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Bond University alumna and physiotherapist Renee travelled the world with The Walt Disney Company. She the returned home to launch her performing arts physiotherapy clinic. She now supports Queensland Ballet’s elite athletes and runs workshops with Gold Coast dance studios. Renee believes health education and research will improve the performing world by leaps, bounds and pirouettes.

“A big part of being a physiotherapist is teaching people about their body, and that their body is never working against them, it always tries to help,” she says.

She believes the performing arts industry will see great improvements as specialised physiotherapy grows.

“For a long time, dancers have been treated as only artists, but they’re also athletes,” she says. “Their loads are big. Sometimes they’re doing eight shows a week in front of thousands of people, so they need to be at their peak at all times.

“The athletic performance load of dancers and their injuries need to be taken seriously.”

Click here to read more about Renee’s journey.

Artistic Sports Physio is based in Nerang on the Gold Coast. Services include, physiotherapy, pre-pointe assessments, dance workshops and clinical Pilates. Treatment planning is aimed to keep you dancing with minimal time off from your sport. Click here to book an appointment with Artistic Sports Physio.

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Causes of a back stress fractures:

Movements that involve repetitive backwards bending and rotation can cause low back stress fractures. For example, constantly arching your back backwards by doing bridges, walk overs and back bends in acrobatic classes can load your back unfavourably over time.

Symptoms of a back stress fracture:

• Pain that is worse with backwards bending activities.
• Pain is one-sided.
• Tenderness when pressed over the effected area.
• Pain can get worse with standing.
• Pain eases with rest.

How to diagnose a back stress fracture:

Your clinician will take a thorough history and conduct a physical examination. Imaging such as x-ray or MRI scan can help diagnose a stress fracture.

How long does a back stress fracture take to heal?

A stress fracture typically takes about 8-16 weeks to settle. At Artistic Sports Physio, a graduated return to sport plan can be tailored to your recovery time frame and your performance goals. A physiotherapist will work with you to identify areas in your body that can be improved to ensure you are executing your sport with optimal form.

If you are concerned about your back and have had ongoing back pain in your sport, book in for a consultation.

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What is a good amount of time to balance for?

An ideal time of balancing on demi pointe is for 10 seconds.

How to test your balance on demi pointe;

1. Stand facing the barre or something at home of a similar height.
2. Rest your hands on the barre.
3. Stand on the testing leg in parallel and place your other leg in cou-de-pied.
4. Rise onto your highest demi pointe, keeping your knee straight.
5. When you feel you have your balance, release your hands and hover them above the barre.
6. Try to balance for as long as you can in this position.

If you are unable to balance for 10 seconds, try practicing the exercise regularly and you will improve over time.

Other tests to try are demi-plie flexibililty, pointe range of motion and calf strength.

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No matter how many times a week you dance, dancing on the correct floor will prevent a multitude of problems when it comes to your physical health.

What is a sprung floor?
A sprung floor is a layered flooring system that is designed to provide spring under impact. It will absorb shock and return energy, meaning less impact goes into the performer’s body. The ideal sprung floor will also have adequate traction, providing stability and reduce the fear of slipping.

Why is it better for your body?
A sprung floor reduces the risk of injuries because of the shock absorption and good traction. Injuries that can be avoided include jumper’s knee, patellofemoral pain, ankle sprains, metatarsal fractures, shin splint and stress fractures.

A floor may have up to 50% of shock absorption value, meaning the floor will absorb 50% of the impact, allowing only 50% to be absorbed by your body as opposed to 100% of impact on a concrete floor.

What if a sprung floor is not an option?
There may be incidences when you are required to perform on a concrete surface or on a stage that is not so forgiving on your joints. Shock absorbing insoles or cushioned socks may be an option that is going to give you some reduction in impact to your joints.

Read more about types of sprung floors.

Read more blogs here.

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If an athlete performs their sport well, with perfect form and sits slumped on the couch at the end of the day is this necessarily a bad thing?

I believe that posture should be always changing. Spending hours stooped in a chair puts prolonged stress on the structures of your body. Counter-stretches and reverse postures are recommended if you spend hours in the same position. Reverse postures and counter-stretches are what we see in cats and dogs when they rise from sitting. They stretch out their back and limbs prior to moving as a intuitive activity.

Sitting stooped in a chair can make you feel stiff and sore but perhaps pain then comes from a lack of movement rather than poor posture? Try changing positions every 30min and try a counter-stretch when you rise from sitting: place your hands on your back and lean backwards and hold for 20seconds.

Check out more blogs here.

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Safe partner stretching is a great way to get that extra bit further than you can’t get on your own.

Remember, your partner can’t feel what you feel, so communication is the key to get the greatest benefit from those helping hands!

🤸🏼‍♀️When you are not feeling much: Ask your partner to stretch a little further or try to adjust your position to exactly how your coach has described it.

🤸🏻When you feel a deep stretch that is not causing pain and is not pulling your joint into an unnatural position:
Let your partner know this is perfect and hold here. Try to breath and go with the stretch, rather than tense up and create resistance.

🤸🏼‍♂️When the stretch is causing pain or feels too powerful:
This is too much, ask your partner to reduce the stretch until it becomes a more comfortable deep stretch.

Don’t forget to book in with your physio if you have any lingering discomforts.

Check out more blogs here.

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Pillows are made from various materials. Here are a few of the most common around today;

Memory Foam Pillows: a high density pillow that molds to the shape of your head by reacting to your body heat. It returns to it’s original shape when you are not lying on it. This is a very great all round comfortable pillow and most people are happy with this pillow. If you are a hot sleeper, you may find this pillow doesn’t circulate the air enough. You may need a better ventilating material or use a bamboo pillow case to keep cool. Some memory foam pillows are adjustable, you can take out particular parts of the pillow to decrease the height and make it custom to your neck size.

Latex pillows: either synthetic, natural or a mix of both, Natural latex is made from tree sap. Cool huh? Latex has springiness while staying firm. These pillows are hypo-allergenic and tend to not be as hot as memory foam.

Feather pillows: a combination of down and feather. These pillows are light and moldable. Feather pillows can last up to 10 years but they may not hold their shape like the memory foam or latex pillows…. allowing you to sink more during the night.

Polyester pillows: These are filled with fibrefill, a man-made fluff. They come in various densities and they can be machine washed. Being synthetic, it may not be as airy as other pillows. After several washes, you will find the material clumps.

Your pillow should be replaced roughly every 2 years (depending on the material). Wash your pillow slip regularly to avoid build up of bacteria.

If you would like a recommendation for a pillow please DM Artistic Sports Physio as we have an excellent supplier in Australia that you can buy direct from their website. 😊

Check out more blogs here.

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Are you suited for CranioSacral Therapy?

If you have any postural or functional compromises, particularly, long term dysfunctions then CranioSacral Therapy is for you. Problems from within your body can influence the rhythm and communication of your spinal cord. For example, surgical scarring can lead to tightness of your fascia and can create tension through other parts of your body as it tries to compensate for the adhesion. Headaches and other musculoskeletal problems can be the outcome of tension from other regions of the body. CranioSacral Therapy is aimed to assess and treat the cause of the pain, rather than just the painful site.

This type of therapy requires extra training. Ensure your health practitioner is trained in this treatment method prior to booking an appointment.

If you would like to learn more about this technique as well as read supportive literature go to https://www.upledger.com/.

Book in today to discuss if this treatment is suited to you.

Check out other treatment techniques here.

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Strength work should be different to your performance training. For example, a ballet dancer will benefit from using weights with lunges or a leg press machine to build a strong platform to take off for jumps with more power, height and control.

What should your strength training involve?

• Weights or at least your own body weight
• Aim to use big muscle groups requiring whole body stability. For example, squats and push ups.
• Incorporate a good breathing technique, especially for vocalists and wind instrumentalists.

For more tips on breathing click here.

You can participate in strength training up to 3 times a week. Machines at the gym can assist you to isolate muscle groups, while lifting weights without the help of machines will challenge your stability more. If you don’t like the idea of signing up to a gym you can purchase some dumbbells and resistance bands and get a good workout at home. There are plenty of ways to get strong without the use of any equipment at all. Body weight exercises are very challenging and can build your strength without overloading joints.

Book in with a physio to see how they can help you improve your performance.

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• Muscle fatigue
• An overall feeling of being tired.

Both of these symptoms may lead to a decreased level of sports performance and place you at higher risk for injury. Learn to be nurturing to your body in this phase. Get plenty of rest, run a bath, don’t push yourself if you really don’t have to.

• Higher
• More forceful and
• Less fatigable

This is the time to try new skills, push yourself a little more. It’s a great time to compete!

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Research has shown that the best activation of your deep local muscle system (loosely termed ‘core’) occurs when the part of your exercise with the most effort is with the exhale. With this technique, your diaphragm and pelvic floor draw up and the deep abdominal muscles draw inwards. This allows them to be optimally activated during the most difficult part of your task. Click here to learn more about your core muscles.

Below are a few examples of how to use your breathe with different exercises…..

• Breathe out with the effort of pulling your chest to the bar during a chin up exercise.
• Breathe out while your legs straighten when coming up from a squat.
• Breathe out with the concentric contraction of rectus abdominus during a sit-up (the sitting up part).
• Breathe out as you retiré and perform a pirouette.
• Breathe out when rising from a plié.

To learn more about breathing techniques, try this breathe control exercise from Pilates Anytime. It will bring awareness to your breathe and give you an understanding about a few of the different ways you can breathe http://contacts://www.youtube.com/watch?v=83gFimG3PW4

Contact the clinic to book a core system and breathing assessment.

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It is easy to test your demi-plié flexibility. All you need is a ruler and a wall!

To measure:

1. Place a ruler outward against the wall (in the studio I have a marked piece of tape along the floor as can be seen in the photo).
2. Face the wall and place your toes at the wall.
3.  See if your knee touches the wall without the heel lifting. Try to maintain your foot arch and avoid rolling the knee inwards.
4. If this is easy then try to bring your toes further away from the wall.
5. See how far your foot can start away from the wall while keeping the above form.
6. The furthest you can have your toes from the wall while keeping your heel down, the greater your demi-plié flexibility.

The left and right sides should be relatively similar. This is a height dependent test but the average length for a dancer is around 10cm.

If you experience pain at the front of your ankle, our blog about anterior ankle impingement may help.

You can measure your calf endurance too!

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What causes the pain?

Anterior ankle impingement pain can be caused from either bony compression or soft tissue compression at the front of your ankle joint as you reach the end range dorsi-flexion position.

How can it be treated?

Most of the time the anterior ankle impingement pain can settle with rest, anti-inflammatories and ice. It is important that you address any biomechanical factors causing your impingement (e.g. tight hamstrings which can pull the fibula and ankle bone out of alignment, calf strength and flexibility).

What further investigations can be done?

Seeking an x-ray will rule in or out any bony factors that are causing your  pain. If there is a bony cause of the anterior impingement, an x-ray may report of an osteophyte. If this is found to be the case,  a specialist opinion should be sought. Some bony causes of anterior ankle impingement require arthroscopic surgery to remove the osteophyte.

Book here for an appointment if your symptoms don’t settle.

Measure your demi-plié flexibility and your calf endurance to see if these could be contributing factors.

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Your deep ‘core’ system are a group of muscles that when contracted, cause tension around the spine without a direction of pull unlike the external global muscle system. The main core muscles of the trunk include;

• Multifidus
• Transverse Abdominis
• The Pelvic Floor
• The Diaphragm

These four muscles create a canister that provides stability to the trunk during movement. Unlike more exterior muscles, these muscles have a role in staying activated at a low tone over long periods of time. In contrast: imagine the biceps muscle: working hard to carry a bag of groceries. If the bag of groceries is carried for a long distance or a long period of time, you will find your arm gets tired. The core muscles don’t require hard work to do their job, just endurance. Less is more when it comes to activation 😉.

Ask your physio to test your core system and teach you the best cues for engagement or book online at Artistic Sports Physio.

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A unique muscle bringing awareness to your voice and posture. The omohyoid muscle originates at the scapula (your shoulder blade) and attaches to the hyoid bone, a bone that lies at the base of the mandible and is a point of attachment for a lot of muscles that control the larynx and hence, your voice. The omohyoid muscle assists with depressing the larynx whilst singing.

Try this postural exercise when singing and see if you can feel the freedom in your shoulder blades: Feel the tips of your shoulders grow wide when you release sound. A good way to feel this is to stand in a door frame, place your hands against each side and gently press the heels of your hands into the door frame, feeling for an opening through the shoulders.

Want to get an more in depth assessment on your voice and posture? Book in today to check what effect your posture has on your voice. Click here to learn more about vocal physiotherapy.

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Young dancers may be more susceptible to injury than adult dancers due to skeletal immaturity and lack of developed strength and stability. Until the age of 14 (16 in boys) the foot is still growing.

Research has found, ideally you have to be older than 11, have been training for at least three years and attending class at least three times a week. Beginning too early could mean you put excessive load on a growing body, encourage poor technique and risk injury. Attending class less than three times a week can lead to slower progress.

Prior to going en pointe, aim for perfect placement and coordination. Your body should lift off your feet with straight knees, stable balance, on your highest demi-pointe without the heel sickling or fishing, and without the toes curling or clutching.

Don’t be in a rush to begin pointe. Some dancers begin pointe work at 16years of age and continue on to have successful careers. Besides, there is no point getting up en pointe if you’re unable to do anything while you are up there.
It is important to note that not all bodies are suited for pointe work.

Want to find out if you have what it takes to go en pointe? Purchase the readiness for point eBook or book an appointment to assess your readiness for pointe shoes.

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Try this relevé alignment test……

🌼Rise onto demipointe🌼

🟡Roll the foot out over the last 2 toes and feel the outside muscles of your lower leg contract.
🟡Now turn the outer border of the heel towards the ceiling bringing your weight back into the centre of your foot.

🟡Roll your foot inwards over your big toe so your weight is going through the inside of your foot. Feel the inner muscles of your lower leg contract.
🟡Now lift the inner arch up towards the ceiling.

For the perfect relevé……….

🌼Now imagine you have a stirrup under the arch of your foot and the stirrup is pulling the heel up equally on both sides. Rise onto demi🌼

🟡You should feel that you are equally contracting both sides of the lower leg and your weight is positioned over your 1st and 2nd toe.
🟡Imagine the stirrup under your heel lifting your arch up even higher onto your demipointe.

🟡Check the post: how do your calves measure up to test your endurance.

This plus other tips are included in the dancer’s handbook.

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Stress, anxiety, and worry can present in physical form within our bodies.

Many times performers have presented to physio with debilitating pain in the knees, neck or shoulders without significant pathology seen on a radiology scan.

This is because when we are stressed, the body sends inflammatory markers through the body, causing us to feel pain despite having a perfectly healthy body!

Finding ways to decrease stress and manage anxiety may help combat musculoskeletal pain;

🌼Are you taking on too much? Are you entering too many dance comps, with increasing rehearsals and trying to keep your casual job?

🌼Do you have to rush to work after class or do you crash with fatigue when you get home from rehearsals and skip a proper recovery or cool down?

🌼Are you missing out on proper meal intake because you don’t have time to eat or prepare meals?

If you begin to have trouble maintaining your workload and find your mental and physical health is suffering… time to reflect and get some time back to focus on your health.

If you still have physical problems book online for an appointment today.

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How to test;

1. Sit with your legs out straight. Make sure you are sitting on the sit bones of your bottom and not slouching the spine.

2. Lock your knees straight.

3. Point your feet forward as hard as you can at the ankle so you feel your calf muscles squeeze hard. You can do one leg at a time.

4. Make your toes stay long, avoid scrunching.

5. Hands may rest on the ground.

Interpreting the test;

1) Looking from the side: A straight line should be seen from the side of the leg to the small toe.

2) Looking from the top: place a pencil so the middle of it is over your ankle joint above the ankle bone: the pencil should sit horizontal across the ankle joint from shin to foot.

From the photo above we can tell that this dancer needs more point range of motion, prior to using pointe shoes as the small toe is higher than the side of the leg.

Check out the perfect relevé and how do your calves measure up for further tips to improve your dance technique.

This plus other tips are included in the dancer’s handbook. However, if you still have any problems, book online for an appointment today.

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