Injury Prevention in Highland Dancers

1
Injury Prevention in Highland Dancers

• Jennifer M Johnson DipSim(H), CAT(C)

2
Injury Prevention

• Jennifer Johnson DipSIM(H), CAT(C)
• Athletic Therapist
• Experts in areas of
• Injury assessment and Rehabilitation
• Emergency Care
• Education
• Sports Specific Rehabilitation
• Total Active Care
• Difference from Physiotherapist?

3
Injury Prevention

• Background on Me!
• Brock University, St. Catharine's, ON
• Sheridan College, Oakville, ON
• National Certification Exam, Montreal, QB
• Sports
• Highland Dancing Picture
• The S.M.A.R.T Clinic Inc.
• Private Clinic
• Workplace Clinics

4
Injury Prevention

• How can we prevent injuries?
• Know your body
• 2. Know what the mechanisms are

5
Injury Prevention

• 1. Know your body Body Basics
• Energy systems
• Anaerobic (ATP-CP) Energy System
• ADP CP both are chemical compounds stored in
  our muscles that make up ATP which produces
  energy. These compounds combine for only 5-8
  seconds of work.
• To train this system you would need sessions of
  4-8 seconds of high intensity work at near peak
  velocity. I.e.. Sprints of 20 meters with 45
  seconds recovery and repeat 20 times.
• This training is good for sports such as
  sprinting. I.e.. Usain Bolt, almost specifically
  uses this system to run the 100 meters.

6
Injury Prevention

• Anaerobic Lactate (Gycolytic) System
• Once the CP stores run out, the body resorts to
  the stored glucose to use ATP
• This system is used in 10-240 seconds of work.
• Sports Dancing, Figure Skating, Running,
  Basketball etc.
• Aerobic Energy System
• Utilizes proteins, fats and carbohydrate for ATP
  production.
• Any activity from 4 minutes on.

7
Percentage Contribution of Energy Pathways
8
Injury Prevention

• 2. Why we get injured!
• Overuse/Overload
• Repetitive micro trauma
• Occurs when athlete changes the mode, intensity
  or duration of training
• Overuse can lead to poor performance, fatigue and
  disturbed sleep patterns
• Extrinsic factors that contribute are poor
  technique, improper equipment and changes in the
  duration of frequency of activity
• Most common cause of overuse Training Errors
• Follow the principles of F.I.T
• Frequency, Intensity, Time
• We change one of these factors and we can control
  overuse/overload trauma

9
Pain Scale of Overuse Injuries

• Phase 1. Stiffness or mild soreness after
  activity, usually gone within 24 hours
• Phase 2. Stiffness or mild soreness before
  activity that is relieved by warm-up, returns
  after activity and usually last up to 48 hours
• Phase 3. Stiffness or mild soreness before
  specific sport. Pain is partially relieved by
  warm-up. It is minimally present during
  activity, but does not cause athlete to alter
  activity.
• Phase 4. Similar to phase 3, but more intense,
  causing athlete to alter performance. Mild pain
  occurs with activities of daily living, but does
  not cause a major change
• Phase 5. Significant pain before, during and
  after activity, causing alteration. Pain occurs
  with ADLs but does not cause major change in
  them
• Phase 6. Phase 5 pain that persists even with
  complete rest. Pain disrupts simple ADLs.
• Phase 7. Phase 6 pain that also disrupts sleep,
  pain is aching in nature and intensifies with
  activity.

10
Injury Prevention

• Body not in shape for specific activity
• Training for your sport
• Highland Dancing
• Elevation Hop for a 6 step fling holding onto a
  bar, then give about 30 sec break and perform a
  proper 6 step fling
• Turn Out Froggy sit, lying on stomach, bend your
  knees and put the sole of your feet together
• High Cuts Plyometrics, leaping, bounding etc..
• Upper Body Core training the deep muscles in
  the trunk of our body

11
Injury Prevention

• Fitness Training for Highland Dancing
• Principle of Overload
• For a muscle to increase its present strength
  level, one must force the muscle to do more than
  it is used to doing
• For example 8 step flings
• Interval Training still perform regular steps
  for dances but the difference is the number of
  flings you do and the rest in between.
• For example Use your heart rate as your guide
  to rest intervals or about 30-60 seconds of rest,
  then do the dance again, repeat about 6 times.
  Great off season training method
• During Season you should be maintaining
  fitness
• Perform one of the above methods 1-2 times per
  week.

12
Injury Prevention

• Proper Warm-up and Cool Down
• Proper Stretching of muscles
• Proper Strengthening of muscles

13
Injury Prevention

• Warm-Up and Cool Down
• Warm-up goal is to warm up the muscles and
  connective tissue before beginning vigorous,
  weight bearing dancing
• Warm up should mimic dance movements, therefore,
  you should have movement in several different
  planes and involve multiple joints
• In dancing the warm up should mimic stresses our
  feet, ankles and legs will face. be careful not
  to make the movements so perfect that it produces
  the very injuries we wish to avoid
• Warm up should consist of 10-15 minutes of
  activity sufficient to elevate body temperature
  without causing fatigue
• Dancing should begin within 15 minutes of the
  warm up, the beneficial effects of a warm-up are
  lost after 45 mins of rest.

14
Injury Prevention

• Warm-up Benefits produces mechanical and
  neurological effects which increase the bodys
  ability to react quickly to stimuli and to dance
  longer without fatigue. Allows connective tissue
  to to become more elastic and easier to stretch.
  Lubricates our joints, blood flow to the muscles
  and the exchange of oxygen increase.
• Cool Down a period of 5-10 minutes which
  follows the last dance.
• Cool down helps remove metabolic wastes from
  muscles
• allows dancers heart rate to gradually decrease
  below 100 beats per minute
• Helps to reduce hypertonicitiy (spasm)

15
Injury Prevention

• Importance of Stretching
• Benefits
• Decreased incidence of injury
• Functional range of motion
• Increasing joint range of motion
• Re-align muscle fibers, therefore, speed of
  rehabilitation
• Improve muscular efficiency, therefore increase
  level of skill
• Decrease muscle fatigue
• Decrease delayed onset muscle soreness
• Overall, good muscle and stability balance

16
Injury Prevention

• Types of Stretching
• Static vs. Dynamic
• Static Stretching stretches we perform in a
  still and static position
• Usually performed after an activity during a cool
  down routine
• Static Flexibility is increased when the muscles
  are somewhat fatigued
• Dynamic Stretching stretches we perform when in
  motion
• Usually performed before an activity after a
  warm-up routine
• Movements that duplicate the movement
  requirements seen in training or competition
• All exercises are performed while walking over a
  distance of 15-20yds.
• Examples lunge walk, twisting lunge walk, side
  lunge, walking knee tuck, walking knee tuck with
  foot lift, toe walking, butt kicks/high knees,
  and leg swings

17
Injury Prevention

• Strengthening Our goal for conditioning is to
  prepare our bodies to do unusual and unique
  movements that separates dance from pedestrian
  movement.
• 3 Principles for strength training
• Overload Principle strength of a muscle cannot
  be increased unless the muscles are stressed or
  worked beyond their normal workload. Achieve this
  by increasing the duration, intensity or
  frequency of the exercise program
• Principle of Specificity the way you strengthen
  a muscle group should be as similar as possible
  to the dance movements you do in class or on
  stage.
• 3. Principle of Reversibility the loss of
  strength that happens when you stop training.
  Need to maintain at least 2 times a week

18
Injury Prevention

• Core The deep muscles with in the abs and back
• These muscles are where movement originates and
  our source of stability.
• Benefits
• more functional workouts that translate into
  daily life activities
• Improved performance in your sport
• Reduction in the risk of injury
• Better ability to function each day
• Interesting workouts that challenge you in new
  and different ways.

19
Injury Prevention

• Core Continued
• Add equipment to exercises
• Stability balls
• Wobble boards
• BOSU
• Yoga/Pilate's
• Foam Roller
• Examples of exercises
• Wood chops
• Pikes on the ball
• Side plank
• Ball crunch with med ball

20
Injury Prevention

• Strengthening for Kids
• With highland dancing weight training is not
  optimal for any dancer, no matter what age.
• Using tubing exercises as previously suggested is
  a safe and effective strength tool
• With children just remember a few things
• Give children realistic expectations
• Supervise Technique
• Proper instruction
• Allow gradual increase
• Vary your exercises
• Adequate rest times

21
Injury Prevention

• Highland Dancing
• Common injuries
• Repetitive Strain/Overuse Injury
• Shin Splints The term "shin splints" refers to
  pain along the shinbone (tibia) the large bone
  in the front of your lower leg. The pain is the
  result of an overload on the shinbone and the
  connective tissues that attach your muscles to
  the bone.
• Sign and Symptoms pain in the front of the
  inner leg below the knee. Pain is often noted at
  the early portion of the workout, then lessens
  only to reappear near the end of the training
  session. Shin splint discomfort is often
  described as dull at first. However, with
  continuing trauma, the pain can become so extreme
  as to cause the athlete to stop workouts
  altogether.

22
Injury Prevention

• Shin Splints Causes
• A sudden increase in frequency or intensity of a
  workout schedule. This increase in muscle work
  can be associated with inflammation of the lower
  leg muscles, those muscles used in lifting the
  foot. Such a situation can be aggravated by a
  tendency to pronate the foot (roll it excessively
  inward onto the arch).
• Similarly, a tight Achilles Tendon or weak ankle
  muscles are also often implicated in the
  development of shin splints

23
Injury Prevention

• Plantar Fasciitis inflammation of the band of
  tissue that runs from the heel along the arch of
  the foot
• Signs and Symptoms People with this condition
  sometimes describe the feeling as a hot, sharp
  sensation in the heel. You usually notice the
  pain first thing in the morning when you stand.
  After walking for a period of time, the pain
  usually lessens or even disappears. However,
  sharp pain in the centre of the heel may return
  after resting for a period of time and then
  resuming activity.
• Causes
• Excessive weight load on the foot
• Mechanical imbalances of the foot
• Sudden increase in walking, running or training
• Tight calf muscles
• Wearing improper shoe support

24
Injury Prevention

• Muscle Strains A stretch, tear or rip in the
  muscle.
• Signs and Symptoms local pain that is increased
  with muscle movement, loss in strength, swelling,
  bruising, and local tenderness
• Causes occurs when a muscle contracts too
  quickly, is stretched beyond its limits or
  repeated trauma over time that creates a
  repetitive strain

25
Injury Prevention

• Prevention!
• Biomechanical excessive foot pronation, flat
  feet, fallen arches, or high or low arches.
• Muscular Strength and Flexibility Achilles
  usually too tight, under developed muscles at the
  front of the leg
• Training Program overload, F.I.T principles
• Be aware of the initial signs of shin splints,
  plantar fasciitis or a muscle strain.

26
Injury Prevention

• Exercises
• Flexibility low back, hamstrings and Achilles
  stretches
• Strengthening quadriceps, hamstrings, abdominal
  and anterior muscles of the leg
• Cross Training non weight bearing activities
  such as biking and swimming in overall training

27
Injury Prevention

• If you get an acute injury?
• Injury Management know what to do, how you take
  care of an injury in the first 72 hours can
  affect your rehabilitation and healing time.
• RICE/PRICEM/ICE etc
• Rest
• Ice
• Compression
• Elevation
• Medication
• Protect

28
Injury Prevention

• Nutrition
• Without proper nutrition the body can fatigue
  before competition is complete. If the body is
  fatigue it increases your chance of an injury.
• If a body is given 24-36 hours to fuel,
  performance can be maintained optimally
  throughout the event.
• Items to avoid
• Caffeine, carbonated beverages, high fiber
  cereals (bran), dried beans, cabbage family
  vegetables, fatty foods like hot dogs, bacon,
  fried foods and dried fruit.
• Foods such as rice, plums, dairy foods, apples,
  pastas, peaches and nuts are all low gylcemic and
  will help sustain availability of carbs during
  exercise.

29
Injury Prevention

• Nutrition for Recovery
• Exercise depletes the muscle and liver glycogen,
  dehydrates the body and increases the likelihood
  of muscle damage. If you exercise while depleted
  or dehydrated, it can cause your performance to
  suffer, but the risk of tissue injuries increase.
• Drink beyond thirst
• Timing muscles most receptive to fuel within 15
  minutes after exercise, failure to capitalize on
  this opportunity delays recovery and increases
  your risk of poor performance and injury
• Examples of Recovery food bagels, cereal, sport
  drinks and sport bars.

30
Injury Prevention

• Nutrition Continued
• Meal the Night Before 2-3 glasses of water, meal
  2/3rds carbohydrates
• Day of the Event
• Fluid 2 hours before, glass of 16oz water, 30
  minutes, another 16oz glass, 5-10 minutes, 8oz
  sport drink
• Meal ideas 3 hours before event, sandwich,
  yogurt and bagel, spaghetti
• 1 hour before cereal bars, granola bars, bagels,
  crackers, pretzels and sport bars.

31
Injury Prevention

• Summary
• Know your body
• Energy system
• Technique
• Listen to your body
• Know what could cause an injury, then you know
  how to avoid one
• Warm-up, stretching, strengthening and Cool Down

32
References

• Arnheim, D. D., Prentice W. E. (1997).
  Principles of Athletic Training. 9th Edition, 6,
  146.
• Handling Dance Injuries. http//www.scottishdance
  .net/highland/Injuries.html
• Grant, K. E. (1999). Dancing our Feet off
  Without Injuring Them.
• Grant, K. E. (1997). Tender loving Care for
  Dancers Legs.
• Coloradoan, Fort Collins. (2008). Ballet
  Dancers Require Nutrition and Cross Training
• Energy Pathways.
• http//www.brianmac.co.uk/energy.htm
• Sheridan College Lecture Notes Flexibility.
  Oct, 2001.
• Managing Overuse Injuries A Systematic Approach
• http//www.physportsmed.com/issues/1997/05may/ocon
  nor.htm
• Highland Dance Exercises.
• http//www.scottishdance.net/highland/Exercises.ht
  ml
• Sheridan College Lecture Notes Nutrition.
  March, 2002.
• Dancing Smart. http//www.thebodyseries.com/newlet
  ters/2005/03_04_0520Strength.html
• Plyometrics, or Jump Training for Dancers.
  http//www.thesportjournal.org/article/plyometrics
  -jump-training-dancers
• Dance Universe Conditioning and Cross Training
  for Dancers. http//danceruniverse.com/stories/20
  0712/crosstraining
• Understanding and Enhancing your Core Strength.
  http//exercise.about.com/cs/abs/a/corestrength.ht
  m
• Strength Training for Kids. http//sportsmedicine
  .about.com/cs/kids/a/aa120800a.htm

33
Injury Prevention

• Thank You for Having Me!
• Any Questions?