Inside PT
Photo by Nathan Sayers, modeled by Nicole Buggé

You may not understand exactly what causes a tight IT (iliotibial) band, but you've probably experienced that uncomfortable tension along the outside of your thigh. While it's not actually a muscle, the IT band may require daily stretching, says Suzanne Semanson, physical therapist at New York University Langone Medical Center's Harkness Center for Dance Injuries. The IT band is made of fascia, or tough connective tissue, that attaches to the pelvis through the tensor fascia lata (or TFL)—a small muscle between the pelvis and femur—and runs down to the outside of the knee.

When you're dancing with a fully extended knee, the IT band stabilizes the knee so that it doesn't move sideways out of alignment. However, “it is commonly tight in dancers due to compensatory patterns and overuse of the TFL," says Semanson. For example, if you force your turnout too much from your knees or rely on the TFL (instead of muscles in the hip) for développés to the front or side, this area might be too tight. The IT band and TFL can also build up excess tension from the demands of dancing several hours a day.

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As dancers gear up for year-end performances, the extra workload can take its toll. If you've pulled a hamstring, or are worried it might happen, read up on Amy's advice for proper healing.

A pulled hamstring—tears that occur in the muscle when the hamstring is suddenly overstretched or overloaded—needs to be taken seriously if you want to heal properly. I didn’t take enough precautions when I pulled mine years ago, and my flexibility in that leg has never felt quite the same.

“Hamstring injuries can take a long time to heal due to the potential accompanying injury to the nervous system,” says Andrea Zujko, PT, DPT, OCS, COMT, clinic manager of Westside Dance Physical Therapy in New York City. Recovery time depends on the severity of the strain, and Zujko discourages self-diagnosing. “A physical therapist can help you more clearly diagnose the injury and develop a prognosis and plan to return to dance.”

The Finnish National Ballet in William Forsythe's In the middle, somewhat elevated (photo by Sakari Viika)

One thing is certain—don’t stretch a pulled hamstring too soon. For the first five days (longer for serious strains), don’t dance or stretch. Do use ice and compression during the first 72 hours. Then, you can gradually start gently releasing the soft tissue using a tennis ball, Zujko says, followed by range of motion exercises and pain-free stretches, including this one: Lie on your back with both knees bent, keeping a neutral spine and pelvis. Raise the injured bent leg to a tabletop position, with the angle of both your thigh and lower leg at 90 degrees. Holding on to your thigh, gently straighten and bend the leg through a pain-free range (keeping the foot relaxed and the leg parallel). Do 5 sets of 10 throughout the day when you’re warm. As your hamstring heals, you can progress to a sustained, passive stretch, using a yoga belt. Hold the stretch for 30 seconds, doing 5 repetitions two to three times a day.

Isometric strengthening exercises can help, too, Zujko says. For example, sit comfortably on a chair, keeping the knees at a 90-degree angle. Using 5 to 10 percent of your strength, gently press your heel into the floor to create a light contraction in the hamstring, holding for 5 seconds; repeat 10 times.

Have a question? Click here to send it to Amy and she might answer it in an upcoming issue!

Help! All of my friends are going to impressive summer intensives, but I didn’t get in anywhere fancy. I feel like a total loser because I’m just going to a small school. Any advice? —Heidi, TX

I understand what you’re going through—I remember when a girl from my studio received a full scholarship to the Joffrey Ballet School’s summer intensive. I couldn’t help but feel inferior about the smaller program I was going to. But I ended up having an amazing experience! I had wonderful teachers, made great friends and came back a much stronger dancer.  I’m not the only dancer who has reaped enormous benefits by attending a smaller program. Raychel Weiner, a dancer with Oregon Ballet Theatre, spent two summers at prestigious intensives, but her teacher saw little improvement. “She said, ‘You’re not getting the individual attention that you need. Why not try a smaller place?’ ” recalls Weiner. She enrolled at Kansas City Ballet’s (now defunct) satellite program in Crested Butte, CO. At 16, she was the oldest of about 20 students. Although she was leery at first, Weiner grew to appreciate the extra attention. “There were more opportunities to ask questions,” she says. “It was a far more intimate setting and I responded better to that.”

Going to a smaller school can also have professional benefits. “Not everyone gets into American Ballet Theatre or New York City Ballet,” explains Weiner. “It’s smart to have smaller companies recognize you.” She’s right—I received my first professional job through Milwaukee Ballet’s summer intensive. Try not to compare yourself with your classmates. “This is your time to grow and learn,” says Weiner. You have a great opportunity this summer, so make the most of it!

How can I improve my extensions? I can do the splits on both sides, and if I hold my leg, I can get it up. What do I need to do to get it to stay there? —Rebecca, CT

Extension is a combination of flexibility and strength. Luckily, it sounds like you have good flexi­­bility. Now you need to strengthen the proper muscles in order to hold your leg in position. I’ve always struggled with extensions because I’m terribly inflexible, but once I added core exercises to my stretching routine, I noticed major improvement.

Try taking Pilates mat classes to build strength in your stomach, hip and back muscles. I like doing the Stomach Series before ballet class. Check out The Pilates Body by Brooke Siler, which breaks down each exercise with photos. You can also try a varied series of crunches that target your lower abs and obliques.

A strong supporting leg is also important. As you développé, push down into the floor with the supporting leg to create more stability.

Before class, practice feeling the right muscles. Stretch with your leg on the barre in proper ballet positions—meaning your hips are square and your standing leg is directly underneath you and engaged. Then use your hand to hold your leg in position, such as in a développé devant, à la seconde or arabesque penchée. Test your strength by letting go and seeing how long you can hold it there, and then slowly lower to tendu.

I just found out that I have micro-tears in my right calf muscle. How can I help it heal so that I can keep taking classes and auditioning? How do I stay in shape? —Cherie

I spoke with Michael Leslie, San Francisco Ballet’s physical therapist, about your calf. Luckily, he thinks you have a mild injury that should heal quickly if you take care of it properly. Listen to your symptoms and train accordingly.

You shouldn’t need to take time off, but Leslie recommends gradually building up to taking an entire ballet class. Start by only taking barre, steering clear of anything that irritates your calf. You can also try non–weight-bearing exercises like floor barre, Pilates or the stationary bike. Over time, slowly incorporate center exercises. “You’ll need to be careful during the last 20 minutes of class,” says Leslie. “Listen to your body, and don’t jump as long as you’re in pain.” Since you’re using pain as your guide, avoid masking it with anti-inflammatories.

Overstretching your calf (especially by using slanted board calf-stretchers) can cause further muscle tears. For a milder stretch, try flexing your foot, using muscles in the front of your shin, with both a bent and straight leg. Leslie also recommends wearing a street shoe with a small, stable heel or using a quarter-inch heel lift to prevent further overstretching. You should feel improvement within a few weeks.

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