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What does your pre-class warm-up look like?

If it is anything like mine was, it was sitting around in a circle with my dance friends, chatting and sitting in a split of some kind. Occasionally, I might have swung a leg to and fro a bit to warm up the hips. In hindsight, this never actually ‘warmed up’ anything! A recent study* has looked at Neuromuscular warmups compared with a ‘traditional’ dance warmup up and the relationship with overuse injuries. They found that dancers utilising a traditional approach had 2 more injuries per dancer over a 2 year period than dancers using a neuromuscular approach.


Neuromuscular warmups

So what does a neuromuscular warm up look like?

Well, let’s first define the term neuromuscular: Neuromuscular is defined as all the muscles in your body plus the nerves that activate them. While dancers probably mostly think about the muscles that are helping them to make the movement, most are probably not thinking about the nerves that make it all happen.

Nerves are responsible for:

  • Selecting the right number of muscle fibres required for the movement

  • Ensuring the firing pattern of the muscles is correct (co-ordination)

  • Feeding back proprioceptive information back to the brain so that it can make adjustments as required to the movement (think uneven floors).

  • And much more!

So, when warming up, we need to make sure we are waking up or priming both our muscles and nerves. Research in athletes (which is more comprehensive and plentiful than dance studies) backs this idea up, showing that neuromuscular warm ups reduce injuries.


So what does a neuromuscular warm up do?

Firstly, it warms up the muscles by pumping oxygen rich blood to the areas that are being used. Muscles respond better to demands placed on them when they are warm and have adequate supply of all the nutrients and components to make them work such as energy stores.

Research has shown that warmed up muscles are less susceptible to injury. Secondly, non-dance (or non -port)specific strength, power and co-ordination exercises prime the muscles for the more specific dance demands placed on them after warm up, without contributing to injury risk due to overuse.


What should a warm up look like?

Cardio – You want to get your heart rate above what is normally is at rest. If you don’t have access to a smart watch which can read your pulse, go for a rate of perceived exertion at 5 – 6 / 10, which would be moderate intensity. You can still speak, but you may be puffed. This can be exercises like skipping, jogging on the spot, step ups, jumping jacks or a mix of all of them.




Strength – This is where an exercise physiologist specialised in dance injury prevention can really help. They can look at your weaknesses and find any muscle imbalances and guide you best on which muscles to activate before commencing your class. As a general guide though, select exercises that work the muscle groups you will be using for that class. Generally this is all your major muscle groups – particularly the legs. But if you are doing partner work or acro, then you may also need to include your arms and shoulders. You can use Therabands if you have them, otherwise body weight and / or floor exercises are fine too.



Neuro – Waking up your nerves (and your brain!) can also help reduce the risk of injury. So also do some balance work or quick forward, back and sideways jogs.







Time – You should probably ensure you are warming up around half an hour before your class. This will give you ample time to add all three components into your warmup….and get a bit of a chat in with your class mates as well.





Now what about stretching?

Research shows that intense static stretching where you hold the one position for long periods of time actually decreases your muscle activation, power required for jumps and generally limits your ability to perform to you best ability. So swap your long static stretches before class for dynamic (not ballistic) stretches. This means moving through your full range of motion, but not staying there.


Check with your exercise physiologist for examples of what you can do. Reserve your static stretches that you want to use to extend your range (i.e. get deeper splits) for after class when your muscles are very warm and will respond better, and you no longer need them to produce power for jumps or other moves requiring power.


Still got questions?

Contact me at dancewright.com.au or on 0493 536 222 for a consultation to personalise your warm up today! Otherwise, post your general question on Dancewright’s Facebook page and I'll get back to you with more information.


*Reference:

Kauffmann JE, Nelissen RGHH, Stubbe JH, Gademan MGJ. Neuromuscular warm-up is associated with fewer overuse injuries in ballet dancers compared to traditional balletspecificwarm-up. J Dance Med Sci. 2022;26(4):244-54. https://doi.org/10.12678/1089-313X.121522e



Snapshot: A quick look at some 'hot off the press' dance medicine research.....

Great News! Researchers have shown that Mat work Pilates improves spinal flexion and extension and neuromuscular efficiency in the internal oblique and multifidus muscles. Yay!

The Journal of Dance Medicine & Science have released their most recent volume containing a research article on: Effect of Pilates Mat Exercises on Neuromuscular Efficiency of the Multifidus and Internal Oblique Muscles in a Healthy Ballerina

Hypothesis: Dancers could benefit from Pilates exercises to stabilise their trunk muscles, improve joint stability and neuromuscular efficiency (NME): relationship between electrical activity and force of the muscles.

Method/ Focus: This study looked specifically at the Internal oblique and multifidus muscles. They delivered an 8 week Pilates program to a 24 ear old amateur ballerina.

What they Found: Spinal flexion and extension torque increased, and electromyography (EMG) activity decreased (resulting in greater neuromuscular efficiency).

Why is this important research? :

- Lower back and other such injuries affect 95% professional ballet dancers. It is important to look after our backs and reduce the risk of injury.

- The 'Core' incorporates 29 pairs of muscles supporting the hip, pelvis, lumbar spine complex and is used essentially in all dance movements.

- Stability of core defined as “…ability to control the positioning and movement of the trunk over the pelvis and to transfer strength to the upper and lower limbs. “ (p. 80) This is imperative to dancers for spinal safety.

- Multifidis and Internal Oblique muscles contract, stabilise the trunk and keep the spine in neutral position so were the focus of this research.

Discussion: While other studies have shown similar results on general population, this is an important finding for the dance medicine community and will hopefully lead the way to further studies with more participants and more longitudinal research to show how similar programs affect dancer back injury rate.

What other muscles or movements would you like to know about? Comment below and let me know!

Anatomy Lesson

Multifidis

What’s the Multifidis? It’s a series of small muscles that run pretty much the entire length of the spinal column. Check out the page below for a quick video with more information. https://www.physio-pedia.com/Lumbar_multifidus

Internal Oblique

The IO is a sheet like muscle that is underneath the External oblique muscle with fibres that run diagonally from (roughly) the top of the hip bone (Iliac crest) to the lower ribs and central abdominal tendon. More specific abdominal anatomy information can be found HERE.

Neuromuscular Efficiency

What is neuromuscular efficiency? Essentially it is the ability of the nervous system to properly recruit the correct muscles to produce and reduce force as well as dynamically stabilize the body’s structure in all three planes of motion. (https://www.sharecare.com/health/functions-of-the-nervous-system/what-neuromuscular-efficiency) Efficiency means that the minimum amount of neurons (nerves) should be used in order to create the movement and / or force required without compromise. Just like dancers train muscles to move in a certain way, we need to train nerves to function to gain the most benefit for least amount of ‘effort’. So a reduction in EMG activity indicates a more efficient system.

Torque

Normally Torque is referring to a twisting / turning force, but it is a bit more complicated when you are talking about the human body. This video goes into a little bit more detail regarding force in the human body. Watch Here

So keep up your Pilates cross training dancers! Train to be a Stronger, Safer and more Informed dancer. Haven't started your Pilates journey yet? Check out https://www.dancewright.com.au for a great start up package today!

Original Article:

Panhan, A., Goncalves, M., Eltz, G.d., Villalba, M.M., Cardozo, A.C., Berzin, F., 2019, Effect of Pilates Mat Exercises on Neuromuscular Efficiency of the Multifidus and Internal Oblique Muscles in a Healthy Ballerina, Dance Medicine & Science, 23(2), 80 – 83, doi: 10.12678/10/*-313x.23.2.80

Picture Credits:

Multifidis - https://commons.wikimedia.org/wiki/File:Multifidi.png

Internal Oblique -

https://en.wikipedia.org/wiki/Abdominal_internal_oblique_muscle


We're on them all the time and as dancers we ask quite a bit of them...especially if you are going en pointe. But how well do you know your feet? What magic lays beneath your skin working to get those toes pointed, that leg jumped? Well, over the next two blog posts I'm going to take you through the ins and outs of your feet, plus how you can strengthen them to both protect them and get the most out of them. In part one we look at the bones and intrinsic muscles......

Bones

There are 26 bones in the foot, making up 34 joints.

The rear foot contains 7 tarsals – the largest bones in the foot, irregular or cuboid in shape and bear the majority of your body weight when standing, mainly through the talus and the calcaneus.

The other bones are:

* Navicular

* Cuboid

* Medial (inside) cuneiform

* Intermediate (middle) cuneiform

* Lateral (outside) cuneiform

These bones can move in a few different directions (up / down, side to side) allowing movements such as pronation or inversion (rolling the foot) or eversion (sickling the foot) and assisting with balance and landing when working together with the bones of the midfoot.

The midfoot contains the 5 metatarsal bones. These are longer bones rather than cubed bones and provide articulation for movements such as walking between the rear foot and forefoot.

The forefoot contains 14 phalanges making up the toes. Each toe has three phalanges except for the big toe which only has 2.

These bones are so important to the foot and its function in dance.They:

*Provide a structure for the attachments of muscles, ligaments and tendons

* Provide leverage and articulate to create movement and propulsion

* Provide absorption and distribution of energy and force such as landing from a jump.

Intrinsic Muscles

In this section we will look at the intrinsic muscles on the underside of the foot. Many of these muscles are used in dancing for the finer articulations such as demi pointe work, expression and articulation when pointing the foot, pointework and landing from jumps. These intrinsic muscles work in conjunction with longer muscle complexes that originate from higher up the leg or knee. These will be looked at in part 2.

There are four layers of muscles in the underside of the foot. Yes! FOUR!

Starting from the fourth or deepest layer, there are four bipennate muscles (fibres fan out from a central tendon, similar to the calf muscles) between each of the tarsal bones called the dorsal interossei.

These serve to abduct (diverge) the tarsal bones and are on the dorsal (top) part of the foot.

Three muscles (plantar interossei) attached to the third, fourth and fifth toes join the tarsals and lower end of the metatarsals and work with the dorsal interossei to produce flexion (eg. Pointing your foot) and control the movement of the toes during movements like jumps.

The third layer has a number of longer muscles that run from the rear or midfoot to the base of the toe bones.

There is also a muscle running across the ball of the foot (adductor hallucis – transverse head) .

Combined, these muscles help to maintain the arch of the foot and flexes (points) the toes.

In the second layer, we have the lumbricals acting as a kind of accessory to the flexor digitorum longus, both pointing the toes and extending the toes (such as in demi pointe).

The outer most layer, the first layer, has three main muscles: The flexor digitorum brevis which points the toes, abductor hallucis which abducts the big toe (moves it outwards/ away) and the abductor digiti minimi which abducts the little toe.

Now that you know a little more about the intrinsic muscles and what they do, you can see why it would be important to ensure they are properly strengthened and flexible. The next section will go into a couple of exercises that can help strengthen these important muscles.

Strength and Flexibility

As with any strengthening exercise, the muscles need to be challenged in order to increase in strength

1. Ball plantarflexion

Previously, dancers have used TheraBand’s to help strengthen their feet, but new research shows that this needs to be done with care. The ballet blog has a great article on the how and why HERE. (You will need to sign up to the ballet blog for free to access the article “ Why we should avoid pointing into a TheraBand")

Instead, dancers can use a small Pilates ball instead slowly pointing the foot into the top of the ball and pressing down, articulating through the tarsal and metatarsal joints, then reversing into a flexed foot.

The key to this exercise and any other exercise pointing the foot is to keep the toes extended and long DO NOT crunch the toes! Repeat this exercise 10 – 15 times each foot.

2. Piano toes

Another exercise that works and challenges the intrinsic muscles, particularly those that work with abducting or adducting the toes is ‘piano toes’. This exercise starts off with the foot flat on the ground, with the toes flexed as if on demi-pointe. Then, one by one from the little toe, the toes are lowered to the ground. Repeat this exercise 3 – 5 times each foot, then repeat again, reversing the order! For a good demonstration of this exercise watch HERE.

3. Towel Scrunching

For this exercise you can use a thin towel or TheraBand laid flat underneath your foot (or both feet) with a large section extending out from the toes (this is the part you will scrunch) . Using the toes, you will gradually scrunch the towel by planting your toes down flat and drawing them towards your heel. Repeat up to 3 mins each foot, depending on your current strength. For a good demonstration of this exercise watch HERE.

Good luck! and stay tuned for part two which will go into more detail about the muscles in the foot, common injuries and more exercises!

*A reminder that this information is for educational purposes only and is not meant as a substitute for proper diagnosis or treatment by a medical professional.

Credits

Pictures:

Bones of the foot: http://heritance.me/bones-of-ankle-and-foot-labeled/bones-of-ankle-and-foot-labeled-human-anatomy-details-leg-bone-structure

Dorsal interossei: https://human-anatomycharts.com/v/dorsal-interossei-of-the-f.asp

Third layer of the foot: https://www.howtorelief.com/adductor-hallucis-origin-insertion-action-nerve-supply/

Second and First layer of the foot: https://www.orthobullets.com/foot-and-ankle/7003/layers-of-the-plantar-foot

Ball exercise: http://www.flx.life/foot-strengthening-release-1/2016/2/26/2-key-exercises-to-improve-your-arch

Bibliography:

de Mello Viero, C., et. al. (2017). Height of the Medial and Lognitudinal Arch During Classical Ballet Steps. JDMS, 21(3), 109 - 114. doi:10.12678/1089-313X.21.3.109

Haas, J. G. (2010). Dance anatomy. Champaign: Human Kinetics.

Hall, S. B. (2007). Basic biomechanics (5th ed.). New York: McGraw Hill.

Marieb, E. (1998). Human Anatomy & Physiology (4th ed.). Menlo Park: Benjamin /Cummings Science Publishing.


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