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In this Youtube video is demonstrates how you excercute a squat in a safe and correct way.

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How to do a Squat Properly: Watch the Muscles in 3D

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one dance uk is a organisation that helps dancers in the UK find the correct lifestyle in nutrition to help them maintain a strong dancer.

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One Dance UK and People Dancing to support dance artists, teachers and organisations to make dance & its health, social and creative benefits more accessible.

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We are excited to announce the formation of our Dance Medicine and Science Expert Panel who will specifically advise the Healthier Dancer Programme. Drawing upon the knowledge and expertise of this panel enables our Healthier Dancer Programme to offer the most up-to-date advice, informed by current practice and research, out to our members and the wider industry.

The panel members are drawn from various areas of practice including: academia, company healthcare management, nutrition and dietetics, orthopaedic surgery, osteopathy, psychology, physiology, physiotherapy, rheumatology, sports and exercise medicine, and sports therapy. All panel members have extensive experience of working with dancers of various genres, most notably including ballet, contemporary, and musical theatre.

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Dance Medicine and Science Expert Panel - One Dance UK

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We are excited to announce the formation of our Dance Medicine and Science Expert Panel who will specifically advise the Healthier Dancer Programme. Drawing upon the knowledge and expertise of this panel enables our Healthier Dancer Programme to offer the most up-to-date advice, informed by current practice and research, out to our members and the wider industry.

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This is a image shows us what exercises to execute, if we want to increase our stamina.

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This article highlights the most common injuries in the dance industry and give you assistance on how to prevent a injury.

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Sports Injuries Fitness and Performance Exercise-Related Injuries and Exhaustion Sports Injuries

Featured Experts:

Dance may look effortless, but it requires a lot of strength, flexibility and stamina. It also comes with a high risk of injuries. Whether you are a dancer, the parent of a dancer or a dance teacher, you should be aware of the most common dance injuries and learn how to avoid them.

Johns Hopkins performing arts physical therapists Andrea Lasner and Amanda Greene share valuable information about dance injury treatments and prevention tips. Lasner and Greene, both dancers, have turned their love for the art into a means of helping injured dancers.

What are some common dance injuries?

A few studies that looked into dance injuries found that injuries from using your joints and muscles too much ( overuse injuries) are the most common in dancers. The majority of these overuse injuries involve an ankle, leg, foot or lower back. Some common dance injuries are:

Hip injuries: snapping hip syndrome, hip impingement, labral tears, hip flexor tendonitis, hip bursitis and sacroiliac joint dysfunction

Foot and ankle injuries: Achilles tendonitis, trigger toe and ankle impingement

Knee injuries: patellofemoral pain syndrome

Stress fractures: metatarsals, tibia, sesamoids and lumbar spine

Dancers are also likely to develop arthritis in the knee, hip, ankle and foot

Generally, dancers have a much lower rate of anterior cruciate ligament (ACL) injuries than other athletes. One explanation could be that dance training involves much more intense jumping from an earlier age than other sports, which helps improve muscle control.

How do I know if the pain is from an injury?

In most cases, the pain you experience after dancing is muscle soreness that usually subsides within 24 to 48 hours. Sometimes, it takes a few days for muscles to get sore, which is also normal. However, if you experience the following types of pain, you may have suffered an injury:

Pain that wakes you up at night

Pain that is present at the start of an activity

Pain that increases with an activity

Pain that makes you shift your weight or otherwise compensate your movements

If you experience such pain, consult with a medical specialist - preferably a physical therapist or physician with experience in treating dancers. They will be able to determine whether additional testing is needed and will formulate an appropriate treatment plan.

Why do dance injuries happen?

Dance is a physically demanding activity. Dancers perform repetitive movements for several hours a day. Studies have shown that dancing five hours a day or longer leads to an increased risk of stress fractures and other injuries.

On top of the intensive training, many dancers get little time to recover between the sessions and have no "offseason." Restrictive diets and unhealthy body weights may also contribute to dance injuries. Proper nutrition is important for dancers of all ages.

How do dancers get ankle sprains?

Ankle sprains are the number one traumatic injury in dancers. Traumatic injuries are different from overuse injuries as they happen unexpectedly. When an ankle is sprained, ligaments on the inside or outside of your foot get twisted or overstretched and may experience tears. Ankle sprains often happen due to improper landing from a jump, misaligned ankles (when they roll in or out) or poorly fitted shoes. Torn ligaments never heal to their preinjury condition. Once you've sprained your ankle, you are at risk of doing it again. It's important to build muscle strength to prevent further injuries.

Dance Injury Prevention

How can dance injuries be prevented?

The majority of overuse injuries and even some traumatic dance injuries can be prevented. Follow these guidelines to reduce your risk of injury:

Eat well and stay hydrated before, during and after class.

Get enough rest and avoid overtraining.

Do cross-training exercises to build strength and endurance in all parts of your body.

Always wear proper shoes and attire.

Always warm-up before training or performances.

Lead a healthy lifestyle and get to know your body.

When injuries happen, address them immediately and get advice from a doctor or physical therapist.

What are good cross-training exercises for dancers?

Core and hip strengthening exercises like Pilates and stability-based yoga are great for dancers. And so are aerobic and cardiovascular activities, such as running, swimming or biking. They get your heart rate up and help build stamina for long performances.

Many dancers don't do enough cardio during their regular training. Just 30 minutes three to four times a week is usually enough to improve your endurance. As always, do this in moderation and in short intervals to avoid stressing your joints. Being screened by a physical therapist with experience treating dancers will help you identify individual areas of weakness to address with specific exercises.

How much rest should a dancer get?

While many experts stress the importance of proper rest, there are no specific guidelines on the frequency and amount of rest. However, we know that dancing five hours a day or longer is linked to an increased risk of injury. It is also known that intense activity leads to microdamage, which peaks in recovery 12 to 14 hours after a workout. So it would make sense to take the next day off after a high-intensity activity. Dancers should work at their highest intensity a couple of times per week and then take at least two days off, preferably in a row. Also, a three- to four-week period of rest after the season is ideal for recovery.

Dance Injury Treatment

Should I ice or heat after a dance injury?

If it's a sudden injury, it's best to apply ice first to reduce swelling and inflammation. RICE treatment is a common approach that involves rest, ice, compression and elevation. After a few days, you can switch to heat to increase blood flow to the area and promote healing. However, every person is different. If you feel that ice helps you better than heat, then there is nothing wrong with continuing to ice. But be careful not to ice before dancing or stretching, because you want those muscles to be warmed up to prevent re-injury.

What are my treatment options for a dance injury?

It depends on the type of injury, your level as a dancer and many other factors. For example, for traumatic injuries like ankle sprains, your doctor may recommend RICE, joint protection and physical therapy. For stress fractures you may need to limit weight on your foot by using crutches, wearing a leg brace or walking boots. Surgery is typically used as the last resort. It is best to discuss your treatment options with a doctor who specializes in dance injuries. And if you are working with a physical therapist, make sure he or she is experienced in treating dancers. A big part of physical therapy is correcting the training technique that led to the injury. Otherwise, you risk hurting yourself again by making the same mistake.

What should be in the first aid kit for dance injuries?

Your regular first aid kit might already have many of the essentials for handling a medical emergency. However, when it comes to common dance injuries, you may want to include a few additional items, such as:

Instant cold pack

Pre-wrap and athletic tape (if qualified providers are available to apply)

Elastic bandages (to be used only for compression, not support while dancing)

Crutches

Topical pain reliever

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Common Dance Injuries and Prevention Tips

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Learn from a Johns Hopkins orthopedist and performing arts physical therapists about how to minimize your risk of common dance injuries.

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This website gives you tips and tricks on how you can achieve a healthy lifestyle.

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From Zumba to salsa, dance-based fitness classes are everywhere. But how do dancers and ballerinas themselves stay in shape? Here we speak to leading ladies at some of London's top shows to get their insider fitness tips.

1. Use the plank to tighten and tone. 'A simple plank every day is very good for your whole body to strengthen. Just one minute during the whole day. You can also build up to two minutes when you feel you are getting fitter and stronger,' explains Tierney Heap, a dancer in the Royal Opera House's corps de ballet.

2. Try juicing. Charlotte Gooch, who plays Penny in Piccadilly Theatre's Dirty Dancing, fills her fridge with vegetables, salad, eggs, and yogurt. But her secret is juicing. 'I have recently become a big fan. It's great for energy levels, provides lots of vitamins and nutrients, and doesn't pile on the pounds,' she says.

3. Sample pilates, the exercise of choice. ' Pilates is a particularly useful part of my training. I would recommend it for dancers and non-dancers alike. Starting the day off with pilates gets me energised and gets my body centred,' says Darcel Frederick-Osei, a dancer in The Lion King at the Lyceum Theatre.

4. Or brave a bit of Bollywood. Carol Furtado, a lead dancer in Merchants of Bollywood at Sadler's Wells, recommends Bollywood dancing. It's 'a high energy fitness workout - great cardio - that has you sweating in no time. It's also a great deal of fun, which is more important because if people don't enjoy their workout session, they're more likely to slack off.'

5. Tone the bum with squats. Amy Thornton, dance captain of Matilda The Musical at the Cambridge Theatre, notes that running after 29 kids definitely keeps her fit. But recently, she's become obsessed with squats. 'I'm determined to get a J.Lo bum. I like to do three sets of 20 every day. If I'm feeling extra hardcore, I will tie a resistance band around my legs, just above the knee. It's a killer.'

6. Chill tired muscles. Tierney stresses the importance of handling any pain or niggles. 'Tired muscles must be treated with massages as often as you can. I like to put my legs in a huge bucket of ice and cold water for 12 minutes - painful, but worth it. Lying down with your legs up to drain them is another way of treating sore calves,' she says.

7. Start the day with porridge. Darcel prepares her's on the stove top. 'I don't like microwave packets. And I use water instead of milk because it makes it lighter. I add honey and cinnamon, then I chop a banana on top.'

8. Enjoy cinnamon. Carol begins her day with black coffee to energise her metabolism. She also turns to spice. 'I like to nibble on cinnamon sticks as I enjoy its zingy flavour. It prevents me from snacking between meals and my metabolism benefits from the boost.'

9. Incorporate protein. Several of the dancers focus on protein in the evenings. Darcel recommends turkey breast steaks as they cook quickly. She pan fries them with olive oil, chopped onion, and light soy sauce. 'I have that with boiled and sliced sweet potato and steamed broccoli.'

10. Add in wheatgrass. 'Every morning I have a shot of wheatgrass. I have a busy work schedule, and so I find it keeps my immune system strong, my energy levels high. It's full of nutrients and great for our digestive systems,' says Amy. She adds it to a smoothie, or to a glass of water when running late. 'Be warned: it's not exactly the nicest of tastes!'

11. Try some ballet moves. It's no surprise that full-time dancers spend their days dancing. 'We start with half an hour barre, into centre exercises including, pirouettes, adage, and then into jumping,' says Tierney. If you want to incorporate dancing fitness into your life, try one of London's many classes, such as Ballet-tone, barrecore, BalletBeFit or City Academy.

12. And have fun. 'Challenge yourself. Take a dance class. They aren't just for professionals. It's all about finding things that excite you so you look forward to doing it,' says Darcel.
Danae Mercer is a freelance journalist. Follow her @DanaeMercer.

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12 Health And Fitness Tips Top Ballerinas Swear By

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From Zumba to salsa, dance-based fitness classes are everywhere. But how do dancers and ballerinas themselves stay in shape? Here we speak to leading ladies at some of London's top shows to get their insider fitness tips. 1. Use the plank to tighten and tone.

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During his dancing days, Jared Kaplan used to look down on strength training. "I was a snobby dancer," he says. "I thought, Why would I need to lift weights?" Then Kaplan, 6' 2", was cast in a role originated by a shorter dancer, and realized he needed more power to move as quickly and explosively as someone smaller. He became a weight-room convert, and quickly saw a difference: Once he started a strength-training routine, his body felt less "strained" during demanding performances, and he grew aware of imbalances resulting from repetitive rehearsal of one-sided movements.

Many dancers are intimidated by weight training-or even think it is detrimental. According to Dr. Brent Brookbush, a trainer, physical therapist and president of the Brookbush Institute, they are missing out. "Just think of the relationship between strength and your performance," he says. "Jumping, lifting, holding positions. Resistance training can help with all of that." Whether you call it weight training, strength training or resistance training, exercises that increase your strength by lifting weights (or even just your own body weight) could take your dancing to the next level.

This myth is one of the most pervasive misconceptions about weight training. "Nobody gets bulky by accident. Putting on muscle takes a lot of work. A lot of work," says Brookbush. Supplemental weight lifting once or (ideally) twice a week is enough to make you stronger, but will not cause huge gains in muscle size.

Aesthetics are not the main reason experts recommend dancers strength train. Kaplan, who is now a personal trainer and Pilates instructor, suggests using workouts to reconnect with how your body feels, not just how it looks. "Gym time doesn't have to be about an externally motivated form," he says.

"Research shows that resistance training has no negative effect on flexibility, and may even improve it," says Brookbush. The key, according to Kaplan, is working within a full but safe range of motion. A 2011 study found similar flexibility gains between people who followed a full-range-of-motion resistance-training program and those that followed a static stretching routine.

However, any form of exercise can exacerbate musculoskeletal problems, warns Brookbush. For example, dancers tend to be tight in their thoracic spines, calves and deep external rotators of the hip. If any of those areas feel stiff after your workout, seek guidance from a physical therapist about how to correct that dysfunction.

"Dancers tend to go to Pilates and yoga because they are similar to dance," says Kaplan. While there are benefits to these forms, that similarity has a downside. Any kind of repetitive movement can lead to imbalances in the body that can cause overuse injuries. Use strength training to work muscles in a different way than you do when dancing. "The weight-training room should be for corrective exercise. You need to balance your body out," says Brookbush. "Weight train for strength and endurance. Dance will train you for dance."

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During his dancing days, Jared Kaplan used to look down on strength training. "I was a snobby dancer," he says. "I thought, Why would I need to lift weights?" Then Kaplan, 6' 2", was cast in a role originated by a shorter dancer, and realized he needed more power to move as quickly and explosively a...

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in this source of information, the website gives you a definition of what a Female Athlete Triad is and how Dancers can prevent it.

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This website shows how the Female Athlete Triad effect women in the athletic way.

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Abstract

The number of adolescent girls participating in sports has dramatically increased throughout the last few decades. In the early 1990's, an association between amenorrhea, osteoporosis, and disordered eating was recognized and eventually labeled the 'Female Athlete Triad'. In 1997, the Task Force on Women's Issues of American College of Sports Medicine (ACSM) published a position statement on this triad of conditions that were becoming increasingly more prevalent amongst female athletes. Initially, the 'Female Athlete Triad' was characterized by disordered eating, amenorrhea, and osteoporosis. However, as the number of adolescent female athletes has continued to grow, there has been further research and investigation into this field and the triad has evolved in definition. It is essential for all health care practitioners and other professionals who care for adolescent athletes to be attentive to the clinical signs, detection, evaluation, and management of the female athlete triad, as the sequelae can have a significant impact on the health and well-being of a young person both in the short and long-term.

Keywords: Adolescent, female athlete triad syndrome

Background

First identified in 1992, the 'Female Athlete Triad' was originally characterized by disordered eating, amenorrhea, and osteoporosis ( 1). However, the female athlete triad is now characterized as a spectrum of interrelated conditions and complications that include low energy availability (EA) with or without disordered eating, menstrual dysfunction, and low bone mineral density (BMD), according to the 2007 ACSM's position stand ( 2). The current definition is a much more encompassing description when compared to the original characterizations. This definition emphasizes the continuum of the condition and the fact that athletes may present with any of the three components, and the components do not need to be present simultaneously in an athlete for the individual to suffer negative health consequences. The ACSM's 2007 position was further supplemented by the 2014 Female Athlete Triad Coalition Consensus Statement, which focused on treatment and return to play ( 3). The American Academy of Pediatrics Council on Sports Medicine and Fitness also recently published a clinical report providing guidance for clinicians who provide pediatric care regarding the approach to individuals with female athlete triad ( 4).

While the actual prevalence of athletes who fall under the female athlete triad remains unknown, by the early definition (disordered eating, amenorrhea, and osteoporosis), studies showed 1-4% prevalence among female athletes. Prevalence is expected to be much higher now that the definition is more inclusive (not all three components of the triad need be present) and is likely underestimated due to a variety of factors including, failure by professionals to recognize symptoms, a spectrum of clinical presentation, and lack of symptom reporting by athletes ( 3- 5).

In 2014, the International Olympic Committee (IOC) expert working group introduced a broader, more comprehensive term of 'Relative Energy Deficiency in Sport' (RED-S) for the condition previously known at 'Female Athlete Triad.' The term RED-S is meant to refer to the broad and various impaired physiologic functions that can be caused by relative energy deficiency and is meant to be inclusive of male athletes who may also be affected ( 6, 7). However, authors of the Triad Consensus papers have alleged that the umbrella term RED-S may have the potential to confuse and detract from the body of research and clinical work done to date regarding the female athlete triad ( 8, 9). For the purpose of this review, we recognize the broader RED-S terminology and concepts, but focus on the diagnosis known as the female athlete triad.

Decreased EA

The primary disorder driving the pathophysiology of the rest of the triad is decreased EA. Originally, this portion of the triad was labeled "disordered eating." The definition has broadened and it has been recognized that an athlete does not have to have an officially diagnosed eating disorder to manifest the other complications of the syndrome ( 1- 4). An athlete that has a negative energy balance, from a variety of factors, may be at risk for developing the female athlete triad. Negative EA may occur by failure to maintain adequate nutrition and caloric intake for the level of rigorous physical training an athlete puts on their body. Negative EA can also occur via decreased caloric intake as is seen in dieting behaviors, specific lifestyle and dietary practices such as veganism, food restriction, purging, stimulant use, or laxative use. Negative EA through some of these methods may be part of a clinically defined eating disorder ( 2, 10).

Menstrual disorders

Adolescents with the female athlete triad can present with a variety of menstrual abnormalities including amenorrhea, oligomenorrhea, and problems with ovulation. Amenorrhea can present as either primary or secondary. Primary amenorrhea is characterized as a lack of menarche by age 15 years in the presence of other secondary sexual characteristics or the lack of menarche approximately 2.5 years after development of secondary sexual characteristics (typically by age 13 years). Secondary amenorrhea is characterized as an absence in menstruation for more than three cycles or six months in females who have had regular menses. Oligomenorrhea is defined as menstrual cycles that are greater than 35 days apart. In the adolescent population, it can be difficult to correctly distinguish menstrual irregularities, as their hormonal system may still be maturing. The ACSM recommends screening for female athlete triad, and potentially other underlying medical issues, in any athlete with a total of 6 months of amenorrhea or oligomenorrhea ( 2).

Decreased BMD

Abnormal bone development, osteopenia, and osteoporosis can be part of the female athlete triad and are particularly problematic to the adolescent population. Estrogen plays an important role in the physiology of BMD and bone formation and hypoestrogenemia can have a negative impact on musculoskeletal health ( 3). A continuous process of osteoblastic and osteoclastic activity, mediated by estrogen, contributes to initial development of ongoing bone health ( 14). To obtain optimal BMD, adequate nutrition, including overall EA, vitamin D, and calcium, and moderate physical activity with weight-bearing exercise is required. This process is especially important for adolescents, as 25% of bone mass accrues during the two years surrounding menarche. The greatest addition of bone mass happens in puberty with approximately 90% of peak bone mass attained by 18 years of age ( 3, 4, 14). When normal processes are interrupted (such as in a hypoestrogenic state), an athlete's bones may become weaker with decreased BMD, and more prone to injury and risk of fracture ( 14). A study has shown athletes who self-report amenorrhea or oligomenorrhea had a 3 times greater risk of musculoskeletal injury ( 5). An adolescent with the female athlete triad is at risk for suboptimal bone mass acquisition and although BMD may stabilize or improve, depending on the duration of the triad, they may never return to normal age appropriate BMD. This could have lifelong effects ( 15).

Assessment

Individuals who warrant screening for the triad include athletes with a history of stress fractures, multiple pathological fractures, overuse injuries, and/or menstrual irregularities. The ACSM recommends screening all female athletes for the triad if they have had a total of six months of amenorrhea or oligomenorrhea ( 2). Additional specific risk factors or behaviors include a history of critical comments about eating or weight from a person of influence, a history of depression, a history of dieting, an obsessive or perfectionist personality, frequent weight fluctuations or pressure to lose weight, early initiation of the sport, overtraining, recurrent injuries, and inappropriate coaching behavior ( 3). Practitioners should be aware of "thin sports", such as long distance running, gymnastics, figure skating, dance, and cheerleading, which pose an increased risk for an athlete having the triad ( 10, 12, 19).

During the initial assessment, a health care provider should obtain a complete history from the patient, particularly focused on diet, exercise/sport type and frequency, menstrual history, body image, medication and supplements taken, including contraceptives, and history of injuries. Although the current pre-participation form endorsed by the American Academy of Pediatrics (AAP) includes eight questions pertaining to the triad, the 2014 Triad Consensus Panel recommends a more Triad-specific set of 12 questions that can be followed by an in-depth evaluation if concerns arise ( 3, 18, 20). The screening questions are as follows: "Have you ever had a menstrual period? What was your age when you had your first menstrual period? When was your last menstrual period? How many periods have you had in the last 12 months? Are you taking any female hormones (estrogen, progesterone, birth control pills)? Do you worry about your weight or body composition? Are you trying to or has anyone recommended that you gain or lose weight? Are you on a special diet or do you avoid certain types of foods or food groups? Have you ever had an eating disorder? Have you ever had a stress fracture? And have you ever been told you have low bone density (osteopenia or osteoporosis)?" ( 3).

During the physical exam, it is important to include orthostatic blood pressure measurements with vital signs and to include a Tanner staging exam. It is important to document body mass index (BMI) and to look for physical exam findings found in individuals with eating disorders (ex: cold extremities, lanugo, knuckle scars, parotid gland enlargement) ( 20). Initial work-up may include evaluation of complete blood count (CBC), comprehensive metabolic profile (CMP), thyroid function tests, urinalysis (UA), and pregnancy test. In addition, vitamin D and calcium levels can be obtained ( 4, 20). Laboratory testing should be based on individual patient presentation and which components of the triad are present, as well as any other accompanying history or physical findings that would suggest underlying abnormality. During screening and assessment, an electrocardiogram (EKG) may be warranted ( 4, 11).

Formally evaluating EA, especially in adolescents, can be somewhat difficult. Methods to assess EA are improving, but are not exact. BMI calculation can be a starting point in assessing EA, with low BMI suggesting deficiency. However, it is important to note that overweight athletes can also be energy deficient. The gold standard for calculating EA involves a 72-hour food log in addition to accelerometer data, heart rate monitoring, or exercise journal self-report for calculation of energy expenditure ( 12). Logistically, calculation of energy expenditure is not always practical or accurate in daily practice. It is important to get a detailed dietary evaluation utilizing a registered dietician if caloric intake in relation to energy expenditure is a concern. Web-based calculators can be used to estimate energy expenditure, but again these calculations come with inherent error ( 3).

When evaluating menstrual abnormalities, it is important to initially rule out pregnancy. Secondary amenorrhea should prompt exclusion of other specific endocrine disorders, such as thyroid conditions, hypothalamic or pituitary disorders, polycystic ovarian syndrome, or hypercortisolemia. Additionally, in those with primary amenorrhea, structural abnormalities must be ruled out ( 3, 4).

To evaluate bone density in adolescents, the main diagnostic tool used is the dual-energy X-ray absorptiometry (DEXA). In individuals less than 20 years of age, the posteroanterior aspect of the spine and the whole body minus the head are preferred testing sites ( 2). For adolescent athletes, the Z-score is more appropriate for measurements, as it compares BMD to age and gender matched controls ( 11). The ACSM defines a low BMD as a Z-score between −1 and −2 with clinical risk factors, and osteoporosis as a Z score less than or equal to −2 with clinical risk factors. Clinically significant fractures include: long bone fracture of the lower extremity, vertebral compression fracture or two or more long-bone fractures of the upper extremities ( 2, 21).

Management/treatment

The management of an individual with female athlete triad should have a multidisciplinary approach. Treatment of the three triad components and recovery of energy status, menstrual status, and bone health occur at different rates. Initial management should focus on the low energy state. Management is mostly supportive in nature and non-pharmacological treatment modalities should be initial management of the triad. When energy balance is restored, it is then possible to restore normal menses and enhance bone density. In 2014, the Female Athlete Triad Coalition Consensus Statement developed recommendations for treatment and return to play ( 3).

If a clinically diagnosed eating disorder has been identified, it is important to have a mental health practitioner as part of the treatment team. Cognitive behavioral therapy (CBT) has been studied and may be beneficial to be included in the athlete's treatment plan. Contracts have also been used to aid in compliancy throughout a treatment regimen ( 3).

Weight gain alone has been shown to improve BMD. Weight-bearing exercise also has a beneficial effect on BMD. Dietary supplements of Vitamin D and calcium should be started. The current recommendation for adolescents is 1,300 mg of calcium per day and 600 IU of Vitamin D per day. There have been initial studies done that show increase in BMD with use of mechanical stimulation, such as vibratory platforms. More research must be done on these modalities before strong recommendations can be put in place. Improvements in BMD occur more slowly than other components of the triad. Research is lacking to support pharmaceutical treatment, such as use of bisphosphonates, of low BMD in the setting of the triad ( 3, 23).

The athlete must be cleared both psychologically and medically before they can return to their sport and decisions regarding level of sports participation and return to play should be based on level of medical risk in which the athlete is categorized ( 3). There are no standardized guidelines for return to play and plans should be individualized based on the athlete. However, the ACSM suggests utilizing a multidisciplinary approach with risk stratification based on evaluation of health status or medical factors, evaluation of sports participation risk, and modifying factors such as timing/season or internal/external pressures ( 3, 24). Ideally, abnormal findings on exam should have normalized and the athlete must agree to the treatment and management plan. Education, maintenance of a therapeutic alliance, and utilization of a multidisciplinary approach are key to athlete adherence to treatment and management strategies ( 3, 19).

Long term effects

Even with management and treatment, athletes with the triad are at risk for long term sequelae. First of all, because adolescence is such an important time for bone growth and acquisition, it is possible to stabilize but never quite return to optimal BMD. Athletes with the triad and concomitant eating disorders are at a high risk of maintaining sub-optimal BMD ( 15).

Conclusions

The Female Athlete Triad is a condition of low EA, menstrual irregularities, and low BMD. This triad affects many adolescent athletes and can lead to serious long term negative sequelae if not correctly identified and managed. Athletes presenting with one component of the triad are at risk for and should be evaluated for the other components. It is important for all those who work with these athletes to be able to identify individuals at risk and either directly screen the athletes or refer to the appropriate health care provider. Early screening and intervention is vital, especially in adolescents who are still in the process of growing and maturing. The annual health maintenance visit with a primary care health care provider or the sports pre-participation evaluation are opportunities to screen adolescents for the female athlete triad. Health care providers and professionals working with adolescent athletes have an opportunity to provide education regarding the female athlete triad and contribute to preventive strategies for youth athletes at risk.

Acknowledgements

None.

Footnotes

Conflicts of Interest: The authors have no conflicts of interest to declare.

References

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The female athlete triad: special considerations for adolescent female athletes

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The number of adolescent girls participating in sports has dramatically increased throughout the last few decades. In the early 1990's, an association between amenorrhea, osteoporosis, and disordered eating was recognized and eventually labeled the 'Female Athlete Triad'.

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NIDMS is a organisation that helps dancers in the UK gain knowledge on the biomedical side of training.

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Dancers' education, healthcare and research, NIDMS, United Kingdom

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The National Institute of Dance Medicine and Science (NIDMS) aims to enhance dancers' health, welbeing and performance through high quality scientific knowledge and by providing better, more affordable access to dance-specific healthcare.

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Here is a image highlighting all the issues a Female athlete triad can have on a dancer.

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This article highlights how much  elements like the earth, fire, air and water  have a impact on everyday life styles dancers have.

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Here in this article it shows how self and physical expression makes a dancer perform.

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Dance - The aesthetics of dance: One of the most basic motives of dance is the expression and communication of emotion. People-and even certain higher animals-often dance as a way of releasing powerful feelings, such as sudden accesses of high spirits, joy, impatience, or anger.