"Fatigue makes fools of us all. It robs you of your skills and your judgment, and it blinds you to creative solutions. It's the best-conditioned athlete, not the most talented, who generally wins when the going gets tough." - Harvey Mackay
Participation
in any type of physical activity bears the risk of injury. Injuries occur in all types of sports
programs and across all forms of dance.
With the increased availability of educational information about
cross-training and caring for the body, Sports Medicine and Dance Medicine
professionals are hoping to decrease the incidence rates, but it is interesting
to look at when injuries are more apt to occur and why.
Studies
within the dance community have indicated injury rates as high as 95% in
professional ballet dancers and 82% in professional contemporary dancers. Injury rates in dance are comparable to those
in other professional sports.
Research
has shown that 67% of dance injuries occur late in the day and that 75% of all
injuries occur during preparation for performances when bodies are tired and/or
overworked. The lack of time and resources for tissue
repair, additional hours of rehearsal, and constant repetitive movements when
rehearsing specific phrases from dance pieces have all been cited as
causes.
Dancers are
known for diets that are low in nutritional value. They are constantly going to extremes to
avoid foods that may cause them to gain weight or diminish the aimed for aesthetic
in the dance community. Performance and
rehearsal schedules allow little time for careful meal planning and food
consumption, and it is difficult for dancers to consume enough calories to
equal the amount of calories burned during an intensive performance season.
Additionally, a large percentage of female professional
dancers are amenorrheic, or do not have regular menstrual cycles. The absence of a monthly period results in
abnormal estrogen levels which reduce the amount of calcium that the body can
absorb and use for repair.
Although
most athletes’ bodies are able to use protein to recover quickly from minor
muscle tears, this is not the case for dancers.
Without a proper diet filled with additional calories for tissue repair,
the body is placed under stress during normal situations. Once the intense performance season begins,
the body is unable to care for itself efficiently.
When this
nutrition deficit is combined with a rehearsal/performance schedule that allows
little time for rest and recovery, dancers are placed at a high risk for
injuries. While a minor breakdown in
body tissue can be sufficiently repaired during an interval of rest, in
dancers, who do not have sufficient rest time, the breakdown of tissue becomes
greater than the body’s ability to repair, or remodel.
When the
same muscle groups are used repeatedly during long hours of rehearsal and
performance, they grow tired and use up their energy reserves. When the central nervous system (CNS)
receives the message that a muscle is fatiguing and having difficulty holding a
contraction, it either tries to get the muscle to work harder, or activates
surrounding muscles (synergists) to help.
Muscular
fatigue is only one piece of the puzzle.
Long work hours also stress the central nervous system. The CNS uses sensory input to determine where
the body is in space. Messages
communicated through visual clues and proprioceptive clues help the CNS
determine which muscles need to contract and to determine the force that must
be used to keep the body moving safely. Although
the body is engineered so that the CNS will protect the tired muscles by
directing adjustments in the body, when the CNS is stressed, its ability to
direct these adaptations slows down. The
delayed response affects motor control and coordination. Landings from jumps and the body’s ability to
slow down after leaps or turns are affected.
As a result, the way the body normally distributes the stress over the
bones and joints is also compromised.
The change
in stress distribution and the lag time in reorganizing the muscular response set
the body up for injuries. All of these
factors explain why most dance injuries occur late in the day or during an
intense performance season. Since dancers
have a very high pain tolerance, when they get injured, they often do not
realize it immediately. Moreover,
injured dancers tend to “dance through” the pain so they do not lose roles or
jobs.
In an ideal
world, major rehearsals could be scheduled early in the day before the body is
fatigued, and schedules could be designed to accommodate rest periods for
dancers to allow for ample recovery time.
Unfortunately, rehearsal space is not always available at ideal times,
and dancers need to be able to accommodate the schedules of theater personnel,
musicians, and stage, sound, and lighting crews.
Additionally, audiences are only available after the traditional workday
ends – in the evening.
Educating
dancers to listen to their bodies, eat properly, cross-train, and using periodization training can be helpful. Rather
than “dancing through” pain, dancers should be encouraged to care for injuries
before they become chronic or more serious.
While eating properly has always been a challenge for dancers, a bit of
knowledge about healthy foods and the convenience of food today make it
easier. Cross-training will strengthen
all of the muscles in the body so that when some muscles fatigue, the
synergistic, or helper muscles, will be prepared to start working, and
periodization training can help prepare the dancer for performance season and
alleviate some of the stress on the body.
We are
given one body to last our entire life.
It is up to us to learn as much as we can about how to dance in a way
that preserves its health to the best of our ability.
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Liederbach, M. Schanfein, L. & Kremenic, I. What is
known about the effect of fatigue on injury occurrence among dancers? Journal
of Dance Medicine and Science. 2013;17(3):101-8.
Murgia, C. Overuse, tissue fatigue, and injuries. Journal of
Dance Medicine and Science. 2013;17(3):92-100.
Shah, S., Weiss, D. & Burchette, R. Injuries in professional modern dancers:
incidence, risk factors and management.
Journal of Dance Medicine and Science. 2012;16(1):17-25.
Tajet-Foxell, B. & Rose, F. D. Pain and pain tolerance
in professional ballet dancers. British
Journal of Sports Medicine. 1995:29:31-4.
With the
Nutcracker performance season upon us, dancers will be spending extra hours in
rehearsals, numerous hours in theaters, and will be expending tons of energy
entertaining countless audience members.
While performing is the ultimate goal of dance training, it still takes
a toll on the body. My last post
addressed the risk of injuries that result from overused and fatigued muscles. Over the long term,
cross-training and periodic training can help prepare dancers for the stress of
performance, but it is also important for dancers to know how to care for their
muscles during the performance season.
Muscles
should definitely be stretched once a performance and/or rehearsal are
completed. Static stretching in the
wings before an entrance will not help a performance. Instead it may hinder it! My post on different types of stretching will help you
understand why static stretching before a performing may actually decrease a
muscle’s ability to contract efficiently.
When static stretching follows a performance, however, it is a valuable
part of the cool-down that keeps dancers flexible and allows time for the
internal temperature of the muscles to gradually decrease. Stretching and cooling down reduce the
chance that muscles will cramp or go into spasm when leaving the studio or
theater. Being sure to wear warm clothes over dance clothes will also help keep muscles from
cramping when dancers leave a warm studio or theater and move out into colder air.
