DIS-TANZ DIARY #13

AN ONLINE CONGRESS FOR DANCE MEDICINE

Mar 20, 2021 in DIS-TANZ-SOLO

Tanzmedizin Kongress Page Title Photo

In a way, it was almost fortunate that ta.med‘s annual Dance Medicine Congress was held online due to COVID-19. The organizers had undoubtedly put a lot of effort into transforming a live event into an online congress, and had put a lot of attention to detail into both the graphic and interactive aspects of the offering. In any case, it made it all the easier for me to participate in this year’s edition as part of my research and training project. Of course, it was clear from the outset that the various presentations at such a comprehensive congress would vary in quality and depth. So while the lectures themselves, as well as the associated Zoom exchanges, were overall really interesting, there were two observations that stood out throughout the week:

First, many of the contributions related to the work of professional ballet dancers or to working with amateurs. Specific points of contact for contemporary artists were few. I haven’t quite figured out why this is. Many of the topics discussed seemed very easily transferable to contemporary requirements or even had a reference to ballet only in the lecture name, possibly because the speakers themselves had a background in the field or to more directly address ballet educators as a potential target audience. However, as several speakers during the congress expressed the desire to raise awareness and interest in the topics of dance medicine and dance science, not least in the contemporary field, I am convinced that with a slight shift in focus there is still much potential to attract further audiences.

The second point may seem somewhat contradictory at first glance: I felt that some of my fellow audience members were occasionally overwhelmed because simple concepts were explained in more complex language than perhaps necessary. But at the same time, I would have personally liked to hear a bit more in-depth information on some of the topics or to discuss even farther-reaching ideas on how to integrate important scientific research findings into the work practice of professional dancers and educators. Perhaps a helpful idea for future editions might be to establish different lecture categories or to define clearer target audiences for each lecture.

In any case, I would like to encourage every artist to take an interest in the programs offered by ta.med. The congress was certainly a valuable opportunity to broaden one’s horizons and to exchange ideas with colleagues. And for me personally, it was certainly a great opportunity to take a closer look at topics that I am currently researching anyway. The interaction between scientific research and dance should be much greater than it is at the moment. There is no question that both sides can only benefit from an increased exchange.

Here’s an overview of the presentations I attended during the week and their respective abstracts:

Anita Kidritsch

Performance limits vs. performance resources: what "measure" do performance tests allow compared to screenings?

(Leistungsgrenzen vs. -ressourcen: welches "Maß" ermöglichen Leistungstests gegenüber Screenings?)

Lecture in German

This presentation provides an overview of existing standardized tests published in peer-reviewed journals on dance medicine topics. As a basis for a critical discussion of the tests, the articles were evaluated using critical appraisal tools and the available information on the testingof quality criteria was analyzed. The presentation distinguishes between the concepts of aptitude tests and screenings and derives recommendations for practical implementation.

Angélique Keller

Discussing the development of a pre-season (pre-performance) preparation workout for professional ballet dancers

In the professional dance world, the idea of a progressive come-back after the long summer holiday to avoid injuries is of high priority. The presenter suggests an approach copying periodization ideas from the sports world by introducing a structured 8-week pre-season conditioning program designed and tailored especially to the needs of the company. Most supplemental training of professional dancers is often unstructured and takes place outside of the studio. An implementation of such a program designed and delivered by a conditioning expert inside the studio may close the existing gap between off-season and the performance phase as far as the physical fitness of dancers is concerned. The 8-week conditioning program presented will give ideas for aerobic and anaerobic conditioning, strength training, stability and proprioception training for the lower limbs, jump training showing a variety of fitness training inside a ballet studio. The presenter will discuss barriers and successes encountered during this process. Thoughts with regards to overtraining and exercise addiction in dance will be added.

Gerd Mittag

Pilot study in the field of teaching strategies within certain class structures in Middle Eastern Dances

INTRODUCTION: This study investigates the effects of pedagogic and didactic methods, such as Holmes and Collins’ PETTLEP model, Ryan and Deci’s Self-Determination theory (SDT), Ames and Archer’s Achievement Goal theory (AGT), and Epstein’s TARGET model for Middle Eastern Dance (MED) students regarding well-being and Basic Psychological Need Satisfaction (BPNS) when implemented in specific class structures, as suggested by Mittag. In line with Mainwaring and Krasnow, these strategies for structuring a class include "1. clarifying the process and goals of the class, 2. discussing various influences that affect the dancer’s progress, and 3. clearly defining the class structure and content".

METHODS: These structural considerations and the afore-mentioned theories have been modified for MED pedagogy and were implemented and tested in six class interventions. Anonymous scientific surveys in form of pre- and post-tests at eight non-vocational dance schools in Germany and Switzerland within 12 courses of different levels with 115 volunteering students in total, comprising 109 post-test participants, were conducted.

STATISTICS: Independent t-tests with .05 as significance level showed enhanced perceived competence, greater perceived autonomy, augmented perceived relatedness, a generally better learning climate, and higher perceived effort.

RESULTS: Significant p-values and large to very large effect sizes (d) after Cohen and Rosenthal were found in all queried categories.

CONCLUSION: This study closes a knowledge gap in the field of MED pedagogy and underscores the necessity for clear class structures and teaching strategies, as explained in Mittag’s first MA-thesis.

Anna Schrefl

A kinematic analysis of calcaneal eversion in a contemporary dancer’s demi-plié

BACKGROUND: Dancing requires a high range of motion in the foot as well as a good shock absorbing system formed by the foot and ankle joints. Although there is a broad consensus in dance that excessive calcaneal eversion can cause injury and should be avoided, calcaneal eversion is discussed controversially in the dance literature. An increased research focus on the biomechanics of dance – particularly research pertaining to the foot and ankle joints – might help to resolve this controversy.

OBJECTIVES: The study’s main purpose was to generate hitherto lacking kinematic data of calcaneal eversion in a dancer’s demi-plié.

METHODS: Thirty-two contemporary dancers performed three trials in two different conditions: demi-plié in parallel and in turned-out positions. The motion capture system FASTRAK was used to measure calcaneal eversion and foot and lower leg alignment during demi-plié.

RESULTS: Maximal calcaneal eversion in turned-out demi-pliés was 3.36°±4° and total range of motion (i.e., maximal minus minimal angle) of calcaneal eversion was 3.73°±1.42°, where the large standard deviations indicate substantial variability across participants. Calcaneal eversion was significantly different between turned-out (3.36°±4°) and parallel (1.17°±4.06°) demi-pliés, as was the alignment of lower leg and foot, where the lower leg tracked more medially relative to the foot during turned-out pliés. Crucially, both the magnitude of calcaneal eversion and its temporal coupling with ankle dorsiflexion were highly variable across participants.

CONCLUSIONS: Average calcaneal eversion is a poor indicator of the role calcaneal eversion plays in the demi-plié of contemporary dancers. Rather the temporal coupling between calcaneal eversion and ankle dorsiflexion needs to be considered.

Anita Ginter

Treatment of the myofascial complex as a prerequisite for complete rehabilitation after trauma

(Behandlung des myofaszialen Komplexes als Voraussetzung für vollständige Rehabilitation nach Trauma)

Lecture in German

The goal of successful rehabilitation after injury is to restore full mobility, strength and coordination. It is essential to minimize the chronification of disorders through adaptive responses of the body to the injury. Not only the directly injured joint structure but also its myofascial and neurological-reflectoric associated structures must be considered.

The "comprehension of the musculoligamentofascial connections is therefore fundamental for the understanding of muscular treatment in sports physiotherapy". Good mobility presupposes the unrestricted mobility of the fascial envelopes among each other. Here there is a cross connection to the metabolism via the basic substance.

Healing of microtraumas leads to structural changes in the fascia involved, and much more.

Via fascial structures, our self-awareness of tension patterns in the body and in regard to the alignment of body structures to each other is organized.

Since fascia are both sensitive and contractile, the nervous system calculates appropriate movement programs depending on feedback from the fascial system.

In sports injuries, the mechanism of trauma usually results in a sequence of disturbances in the muscles around the involved joint. If these disturbances are not consistently worked through, complete rehabilitation of the harmonious muscle function around the corresponding joint cannot be achieved. Consequential damage is pre-programmed. Corresponding characteristic muscles for the most frequently affected joints should therefore always be examined for corresponding disorders.

Another consequence of trauma affecting bones and joints are the so-called intraosseous lesions, which affect the internal structure of the involved structures due to pressure and shear forces. These disturbances affect the fascial structures up to distant regions and cause adaptation reactions of the body, which also disturb the coordination around the affected joint, making complete rehabilitation difficult.

Knowledge and therapy of these factors can make rehabilitation of injuries much more effective.

Anne Stranka

Active regeneration and heart rate variability - why it makes sense to take a deep breath

(Aktive Regeneration und Herzratenvariabilität – warum es sinnvoll ist durchzuatmen)

Lecture in German

In dance medicine we have already dealt with many topics. Which possibilities of supplementary training methods can be helpful? Which therapy is most effective and what is the best diet for dancers? What has been largely ignored so far: Regeneration, resilience, heart health.

Heart rate variability (HRV), which has long been used in many areas of high-performance sports for active training control or for preparing for competitions, could be a door opener to individual and health-promoting dance training. It is important to train the autonomic nervous system in order to strengthen the dancers' ability to regenerate and adapt. Such a training can be done by different methods, e.g. by mindfulness and breathing exercises, meditation, the diving reflex or an adapted and individual training plan.

HRV is thus a useful and simple parameter that can be used to measure the respective personal vegetative state. At the same time, a mindful approach to HRV promotes a significant reduction in stress and can thus become an instrument for emotional stress management, which can have a positive effect on issues such as stage fright and test anxiety. An intelligent and individual training could give dancers and artists the possibility to regenerate better, promote their creativity and strengthen the mindful handling of themselves on the different health levels.

In the lecture I would like to present some methods that positively support HRV, some studies and also my own test series, which gives room to bring another important building block into dance training.

Eric Franklin

Free hips, balanced Psoas

(Hüfte & Psoas: beweglich und frei)

Lecture in German

As one of the most central muscles, the psoas wraps around the lumbar spine. With a pronounced hollow back, the psoas is often shortened and strained.

A "psoas awareness" and training that corresponds to it promotes uprightness in the pelvis and spine, frees the lower back and improves mobility in the hip joints.

In this 2-hour webinar you will learn:
- The integration of the hip joint and psoas - for ideal posture and efficient movement
- How the fascia of the psoas, abdominals and pelvic floor dynamically work together
- Effective (anti-arthritis) exercises for a healthy and free hip joint
- Learn to stretch the psoas properly – for optimal strength and flexibility
- Exercises against a "snapping hip" to center the femoral head in the joint
- Relieve the sacroiliac joint of pain in balancing the psoas and piriformis
- The current scientific status on the actual function of the psoas/iliacus.

Experience a new freedom in the hip joint!

Jack Waldas & Marion Whyte

Organic Ballet - Health and High Performance

Breathing Body Ballet (BBB) is a teaching method designed to facilitate the well-being, artistic expression and technical skill of the dancer. Our primary objective in this workshop is to convey classical dance as an organic art-form based upon natural human movement, thereby guiding dancers to the fulfillment of their potential. BBB ascertains that a dancer’s health is not a rival of aesthetic beauty and virtuosity, but rather its foundation. We see ballet in a state of evolution wherein many influences (i.e. GYROKINESIS®, Spiraldynamic®, Yoga) are co-creating the art-form of today, ensuring that classical dance is perpetually renewed, both artistically and pedagogically.

We firmly believe that all dance can be most effectively learned and healthfully practiced when the outer form is a result of the inner dynamic of movement. It is our pedagogical experience that teaching the basic inner impulse of a movement before requiring a strict external shape is a much more successful method. We understand the human body to be an interconnected, net-like structure that allows the breath to influence the whole body. The BBB method focuses on this tensegral relationship between breath, myofascial connections and 3D movement to impart the dancer with a more integral experience of his own body - that is to say all parts and self-perceptions become a unified self-awareness. This is an ideal state of being for optimal coordination and performance.

In this workshop the participants will perform exercises based upon the waves, circles, and spirals of full body respiration and convert these organic movements into ballet vocabulary.

Martha Richter & Marcus Trocha

Return-to-Dance: A criteria-based algorithm for deciding on readiness to return to dance after injury

(Return-to-Dance: Ein kriterienbasierter Algorithmus zur Entscheidung über die Rückkehr zum Tanz nach Verletzungen )

Lecture in German

The incidence of musculoskeletal injuries in dance is 17% - 95%. Previous injuries may increase the risk. In dance, scientifically accepted and standardized testing programs are lacking to date. A criteria-based return-to-dance examination algorithm will be developed for lower extremity injuries. As a basis for this, existing test batteries from other sports will be used and supplemented or adapted specifically for dance.

Various literature searches will be conducted in the medical databases and in dance-specific literature. First, recognized and studied test batteries of other sports and their diagnostic capabilities will be identified. Dance-specific injuries, their underlying injury patterns, and potential prevention programs will be researched to elicit dance-specific additions and/or adaptations. Based on the results from the literature, a decision algorithm and a test battery consisting of tests that are as valid and reliable as possible will be formulated to address dance-specific stresses.

From the collected scientific information and their own dance medicine and movement therapy expertise, the authors present an algorithm for deciding whether to resume dancing after sustained lower extremity injuries.

The presented return-to-dance examination algorithm is a recommendation of the authors. Its ability to reliably judge the return to ambitious and professional dance will subsequently be tested in the context of a longitudinal study.

Jasmin Hänel

Predictive risk factors of pain occurrence in dance instructors

(Prädikative Risikofaktoren des Schmerzauftretens bei Tanz vermittelnden Lehrkräften)

Lecture in German

BACKGROUND: Dance teachers (TL) rely heavily on their functioning bodies in their professional practice. To date, it is largely unclear whether and to what extent the musculoskeletal system is compromised by dance teaching activities. Pain, as a warning signal, can provide clues to potential health hazards. The aim of this study was to 1) elicit pain prevalences, localizations, and ratings of TL and 2) identify predictors of pain occurrence within the past 3 months.

METHODS: A quantitative, retrospective cohort study was performed on n=166 TL through an anonymous online survey. Data on study population, occupation, and pain prevalences, locations, and ratings were presented descriptively. Binary logistic regression was used to identify predictors of pain occurrence in the past 3 months from population parameters and information on dance teaching activity.

RESULTS: In the past 3 months, pain was present in n=143 (86.1%) of the TL and was frequently localized in the lower back and lower extremity. For being caused by dancing, the pain was rated by the TL as "somewhat true" on average. The binary logistic regression model identified BMI (odds ratio (OR) = 1.15), age (OR = 1.03), and presence of disease (OR = 2.81) as predictors of pain occurrence (LR-Chi2=7.8, p<0.05, pseudo R2=0.06, n=160).

CONCLUSION: A health risk does not seem to emanate in principle from the dance profession, but rather seems to be favored by other contextual factors such as BMI, age and diseases. Education and preventive measures should be implemented early in the dance career.

Grit Reimann

Mental training in practice

(Mentales Training in der Praxis)

Lecture in German

The effectiveness of mental training has been proven for many different fields (Mayer & Hermann). Unfortunately, too little is published about how mental training is actually carried out, so that it often does not go beyond merely trying to "imagine how you do that" in practical application.

Using a concrete example from a technical-compositional sport, mental training according to Eberspächer will be presented and the transferability for the dance field will be discussed.

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More information on this year's Online Congress for Dance Medicine and all other activities of ta.med - Gemeinnütziger Verein für Tanzmedizin at tamed.eu
Header photo by Chris Montgomery on Unsplash
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