Today let’s look at some stretches that you could do to work with the side hip pops.  Let’s start with stretching out the back of the hip.  There are many different ways to work with the turnout and gluteal muscles, and I have shown you recently one of my favorite sitting stretches.  Let’s add another stretch into the mix and see if it works better for any of you.

  Begin lying down on the floor on your back, and crossing one leg over the other.  Lift your other knee up by grasping around the back of the thigh.  Now gently press the knee of the crossed leg away from your body (that would be the right leg in this picture) as you bring the left thigh slowly closer to your chest.

This is an active stretch.  You are actively contracting the turnout muscles on the right side, while you are stretching them by bringing the legs closer to your chest.  In essence, this is a variation on the sitting stretch that was demonstrated a few weeks ago.

It’s good to have many ways of stretching so you can figure out the best ways for you.  We aren’t all built the same – and what works for one person – doesn’t always for the next.

Stretching the muscles on the outside of the hip (the abductor) can be easily done inthe standing position.  The photo on the right shows the most popular way of stretching those lateral muscles.  I also encourage dancers to use a tennis ball or pinkie ball against the wall to release and massage those often tight muscles.

The muscle that usually needs stretching the most is that all important but now always acknowledged  turn-in muscle, the tensor fascia lata or TFL.  Curiously, this week I assisted 5 dancers in getting a good release and stretch of their TFL muscles and it was magical when they came back to standing on one leg.  They felt like they could stand up more easily and effortlessly and access their turnout muscles without strain.

To stretch the TFL – lets use the popular iliopsoas lunge stretch and then shift from stretching the front of the hip to feeling the stretch towards the outside of the front of the hip.  The picture on the left is stretching the front, and then as the dancers turn towards their front leg they can feel the stretch moving to the side and are now stretching the TFL muscle.  If you don’t feel a stretch in that area – no problem – typically means you aren’t tight there!  But if you do feel a strongish stretch it would be a good variation to add into your stretching repertoire.

These muscles aren’t going to change their tightness overnight – but you’ll know you are on the right track if you stretch (especially, the TFL) stand back up and see if there is any difference in your ‘popping’ action at the hip.  It will be a softer clunk – or perhaps not pop, click, snap, at all!  (Hmm…all of a sudden I have a sudden desire for rice krispies:)

I hope everyone has a glorious Thanksgiving week.  I am thankful and appreciative of having such a warm and welcoming dance community – thank you for being a part of my life!

Deborah

“Dance is the hidden language of the soul”  Martha Graham

The hip popping that is being shown in this clip is being caused by a tight IT Band snapping over the greater trochanter of the femur.  Huh?… what muscles/where are those spots you might ask?

The greater trochanter is the bump that is on the outside upper part of the thigh bone right before it angles in towards the center of the hip joint.

The IT Band, otherwise known as the iliotibial band, crosses over that area.  The iliotibial band is the fascial band that runs down the side of your leg that the gluteus maximus and the tensor fascia lata (TFL) muscles connect into high on the leg, and the band connects then to the bones below your knee.

The gluteus medius and minimus don’t connect directly into the iliotibial band, but their tightness creates an imbalance around the hip that may lead to this snapping or popping hip problem.

When there is excessive pull or tightness from one or more of these muscles the IT band will ‘snap’ or ‘pop’ over the greater trochanter when you lean into or stick your hip out to the side.  that is what you are seeing as the clunk in the clip.  It’s pretty impressive, huh?  I’ve been asked by dancers if they are dislocating something because it is disconcerting to have such a significant pop, snap, clunk… however you want to describe it.

The good news is…. you can work to decrease the tightness around the area and the clunking, popping, and snapping will diminish.  The other benefit to addressing this?  As you decrease the tightness your range of motion should improve and consequently make movements of the hip joint, like développé, battements, ronde jambe, etc. easier and more efficient.

Stay tuned… next week we will look at the 3 different muscle areas and I’ll give you ways to release each area!  Have a productive and joyful week!

Deborah

“Education is the key to injury prevention”

I know I’m someone that always looks at this muscle carefully when I am assessing someone’s standing alignment.  It is such a major postural muscle and so strongly influences how the pelvis sits on the legs that deserves some extra attention.  When overly tight it can pull the lower back into a swayback. When it is overly weak it makes it hard to get the leg much over 90 degrees.  The quadriceps which also are hip flexor muscles like the iliopsoas (or psoas as many people shorten it to) are working hard, but they simply don’t have the leverage to get the leg up as high as what is necessary for dance today.

I was recently in Seattle working with students from the Allegro Performing Arts Academy and showed them a way to inconspicuously strengthen their iliopsoas while sitting in school waiting for class to begin.  By the way…. these students were wonderful!  So curious, open, and willing to work hard to improve their technique by understanding how the body really works!

The picture below shows them sitting on the front edge of their chairs, with their arms folded in front, keeping weight on both sits bones (or ischial tuberosities as they are called)  Without shifting backwards on the pelvis, or over to one hip they lifted one leg up and then lowered it to just touch the toe to the ground before repeating it 10 – 15 times.  Didn’t take very long to feel that very deep ‘tired’ feeling deep in the front of the hip.  That’s like practicing lifting the leg into the beginning stages of a développé before extending the leg (of course without dropping the knee… at least that’s the goal:)

It’s such an easy way to work strengthening the iliopsoas, and then you can simply swivel around and do a sitting lunge stretch to release the tightness form the iliopsoas.

A different way of strengthening was shown in a previous post and I’d like to repost that video in the newer format for all those who had trouble opening it.  You can use a theraband wrapped around the thighs and then slowly working to come more upright to simulate doing an extension to the front.  Of course the more you are upright – the harder it is!  Remember to slightly turnout the leg when practicing these as well as doing them in parallel.  It won’t take long…. just 3 or 4 weeks for you to see and sense improvement in the control and height of your extension.

Have a great week!

Deborah

“Education is the key to injury prevention”

Today’s video blog shows you my new favorite way of stretching the turnout muscles.  No floor needed… just a chair:)  Makes it easy for a dancer to get a quick stretch in while at school or sitting at the desk.

Last week’s post on testing turnout got some great comments from dance teachers that you’ll want to check out! It’s great to hear from dancers ‘in the field’ so keep those comments coming!

Click the image below and you’ll be taken to the 4 minute video clip.

If you have questions please send them to questionsfordeb@gmail.com

See you next week when I explain the details of the tried and true clamshell strengthener!

Favorite Turn Out Stretch

Thanks, Jennet

Good question!  I’m going to answer via video… I learned how to insert pictures into the video to make it better…. I think I’m really going to like video-blogging!  Just click on the picture below – a new window will open up with the under 5 minute video answer.  Enjoy!

Deborah

“Education is the key to injury prevention”

]]> http://blog.thebodyseries.com/hips-knees/is-turnout-test-accurate/feed 14 http://blog.thebodyseries.com/hips-knees/knee-hurting-hamstrings-tight?utm_source=rss&utm_medium=rss&utm_campaign=knee-hurting-hamstrings-tight http://blog.thebodyseries.com/hips-knees/knee-hurting-hamstrings-tight#comments Mon, 03 Jan 2011 21:30:13 +0000 deborah http://blog.thebodyseries.com/?p=648 Reminder…. the New Year’s special ends in less than 48 hours!  (Through Jan. 5th) Just put TBS2011 into the coupon box to get the $45 off.

Onto the questions of the week….

I have just started dancing! I’m 18 years old and a freshman in college! Today during tap class I was brushing my left foot while hopping on the other. My hopping knee started to hurt a bit so I stopped. I read your article on pronation, and I used to wear little inserts occasionally to help with my feet, but that was in my early teen years and it wasn’t really monitored. My knees have given me trouble randomly throughout my life, and I’m starting to think the problem is with my knees not my feet. I am an aspiring actor who is taking dance to help get in touch with my body, and I don’t want to end up with a serious injury.

Any advice? Who should I go to? Should I wear inserts in my tap shoes? I don’t know what to do!
Thank you!
Laurel!

Congratulations on starting to dance – doesn’t it feel great!!  I want to say that I know dancers who went on to dance professionally – after starting in college – so it’s never too late!

I wouldn’t jump to putting the inserts into your tap shoes.  My first thought is that you probably haven’t been jumping on one leg very much and your quadriceps are weak.  It takes a lot of strength to do multiple jumps on one leg – no matter whether you are in tap class or ballet class.

Start strengthening by simply standing on one leg (in good alignment) and even weight on the 3 points of the foot.  Can you easily stand on one leg and toss a ball back and forth between your hands for up to a minute?  Then progress to standing on one leg and doing baby demi pliés. Watch for locking back into hyperextension when you straighten.  Just come up to straight, and go 2 – 3 inches into a demi plié.  As you build strength you can deepen your demi plié, but that take some time.

Single leg demi pliés are a simple but very effective way to strengthen the muscles around the knee!  Hope you get to take another dance class next semester!

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I am a 13-year old dancer and I’ve been dancing for 9 years, however I have flexibility problems.  The main thing that I feel is holding me back is my having tight hamstrings (although my hips, calves, and Achilles tendon are also tight).  It’s probably something hereditary, because my mother said she has had tight hamstrings all of her life and could never fix it.  Because of my tight hamstrings, I can’t get into my middle split, and it affects my developpes and grande battements in all the positions.  I was wondering if you had any suggestions on how to fix this.

Thanks! -Cailin

Tight hamstrings really plague a lot of dancers, Cailin.  They will affect your extensions – more than your middle splits.  (although they strongly influence regular splits)

I’m going to show you my favorite variation on hamstring stretching.  Place your leg on a chair or other surface that is below hip level. Gentlypress your heel into the chair while flexing forward at the hip joint.  Keep your pelvis square while flexing forward and keep pressing down on the chair throughout the entire stretch.  Go only as far as is comfortable and come back up.  Do the other side.

You may notice that this way of stretching feels different – you might feel the stretch over a larger area.  It is a dynamic way of stretching your hamstrings.  Do this stretch consistently for a few weeks and note the difference in your flexibility.   I’ve had dancers who haven’t improved with regular hamstring stretching begin to see a difference with stretching in this way.

Happy stretching!

Deborah

“Education is the key to injury prevention”

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I L O V E  your blog - and I have a question.  (I am a computer dunce and could not figure out how to put this question on your blog for an answer)

I recently worked with (I am a Pilates and movement instructor) a dancer with a significant leg length discrepancy – her left leg is 1.8 centimeters longer than her right (femur is .6 c longer and lower leg is 1.2 c longer) .

The left side of her tailbone often hurts as does her left inner thigh.  She dances quite intensively and is experiencing more and more subtle aches – especially across her sacrum.

Suggestions for working with her to address her leg length issue??????
Thanks so much,
Tara

Great question, Tara.  When working on the reformer I would do my best to even out her leg length by having her stand or work with one of the foam nonslip cushions.  Look at her standing alignment both without anything under her left leg and then with standing on a pad. Does her alignment improve?

If placing a pad under her foot allows the weight to pass more evenly down the spine, through the pelvis and into the legs – that’s a good thing!  It’s quite common to have the lateral curves of the spine straighten out with a pad under the foot and that’s when you know it is something that should be corrected all the time by placing a heel lift in their regular shoes as well as their soft slippers, jazz or tap shoes.  There isn’t much to do with a pointe shoe – but if she corrects the inequity the majority of the time, being on pointe shouldn’t be a problem.

Best of all – this dancer will intuitively know whether or not the lift makes her standing, walking and dancing feel better – and the ache across the lower back and sacral area should disappear.

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My name is Tina and I am a 23 year old dancer residing in New York… Anyways, I have a question my tendon in my left foot pops when I go into releve or point and flex sometimes… its not all the time but enough to be annoying… feels like the tendon is moving over the bone or something… Maybe the Post Tib tendon? Anyways, I do pronate and have orthotics but I don’t know how this happened one day I just woke up and it was popping.  It doesn’t hurt but I don’t believe popping is good because it will eventually wear on the tendon… I want to dance still… I’ve been doing some peroneal strengthening exercises and checking out my alignment in releves… I just dont know what else would help… if you have anything suggestions or feedback that would be great and thanks!

Tina – you are on the right track with checking your alignment and keeping yourself out of pronation.  That’s great that you have orthotics for your regular shoes.  You might try taping your feet for pronation while dancing to see if that decreases the popping (there just aren’t goodorthotics for dancing, unfortunately)  and I would also go to a good podiatrist that will take the time to massage and manipulate your feet if some of the smaller bones you see that make up the arch of the foot.

I have a dear friend who was a professional ballet dancer and went every few months to her podiatrist in Chicago to keep her feet in good shape.  She was one of those loosey-goosey dancers – that I lovingly admired for her turnout and extensions – but it did mean that she had more joint laxity and was prone to ankle problems.

You’re right to want to get on top of this – because it is a change from normal for you – and over time will create strain on the posterior tibialis tendon.

Good luck!

“Here’s to the bright New Year, and a fond farewell to the old; here’s to the things that are yet to come, and to the memories that we hold.” anonymous

Happy New Year!

Deborah

At nearly 50, I’m still teaching, taking class and performing with a small dance ensemble. I’m still in good shape but lately, past 3 months, have had knee trouble. MRI revealed a worn meniscus, inflammation and a twisted condyle (?) Doctor said I had an “old persons knee” and was headed for a knee replacement. is it possible to come back to dance again after knee replacement, if so at what level?

Thanks for your feedback.
Laura

According to the American Academy of Orthopaedic Surgeons, the simple answer is you can expect to get back to your pre-surgery level of activity but without the pain after an appropriate amount of time.  That amount of time will vary from person to person but generally full activity could take up to a year after surgery.

Now for my questions and response:)

I’d be curious (I’m always curious) whether you are having challenges with one knee or both knees.  If it is just one knee I wouldn’t have the surgery (or at least go back to dancing) until you figure out why that knee was being stressed more than the other.   Start gathering details about what you know about your dancing.  Is one 5th position easier than the other?  Do you have better turnout on one leg – a big preference when turning?  All of these clues help to determine what you may need to correct in order to

• slow down the degeneration
• prevent the same stressors from returning post surgery if you decide to have surgery

Most active people will show some signs of wear and tear at the knees – especially dancers.  (That is the way one of my favorite doctors put it to me – isn’t that better than saying you’ve got an old person’s knee?)

Wear and tear happens to a greater degree when the alignment of the knee or muscle balance is less than optimal.  The knee is truly at the mercy of what happens above and below it.  If there is rolling in at the foot, standing with hyperextended knees, or sitting into one hip – all of those common patterns will negatively influence the health of the knees over the long term.

We are never too old to make changes to our inefficient patterns and habits.  Being physically active is actually essential to the health of our joints.  The cartilage at the knee that covers the ends of the bones is avascular – meaning it doesn’t have it’s own blood supply.  It needs movement to help pump in essential nutrients and oxygen.  Have you ever noticed how quickly arthritis worsens in people who become sedentary?  We need to be concerned with  following the anatomical principles of the body in order to minimize potential damage to our joints.

I have always and will continue to believe that dancing is one of the best activities one could put their children into to because of the focus on alignment and muscle balance.  I also know that dance, especially some forms, have been taught by teachers who do not understand anatomy and are teaching the ‘it should look like this’ method.

Educating teachers and dancers to work with anatomical principles will still create the beautiful dancers – but without the lifelong physical consequences such as bunions and joint distortions.  And that is why I have created this newsletter and the educational products that are in my store.

My 2011 New Year’s special will run from today through January 5th.  Purchase Essential Anatomy: A Multimedia Course for dancers and dance teachers for $149 and receive either a free DVD – or – simply get $45 off one of the best tools for dance teachers to learn important anatomical principles.  Simply put TBS2011 in the coupon box when purchasing and hit apply in order to see your $45 discount.

Here is a review from a recent purchaser.

“Deborah’s Vogel’s “Essential Anatomy Course” is absolutely essential for every dance teacher wishing to optimize their teaching!  The course is composed of 10 video lectures with corresponding lecture notes and study guides making it easy for a busy studio owner/mom to find time to learn more about anatomy.  Ms. Vogel explains basic anatomy from a dance perspective and provides exercises on how to gain more strength and flexibility for demanding dance movements.  Information regarding Osgood Schlatter’s disease has proven particularly relevant as I am currently working with a student suffering from that disease.  Her teaching tips at the end of course are incredibly helpful and I will be sharing them with my faculty at our next meeting.  Thank you Deborah for creating this course for dance teachers!      ~-Kimberly McEachern, Huntington Academy of Dance

Hope your holidays are wonderful and wish all of you a successful 2011!

Remember to click here for the New Years Special and don’t forget to put TBS2011 in the coupon box!

Warmest regards and deep appreciation for being a part of my dance community…

Deborah

Here is my dilemma – I would venture to state that roughly 100% of the students over the age of 8 are forcing their turnout – most with rolling in the ankles, some with exaggerated anterior pelvic tilts, most way over crossing their fifth positions.  I don’t allow any of those things in my classes, and am using several of your books to educate these young dancers so they can have a successful and safe dancing experience.

How do I help these students survive in other teachers’ classes?

If you do post this question (and I hope you will as it is vitally important) could you please make me “Anonymous”?  I don’t want to cause problems at this school as I think the students need me there.

Thanks!

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This is an excellent question and a common problem.  It is challenging to fix, though, if the teachers are encouraging the students to stand overly turned out – and it is also challenging because sometimes the students are the ones that are pushing their turnout because they want to ‘look good’.  I am going to focus my answer on what you can do with the students rather than trying to change the other teachers.  It’s really hard to create change in another teacher’s teaching methods especially if you don’t have the support of the studio owner.  You and I know that teaching ballet to young students using anatomical principles while encouraging the joy of dancing is very challenging!

The one exercise to illustrate how much functional turnout a dancer is working with is the clamshell exercise.  I’m going to add a variation on here for the younger dancers.

Have them on the floor, lying on their side with their buttocks touching the wall and their spines lengthened along the wall and their knees bent with their feet in line with their hips.  Being up against the wall will give them feedback whether they are rolling on their hip.  Then have them do the clamshell exercise and keeping the feet together open and turnout the top leg.  How far could they go?  So many dancers are hardly getting above 45 degrees!  It’s strange but true that I will find dancers who have more turnout at their hips than what they are able to functionally use in movement.

So that is the first focus I would offer to your students.  Develop the strength at the hip joint to accurately use their turnout.  After doing the clamshell exercise, make sure to tell them to stretch the turnout muscles!

Next I would encourage the students to practice barre without the barre.  It is much harder to over rotate when you aren’t gripping the barre.  Have them do that barre in stocking feet rather than soft slippers.  They may be able to feel the weight on their feet more easily and hopefully self-correct to bring the weight evenly on the pads of the big toe, little toe and heel.

Last suggestion I would have is to impress upon them to focus on their movement, rather than their positions.  This is a hard concept to get across because so many budding ballerinas are looking at pictures of a gorgeous dancer in a magnificent poses.  To help them focus on their movement I would have them begin to play with qualities.  Ask them to exaggerate what moving with tension and using all of their muscles feels like.  (this is commonly what they are doing☺ )  Then ask them to move gently, slowly, without any sharpness to their movement.  Try giving them different imagery to help.  A rubber band when stretched slowly won’t snap – but if it is stretched too quickly it may break or snap back.   Explore how a feather floating on the wind moves… and bring that into their demi plies or tendues.  Experiment with many images, including contrasting ones as well.

The goal is to have them thinking and feeling in new ways about their dancing, which in turn will give them better feedback encouraging them to more easily create changes in their patterns.  Perhaps a back door approach – but you never know what is going to create an aha moment.

I’d like to open up this conversation to other teachers…. What do you do to help young dancers use their turnout effectively and efficiently, and most importantly – safely?

Post your comments in the boxes below!

Have a great week!

Deborah

“Education is the key to injury prevention”

Sincerely,
Josh

Unfortunately, Josh, you can’t undue the tibial torsion once you have it – but it doesn’t have to stop you from dancing. You do, however, need to focus first and foremost on keeping the weight even between the 3 points of the foot, the pads of the big toe, little toe, and heel. The knees will not be over the middle of the foot as we so often hear in dance class. For the dancer with tibial torsion if they pull the knees out to get them over the middle of the foot they are doing it by supinating the foot or overly using the sartorious muscle to pull the knees out to the side. Then you’ll have more problems than just pulling the knees out to the side!

The treatment? To simply balance out any muscular imbalances and keep the weight on the feet properly placed while working the turnout as well as you can from the hip – not the knees and feet.