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How To Correctly Work On Your Knees

In this video Lisa discusses why working on your knees needs to be thought about very carefully and should always be approached with caution. The risks involved when working on the knees are also dramatically different for adolescents compared with adult dancers, and what may be safe for an adult professional dancer may not be so safe for your average 12 year old!

 
 
 
 
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Wistia video thumbnail - Episode Three - Working on your knees
 
 

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The reason why working on the knees is more dangerous for adolescents is due to the anatomy of the knee, and especially the specifics of it's anatomy during periods of growth. Most long bones in the body have a growth plate at each end (proximal and distal) to allow for development. These growth plates are more active at various times in our lives, however the rate of growth, and the exact ages that it fully closes are different in every individual. Typically the growth plates around the knees do not settle until about 12-19 years of age (1, 2). 

The adolescent leg grows approximately 23 mm/year, with most of that coming from the knee (15 mm/year):

    •    distal tibia - 5 mm / yr (3/16 in)
•    proximal tibia - 6 mm / yr (1/4 in)
•    distal femur - 9 mm / yr (3/8 in)
•    proximal femur - 3 mm / yr (1/8 in)

The tendon from the knee cap, the patella tendon, attaches onto the tibia at the tibial tuberosity, which also happens to be where one of the major growth plates in your lower leg is (the proximal tibial epiphyseal plate). Many young students begin to develop painful and unsightly lumps on the front of their knee from constant pulling in this area during periods of growth, often termed Osgood Schlatters disease. While this is painful when they are are young, it can also cause problems well into adult hood, especially in any situation requiring kneeling (such as in a performance of Swan Lake!)

     

Aggressive work on the knees can actually cause the bone be cleaved off, due to too much load in this area during a period of sudden growth or intense activity. The photos below are from an 11 year old dancer who was doing a significant amount of dancing during a sudden period of growth. You can see the damage to the bone where the patella tendon attaches to the lower leg. 

Osgood Schlatters

If young dancers are doing any work on their knees it should be pain free and silent. This is achieved by working correctly through the outer part of the leg, rather than directly down onto the knee, as demonstrated in this excellent, tongue in cheek, video by Paul Malek from Transit Dance in Melbourne.

https://www.facebook.com/paulmalekofficial/videos/1982645658630407/ 

We also advise to wear knee pads whenever dancers are doing work on their knees. The extraordinary dancer Sylvie Guillem wears them as part of her costume in PUSH, so if it is good enough for Sylvie, then it is good enough for a 13 year old eisteddfod group! Too many dancers in their 30’s and 40’s struggle with simply going up and down stairs, due to incorrect technique in their younger years. You only have one set of knees, so please take care of them them!

References:

http://www.orthobullets.com/pediatrics/4024/proximal-tibia-epiphyseal-fractures--pediatric
http://www.wheelessonline.com/ortho/growth_of_proximal_tibial_epiphysis
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