To answer these questions as clearly as possible, I have put some brief pointers below, but am also putting together a series of more comprehensive posts, each one dealing with a different position or issue, combined with some fabulous cartoons (courtesy of my amazing Dad - Mike Howell) to illustrate the potential dangers dangers and considerations of over stretching. Keep an eye out for each one as it is released:
6. What is the long term effect on these students hips, back and knees as they move from being a passionate young dancer into either a professional dance career, a teacher, or a 'normal' person trying to live a healthy life?
Excessive mobility in any joint requires more fine, co-ordinated control of the stabilising muscles around it and will require a huge amount of dedication to 'rehab' style exercises to remain pain free. It is essential that dancers have good postural control and endurance, and spend time keeping each joint healthy to avoid the pain associated with excessive mobility and joint degeneration. Without this strength and articulation, individuals are often plagued with long term back and hip pain that can be very hard to treat due to the instability of the joints.
7. Is there another way of achieving the same level of mobility safely?
Simply put, I consider stretching into the direction you want to go the slowest and most dangerous way of actually getting there. Pushing into a restriction often engages a reflex contraction of the tissues which will have to be pushed through, potentially causing soft tissue (or ligament/capsular) damage. Instead of over stretching and forcing young bodies into the direction that they are trying to achieve, I focus on using that 'stretch' as a test, analysing what is actually causing the restriction, then performing calculated, specific mobilisations, and releases of those individual structures. Then, when the movement is tried again, it is much easier. This can all be done without pain or the risk of damaging muscles or ligaments.
Working correctly with the fascial system can also give enormous increases in mobility with no risk of damage. Our understanding of the nature of fascia has exploded exponentially in the last 20 years, and it no longer means aggressively using a Foam Roller or Deep Tissue Massage. Fascial mobilizations such as those shown for the upper back HERE and the hips HERE may feel very easy to do, but can have a profound effect on your mobility.
For instance; a Google search on the word "Fascia" in 2001 gave approximately 1500 entries. Search for that word now and you will get "approx 48,000,000"....! It is essential that we upgrade our training techniques to "move with the times" and use this amazing new research in the best possible ways.
Students must learn to work with their own body, and how to be sympathetic with its quirks rather than fighting it, resulting in greater, more usable flexibility, with far less risk of injury. I have turned my attention to training teachers and health professionals safer ways to work with their dancing students to make dance training safer world wide. For detail on the Level Two - How To Train Extreme Mobility Safely course, CLICK HERE
8. Is PNF Stretching OK?
No. not in adolescents.
While many adults find PNF or Contract / Relax stretching an effective way to increases their mobility, I do not believe that this technique should be used in students under the age of 16. Many major muscles, including the hamstrings and quadriceps attach onto major growth plates. Aggressive stretching during periods of growth may result in Avulsion Fractures (where a fragment of bone is torn away from the main bone). These injuries are often hard to rehab and often require a long time off dancing to do so.
9. Why can some people do it easily and others can't?
Physiologically, we are all different. Some people naturally have more mobility in their ligaments than others and will find it easy to go into some positions. Often the ones who find it easy need the most care, as their ligaments will be less resilient long term. I have seen many students posting photos of their excessive mobility online who I suspect have undiagnosed Ehlers-Dalos Syndrome. If a student has this condition, it is even more important to ensure that their training does not over stretch their already weak tissues.
Classifications vary, but it is important for all teachers to know the differences between the following:
Individuals with more mobility in their joints will often also find it harder to sustain a good postural position, resulting in constantly sore lower back and neck muscles. Those with Joint Hypermobility Syndrome or Ehlers Danlos Syndrome may also have issues with their bladder and bowel as all of their connective tissue is affected.
If you are involved in training young students it is very important to be aware of the possible dangers that exist, and to understand that training young adolescents is different than training adults. It is our responsibility to learn the safest possible ways for them to achieve their goals, as well as educating them on the appropriateness of their goals to their chosen career. This is why I am putting so much effort into developing comprehensive teacher training courses to give teachers and health professionals the skills to help students do amazing things safely.
I am very worried about what is going on in some "master classes" and workshops where average kids are being forced into positions, with the promise that it will make them famous - when in reality it is more likely to injure them. Forceful over stretching in one session is not the way to get more mobile.
Over stretching excessive joint mobility is different to excellent flexibility and is not a requirement for success as a professional dancer. We need to be thinking of our students as human beings with so much potential, not just disposable performing ponies. I can say for sure that if I am ever blessed with a daughter I will certainly not be letting her put her body at such risk for the sake of someone else's entertainment. There will always be someone who is willing to do this - but I anticipate a very long life and I would rather she enjoy all of it!
I also do not subscribe to the suggestion that performing at an elite level has to result in long term damage! My focus is on giving athletes long, sustainable careers, where their body is continually honed, refined, and specifically trained to achieve the ultimate level of performance. This in turn makes them an exceptionally high functioning human being beyond their performing career. This does take time and effort, but the results are well worth it.
We just need to change our mindset as it does not have to be a one or the other scenario. It just needs more education, and more care. If you have any questions about specific stretches, or you would like to learn how to get more mobility safely, please feel free to CONTACT US at Perfect Form Physio for a session in the clinic with one of our amazing Physiotherapists or via SKYPE.We work closely with dancers all the time - so we know what your needs are, and can help you find safer ways to improve your mobility.
I hope this all makes sense, and answers all of the questions that have been put forward. I will continue adding articles on this topic, so keen to hear your feedback, and anything I may have missed!