Introduction
Classical
ballet training encompasses the most advanced science of human movement mechanics existent
today. The mechanical ideal represented in classical ballet training is the most stable
relationship of the spine and extremities and is a foundation for all sports specific
movement.
The purpose of this training guide is to
help the dancer, dance instructor, coach, athlete and parent understand the most common
mechanisms of joint injuries, how to prevent future injuries and ultimately optimize
performance.
Analysis of the Mechanical Ideal
The following diagram
outlines the mechanical ideals of spine and extremity alignment illustrated in classical
ballet training:
Understanding The Mechanism of Joint Injury
The Shoulder Complex
This diagram
outlines specific postural alignment problems of the shoulders:
Injuries Caused by
Incorrect Postural Alignment of the Upper Extremity
in Dance and Sport Specific Training
The anterior position of the shoulder to
the torso causes hyperlordosis (increased curvature) of the neck, stressing the lower
cervical vertebra. This postural pattern, when combined with rotational and compressive
loading, has been found to contribute to the mechanism of nerve impingement of branches of
the Brachial Plexus. Any pressure to the neurological component of the spine or
extremities can contribute to the mechanism of injuries in the shoulder (long head of the
biceps tendon/rotator cuff), elbow, wrist and hand complex.
These pictures illustrate examples of the upper extremity alignment problems described
above.
A plumb line from the base of the occiput,
should run through the anterior head of the humorous bone. Correct alignment of the
shoulder complex encompasses simultaneous contracture of the latissimus and pectoral
muscles. This accomodates the straightening of the cervical spine and contraction of the
sterncleidomastoid muscles.
Range of Motion & Correct Postural Alignment of the Upper Extremity
The range of motion of the
shoulders directly influence the capacity of the dancer or athlete to maintain correct
postural alignment of the upper body during exercises at the ballet bar or sports specific
training.
The Shoulder Stretch
While holding the shoulders back and down,
the student grasps a rod or strap in the front of the body. The rod or strap is slowly
brought overhead, keeping the arms straight while moving through the full rotation of the
shoulder joint until the arms are behind the torso.
Note: The ideal range of motion is when the
arms are approximately shoulder width throughout the above exercise. The further the hands
are spaced relates to the restriction that exists in the shoulder complex. With this
restriction, the student is incapable of maintaining correct alignment of the shoulder to
the torso in ballet or sports specific training.
Full range of motion of the shoulders is a
prerequisite for the dancer or athlete to maintain correct postural alignment of the upper
body. Any exercise or movement without proper alignment increases joint stress and
incorrectly strengthens the joint complex.
The Lower Extremities
Injuries Caused by Incorrect Postural
Alignment of the Lower Extremity in Dance and Sport Specific Training
1. Hip-Pelvis-Spine
Lack of hip range of motion
during training causes the lower spine and pelvis to abnormally compensate. Stress on the
lower spine and pelvis can lead to the impingement of nerves innervating the lower
extremities causing progressive joint injuries.
2. The Knee Complex
Internal rotation of the knee occurs when
the hip lacks sufficient range of motion. This internal rotation corresponds with the most
common knee injuries that exists today.
Note: When dancers with natural range of
motion beyond 90 degrees in each hip joint, do not learn to turnout from the hip,
restrictions develop in both the hip, knee, ankle and foot complexes. The repetitive
introduction of loads to the internally rotated knee results in progressive changes on the
tendon, ligament and bone level which can eventually lock the joint complex into the
stressed alignment pattern.
3. The Ankle-Foot Complex
Internal rotation of the knee leads to
torsional stresses on the ankle-foot complex causing tendonitis and progressive joint
injuries. This abnormal pattern also contributes to abnormal ossification patterns of the
foot (bunions on the internal aspect of the first metatarsal head).
These pictures illustrate
examples of the lower extremity alignment problems outlined above in dancers in upper
level classical ballet training.
A plumb line from head of the hip should
run through the patella, the center of the ankle complex and the first and second
metatarsal heads of the foot. Lack of flexibility in the hip corresponds with the internal
rotation patterns of the knee joints illustrated above.
Range of Motion & Correct Postural Control of the Lower Extremities
The capacity of the dancer or athlete to
establish the correct alignment of the knee,ankle and foot is directly related to the
functional range of motion of the hip.
The following illustration
demonstrates the test and stretch for the range of motion of the hip complex:
The Hip Turnout Stretch
In a seated position, both lower legs are
brought to 90 degrees to the upper leg. Place the ankle of the upper leg onto the knee of
the lower leg. The goal is to bring the upper knee to the lower heel.
Note: The ideal range of motion is attained
when both legs freely align in a parallel position, both while sitting and lying with the
back flat on the floor. The degree of restriction that exists in the hip directly relates
to the danceršs or athletes ability to maintain correct alignment of the hip, knee and
ankle foot.
Dancers who have not developed sufficient
hip range of motion, but have been trained to work in 180 degree turned out positions
illustrate a compensatory pattern of hyper-mobility of the tibia (lower leg) on the femur
(upper leg).
A lack of turnout and hip range of motion,
due to soft tissue restrictions, can be increased with a stretch regimen isolating the hip
complex.
Note: Range of motion of the shoulder and
hip was the primary focus during the Structural Analysis classes taught to all levels
during the International Summer Program for the Nutmeg Conservatory for the Arts. Every
dancer illustrated dramatic improvement in shoulder and hip range of motion during the six
week program. After new levels of flexibility were established, retraining included
accentuated ballet specific exercises to help the dancer to incorporate this new range of
motion.
Full range of motion of the hips is a
prerequisite to the capacity of the dancer or athlete to maintain correct postural
alignment of the lower extremities. Any exercise or movement without proper alignment
increases joint stress and incorrectly strengthens the joint complex.
All Rights Reserved:
Copyright Š 1997 Stephen M. Apatow,
Biomechanics Specialist & Technical Consultant
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