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Flexor hallucis longus tendon injury in dancers and nondancers.

Thirty-one cases of flexor hallucis longus injuries in 26 patients were treated over a 16-year period (1977-1993). Groups were divided into dance-related injuries (group I) and other causes (group II). The two groups were compared with regard to age, activity, duration of symptoms, operative findings, histopathology, and postoperative time to resumption of full activities. Twenty-seven cases required surgery for unsuccessful nonoperative treatment. In group I, 71% of patients had a partial longitudinal tear of the flexor hallucis longus compared with 30% in group II. Another common finding was isolated tenosynovitis (21% in group I and 53% in group II). Eight cases had magnetic resonance imaging (MRI) evaluations before surgery. Clinical correlation was found to be an important factor in interpreting the MRI. Dancers tended to have symptoms for a longer period of time before seeking treatment than did nondancers. Follow-up was 19.2 months for dancers and 25 months for nondancers. Surgical correction of tenosynovitis, pseudocyst, and tendon tear yielded good or excellent results in 14 of 15 dancers and 9 of 11 nondancers. Surgical treatment of tendon tears and other pathologic tendon conditions gave consistently good results in patients with refractory flexor hallucis longus disease.

Adolescent↗

Influence of yard work and weight training on bone mineral density among older U.S. women.

The purpose of this study was to determine the influence of type of physical activity on bone mineral density among older U.S. women. Findings from the present study indicate that jogging, swimming and calisthenics were weak predictors for high bone density values. Bicycling, aerobics, walking and dancing were moderate predictors for positive bone density. Yard work and weight training were strong and independent predictors for positive bone density.

Aged↗

The queering of Swan Lake: a new male gaze for the performance of sexual desire.

This essay argues that, by re-gendering the ballet classic Swan Lake, choreographer Matthew Bourne has also queered it. He thrusts center stage an unstable relationship between two male characters, and in so doing, de-centers the conventionally fixed categories of sex, gender and sexual desire. He also forces a long-simmering relationship between homosexuality and dance out of the closet and into mainstream popular culture. Applying Mulvey's theory of spectatorship and Butler's theory of gendered performance, the essay describes how viewers may be intrigued, rather than repulsed, by the ambiguities surrounding Bourne's portrayal of sexual identity.

Art↗

The biological basis of human history.

Well-known physiological peculiarities of human bodies had much to do with raising our ancestors to the top of the food chain: erect posture, binocular vision, an unusually efficient cooling system, and an omnivorous diet. But these capabilities pale beside the advantages that accrued to proto-humans and then to humans from expanding and more precise modes of communication: first dance, then language. Still later, transportation and communication transcended limits set by human muscles with the invention of wind-propelled flotation and animal caravans, while writing overcame limits of personal memory and face-to-face dissemination of information. Contacts across local social and cultural boundaries tended to propagate best practices, making humankind a uniquely dangerous, constantly changing parasite upon other forms of life.

Adaptation, Physiological↗

Overuse injuries in classical ballet.

Successful management of classical ballet dancers with overuse injuries requires an understanding of the art form, precise knowledge of anatomy and awareness of certain conditions. Turnout is the single most fundamental physical attribute in classical ballet and 'forcing turnout' frequently contributes to overuse injuries. Common presenting conditions arising from the foot and ankle include problems at the first metatarsophalangeal joint, second metatarsal stress fractures, flexor hallucis longus tendinitis and anterior and posterior ankle impingement syndromes. Persistent shin pain in dancers is often due to chronic compartment syndrome, stress fracture of the posteromedial or anterior tibia. Knee pain can arise from patellofemoral syndrome, patellar tendon insertional pathologies, or a combination of both. Hip and back problems are also prevalent in dancers. To speed injury recovery of dancers, it is important for the sports medicine team to cooperate fully. This permits the dancer to benefit from accurate diagnosis, technique correction where necessary, the full range of manual therapies to joint and soft tissue, appropriate strengthening programmes and maintenance of dance fitness during any time out of class with Pilates-based exercises and nutrition advice. Most overuse ballet conditions respond well to a combination of conservative therapies. Those dancers that do require surgical management still depend heavily on ballet-specific rehabilitation for a complete recovery.

Ankle Injuries↗

Effects of running and other activities on moods.

The purpose of this study was to compare the moods and mood variations of runners to those of aerobic dancers, weight-lifters, and nonexercising controls. The subjects, 70 undergraduates, were participants in a jogging and conditioning, a weight training, an aerobic dance, or an introductory psychology class. A time-series design was used in which all participants completed eight Profile of Mood State questionnaires over a 6-hr. period that centered on the time of the class. Four questionnaires were completed during the second week of classes and the other four about midsemester, approximately 6 wk. later. Runners had a significantly more positive mood profile than nonexercisers and a somewhat more positive one than weight-lifters, but those of runners and aerobic dancers were similar. Changes in moods across time in relation to activity and across semester suggest that exercise, particularly aerobic exercise, helps the regular participant not only to cope with stress but also to have a generally more positive feeling of well-being.

Adolescent↗

Physical fitness, body image, and locus of control in college women dancers and nondancers.

This study assessed the correlations among measures of physical fitness, body image and locus of control in college freshman women dancers and nondancers. 39 students enrolled in courses in modern, ballet, and jazz dance, and 120 students enrolled in an introductory personal health course were administered the Hall Physical Fitness Test Profile, the Winstead and Cash 54-item short-form Body Self-relations Questionnaire (BSRQ), and the Adult Nowicki-Strickland Locus of Control Scale. Analysis showed dancers were more physically fit, scored more positively on the BSRQ physical fitness and health domains, and were more internal in their locus of control than the nondancers. There was no significant difference between dancers and nondancers on the BSRQ appearance domain. The significant positive correlation between BSRQ health and physical fitness among dancers was not observed among nondancers. The significant positive correlation for BSRQ appearance and health was noted for nondancers but not for dancers.

Adolescent↗

Scores on exercise dependence among dancers.

A number of researchers have suggested that the syndrome of exercise dependence (addiction) is paralleled by a tendency towards eating disorders such as anorexia nervosa and bulimia. As considerable research has reported a high incidence of eating disorders among dancers and as rigorous physical demands are inherent in dance, we hypothesized that dancers would present a higher profile of exercise dependence on the Negative Addiction Scale than other athletes. To test this hypothesis, 47 female ballet and modern dancers completed a survey on exercise dependence adapted from Hailey and Bailey (1982) to assess quantitatively exercise dependence. Scores were compared with those obtained from 39 female endurance (running) athletes and 16 female nonendurance (field hockey) athletes. Significantly higher scores on dependence for dancers than for endurance or nonendurance athletes were noted. The data indicate that dancers may be at greater risk for psychophysiological problems associated with exercise dependence than other athletes and so should be monitored for symptoms.

Adult↗

Effect of teaching with mirrors on body image and locus of control in women college ballet dancers.

This preliminary study assessed the effect of mirrors in dance instruction on body image and locus of control of women college ballet dancers. With the same instructor in two beginning ballet classes 8 women were taught using mirrors and 13 women were taught without mirrors. Subjects completed the Cash 69-item Multidimensional Body-Self Relations Questionnaire, and the 40-item Adult Nowicki-Strickland Locus of Control Scale during the first and last classes of a 14-wk. semester. Body-areas Satisfaction increased for the nonmirror class yet decreased for the class taught with mirrors. For the nonmirror class, there were significant increases in Appearance Orientation and Externality. Analysis suggested that the use of a mirror in the teaching of ballet may be an element which contributes to the low body-image scores of the 21 women ballet dancers. Replication with a much larger sample is required to draw conclusions.

Adult↗

Injury in ballet: a review of relevant topics for the physical therapist.

Currently, there is a need for a review of the literature on ballet injury as it pertains to the physical therapist. Relatively few articles have reviewed ballet injury prevalence and mechanisms of injury. The purpose of this paper was to provide a thorough literature review of the prevalence of ballet injury and mechanisms of injury. Environmental factors and footwear relating to ballet injury were also reviewed. The literature indicated that 65-80% of ballet injuries are in the lower extremity, 10-17% occur in the vertebral column, and most of the remaining percentage are upper limb injuries (5-15%). The etiology of common lower limb conditions included an incorrect turnout; soft tissue imbalances; reduced quadriceps performance; "rolling in of the foot;" inversion sprains; and frequent pliés, pointé, and demipointé work. Spinal conditions were reported to result from hyperextension and hyperlordosis of the lumbar spine as well as the psoas insufficiency syndrome. It was revealed that inappropriately fitting footwear lead to various foot conditions and abnormal lower kinetic chain biomechanics. Environmental factors, such as the dance surface, also have implications in ballet injury. The author concluded that ballet injuries have a multifactorial etiology that primarily involves the interplay of compensatory biomechanics in the spine and lower extremity, environmental factors, and footwear. In addition, some clinical recommendations have been made regarding the physical therapy management of ballet injuries.

Arm Injuries↗

Patellofemoral pain in female ballet dancers: correlation with iliotibial band tightness and tibial external rotation.

Review of the literature reveals that ballet dancers have a high incidence of idiopathic patellofemoral pain. Twenty-four female ballet dancers were subjects in a study of the relationship between: 1) iliotibial band (ITB) tightness and patellofemoral pain, and 2) ITB tightness and degrees of tibial external rotation used in the dance demi-plie. Dancers were initially assessed by questionnaire to determine if any had knee pain. Twelve subjects met the study criteria for patellofemoral pain, and 12 dancers without knee pain served as controls for the study, Iliotibial band tightness was measured (Ober test), and degrees of tibial external rotation used during knee flexion (demi-plie) in standing were measured in both legs of all 24 subjects (48 legs). Chi-square analysis of the collected data revealed that there was an association between ITB tightness and patellofemoral pain in the dancers. Data analysis using the Wilcoxon Rank Sum test revealed that the degree of tibial external rotation used by dancers with iliotibial band tightness was significantly greater than those without ITB tightness. This study confirms the assumption that ITB tightness in dancers may be a contributing factor to patellofemoral pain. Follow-up study is indicated to determine if the preservation or restoration of functional ITB length is effective in the prevention and/or treatment of patellofemoral pain in ballet dancers.

Adult↗

Balance abilities of professional dancers on select balance tests.

Documentation that dancers have better balance abilities than nondancers is important because of the number of dancers who sustain injury and then are referred to physical therapists for treatment. The purpose of this study was to compare balance abilities of professional dancers with nondancers on selected balance conditions. Fifteen dancers and 15 age- and gender-matched nondancers maintained one-legged stance under six combinations of visual and support surface conditions (Foam and Dome Test modified from two feet to one foot). Each condition was maintained for 30 seconds. A composite balance score was obtained for each subject by summing the number of seconds the individual maintained balance for each test condition. There was a significant difference in the mean composite balance score (across the six balance conditions) for the dance group compared with the control group (731 seconds and 563 seconds, respectively). Under sensory challenged conditions, it appeared that dancers were better able to maintain their postures upright against gravity. The balance strategies and techniques learned by professional dancers should be carefully analyzed to determine if they could be incorporated into treatment programs for nondancers who have balance instability and dancers who are injured.

Adult↗

A ballet dancer with chronic hip pain due to a lesser trochanter bony avulsion: the challenge of a differential diagnosis.

Physical therapy assessment involves confirmation of a medical diagnosis. To help discuss this process, this case report is presented regarding a ballet dancer who experienced 6 years of chronic hip pain and dysfunction. Many diagnostic tests and surgical procedures were performed by various physicians in search of a diagnosis. Physical therapy assessments did not support the working diagnoses, and treatment given according to evaluation findings was not effective. Initial hip radiographs revealed a bony ossicle at the lesser trochanter, which was overlooked. Hip radiographs taken 5 years later revealed the same bony ossicle. Ultimately, surgical removal of the ossicle eliminated the hip pain, and the patient returned to full activity and dance again. With the attempt to confirm the patient's diagnosis, the physical therapy approach to problem solving is discussed. This case gives an example where it is important to question the physician's diagnosis when the physical therapy assessment and treatment response do not support it. it is also evident that an in-depth physical therapy assessment may be self-limiting if pathology has not been ruled out properly by the physician.

Adolescent↗

Unilateral jump behavior in young professional female ballet dancers.

In the field of dance, lateral body actions should be differently influenced by training. Classes should develop symmetrical jump behavior by the alternate working of the two body sides. In contrast, asymmetrical training effect linked to hemispheric laterality should be also expected. Indeed, for aesthetic reasons, the preferred led has to give the jump direction while the other leg has to carry out the impulsion during take-off. In addition, and for functional reasons, the preferred leg also has to ensure a soft landing and to avoid imbalance upon landing. To address the question, we studied ten professional right-footed female ballet dancers in a unilateral experimental task: the maximal vertical jump (MVJ). The MVJ height was compared for each leg in ten trials. In addition, the side of the leg usually involved in a choreographic bilateral task was determined. All these right-footed dancers selected their left leg as the impulsion leg for the choreographic jump so as to reserve the right leg for the expression of the artistic gesture linked to emotional laterality. However, ANOVA did not show differences between the right and left legs in MVJ. In these young ballerinas, jump actions of the two body sides seem to develop symmetrically by class training effects.

Adolescent↗

Many ways to grow: creative art therapies.

So often, the prevailing thought surrounding treatment is that to be effective the treatment must be serious in tone. Yet, when you ask creative art therapists to describe their work, more often than not they will say that the ability to mix enjoyment with clinical technique is the "secret of our success." Again and again, recalcitrant, angry, underfocused, lethargic, and delayed children spring to life within an arts therapy session. Whether the modality used is music, dance, or the visual arts, children find in it the pleasure, stimulation, fun, and communication that may be missing from other aspects of their world. The creative art therapist helps a child by presenting the two-pronged approach of using the art form to foster mastery while allowing it to be a metaphor for ideas and concerns. Thus, both the process of "making something" and the symbols within the content are simultaneously providing therapeutic acid. Most exciting is the ability of the creative art therapist to unlock the child's inner world and bring new vitality to children and families alike. The creative art therapies are an important and unique tool among the constellation of health services.

Art Therapy↗

Older adults and the arts: the importance of aesthetic forms of expression in later life.

The purpose of this study was to examine the importance of aesthetic forms of expression in a randomly selected Swedish population age 65 to 89. Data were based on semi-structured interviews with 166 participants. Results revealed dance, music, literature, and pictures were important for this group of elderly individuals in promoting successful aging, and the connection to their everyday life was apparent. Participants considered viewing natural scenes and looking in a photo album as important aesthetic activities. The aesthetic forms of expression contributed to physical and intellectual activities, as well as to interaction with other individuals. Aesthetic experiences were related to feelings of timelessness and spacelessness, and served as sources of gratification.

Aged↗

Social and cultural vulnerability to sexually transmitted infection: the work of exotic dancers.

This article examines the social and cultural factors that influence the vulnerability of female exotic dancers to sexually transmitted infections. Results are based on a qualitative, exploratory study using observations in 10 clubs and in-depth interviews with 30 dancers in southern Ontario. The social and cultural context within which exotic dancing takes place contributes to a chronic state of sexual harassment and sexual assault in the strip clubs. Women are pressured by economics and by their customers to engage in sex for pay. The defence mechanisms that some women use to deal with these work conditions also contribute to women's vulnerability. The social structure of strip clubs and their policies toward employees and customers can either reduce or exacerbate the vulnerability of dancers. Workplace policies and health and safety standards appear to be the most effective ways to decrease the vulnerability of dancers. Public health units can work with employers and dancers to establish workplace policies and programmes that contribute to the health and wellbeing of dancers.

Adolescent↗