At 14, the student was still complaining of sore hips, so another set of images were taken. She was also told by a friend to come and see us at Perfect Form Physio for treatment for her ongoing hip pain.
In these images the pelvis has begun to fuse (as it should), however the head of the femur (thigh bone) is flattened and the shape of the socket is shallow. There is also development of a "pincer type deformity" at the top of the hip socket that was not present in previous x-rays that will contribute to anterior hip impingement. Bone develops in response to load, so it is probable that this developed in response to repeated compression after kicking her right leg up repeatedly...
What does the future hold?
This dancer will continue to struggle with pain in her hips due to anterior hip impingement and the bony changes in the hip socket. She will most likely be requiring an early total hip replacement due to this. With very careful rehab we were able to drop her pain levels, but she will need to be extremely diligent in maintaining these in order to be able to continue to dance.
Unfortunately, there are still many teachers still advocating this type of aggressive stretching in young students, who seem to have little awareness of the long term consequences it can have. This type of training IS NOT NECESSARY in developing good turnout range in dancers.
There are actually six different ranges of turnout in the hip.
- Standing Leg Turnout
- Turnout en Fondu
- Turnout in Retiré
- Turnout Devant
- Turnout a la second
- Turnout Derrière
It is important that each one is looked at in isolation and the true restrictions to range identified. Once you know exactly what is blocking the range, then you can work on safe and targeted releases to open up your flexibility in that direction. Working out what is making that particular structure tight in the first place is even more important!
Simply pushing into over splits in second (especially with a partner pushing on the sacrum) is very dangerous. For more information about this, please read my "Is Over Stretching Bad?" blog post.
To learn more about how to specifically assess and treat your own hips take a look at our Training Turnout Manual!
If you are a dance teacher or health professional and would like to dive deeper into this topic, click on the links below to find out more about our Online Teacher Training workshops.
If you are looking to delve deeper into this topic, check out the following programs:
Tips for Turnout: This ‘Tips for Turnout Guide’ is a great starting point for anyone wanting to learn more about how to maximise turnout safely, and is the first resource in our Training Turnout Series. It gives you tips on improving your range, developing control of your standing leg and specific ways to increase the height of your développé devant.
Training Turnout: Deepen your exploration of the anatomy of the dancers’ hip with this unique Training Turnout eBook. As the second resource in our Training Turnout series this program is a great follow on from our Tips for Turnout Program. Learn how to assess and understand the structure of your own hips, strengthen standing leg turnout and turnout en fondu as well as develop extraordinary control in your adage.
Training Turnout in Tiny Dancers: If you are dance teacher, this is the perfect continued education course for you. In this systematic and comprehensive approach to training turnout in tiny dancers, Lisa and Beverly provide dance teachers with direct techniques to use in class to safely develop optimal range and control of motion in all dance students. This program begins by establishing strength and control in parallel, before adding on the control of rotation, which is hugely important in the long term health of dancers’ hips. Using elements of fun and creative play to bring scientific and detailed training programs into dance schools is a unique and effective way to help thousands of young students worldwide
Level One Dance Teacher and Therapist Training: This unique course covers a multitude of assessment and treatment techniques to individualise a dancer's training. With special focusses on Postural Control, Core Stability, Flexibility, Basic Classical Technique, The Dancers Hip, Allegro, Spinal Mobility and Arabesques, it is suitable for anyone working closely with dancers.