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Photo Tanya Ghosh Photo Tanya Ghosh

NeuroSport NYC’s Top Broadway Injuries (and how to prevent them!)

Body wear-and-tear is one of the less glamorous aspects of a life in performance. Painful injuries can really slow your roll, and for dancers who perform repetitively, multiple times a week, injuries can mean unplanned time off from contracts. Luckily, you are your own best asset when it comes to the treatment and prevention of injuries, and we are here to help.
DancePulp teamed up with Natalie Kinghorn (Master of Physical Therapy and co-owner of  NeuroSport NYC) and Ashley Hodges (Physical Therapist, Doctor of Physical Therapy, and Active Release Technique Certified staff at NeuroSport NYC) to bring you some valuable injury identifiers and prevention methods to keep you on your toes and off the table. With years of experience with dancers on and off-Broadway as well as on high intensity international tours, these NeuroSport Physical Therapists have seen it all.
Lumbar Spine | Photo Tanya Ghosh

Lumbar Spine | Photo Tanya Ghosh

Lumbar Strains
What’s happening

The low back ligaments, tendons, and muscles (or combination of these) over stretch to the point of injury. This results in microscopic tears of varying degrees in these tissues.

Why

Lumbar strains are common when dancers work on raked stages or wear heels which alter the alignment of the entire spine. Also, performers are often put in heavy costumes and head pieces which place a great amount of strain on the spine. Strains can also occur with repetitive partnering lifts with poor form.

What to do

It is important to strengthen and stabilize the core and hips. Pilates is great method for dancers struggling with lumbar issues, and can be studied in groups or privately, in mat or reformer classes. Dancers should also get educated about their posture and how to improve day to day carriage of the spine.

Cervical Spine | Photo Tanya Ghosh

Cervical Spine | Photo Tanya Ghosh

Cervical Strain
What’s happening

Cervical strains are caused by damage to the muscle or the tendons, bands of tissue that connect muscles to bones in the upper back and neck area.

Why

This injury is often due to heavy neck pieces, wigs, and neck heavy choreography which can cause whiplash injury. (The Lion King, for example, has a lot of heavy costumes and headpieces that requires a lot of neck and scapular stabilization.)

What you feel

Pain, decreased range of motion, and tightness in the neck. The muscles may feel hard or knotted. It may be painful when you rock your head from side to side or backward and forward. You may also get headaches at the base of the skull that radiate towards the forehead.

 What to do

Strengthen the cervical spine and perform exercises that aid in scapular stabilization. It also helps to strengthen the rotator cuff (muscle group surrounding the shoulder joint). Again, Pilates and postural education can really help in prevention of this one.

Knee | Photo Tanya Ghosh

Knee | Photo Tanya Ghosh

Knee Issues Patellar Tendonitis and ITB Syndrome
What’s happening

Patellar Tendonitis is an injury to the tendon connecting your kneecap (patella) to your shinbone. The patellar tendon works with the muscles at the front of your thigh to extend your knee so you can kick, run and jump. ITB Syndrome (Iliotibial Band Syndrome) occurs when the iliotibial band, the ligament that runs down the outside of the thigh from the hip to the shin, is tight or inflamed. The IT band attaches to the knee and helps stabilize and move the joint. When the iliotibial band comes near the knee, it becomes narrow, and rubbing can occur between the band and the bone.

Why

Wearing Bad footwear (on and offstage!), jumping, and squatting on raked stages contribute to these issues. For example, The Hedwigs are males performing in heels in which the choreography requires a lot of jumping and squatting. Performers in Sleep No More are required to navigate many flights of stairs for 3 hours a night. The cumulative effect of the repetitive nature leads to overuse and inflammation.

What you feel

Pain from patellar tendonitis is felt just below the patella. The pain is most noticeable when you move your knee or try to kneel. ITB Syndrome can be mistaken as a knee injury because pain and swelling will mostly happen where the IT Band connects to the know. But you’ll know the difference if you bend your knee at a 45-degree angle. If you have an IT band problem, you’ll feel pain on the outside of the knee.

What to do

Get a foam roller! Foam rolling the ITB regularly can greatly reduce tightness and strain. Also, focus on  strengthening the muscles of the butt, the gluteus maximus and medius. Single leg balances are great for this muscle group. Quad strengthening all also take the pressure off your knees.

Rotator Cuff | Photo Tanya Ghosh

Rotator Cuff | Photo Tanya Ghosh

Rotator Cuff Impingement and Tendonitis
What’s happening
Your shoulder’s rotator cuff tendons are intermittently trapped and compressed during shoulder movements. Your rotator cuff tendons are protected from simple knocks and bumps by bones (mainly the acromion) and ligaments that form a protective arch over the top of your shoulder.
Why
Shoulder issues are common in shows that require a lot of lifting and partnering or push/pull choreography. It is difficult to find your center when not on a flat surface and then lift weight above your head from there, so Broadway and tour sets can often cause problems. Overloading the shoulder joint is a common cause of tendonitis in this area.
What you feel
Pain and stiffness when you raise your arm and also lower it from an extended position. You lose strength and motion.
What to do
Tightness in the pectoral muscles and latissimus dorsi  muscles of the back will make you susceptible to shoulder injuries. Stretch these muscles often, especially when partnering. Also focus on rotator cuff strengthening and scapular stabilization.
Ankle Joint Dysfunction | Photo Tanya Ghosh

Ankle Joint Dysfunction | Photo Tanya Ghosh

Ankle Sprain/joint dysfunction
What’s happening

The ligaments of the ankle tear.  Most commonly, the anterior talofibular ligament and the calcaneal fibular ligament are at risk for dancers.

Why

Ankle issues can occur because of a wrong step or bad landing where the weight is not correctly distributed. In Broadway shows, dancers are often in heels or other non-supportive shoes. This can cause weakness, instability and overuse of the ankle.

What you feel

Pain, instability around the outside of the ankle joint. You can also experience bruising, swelling and poor balance.

What to do

Plyometrics, also known as “jump training” train muscles to exert maximum force in short intervals of time, and can strengthen the ankles and feet. Look for other exercises that can strengthen the other muscles of the leg and glutes, reducing pressure on the ankle. If using a Pilates reformer, focus on footwork.

Some of the major injuries we see in the dance/performing world we mostly attribute to overuse. Most performers do 8 shows a week so there are cumulative effects on the body from doing the same movement 8 times a week.We work with performers at the clinic and at theaters to help prevent and fix these injuries. A lot of our work at the theaters is maintenance and prevention. We do a lot of soft tissue work, joint mobilizations, cupping,  ultrasound/estim and neuromuscular re-education. We combine many methods and techniques when doing manual work: such as Active Release Techniques, methods from Institute of Physical Art  Paris technique, and many joint mobilizations.
Along with manual work, neuromuscular re-education has to take place to rehabilitate an injury and reprogram the body. We use several Pilates techniques on and off of the reformer, balance and proprioception work, plyometric training, cervical and lumbar stabilization, functional training, and dance specific exercises.The most important thing and the most difficult thing is rehabilitating and re-educating while the patient is still in full performance mode. It can be difficult to find the balance and not overworking during PT.
–Natalie Kinghorn ,  MPT , Neurosport NYC
Post by Kenna Tuski

Kenna Tuski, a Portland Maine native, graduated from SUNY Purchase Conservatory of Dance with honors in the spring of 2013. Kenna was given the opportunity to study abroad at Taipei National University of the Arts in Taiwan in her Junior year at Purchase. In 2013–2014 Kenna worked with pop singer Betty Who as her personal assistant and tour manager. Kenna danced with Nimbus Dance Works and was assistant coordinator of their 2013 Nutcracker Production. She has toured nationally and internationally with Shen Wei Dance Arts and in 2014 became a performer in Punch Drunk’s Sleep No More.

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