet stereotype. This article made me reflect on my life and my body struggles. I would like to share you my experience as a "fat" dancer. 

Misty Copeland, photo by Gregg Delman

MY EXPERIENCE

     I danced mainly in Japan alongside many skinny Asians. I was often referred to as "that fat girl" by my ballet teacher.

     However, I was able to land a lead role in Don-Q's 2nd Act for our recital when I was 15. A year later, I made through the corps de ballet audition for Japan Ballet Organization's production of Swan Lake. I started to eat a normal breakfast, followed by an apple for lunch, and a small portion of food for dinner. I lost weight, but not as much. I wanted to look like the other girls, but I couldn't. 

Myself (2nd row, middle) as a swan, from Swan Lake (2009)

     Swan Lake rehearsals were a nightmare because I was the "fattest" girl out of 50 other dancers… including male dancers.  Being 164cm tall, weighing 55 kg, and having approx 21% body fat, I would normally be considered to have a normal body. During the dress rehearsal, we were given white tutus that were previously worn by a company of skinny women. It took two people to hook it on to my body, and when one of the costume tailor saw how tight it looked on me, she sent me to the head tailor, who simply said, "lose 2 kg by next week."

     I usually took my stress out on food. When I was in Boston for 5 weeks during the Summer Dance Program, I was under so much stress that I binged every morning and night in the dormitory cafeteria. Compared to other girls with female triad and eating disorders, you could say that I had a healthy life. But, I did go through some crazy moments where I would start feeling guilty, and sometimes cry, after drinking a bottle of juice or eating a bag of chips. My brother soon picked up on my behavior and started to finish what I started to eat so that I wouldn't feel bad about myself. 

     After switching to another dance studio and told the teacher that I want to get really serious about dancing, she nicely replied, "I don't think it's possible, but I would love to give you my full support. As a first step, you'd have to stop eating dinner." 
     
     That's when I realized that maybe, ballet is not for me.



THE BODY EXPECTATION IN THE DANCE-WORLD

     Let's look at the requirements to audition for dance companies in 2014: 

• The Saint-Petersburg State Academic Theatre of ballet of Boris Eifman
• Female: minimum 172 cm tall; Males: minimum 182 cm tall
• Aalto Ballet Theatre Essen
• Minimum of 182 cm tall
• The Polish National Ballet
• Female: max 175 cm; Male: min 180 cm
• Cincinnati Ballet
• Females: max 5'7"; Males: min 5'9"
• Moulin Rouge (France)
• Females: min 175 cm (5'9"); Males: min 185 cm (6'1")
• Bollywood female dancer contracting in India
• Min height: 170 cm (5'7"); Min weight: 50 kg (110 lbs)
• Prague Chamber Ballet
• Males: min 170 cm

     With these height requirements, companies would most likely hire female dancers if they weigh around 110-120 lbs. Although this is not always the case, but there are more companies that set height requirements. 

     It is known that ballerinas have significantly lower body mass index than the normal population. In a study of 30 female dancers between the age of 15 to 19, nearly 50% were found to be underweight. Meanwhile, another study showed that ectomorphic (long and thin) body structure with low body fat percentage was linked to injury. Regardless, tall and skinny will remain to be an ideal body shape in ballet.

     Why will it remain like that? Because schools tend to produce and reproduce these ideal bodies of "almost skeletal, hyper-flexible, ephemeral bodies" to fit to the audience's expectations. A 4-year qualitative study on 12 young dancers revealed the process of these adolescents accepting these ideals and strive to achieve the audience's expected bodies. 

     But get this: a study on ideal ballerina body size, results showed that the audience's expectation of ballerinas' body shape is different than that of professional dancers and students. 

SOME THINGS CANNOT BE CHANGED

     About 80% of your height is controlled by genetics. Genetics also controls more than 50% of bone density and lean muscles.  We can all go to the gym and work out as hard as we can, but you can only change yourself to a certain point. 

     So what's my point?

     I believe that it is unhealthy to put yourself into a situation full of people that does not appreciate you. Fitting yourself into an ideal expectation might be necessary in the dance world and other professions, but there are some genetic factors that will prevent you from reaching towards the goal. But, Misty Copeland found a place where she could shine. If you can find a great support system and environment like her, you might be able to accept yourself and move on. 

     For me, I had to step away from ballet, and it worked out great for me because I feel healthier than ever. Other "fat" dancers stuck around, and it turned out great for them. Some majored or minored in ballet in college, or picked up another genre. It's all about your mindset. 

     So what do you think? And what was your struggle like?


REFERENCES

Mihajlović, B., & Mijatov, S. (2003). Body composition analysis in ballet dancers. Medicinski Pregled, 56(11-12), 579.

Pickard, A. (2013). Ballet body belief: Perceptions of an ideal ballet body from young ballet dancers. Research in Dance Education, 14(1), 3-19.

Silventoinen, K. (2003). Determinants of variation in adult body height. Journal of Biosocial Science, 35(2), 263-285. doi:10.1017/S0021932003002633

Seeman, E., Hopper, J. L., Young, N. R., Formica, C., Goss, P., & Tsalamandris, C. (1996). Do genetic factors explain associations between muscle strength, lean mass, and bone density? A twin study. The American Journal of Physiology,270(2), E320-327.

Twitchett, E. (2008). Body composition and ballet injuries: A preliminary study. Medical Problems of Performing Artists,23(3), 93-98.

Young, C. C., Subramanian, R., Niedfeldt, M. W., Guse, C. E., Hoch, A. Z., & Raasch, W. G. (2001). Ballet dancers & audiences: Their perceptions of body image. Medicine & Science in Sports & Exercise, 33(5), S96. doi:10.1097/00005768-200105001-00543

Break A Leg?: An overview of ballet injuries

INTRO

Let's talk about injuries...

Photo by Corbin Smith / thegridto.com

     It may be safe to generalize that high-level athletes and dancers rarely take a break after an injury. Resting can cause you to lose your spot/job; therefore, professionals tend to dance around the injury. From my experience, I realized that dancing with injury was thought to be cool and something to be proud of. It may make them look tough and strong, but the truth is, their body is deteriorating. There are dancers that retire at age 38 -- or younger -- because their body was "worn out" by ballet. 

     That's why, every dancers, directors, and management should know that the proper care for injuries is essential to have a long-lasting career and healthy "employees." Now a days, athletic trainers and physical therapists are pushing harder to persuade companies to hire more professionals to monitor each dancer's injuries.
    


INJURIES IN BALLET
     
     A study on 52 professional dancers in a ballet company recorded all of the injuries over a period of one year. They recorded 355 injuries (mean of 6.8 injuries per dancer) just in one year!! There were: more overuse injuries than traumatic injuries; many lower leg, ankle, and lower back injuries; and most injuries occurred during classes and performances compared to rehearsals. They analyzed that many injuries came from jumping, but since there were more ankle/lower leg injuries in females than males, we can probably assume that pointe shoes play a role in some injuries.

     That study was about adult professionals. Now, let's look at younger dancers. More than a decade of medical records were examined from 476 students in Sweden. 438 injuries were recorded (remember, some injuries can be left unreported), the incidents increased with age, and 76% of the injuries occurred in the lower extremities. The most common traumatic injury was ankle sprains, and tendonitis in the foot was the common overuse injury.

     Ballet injuries in professional dancers were 4.44 per 1000 dance hours. Football injuries was once recorded as 3.5 per 1000 hours played (regardless of its severity). Newer data shows higher numbers in other sports injuries, but my point is, there's a lot of injuries in ballet (and it's not even a contact sport), and it's rarely looked after. 



MANAGE? OR PREVENT?

     I've been stressing that injuries have to be taken care of. But we can't forget that we need to prevent injuries. In one company, 309 injuries in 3 seasons cost $398,396 from worker's compensation insurance (an average cost per injury was $1289). Apparently, this number is similar to that of an athletic team, but remember that ballet companies do not get a lot of funding… 400,000 dollars is a lot of burden. 

     So how do we prevent it?
     There was an interesting study that looked at the difference between Tae-Kwon-Do and ballet. The reason behind this is that ballet and tae-kwon-do uses similar powerful motion and muscle mechanisms. Since there is less injury reporting in Tae-Kwon-Do, they believed that if they compared the two forms of activity, they might be able to find a way to prevent overuse injuries in ballet. Turns out, Tae-Kwon-Do athletes have higher risk of injury when they looked at kicks. 
     From more analyses, they predicted that we could possibly reduce injuries by: reducing the frequency and duration of repetitive movements, allowing enough repair time for recovery (rest!), and incorporate targeted strength training on small muscles involved (take barre exercises seriously!). 

     Other studies points out the different types of floor laid out on the stage and studios. If they're not used to the floor, rehearsing in different venues might raise the risk of injury. 



END NOTE

     There are many ideas about risks and prevention, but I realized that it's really hard to pin-point what causes injury in ballet. On top of that, different types of injuries have different causes and mechanisms of injury. But let me assure you that researchers are looking for answers. There are people working for you so that you won't get hurt. As for now, when you get injured, go to a health professional, and actually listen and do what they tell you to do because to everything they say, they have reasons to back it up. I am looking into focusing on injuries for prevention and management, so stay tuned for that if you're interested.



REFERENCES

Allen, N., Nevill, A., Brooks, J., Koutedakis, Y., & Wyon, M. (2012). Ballet injuries: Injury incidence and severity over 1 year.The Journal of Orthopaedic and Sports Physical Therapy,42(9), 781.

Garrick, J. G., & Requa, R. K. (1993). Ballet injuries. an analysis of epidemiology and financial outcome. The American Journal of Sports Medicine, 21(4), 586.

Leanderson, C., Leanderson, J., Wykman, A., Strender, L., Johansson, S., Sundquist, K., . . . Medicin. (2011). Musculoskeletal injuries in young ballet dancers. Knee Surgery, Sports Traumatology, Arthroscopy, 19(9), 1531-1535. doi:10.1007/s00167-011-1445-9

Shan, G. (2005). Comparison of repetitive movements between ballet dancers and martial artists: Risk assessment of muscle overuse injuries and prevention strategies. Research in Sports Medicine (Print), 13(1), 63-76. doi:10.1080/15438620590922103

Stableforth, P. G. (1990). Sports injuries. Injury, 21(5), 311-313. doi:10.1016/0020-1383(90)90049-Z

Wainwright, S. P., & Turner, B.S. 'Just crumbling to bits'? an exploration of the body, ageing, injury and career in classical ballet dancers. (2006). Sociology,40(2), 237-255. doi:10.1177/0038038506062031

Why do ballet dancers smoke?

INTRO

Since my dance specialty was ballet, I will be talking about ballerinas and ballet dancers, but I am sure that dancers of other dance genre smoke, too.

http://25.media.tumblr.com/tumblr_lk4flltyxw1qb11dro1_400.jpg

I have seen many dancers smoke during their breaks. When I ask them why they smoke, the popular responses were: 
     "Because I'm stressed" and "I'm trying to lose weight"

One of my dancer friend from a prestige ballet school in Japan also smoked. As he complained about the price of cigarettes in the States, he explained, "my teacher is very strict and borderline abusive. In my studio, kids start smoking at age 14 to deal with the stress." 

Let's look at their reasons and break it down…

• "Because I'm stressed"

     There has been studies that explained that smokers are more stressed than nonsmokers. However, these findings were challenged since smokers could have started smoking because they were stressed. BUT, there are sources that suggest that smokers are stressed because they are experiencing withdrawal to nicotine, and smoking relieves the stress because they intake nicotine again, suppressing the withdrawal. 
     So, if you think about it, it's better for you not to start smoking… ever! You will be adding stress to your system.

• "I'm trying to lose weight"

     Many ballerinas believe that smoking kills appetite. Since body shape can determine if you get to keep your job as a dancer or not, it is understandable for them to cling on to anything they believe would help them lose weight and keep them skinny or well-defined. 

    One study published in 2005 monitored weight loss and appetite on mice after smoking cigarettes. On the first day, the mice ate less. On the second day, the weight loss became evident. Smoking also decreased plasma leptin (hormone that tells you you're full) by 34%. So… I guess it works?

BUT WAIT!!!!

Is it actually worth it?

WHY DANCERS SHOULDN'T SMOKE

Now, I'm not going to bore you with a bunch of facts your high school teachers or D.A.R.E. told you in health class. But I will give you reasons why you shouldn't based on what you actually need to be able to be a healthy dancer. 

• You need to breathe to dance, right?

     At least in ballet, breathing is essential not only to stay alive, but also to send signals to other dancers. The movement of the chest is big enough to be able be detected from meters away or even in the corner of their eyes. Why does corps ballet look synchronized? Why can partners move together in pas de deux? It's because they breathe.

     Now, as you may know, smoking can cause chronic obstructive pulmonary disease (COPD). This affects the way you breathe because then, you will be coughing more and you would have to work your muscles just to breathe during exercise. COPD can also make you feel tired. 

     So what kind of graceful dancer wheezes, coughs, and gets tired? 

• Your body won't be able to use Vitamin C

     One of many side effects of smoking is the change in the Vitamin C composition. Nicotine will manipulate Vitamin C so that the body will not be able to absorb, store, or use Vitamin C. You ate grapefruits for breakfast? That's nice. But if you smoke, you might as well just sniff it instead. 

     So why should you care about Vitamin C? People rarely get scurvy these days. 

     Vitamin C helps cells produce collagen and other protein fibers that promote elasticity and strength. Since skin has many fibers, this could explain the reason why smokers look old and wrinkly than nonsmokers. Why would any directors cast you when you look 10 years older for a character who's supposed to be 15, like Romeo and Juliet?  How your skin looks might not be your main concern since you can cake your face with makeup. But fibers make up many tissues in your body such as bones, cartilages, and ligaments. That means if you get injured, and you want to recover ASAP, you're relying on cells to lay fibers down on the injured site to repair damages. 

     No Vitamin C --> less fibers --> longer recovery. That can't be good for your career. 

SUMMARY

     The reasons I listed are not even the full list. There are many, many things that can go wrong. So next time, instead of smoking, or thinking of start smoking, remember that it's really not worth it. If you want a high-quality dancing career, I'd stay away from it. There are many things you cannot control, but what you put in your body is probably one of the few things you have control over. 

REFERENCE

Chen, H., Vlahos, R., Bozinovski, S., Jones, J., Anderson, G. P., & Morris, M. J. (2005). Effect of short-term cigarette smoke exposure on body weight, appetite and brain neuropeptide Y in mice. Neuropsychopharmacology : Official Publication of the American College of Neuropsychopharmacology, 30(4), 713-719. doi:10.1038/sj.npp.1300597

McCann, N., & Lester, D. (1996). Smoking and stress: Cigarettes and marihuana. Psychological Reports, 79(2), 366-366. doi:10.2466/pr0.1996.79.2.366

Parrott, A. (1994). Does cigarette smoking increase stress?Addiction (Abingdon, England), 89(2), 142-144. doi:10.1111/j.1360-0443.1994.tb00870.x

Parrott, A. C. (1999). Does cigarette smoking cause stress?American Psychologist, 54(10), 817-820. doi:10.1037/0003-066X.54.10.817

Parrott, A. C. (2000). Cigarette smoking does cause stress. The American Psychologist, 55(10), 1159. doi:10.1037/0003-066X.55.10.1159

PELLETIER, O. (1970). Cigarette smoking and vitamin C.Nutrition Today, 5(3), 12-15. doi:10.1097/00017285-197000530-00002