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Health and Well Being in the Dance Industry

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Robinson, L. Whyte, S. (2016) Dancers Injured Copying Overstretching Exercises from Social Media [online] Available from https://www.abc.net.au/news/2015-10-12/young-dancers-injured-by-extreme-overstretching-exercises/6847796 [Accessed 04/12/18]

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Dancers injured copying overstretching exercises from social media

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Young dancers are being injured copying extreme overstretching exercises they see online and on social media, a trend that medical professionals say could ruin their careers.

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BJSM (2018) Relative Energy Deficiency in Sport [online] Image Available from https://bjsm.bmj.com/content/bjsports/early/2017/07/03/bjsports-2017-097700/F1.large.jpg [Accessed 04/12/18]

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AlgaeCal (2018) Female Athlete Triad [online] Image Available from https://www.algaecal.com/wp-content/uploads/FemaleAthleteTriad.png [Accessed 04/12/18]

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Mayo Clinic Staff (2017) Stress Fractures [online] Available from  https://www.mayoclinic.org/diseases-conditions/stress-fractures/symptoms-causes/syc-20354057 [Accessed 03/12/18]

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Overview

Stress fractures are tiny cracks in a bone. They're caused by repetitive force, often from overuse - such as repeatedly jumping up and down or running long distances. Stress fractures can also arise from normal use of a bone that's weakened by a condition such as osteoporosis.

Stress fractures are most common in the weight-bearing bones of the lower leg and foot. Track and field athletes and military recruits who carry heavy packs over long distances are particularly susceptible, but anyone can have a stress fracture. If you start a new exercise program, for example, you might develop stress fractures if you do too much too soon.

Symptoms

At first, you might barely notice the pain associated with a stress fracture, but it tends to worsen with time. The tenderness usually originates from a specific spot and decreases during rest. You might have swelling around the painful area.

When to see a doctor

Contact your doctor if your pain becomes severe or persists even at rest.

Causes

Stress fractures often result from increasing the amount or intensity of an activity too quickly.

Bone adapts gradually to increased loads through remodeling, a normal process that speeds up when the load on the bone increases. During remodeling, bone tissue is destroyed (resorption), then rebuilt.

Bones subjected to unaccustomed force without enough time for recovery resorb cells faster than your body can replace them, which makes you more susceptible to stress fractures.

Risk factors

Factors that can increase your risk of stress fractures include:

Certain sports. Stress fractures are more common in people who participate in sports such as track and field, basketball, tennis, dance or gymnastics.

Increased activity. Stress fractures often occur in people who suddenly shift from a sedentary lifestyle to an active training regimen or who rapidly increase the intensity, duration or frequency of training sessions.

Sex. Women, especially those who have abnormal or absent menstrual periods, are at higher risk of developing stress fractures.

Foot problems. People who have flat feet or high, rigid arches are more likely to develop stress fractures. Worn footwear contributes to the problem.

Weakened bones. Conditions such as osteoporosis can weaken your bones and make it easier for stress fractures to occur.

Previous stress fractures. Having had one or more stress fractures puts you at higher risk of having more.

Lack of nutrients. Eating disorders and lack of vitamin D and calcium can make bones more likely to develop stress fractures.

Complications

Some stress fractures don't heal properly, which can cause chronic pain. If underlying causes are not addressed, you may be at higher risk of additional stress fractures.

Prevention

Simple steps can help you prevent stress fractures.

Make changes slowly. Start any new exercise program slowly and progress gradually.

Use proper footwear. Make sure your shoes fit well and are appropriate for your activity. If you have flat feet, ask your doctor about arch supports for your shoes.

Cross-train. Add low-impact activities to your exercise regimen to avoid repetitively stressing a particular part of your body.

Get proper nutrition. To keep your bones strong, make sure your diet includes adequate calcium, vitamin D and other nutrients.

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Stress fractures are tiny cracks in a bone. They're caused by repetitive force, often from overuse - such as repeatedly jumping up and down or running long distances. Stress fractures can also arise from normal use of a bone that's weakened by a condition such as osteoporosis.

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Tancred, B (1995) The Components of Fitness [online] Available from https://www.brianmac.co.uk/conditon.htm [Accessed 04/12/18]

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Sportsmen and women must put their bodies under a certain amount of stress (overload) to increase physical capabilities

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Feeney, D (2014) Wingate Test Exercise Physiology Lesson [online] Available from https://www.youtube.com/watch?v=tss7Z5DwGtE [Accessed 04/12/18

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Nichelle (2010) Improving the Fitness of Your Dancers [online] Available from http://www.danceadvantage.net/fitness-for-dancers/ [Accessed 04/12/18

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Are your dancers fit?

Generally we think of dancers as being physically fit, but today most of us in the dance field recognize that there are 'holes' in typical dance training. Technique classes alone are not enough for the demands of present-day choreography.

Though your dancers may not yet be professionals, if they are studying seriously or competing often they are artistic athletes in training. Conditioning or fitness training can be added to fill any holes, preventing injury and enhancing performance.

In September, I participated in a workshop in Houston, facilitated by Sarah Irvine, a former faculty member of the Dance Science Departments at Laban and Roehampton University. The workshop was an opportunity to participate in and discuss the development of a fitness class, part of a program designed by the Laban Dance Fitness Team to support dancers which has been successfully implemented in programs for career-focused dancers. [ This pdf details some of the research conducted by Irvine and the team]

Cardiorespiratory Endurance

My maximum heart rate:
220 - 33 (my age) = 187
My target heart rate zone:
126 to 153 (70 - 85% of max heart rate)

The cardio component of the 2-hour workshop consisted of a 5-10 minute warm-up and more than 30 minutes of continuous aerobic exercise designed to keep us in our target heart rate (which for dancers is 70-85% of your maximum heart rate: approximately your age subtracted from 220).

What most distinguished this routine from most other aerobics, or aerobic dance classes I've experienced was the increased use of multidimensional movement, familiar dance vocabulary, and dynamics like suspension and fall.

These exercises were carefully selected and rooted in dance and exercise science and I am hoping that the fitness team at Laban might make available some suggested fitness routines in the future. I sadly did not notate the exercises well enough to share with you, however, I will say that what we did actually reminded me a great deal of the Nia classes I've taken, and my college jazz dance classes.

My college professor's extended warm-up for our class was always at least 20-30 minutes of continuous movement that progressed from smaller steps (ball change, marches/walking) to larger full-body steps (chassé or lindy, jazz square) with increasing involvement of the torso and arms. It's a method I've stolen for my own jazz classes - once students know the basic steps, I keep them moving for added aerobic benefit, making it more or less complex based upon experience level.

Cardiorespirtory endurance is the component of fitness probably least addressed in technique classes. Dancers don't get much cardio until they are deep into rehearsals and performance - too little, too late, they may lack the stamina required for the performance (which can lead to injury). You may not have a science team behind you, but consider adding some cardio to your students' training.

DO:

Think about ways you can use direction changes, upper body and torso, and dynamics.

Make sure you include a warm-up and cool-down period (5-10 minutes each).

Once the blood is pumping, keep the intensity going for at least 20 minutes and your students will get some added aerobic exercise in their week.

Have students monitor their heart rate before and after. They can note it in a dance journal to keep track of their progress .

Ask yourself - Is it possible to include aerobic exercise more frequently, before rehearsal, as a special class? Is it possible to adapt the series and use a more contemporary or modern or tap or ballet vocabulary?

Prescription: For dancers who need to improve cardiovascular fitness, 20-45 minutes of aerobic exercise 3-7 times per week (less during the peak of performance season; more in the off-season to avoid over-training and overuse injuries) is recommended. You may not be able to fulfill a student's needs entirely at the dance studio so encourage students in other activities like walking, jogging, cycling, stair climbing, or swimming outside of class.

Power

In addition to the cardio workout, Ms. Irvine also had us experiment a bit with anaerobic exercises. These least resembled dance, however, the inclusion of such work has been shown to improve speed and strength - important for dancers and particularly helpful with jumping.

Suggested exercise modes for increasing a dancer's power include sprint training, interval training, plyometrics, and dance specific repetitive movement phrases with faster, more dynamic movements (allegro, anyone?). On this day we tried the following:

Maniac-style Interval Training - You got it, just like in Flashdance, the movie, we did fast-as-you-can running in place. We got into groups and did short bursts (I believe it was one minute), resting as each group took their turn.

Standing Long Jump - Across the floor we performed two feet to two feet jumps with the goal of getting as much distance as we could (trying for one less than we did the last time across), and also to land as softly as we could using a deep parallel plié and swinging arms.

But where are the pointed toes? There's power in the foot. What about turnout? Isn't this undoing their training? I'm coaching dancers, not track and field! - This is not a replacement for traditional dance training methods but adds functional support for the physiological needs of dancers, who must be athletes as well as artists. In the program implemented by Laban, exercises were gradually modified to include turn out and more closely mimic dance jumps.

Tuck Jumps - Fitting as many tuck jumps as possible into 30 seconds, spending as little time on the ground as possible (and no double bouncing). I found this one difficult - fast twitch is not my specialty but I'm a decent jumper when it comes to repetitive allegro. As I tried this it was absolutely clear to me how this could improve my height and explosiveness in jumps.

Prescription: For dancers who need to improve anaerobic fitness, speed, and strength, it is suggested that 4 to 12 dynamic speed training exercises (using full body weight as resistance) be selected and added to their training regime. Repeating 3 - 6 sets in 10 to 2 minute time frames (or 5 to 10 reps). The intensity should be moderate, with 2-5 minute rest periods between. This is not every day training. Two to three days per week is enough.

Note that dancers will not have identical needs and that the prescriptions above must vary depending on a dancer's deficit in certain areas of fitness. Dancers can be assessed for fitness and should be evaluated by a doctor before beginning a new fitness program. Though most exercises listed above could be facilitated by an experienced dance educator, any training program will be safer and more effective under the watch of a professional trainer or fitness expert.

In addition, I'd like to note that the prescriptions above come from a handout provided during the workshop. Cited as references on the handout are Bompa, T.,O. (1999). Periodization: Theory and methodology of training (4th ed.). Champaign, IL; Human Kinetics. and Hayward. V., H. (2002). Advance fitness assessment and exercise prescription (4th ed.). Champaign, IL; Human Kinetics.

Other than this worksheet, all other information is based upon my understanding, experience, and interpretation of the workshop material. I pass it on to you for informational purposes only. I'd like to get wheels turning, get you thinking and asking questions about fitness for your dancers. Do not, I repeat, do not consider any of the above as medical or health advice. And dancers, do not use this information to design your own fitness regime.

Stay tuned for part two of this article! In it, I'll briefly go over four other components of fitness important to dancers, recap some exercises and tools Ms. Irvine discussed which are used to assess a dancer's fitness, relay a word of caution for those working with young teens, and share a stockpile of helpful links and resources on the subjects of dance science, fitness, and wellness for dancers.

What are your challenges to addressing the fitness needs of dancers at your school?

Do you incorporate any of the above into your training regime?

What are some other ways you include aerobic and anaerobic fitness training in or outside of dance training?

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Are your dancers fit? Generally we think of dancers as being physically fit, but today most of us in the dance field recognize that there are 'holes' in typical dance training. Technique classes alone are not enough for the demands of present-day choreography.

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Healthtl (2018) Warm Up and Cool Down for Dancers [online] Available from https://trinitylaban.wordpress.com/2014/04/02/warm-up-and-cool-down-for-dancers/ [Accessed 04/12/18

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Stahl, J (2017) Proof We Need to Talk About Dancers' Mental Health [online] Available from https://www.dancemagazine.com/dancers-mental-health-2468281638.html [Accessed 04/12/18

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Is the dance world doing enough for dancers' mental health? Judging from the incredible reaction to Kathleen McGuire's recent story on the topic, it seems that the answer is a resounding "no."

Not only did the piece quickly become one of our most-read, readers shared it hundreds of times, and many reached out to us directly with their own stories. On Facebook, Twitter and through email, several people offered up suggestions for how the dance field could improve. We wanted to share some of the top comments we got-because it's obviously a conversation we all need to have.

Some of you offered smart suggestions:

Boston Ballet School has had a close relationship with a mental health professional for a several years now, in addition to a Nutritionist and Physical Therapist as part of their wellness team; services offered to families of the Boston Ballet School. Her article brings up a very important aspect of a dancer's training, and it should be known that institutions are recognizing this is so.

-Jennifer Markham, Faculty, Boston Ballet School

I had a career as a dancer, at the highest level and for many years have been a psychotherapist, so I too am trying rid the dance world of the mental health stigma. I have a blog, which can be reached via my website, counsellingfordancers.com.

Facebook: @counsellingfordancers
Twitter: @counselingdance

-Terry Hyde

Related Articles Around the Web

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Proof We Need to Talk about Dancers' Mental Health

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Is the dance world doing enough for dancers' mental health? Judging from the incredible reaction to Kathleen McGuire's recent story on the topic, it seems that the answer is a resounding "no." Not only did the piece quickly become one of our most-read, readers shared it hundreds of times, and many r...

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Human Muscles Diagram (2018) Image https://anatomical.us/wp-content/uploads/2018/01/human-muscles-diagram-labeled-full-body-naming-skeletal-muscles-c2b7-anatomy-and-physiology.jpg [Accessed 01/10/18]

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Diagram of Human Skeleton (2018) Image http://defenderauto.info/wp-content/uploads/the-human-skeleton-the-skeleton-bones-anatomy-physiology-1.jpg    [Accessed 01/10/18]

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NIDMS RESEARCH

Epidemiological research

Together the NIDMS partners have designed a large-scale, prospective, epidemiological research project, which is needed to fully understand the multi-dimensional causes of injury in different populations of dancers, and the best strategies for preventing and treating them.

This project will be the first of its kind on this scale in dance in the world and any companies and schools wishing to participate or just to find out more should get in touch: manager@nidms.co.uk

Analysis of the data collected will enable the dance sector to develop optimal injury prevention and fitness programmes for dancers working and participating in a variety of contexts, helping to reduce the rate of injuries and get dancers back performing more quickly.

This is a major project which we are still fundraising for so if you would like to make a donation you can via our page.

Research from recent years is included below and most are available as a free download.

If you're interested in a specific area, click on one of the photos below to skip to that topic:

Force measurement/reduction

Weight transfer

Posture/movement analysis

Nutrition and hydration

Brown, M., Redding, E., Quin, E., Stevenson, E. & Howatson, G. (2016). Dietary and exercise behaviours of female contemporary dancers attending a conservatoire. International Association of Dance Medicine and Science 26th Annual Meeting, Hong Kong

Training considerations

Anker, S. & Quin, E. (2016). An investigation of the pedagogical rationales for current mirror use in a Ballet technique class. International Association of Dance Medicine and Science 26th Annual Meeting, Hong Kong

Blazy, L., Quin, E. & Redding, E. (2010). Effects of a 10-week creative dance programme on flexibility and aerobic capacity in 11-13 year-olds. International Association for Dance Medicine and Science 20th Annual Meeting, Birmingham, UK.

Quin, E., Clark , T, Redding, E., Irvine, S., Rafferty, S. & Ehrenberg, S. (2010). A dance screening and profiling programe. Medicine and Science for the Benefit of the Dancer: Creating and maintaining a balanced body. Dance Science Conference, Estonia.

Quin, E., Irvine, S., Rafferty, S. & Redding, E. (2010). Structure and delivery of a dance specific fitness class for contemporary dancers. Medicine and Science for the Benefit of the Dancer: Creating and maintaining a balanced body. Dance Science Conference, Tallin, Estonia

Integrating dance science

Duffy, P., Surgenor, B. & Quin, E. (2016). Technology in Dance Science - Magic and Movement. International Association of Dance Medicine and Science 26th Annual Meeting, Hong Kong

Quested, E. & Redding, E. (2006). When art meets science: An action research approach to improving professional dance teaching and learning. The Learning Conference, Montego Bay, Jamaica.

Redding, E., Chin, S., Hushlak, M.A., Sentler, S. Vahla, A. (2011). In Preparation: A Performance-led approach and a new research methodology for Dance Science.International Association for Dance Medicine and Science 21st Annual Meeting, Washington, DC, USA.

Surgenor, B. & Quin, E. (2016). Walking in someone else's shoes? Reflections on the first cross-cultural dance science academic exchange. International Association of Dance Medicine and Science 26th Annual Meeting, Hong Kong

Safe dance practice

Quin, E. (2016). Warm-up and cool-down habits of dancers in three settings; class, rehearsal, performance. International Association of Dance Medicine and Science 26th Annual Meeting, Hong Kong

Injury tracking, recording and surveillance

Beck, S., De'Ath, S., Aujla, I., Nordin-Bates, S., & Redding, E. (2013). Injury tracking in pre-vocational dancers: findings from the UK Centres for Advanced Training. Poster session presented at the 23rd Annual Meeting of the International Association of Dance Medicine & Science, Seattle, WA.

Clark, T., Watkins, K. & Redding, E. (2011). Injury tracking in a dance conservatoire. International Association for Dance Medicine and Science 21st Annual Meeting, Washington, DC, USA.

De'Ath, S. (2014). An experimental model for collecting real-time and retrospective self-reported injury data based on the IADMS SMCI recommendations. Poster session presented at the 24th Annual Meeting of the International Association for Dance Medicine & Science, October 16-18, 2014, Basel, Switzerland.

Injury prevalence

Alvarez-Franco, A. & Redding, E. (2010). Dancer injuries: findings from a recent survey of professional dancers. International Association for Dance Medicine and Science 20th Annual Meeting, Birmingham, UK.

Strategies/interventions for injury prevention and reduction

Quin, E., & Redding, E. (2010). Dance Injury Prevention Strategies: Injury risk identification, education and prehabilitation at Laban. A Dance Science Perspective. At the fore-front of athletes-care: A European framework of applicable knowledge and standards in practice European Society of Athletic Therapy and Training (ESATT), Poland.

Variables related to injury incidence

Clark, T., McGill, A. & Redding, E. (2011). The relationship between balance and dancers' past and future lower-limb injuries. The Medical Problems of Performing Artists 29th Annual Symposium, Snowmass, Colorado, USA.

Anthropometry

Mitchell, S., Challis, J. & Redding E. (2015). Establlishing normative data for a novel, minimally invasive, method of body composition measurement in dancers. Poster session presented at the 25th Annual Meeting of the International Association for Dance Medicine & Science, October 8-11, 2015, Pittsburgh, PA.

Dance Specific Testing

Angioi, M. PhD; Metsios, G.S. PhD; Koutedakis, Y. PhD; Wyon, M. PhD, University of Wolverhampton, Walsall, UK. (2010). Development of modified hexagonal agility test protocol for dancers: a qualitative preliminary approach (poster presentation). International Association for Dance Medicine and Science 20th Annual Meeting, Birmingham, UK.

Redding, E; Quin, E; Rafferty, S; Beck, S; Aujla, I; Nordin-Bates, S; De'Ath, S. (2015). Dancer aerobic fitness: ten years on. The 25th Annual Meeting of the International Association for Dance Medicine & Science, October 8-11, 2015, Pittsburgh, PA.

Fitness

Angioi M; Twitchett, E; Metsios, G; Koutedakis, Y; Wyon, M (2009) Fitness levels in contemporary dance: a systematic literature review. International Journal of Sport Medicine Vol 30 p1-11.

Clark, T, Blazy, L., McGill, A., Ehrenberg, S., Irvine, S., Quin, E., & Redding, E. (2010). Physiological differences between students, pre-professional and professional dancers. International Association for Dance Medicine and Science 20th Annual Meeting, Birmingham, UK.

Lee, L., Redding, E., Quin, E., Irvine, S. & Rafferty, S. (2010). Physiological responses to a one-year dance-specific fitness training programme among full-time university modern dance students. International Association for Dance Medicine and Science 20th Annual Meeting, Birmingham, UK.

McCleod, H. & Quin, E. (2016). Self reported ratings of importance and engagement level in supplementary fitness training for selected fitness parameters among pre-professional and professional contemporary dancers. International Association of Dance Medicine and Science 26th Annual Meeting, Hong Kong

Redding, E. (2013)Dancers: Fit Bodies?(keynote speaker). International Symposium on Performance Science, Vienna, Austria.

Redding, E. (2015). Putting the science to work in a class: The importance of fitness and conditioning for dance.The 25th Annual Meeting of the International Association for Dance Medicine & Science, October 8-11, 2015, Pittsburgh, PA.

Health and wellbeing

Chasemore, A; Redding, E. (2014). A study of the health and well-being of former professional classical ballet dancers. The 24th Annual Meeting of the International Association for Dance Medicine & Science, October 16-18, 2014, Basel, Switzerland.

Connolly, MK., Quin, E. & Redding, E. (2010). Dance 4 your life: a dance and health study. International Association for Dance Medicine and Science 20th Annual Meeting, Birmingham, UK.

Intensity and efficiency

Beck, S. & Redding, E. (2011). Investigating measures of intensity in dance: relationships of ratings of perceived exertion and heart rate to oxygen uptake.International Association for Dance Medicine and Science 21st Annual Meeting, Washington, DC, USA.

Beck, S; Redding, E; Wyon, M. (2014). Investigating changes in energy system utilization during a year of contemporary dance training. The 24th Annual Meeting of the International Association for Dance Medicine & Science, October 16-18, 2014, Basel, Switzerland.

Quin, E. (2014). Questioning efficiency in dance. The 24th Annual Meeting of the International Association for Dance Medicine & Science, October 16-18, 2014, Basel, Switzerland.

Strategies/Interventions to improve physical performance

Barriers to training

Aujla, I. J., & Redding, E. (2013). Barriers to dance training for young people with disabilities. British Journal of Special Education, 40(2), 80-85.

Commitment, motivation and dropout

Aujla, I.J., Nordin-Bates, S.M., & Redding, E. (2012). Commitment, adherence and dropout among young talented dancers: findings from the UK Centres of Advanced Training. The 22nd Annual Meeting of the International Association of Dance Medicine and Science, Singapore.

Walker, I.J., Nordin S.M., & Redding, E. (2010). Commitment to elite dance training: Findings from the UK Centres for Advanced Training. The British Psychological Society Annual Conference, 14-16 April, Stratford-upon-Avon. First prize winner.

Environment and motivational climate

Aujla, I., Redding, E., & Nordin-Bates, S. (2013). Successful talent development environments in dance. In R. Solomon,& J. Solomon (Eds.), The 23rd Annual Meeting of the International Association for Dance Medicine & Science, October 17-19, 2013, Seattle, WA.

Nordin, S.M., Walker, I.J., Redding, E., Quested, E., & Duda, J.L. (2009). Motivational climate and perfectionism among young talented dancers: Findings from the UK Centres for Advanced Training. 12th World Congress of Sport Psychology, Marrakesh, Morocco.

Nordin, S.M., Quested, E., Walker, I.J., & Redding, E. (2010). Climate change in the dance classroom: Findings from the UK Centres for Advanced Training. International Association of Dance Medicine and Science 20th Annual Conference, Birmingham, UK, October 2010.

Watson, D., Nordin, S. & Chappell, K. (2010). The experience and nurture of creativity in dance: Findings from a government-funded pre-vocational training programme. International Association for Dance Medicine and Science 20th Annual Meeting, Birmingham, UK.

Passion

Aujla, I. (2014). Passion for dance: antecedents, outcomes, and future research directions. The 24th Annual Meeting of the International Association for Dance Medicine & Science, October 16-18, 2014, Basel, Switzerland.

Aujla, I., Nordin-Bates, S., & Redding, E. (2013). Perceptions of teacher behavior predict students' passion for dance. In R. Solomon, & J. Solomon (Eds.), The 23rd Annual Meeting of the International Association for Dance Medicine& Science, October 17-19, 2013,Seattle, WA.

Talent identification and characteristics

Basic needs satisfaction

Balaguer, I., Quested, E., Castillo, I. Álvarez, M. S., & Duda, J. L. (2010). Exploring predictors of life satisfaction, on the stage and in the stadium: A test of the basic needs theory among dancers and soccer players. 20th Annual Meeting of the International Association for Dance Medicine and Science (IADMS), Birmingham, UK. October 2010

Clements, L; Quested, E; Turner, J. (2015). Autonomy, relatedness, competence and the immune respone in a ballet and contemporary school. The 25th Annual Meeting of the International Association for Dance Medicine & Science, October 8-11, 2015, Pittsburgh, PA.

Quested, E. & Duda, J. L. (2010). The social-psychological antecedents of burnout in dance: A longitudinal test of basic needs theory. Journal of Sport and Exercise Psychology, 32, S210.

Motivational climate

Nordin, S.M., Walker, I.J., Redding, E., Quested, E., & Duda, J.L. (2009). Motivational climate and perfectionism among young talented dancers: Findings from the UK Centres for Advanced Training. 12th World Congress of Sport Psychology, Marrakesh, Morocco.

Quested, E., & Duda, J. L. (2007). Motivational climate, needs satisfaction, and wellbeing among dancers. 12th Annual Congress of the European College of Sports Sciences (ECSS), Jyväskylä, Finland.

Quested, E., & Duda, J. L. (2007). Social environmental predictors of motivation regulations and self-perceptions in dancers. 12th Annual Congress for Sport Psychology (FEPSAC), Halkidiki, Greece.

Perfectionism/Body image

Cumming, J., Nordin, S. & Duda, J. (2010). Elite dance students' views on perfectionism and achievement striving. International Association for Dance Medicine and Science 20th Annual Meeting, Birmingham, UK.

Performance anxiety

Predictors and interventions for psychological wellbeing

Somatics and imagery

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NIDMS RESEARCH Together the NIDMS partners have designed a large-scale, prospective, epidemiological research project, which is needed to fully understand the multi-dimensional causes of injury in different populations of dancers, and the best strategies for preventing and treating them.

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IADMS (2018) Image [Accessed 26/11/18] Available from
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One Dance UK (2018) Image [Accessed 26/11/18] https://www.onedanceuk.org

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Resource Paper: Dance Fitness - International Association for Dance Medicine & Science

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This resource paper discusses how to improve fitness in dancers. Good fitness is key to reducing the risk of injury, enhancing performance, and ensuring longer dancing careers.

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There is a misconception that the majority of dancers are physically fit and have strong cardiovascular endurance. Dance activity generally stops and starts utilising the anaerobic system therefore the aerobic system is not engaged. Generally dancers lack cardiovascular fitness this can lead to injury. Ideally cardiovascular training needs to be incorporated into the dance technique class to enhance your dance ability as well as your fitness, health and wellbeing.

Reasons why dancers do not have cardiovascular fitness:

Technique class stops and starts does not engage the aerobic system

Dancers are often overworked with too much time spent in class, rehearsal and performance

Dancers do not engage in enough rest, leisure time and relaxation

Benefits of Cardiovascular Endurance Exercise for dancers:

Improves your posture and health

Enhances stamina which improves your performance ability

Increases oxygen supply to muscles - efficient functioning Improves your anaerobic ability

Reduces the risk of fatigue, enhances concentration and reduces stress levels

Boosts your immune system and reduces the risk of injury

Understanding the Cardiovascular System

Cardiovascular endurance depends on the ability of the heart and lungs to deliver oxygen to where it is needed and to continue for long periods of time under stress.
In reality most types of dance training involves stopping and starting; performing short movement sequences with intermittent periods of no activity where you observe the next sequence, this way of working only develops your anaerobic system it does not develop your aerobic capacity.

Anaerobic and Aerobic Systems

Anaerobic System

Anaerobic simply means without oxygen.
As you begin physical activity there is a sudden demand for energy, the body will use up its first energy store then go onto to use up the stores of glycogen (broken down from carbohydrates) stored in the muscles as the energy is not available in the form of oxygen. This is because the body is working so hard that the demands for oxygen exceed the rate of supply.

Lactic Acid

During anaerobic activity the waste product lactic acid is produced. As there is no oxygen supply to the muscles the lactic acid will build up and can be the cause of muscle soreness and you will be forced to ease of or stop. You will be unable to return to activity until the lactic acid is removed. As you rest oxygen is supplied to the muscles replenishing the energy stores and you soon will be able to return.
When you start any physical activity you will use the anaerobic system, however, if the activity is low in intensity your body will be able to supply oxygen to your muscles and continue as you engage in the aerobic system.

Anaerobic Exercise

Anaerobic exercise is intense exercise lasting approximately one to three minutes (Lactic System) the demand is sudden or large that the heart is unable to pump enough oxygen to the working muscles.

High intensity, short duration:

Running up the stairs

Sprinting

Dance - centre work e.g. short jump sequence

Dance - short sequence across the room

Aerobic System

Aerobic simply means with oxygen
Oxygen is delivered around the body via the blood stream and pumped by the heart. The aerobic system can only work when the energy demand is low intensity for the heart to provide the muscles with sufficient supply of oxygen. In aerobic activity the body is working at a level in which the supply of oxygen is sufficient to the body's demands for oxygen.

The aerobic system breaks down glycogen (carbohydrates) as energy and if you continue over thirty minutes of aerobic activity at low intensity you will begin to break down fats. The only waste products formed are carbon dioxide and water. These are removed as you sweat and by breathing out.

Aerobic Exercise

The oxygen is delivered around the body; the aerobic system can only function when the energy demand is low enough for the heart to supply the muscles with sufficient oxygen.

Low to moderate intensity, long duration activities:

Walking or jogging

Cycling

Swimming

Continuous low intensity dance (such as the five rhythms)

Aerobic Endurance Exercise

This variation is when exercise continues at a low level over a long period of time to build cardiovascular fitness.

Low intensity activities over half an hour:

An hour's walk

30 minute swim

30 minute cycle (stationary bike)

Continuous low intensity dance (such as the five rhythms)

Aerobic Endurance Training

Aerobic endurance is developed through the use of continuous rhythmical activity to improve maximum oxygen uptake (VO2max).

VO2 max is the maximum amount of oxygen that you can use to produce the energy you require for any physical activity.
It is important for dancers to progressively improve their cardiovascular endurance, training only occurs after thirty minutes of continuous activity where the pulse rate is sufficiently increased to improve your maximum aerobic capacity (V02 max). Aerobic exercise strengthens the heart and lungs, (cardiovascular) system. An aerobically fit dancer can rehearse or perform for longer, more vigorously and achieve a quicker recovery. It is beneficial to participate in cardiovascular endurance activities 3 to 5 times per week.

Aims of aerobic endurance training:

Improve the heart and cardiovascular system so blood (and oxygen) can be delivered around the body more efficiently

Increase the body's ability to utilise oxygen

Increase the body's ability to recover from heavy bouts of intense exercise (dance).

Training Intensity

It is important to work out how hard you are working by measuring your heart rate. During exercise your heart rate goes up; the harder you work, the faster the heart beats. Everyone has a maximum heart rate, calculating how close your heart rate is to its maximum during exercise enable you to check the intensity of your workout.

When participating in cardiovascular endurance training, the most efficient way to strengthen the heart is to aim for a training threshold. This is a percentage of your maximum heart rate, and should be the level your heart is working on for 20-30 minutes at least.

Heart Rate Monitoring

Resting heart rate

Find your pulse in your wrist or neck, and count the number of beats for 6 seconds then multiply the number of beats by 10 e.g. you count 12 (12 x 10 = 120) your heart rate is 120 beats per minute (BPM).

Or for 15 seconds and multiply the number of beats by 4

Maximum heart rate

The maximum heart rate is estimated by taking your age away from 220. e.g. 220 take away (your age) 20 = 200 BPM.

Target heart rate for exercise

A target heart rate would be at least 60% or at the most 85% of your maximum heart rate. When you first start a cardiovascular fitness programme, your target heart rate, during exercise, should be 60% of the predicted maximum heart rate. It is optimum to build up to 30 minutes working at 75% of your maximum heart rate.

Cardiovascular Endurance in Dance

Ideally cardiovascular training is incorporated within the dance training itself with the later part of a technique class training the cardio vascular system. For example, travel and jump combinations lasting at least 32 to 48 bars in duration and including longer dance combinations dividing the class so the dancers receive adequate rest period to recover from the cardiovascular workout.

In my personal experience I found African dance training incorporates both the aerobic and anaerobic systems with appropriate rest and recovery periods maybe other dance technique classes can learn from this model.

If cardiovascular training is not an integral part of your dance training it is important that dancers find an appropriate cardiovascular routine to compliment your dance training, rehearsal or performance also allowing for adequate rest periods.

Enhanced cardiovascular endurance can enhance you dance skill, fitness and can prevent injury from occurring due to fatigue. With all dance training a warm up and cool down sequence is required to maintain health and well being and enhance recovery. Improved cardiovascular fitness can enhance you dance ability and help you reach your true potential in dance performance.

Disclaimer: The information contained on this web page is intended as general guidance and information only. Power Dance System and its authors accept no liability for any loss, injury or damage however incurred as a consequence, whether directly or indirectly, of the use this information. All advice on this web page should only be used under the supervision of a qualified dance / fitness / healthcare professional.

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The Importance of Cardiovascular Endurance for the Dancer

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There is a misconception that the majority of dancers are physically fit and have strong cardiovascular endurance. Dance activity generally stops and starts utilising the anaerobic system therefore the aerobic system is not engaged. Generally dancers lack cardiovascular fitness this can lead to injury.

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Comparisons explained and referenced  in word document

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The Meal Plan Site (2018) Meal Plan for a Dancer [online] Available from https://www.mealplansite.com/sports/dancer.aspx [Accessed 01/10/18]

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Meal plan to suit a keen dancer of any type from ballet to street dance

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Carlos Acosta at The Royal Ballet (book)

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Carlos Acosta at The Royal Ballet (book)

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Referenced in word document

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Safe Dance Practice (2018) Image [Accessed 26/11/18]  http://slideplayer.com/slide/4896692/16/images/3/Remember+(Her+Majesty+Just+Bought+Five+Cats!).jpg

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Referenced in word document

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Nutrition: WHO health topic page on nutrition links to descriptions of activities, reports, publications, statistics, news, multimedia and events, as well as contacts and cooperating partners in the various WHO programmes and offices working on this topic.

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The University of Waikato (2011) Macronutrient Percentages [online image] Available from https://www.sciencelearn.org.nz/system/images/images/000/000/568/full/Macronutrient-percentages20151125-6170-1kni8ml.jpg?1448439624 [Accessed 01/10/18]

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Lucas, A (2017) A Healthy Meal Plan for Dancers [online] Available from https://www.livestrong.com/article/162703-healthy-diets-for-dancers/ [Accessed 01/10/18

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Dance Workouts: What Counts, Health Benefits, and Getting Started

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Zumba, hip-hop, salsa, and ballet can all make for a great workout. Choose a style you love and you’ll barely notice you’re exercising.

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Health Policy - referenced in word document

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The Prix de Lausanne Health Policy: Why? And how?

Reaching peak performance in classical ballet calls for exceptional physical, mental, technical and artistic skills. At the same time, and despite the high levels of physical exertion involved, ballet's aesthetic criteria encourage dancers to be lean. To achieve what they believe to be the required degree of leanness, dancers very often control their weight by rigorously limiting their energy intake. This kind of chronic restriction of calories, to maintain excessive thinness, is extremely harmful to a dancer's health in both the short and long term. There is considerable evidence that excessive thinness and malnutrition affects physical growth, pubertal development, morbidity, mortality, cognitive development, reproduction, physical performance and bone health as well as increasing the risk of several adult-onset chronic diseases. Compromising health in pursuit of thinness will not only reduce the dancer's ability to sustain the rigours of a professional career, it can also have severe and extreme consequences. Some of the risks include: Cardiac arrhythmia and risk of heart attack, kidney failure reduced bone health and risk of stress fractures and osteoporosis, reduced or impaired fertility, suppressed immune system, leading to risk of infection, hair thinning and loss, skin problems. Read the whole article
You can also refer to the Rules and Regulations 2019 (article 5).
Dr. Carlo Bagutti and the Prix de Lausanne Organizing Committee:
Is it possible these days to achieve quality performance without taking physical risks?
Reaching peak quality performance in the field of classical dance calls for extremely high physical, technical and artistic attributes. The risk of injury within this quest is relatively low. However, certain dancers might seek to emulate - or be encouraged to emulate - the achievements of dancers with extreme physical capabilities such as exceptional flexibility or flat turn out. Through forcing their bodies to mimic another dancer's skills, rather than gradually enhancing their own, these dancers run the risk of serious 'overload' injuries, with long term consequences to their dancing careers.
In recent years, the Prix de Lausanne has also devoted attention to the issue of excessive thinness, or even anorexia, in young female dancers. Is anorexia a significant or a marginal phenomenon?
Anorexia is far more prevalent in the general population than one might imagine. In certain fields (such as classical ballet, fashion modelling, and sports such as artistic gymnastics, ice-skating and running) where the aesthetic appearance and weight are particularly in the spotlight, it is even more widespread. Nonetheless, the majority of problems stem from eating disorders related to but less serious than fully-fledged anorexia. These anorexic-types of behaviours, which occur more frequently than fully-fledged anorexia, also jeopardize the health of such individuals, particularly if they are young people in the midst of their growth period. There is a growing awareness that the psychological demands of training to be a professional dancer need to be acknowledged and understood. Is it psychologically more difficult to perform ballet than to engage in another artistic or sports discipline? Ballet requires considerable personal investment. From childhood on it is the focal point of the young dancer's life. In itself, experiencing dance through one's body generates tremendous personal passion in both physical and psychological terms. As dancers need to devote so much time and energy to their training, they generally forego the usual balance of leisure and social activities. Therefore, it is extremely beneficial if family support and friendships can be adapted so that the dancer is not always forced to choose between their training and friendships and family activities.

Despite the short period of time in which you, as the Prix's consulting physician, are in contact with the participants, what steps can you take to raise young people's awareness of the benefits of healthy training practices and nutritional choices?
Our health-oriented educational project has a three-pronged thrust. First of all, the candidate receives a medical document that must be completed in the presence of a family doctor. This is accompanied by a detailed questionnaire regarding nutritional behavioural disorders. The aim of this medical file is to raise awareness of potential problems related to disordered eating among candidates, and those around them, and to provide the family doctor with an opportunity to discuss these issues. This information from the family physician, shared with me in strict confidence, allows me to form an opinion of the dancer's state of health and identify dancers at risk. My personal interventions during the competition represent the second focus of our action. Thirdly, In situations that I consider particularly risky, I draw up a strategy for subsequent care and monitoring of the young dancer's health. Doesn't responsibility for the health of these young dancers mostly lie with their parents and those supervising their training? That is absolutely true, but the organizing committee of the Prix de Lausanne feels that it is highly irresponsible to simply turn a blind eye to the health risks related to excessive thinness or to an injury due to excessive strain, as this compromises a dancer's long-term development.

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The Prix de Lausanne Health Policy: Why? And how? Reaching peak performance in classical ballet calls for exceptional physical, mental, technical and artistic skills. At the same time, and despite the high levels of physical exertion involved, ballet's aesthetic criteria encourage dancers to be lean.

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Prix De Lausanne (2018) Image  [Accessed 26/11/18]
https://www.prixdelausanne.org

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An Introduction to Safe Dance Practice (2018) Image      [Accessed 26/11/18]  https://image.slidesharecdn.com/anintroductiontosafepractice-131023053456-phpapp02/95/an-introduction-to-safe-practice-5-638.jpg?cb=1382506529