Controlling body composition - nutrition

From the results of last week's survey (thank you for participating in it!) one issue was raised several times - nutrition and weight control.  So here's a guide on how to begin addressing your nutritional needs while maintaining control over body composition.

Concussion in dance and aesthetic sports

Concussion, also referred to as minor traumatic brain injury (mTBI), is an injury more commonly associated with contact sports than with dancing. There has however been an increase in recent years in the number of reported concussions in dancers, and it is necessary for the dance teacher, director, choreographer and dancers themselves to be able to recognise and react to a concussion when it occurs.

In aesthetic sports such as gymnastics and cheerleading, and in dance related genres such as physical theatre, the reported instances of concussion are significantly higher than in dance, largely due to moves performed while elevated and in performing tricks and stunts. In cheerleading, stunts are responsible for 90% of the concussions suffered by athletes, with the majority of these affecting the bases, rather than the athlete in the air. Across various genres of dance, from street to ballroom to contemporary to lindy-hop, numerous aspects of choreography can pose a risk to dancers if not executed properly. With dance choreography constantly pushing new limits of dancers' physical abilities, and increasingly incorporating tricks and stunts in pieces, it is useful to now consider dance alongside gymnastics and cheerleading as an activity carrying the potential for concussion. 

In a wide variety of sports, it has been found that concussion is under-reported, and that athletes go on to perform or compete after sustaining a head injury. It is imperative for the safety of the dancer or athlete that all concussions are recognised and appropriately addressed. Self-reporting of symptoms has been proven to be ineffective at identifying concussion, and so standardised testing procedures should be in place to ensure concussions are identified and appropriately addressed.

Anterior Pelvic Tilt in Dancers

Correct alignment is crucial to dance technique. A common alignment issue in dancers is an exaggerated anterior pelvic tilt - tilting the the pelvis forward. No two individuals will have identical spinal and pelvic alignment, and so it is perhaps useful to think of there being an  range that can be considered optimal rather than one set alignment that is perfect. The anterior pelvic tilt pulls the body out of correct alignment (outwith the optimal range), resulting in flawed technique and impaired performance. Your lower abdomen will protrude and your backside will stick out. Over and above the artistic flaw, anterior pelvic tilt impairs turnout and prevents proper muscle recruitment, can cause hip pain, back pain, knee pain and flat feet.

The hip flexors connect the femur to the hip and lower back; tight, short hip flexors cause the hip to pull forward. Any misalignment of the hips will effect the back, and anterior pelvic tilt will give a pronounced curvature of the thoracic spine. This in turn may then produce upper back pain, shoulder and neck pain, headaches and migraine.

Healthy hips are essential in dance, the turnout and all subsequent movement of the lower body originates here. While pelvic motion is central to many of the basic movements of dance (for example the battement de vant, a la seconde and derrière all display differing degrees of pelvic motion), the body should have a neutral home alignment. The internal rotation of the hip displayed with APT goes on to effect the lower limbs, producing subsequent internal rotation of both the femur and tibia, reducing turnout. This can cause or exaggerate existing over-pronation of the feet, causing foot, ankle and knee pain. Incorrect alignment further predisposes the dancer to injury.

Flexibility training - is it necessary?

Flexibility training can be divisive issue. Even I'm divided on it. On the one hand, you can improve your flexibility levels to a degree through appropriate training (stretching) methods. On the other, the gains you can make are somewhat limited, and I'll often argue largely outweighed by the likelihood of injury (up to 80% of dance injuries are sustained during flexibility exercises. That's an awful lot.).

Having spent the better portion of my life in dance training and surrounded by other dancers, I can honestly say I've seen a LOT of time wasted on flexibility training for next to no gains. 85% of your flexibility is down to your skeletal structure, 5% is down to environmental circumstances, leaving only 10% down to muscular elasticity.  10%. All those hours spent trying to push that little bit further, and the best you can hope for is 10%.

Staying active during injury recovery

First up before I say anything else - speak to your doctor/physio/surgeon before you go hell for leather into any training routine while you're injured. The last thing you want to do it prolong your recovery or worsen your existing injury. Also, there are times when giving your body a break for at least a couple of weeks might actually be the best thing for it. Speak to your doctor, assess your situation and make your decision.

Training when you're injured can have a lot of benefits if you do it safely; it can slow muscle atrophy if you have limb immobilied, maintain your existing fitness levels, or at least prevent them from dropping too far, and can lessen the psychological impacts of injury. Unfortunately if you're injured and want to stay active, you may have to accept that you won't be dancing for a while. This doesn't mean you can't work on specific aspects of technique or fitness, just be smart about it. Any time I've injured myself I've found boredom and frustration can be one of the worst aspects so finding a way to stay motivated and at least maintain a basic level of activity feels better than nothing.

Hypermobility in dancers

Despite hypermobility being a topic that is frequently discussed in both dance and dance science circles, it was not an area I've ever had a great interest in. My focus has generally been on supplemental strength training and endocrinology, and anything that falls outside of that I've been reluctant to delve into too deeply. That is until I was diagnosed with hypermobility syndrome after my most recent injury. Being the type of person I am, I can't be told something is affecting my body without then poring over every piece of information on the subject that I can get my hands on. I've never considered myself to have above average flexibility compared with both my dancer and non-dancer colleagues, in fact, my lack of hip flexibility and subsequent limited turnout had been a bone of contention for most of my performing life. Sure I had to resort to my knees rotating and sneakily compensating for what my hips lacked (terrible idea by the way), but the rest of my flexibility levels were pretty good so I accepted you can't win them all and figured I was working from a pretty typical physical start-point. I therefore assumed hypermobility wasn't going to be a problem that affected me. Turns out I was wrong - I was blessed with both average flexibility and sub-par joints. Hypermobility syndrome affects the stability and range of motion of several of, although not necessarily all the body's joints and subsequently can have a substantial impact on posture, joint pain, physical performance and proprioception. 

An overview of injury in dance

Dance medicine and science practitioners focus predominantly on three interlinked areas - injury prevention, healthier dance practice and the development of peak performance. When working towards these goals, it can be useful to take a step back and consider the extent of the healthcare issues facing dancers that must be addressed. Injury is the key factor in this, as neither healthy dance practice and peak performance cannot be achieved without addressing the significant problem of injury occurence in the dance profession.

Instances of injury are excessively high in the dancers. Across all disciplines of dance musculoskeletal injury is common in both student and professional dancers. Pushing the body to it's limits and the evolution of evermore demanding choreography means that dance will always be a risky profession; this does not mean however that steps cannot be taken to reduce the risk.
Collecting data on dance injury can be problematic due to dancers often being reluctant to report physical problems to directors or company doctors out of fear of losing professional position or opportunity. Therefore in many studies on dance injury, anonymous self-reporting has proven more useful than company medical records, as is the case with the studies discussed below. The extent of the problem, when providing the security of anonymity to dancers, is shown to be much wider than official company records state. What follows is a brief overview of the issue according to published research.

Research Update: Warm Up & Stretching

A new study has been published in the Journal of Dance Medicine and Science looking at the effect of varying stretching protocols during warm-up on dance performance. Warm-up is a much neglected are of dance research and it's great to see work being conducted in this area.

Overtraining

Overtraining or burnout refer to a condition where athletes or dancers note a marked decrease in physical performance for no apparent physical or medical reason, suffer from prolonged fatigue and display behavioral and emotional changes. Symptoms of overtraining will vary from individual to individual, the most common symptoms include:

• Increased perception of effort during exercise
• Excessive sweating
• Frequent upper respiratory tract infections
• Breakdown of technique
• Muscle soreness
• Sleep disturbance
• Lack of concentration
• Loss of appetite
• Mood disturbances
• Signs of depression
• Decreased interest in training and performance
• Decreased self-confidence

Nutrition - Carbs

Nutritional needs get a whole lot easier to understand if you have a basic understanding of your energy systems and the fuels each energy system uses. Your body has 3 - the ATP-PCr, the Glycolytic and the Oxidative systems.

The ATP-PCr System produces immediate energy and so is able to assist in instantaneous muscle contraction for short periods of high exertion exercise.The Glycolytic System, producing ATP through the breakdown of glucose. The Glycolytic system resynthesises ATP at a faster rate than the Oxidative system, and produces energy for short bursts of activity lasting up to around 2 minutes. The Oxidative System takes longer to be activated through activity than the other energy systems, however it has a higher energy producing capacity and so is utilised in endurance activities. Dance utilises all three energy systems, depending on the specific activities being performed; all three systems use carbohydrate as their main, if not sole, source of fuel.

Working with recreational dancers

Working with recreational community dance groups poses a different set of considerations in class planning. Instead of working with a known quantity, you never know how many dancers you will have; what level of fitness they are at or what level of technique, if any, they have. It can make planning sessions and creating choreography tricky at best. You can have individuals brand new to exercise in with semi-professional dancers, or people who have trained to a high level alongside people with reasonable levels of fitness but absolutely no technical knowledge. Fitness and technical skill can vary wildly, and your job is to find a means of providing a diverse population with a useful, enjoyable and fulfilling class.

Physiological Considerations with Children

Most dancers work with children at some point, whether it's on a daily basis or once or twice a year; through teaching, outreach or company workshops almost all of us will work with young people on and off throughout our careers. In developing the skills of young dancers it's helpful to have an understanding of the implications of various growth stages on their physical performance.

Nutrition for Dancers - Calories

Adequate nutrition is as important for dancers as it is for any other professional athlete, yet very few dancers have ready access to professional nutrition advice. Owing to the pressures (whether perceived or actual) placed on dancers to adhere to specific aesthetic ideals, it is common for dancers to either under-fuel themselves and attempt to control body composition through restricted energy intakes or by experimenting with various fad diets. Insufficient energy intake means you're more likely to become injured due to fatigue or weakness - it's crucial that you fuel your body for the job it needs to do.

Basics of Nutrition - How much and of what?

It can be confusing hearing conflicting advice over what quantity of what nutrients your diet should consist of. How much fuel does your body need, and what is the right fuel for the demands you place on your body? There's no straight answer, everyone's body is different however the bottom line is you need to fuel your body appropriately for the work you need it to do.

Injuries and dancing

Injuries happen, it's a fact of life. Studies have shown that in any given year up to 90% of professional dancers will sustain an injury that makes them lose time from work (it makes for some disheartening reading, but have a look - JDMS study CJSM study SJMSS study and MPPA study). That's a lot of injuries in a lot of dancers. Yes we can do our best to prevent them and we should, because it's possible to reduce the instances of injury and that should be a priority for all of us. However injuries happen in any activity where you are pushing your body to it's limits, and when they do we still need to be able to get on with our lives.

Fanaticism in the Ballet World

I've been reflecting on last week's attack on Sergei Filin. In many ways it's brought the best and the worst of ballet to the world's attention.

There are fanatics in all walks of life; in sport, in business, in medicine, in law... it is not a normal mindset but it exists throughout our society. I would hate it if fanaticism on this extremist level came to be associated with ballet more generally; yes there are fanatics in the ballet world, and yes one of them appears to have attacked Sergei Filin in the most horrific manner. However, the vast majority of those working in ballet, even at the highest most competitive level, find the attack every bit as reprehensible as the rest of the population.

The rules of supplemental training

Supplemental training will make you a better dancer. There's no question about it. Being stronger, faster, more agile, more powerful, more flexible, generally fitter... all of it will improve your dance performance. But it's no good deciding you're going to push yourself and develop outside of the dance studio if you don't do it sensibly. There are some incredibly simple rules you need to follow if you're ever going to make progress in additional areas you're training, otherwise you're just going to waste your time.

Over-pronation of the feet

A degree of pronation is normal, as the foot needs to adapt to contact with the ground, however over-pronation occurs when the arch of the foot excessively flattens or 'collapses', the heel rolls inward and the soft tissues stretch. This is a common problem in dancers of many genres including jazz, modern and theatrical dance, but the problem is most pronounced in ballet dancers.

Strength Training - a note on pas de deux and partnering

This isn't specific to ballet - this is for anyone whose dance style incorporates lifts of any type, whether it's ballet, street, contemporary or lindy hop, ANY style where you are taking someone's weight increases your risk of hurting yourself if you're not careful. It should be pretty self evident that if you're lifting a person, you're going to need the strength to take their weight. You won't get that strength from practicing the lift a few times in rehearsal, you'll get it from strength training outside of the studio.

Aside from the concerns about bulking up, too many female dancers obsess over their weight, at the risk of their health, and avoid weight training themselves due to the worry that it will make them gain weight. Staying at 45kg isn't healthy for the average woman, ballet dancer or not. Too many female dancers control their weight through diet restriction. Get your body fat tested and despite being a size 4, you might be surprised to find it sitting around 20%. Average BF % for female ballet dancers is 17%, for contemporary dancers it's 20%. Compare that with female gymnasts (13%) and runners (14%); the reason it's higher on dancers than other athletes is the lack of strength training and the lack of adequate nutrition.

Going onto pointe

When I was learning to dance I couldn't wait to start pointe work - just like every other girl learning ballet. At my school we were allowed to go on pointe once we got into a certain class (I can't remember which one now, however most of us were between 11-13 years old). It was a rite of passage to start pointe, to get the beautiful, horribly painful shoes and begin weeks of tedious barre work that seemed to go on forever and somewhat killed the romantic notion I had of dancing on my tiptoes. It's such a big step for girls doing ballet that the last thing they're ever going to consider is whether their body is ready for it.

Ah nostalgia, my first ever pair of Swanildas

A colleague of mine did her MSc thesis looking at what criteria dance schools used to assess a girl's readiness to begin pointe work. The results were pretty depressing. Nearly every school used age (usually 12) as the determining factor. Some, like mine, used level. Which worked out about the same as age. Almost none even considered strength or physiology.