ADDing to the support of your knee joints (& technique)

In an earlier post on the anatomy of the knee we included some general guidelines to consider within our teaching and technique.  Today let’s focus specifically on the importance and benefits of accessing the use of the inner thighs (adductors).

 

First, WHY are your adductors so important?

The adductors of the leg (inner thigh) are the support system for our supporting/standing leg, whether in a neutral/parallel or turned out position.   They are a key component when considering our stability in the centre of the room, and our overall performance.

Second, the use of the adductors aids the engaging the most medial of the quadricep compartment – which tends to be underused among dancers.  Among other issues, weak adductors and medial quadriceps creates an imbalance in the quadriceps overall, and leads to issues such as Patellofemoral syndrome.

 

Adductors, the key to efficient alignment and rotation!   Engaging the adductors when standing on two legs aids the activation of the deep rotators in the hip, which in turn fosters the neutral alignment of the pelvis.

 

Leg Shapes

At this point we need to consider leg shape (see figure to the left).  Each student has a unique leg shape in that the alignment of the knee in relationship to the ankle and hip varies.

This includes hyper-flexion of the knee (they always look slightly bent), hyper-extension of the knee (when extended the knees are behind the hip & ankle), bowing of the legs (when extended the knees are outside the line of the ankle and hip), and knock knees (knees closer together than the feet when in parallel) — or any combination of these three can also occur.   In dance, these different leg shapes affect not only our pelvic alignment (and overall posture), but our weight placement AND (in the long-term) the health of our knees as well.

Engaging the adductors also facilitates the engagement of the muscles of the pelvic floor, which in turn engages the deeper abdominals (it’s that feeling of lift that begins from the pubic bone upwards towards your belly button).  In turn this encourages the lift of the anterior crest of the pelvis (ASIS), guiding the pelvis into a neutral, and more effective, alignment.

This concept of engaging the adductors is key in any technique – whether working from a parallel position (anatomically neutral) or a turned out (externally rotated) position.

 

Checking in with Physiotherapists Kevin Dyck and Sam Steinfeld, they answer the following questions:

Can working in your hyperextension cause long term damage?

Long term hyperextension causes lengthening of the ligaments around the knee joint.  Due to the anatomical structure of the knee our ligaments provide the stability for the knee joint. Ligaments are like rubber bands…after they have been stretched or overstretched repeatedly they do not return to their original length.  If the ligaments around the knee are constantly stretched by standing into hyperextension, over time our knees will lack the support they need and injuries occur as other structures like muscles and tendons try to offer support.

What is Patellofemoral Syndrome?

Patellofemoral syndrome is a condition that refers to an incorrect balance of movement between the thigh bone (femur) and the knee cap (patella).  Imbalance of muscle strength and length at the knee leads to an improper tracking of the knee cap in the patella groove which causes pain, inflammation and irritation. Several muscles can be the culprit for the imbalances of patellofemoral syndrome.  The most common is a weak vastus medialis oblique (inside knee muscle) along with a tight iliotibial band (outside thigh muscle-tendon).  Tight calves, tight or weak hamstrings and gluteal muscles, especially gluteus medius, are also sources of patellofemoral syndrome.  Poor pelvic and abdominal control can also cause increased forces of stress to be placed on the knee during turnout in dance.

 

So how can this information be used in the studio?

From 6-12yrs of age (and beyond) we can provide images that help children to find the feeling of activating the inner thigh.  An image that gives them the feeling of resistance without over exaggerating the action  (which can lead to tucking the pelvis) will help them to feel this action.

For example – ask each child to stand in a parallel/neutral position of the feet and to place an big, fluffy, [imaginary] marshmallow between their ankle bones, calf muscles, and upper thighs.   Cue them to hold the marshmallows in place, but not to squish them.    This accomplishes TWO things –  engaging the adductors AND bringing the legs into a neutral alignment (key for those who are bow legged or have hyperextension of the knee).

With adolescent and adult students we can use the same (or similar) image, bringing the action of aligning the pelvis and ribcage into the discussion more specifically.  Regarding leg shape, with the pre-teen and adolescent student we can also ask those students with hyperextension of the knee to bring the centre of the knee in line with the supporting ankle (see figure to the left) while engaging the adductors.  Though at first this will feel as though they are dancing on a bent leg, over time this will prevent unnecessary damage to the cartilage and structures of the knee.

 

How does this apply to young children?

Young children are just beginning to develop the ability to ‘feel’ their muscles and alignment.  As such, combining these concepts can be too much information to process at once successfully.  In my own teaching practice, the focus with young children is on the use of the adductors to bring the legs into correct alignment via imagery.  As students develop more muscular control we begin to discuss in more detail how to align the knees and begin to include more specific exercises to assist with this process.

 

Teaching Ideas:

(Alignment of the legs)

Ages 6 and up –  When doing seated exercises with the legs extended in front, take a moment to check the alignment of each students legs in this position.  Taking the alignment from the knees being side by side will foster a stronger sense of alignment through the legs.  The trick here is to assure children that if their knees are together and their feet are apart that this is ok.  Ask them to imaging holding a small ball or water balloon between their feet to aid with alignment.

(Hyperextension)

For students working with hyperextension in this seated position generally the feet will come off of the floor when then legs are stretched.   When aligning the legs, take a moment to ask them to lower their heels to the floor in this position.   Perhaps having them place their heels on a star (a foam star or imaginary) during the floor exercise.  This will begin the process of understanding in what position the knees are to be aligned when in a standing position.

Author:  Jacqui Davidson

Fa la la la laaaa, la la Alignment!

(2011) Bruce Monk

Alignment is the foundation of  [all] good dance technique and fosters a healthy spine, for life! Because it is so fundamental to the healthy dancer (and individual) it is beneficial to begin preschool classes with a posture exercise and focus warmups for higher levels on posture and alignment as well.   In programs working with individuals in wheelchairs it is also tremendously beneficial to focus on the alignment of the spine as poor posture in seated positions can hinder the use of the arms and flexibility of the upper torso, as well as promote excessive tension.

In our November Newsletter Monique Lavoie discussed the stereotypical posture of a ballet dancer, demonstrating that  poor alignment can hinder our strength and overall balance.     Whether teaching the once, twice, three, or six times a week dance student I feel it is our responsibility to build not only train healthy posture, but to foster students understanding and appreciation of the importance of posture and alignment in all aspects of movement.   Pilates is an excellent tool for retraining our neuromuscular pathways for overall musculoskeletal health.    Monique’s article is a brief discussion, but an important one – click the following link to check out her article.

LINK:  Focus on Pilates (from Nov. 2011 Newsletter)

TEACHING TIP: Use songs (for preschoolers)  and visuals to foster both the understanding and the physical implementation of posture.   In my opinion, when we ‘see’ alignment and begin to apply it, the muscles begin to hold the correct alignment of the bones.  From here the students begin a more organic process of using the muscles to stabilize posture.

 

Using foam shapes (I use dots or stars) play connect the dots with your students (of all ages)!    With the help of an assistant or a student the conversation with the class goes something like this…

 

Where does the teacher look first when checking your posture?    “my feet!”   (place a dot – on the side of a child’s ankle)

Next?  “my knees!”   (place a dot on the side of the demonstrators knee)

And next?  ” my hips!”  (you get the picture)

And next?   ” my ribs!”  (Preschoolers have a hard time with that one sometimes)

Then?  ” my shoulders!”     And then?  ” my head!”

 

This worked wonders with my preschoolers – now all I have to say is “Have you connected your dots?  Are they in a line?” And they will begin to physically self correct their alignment.

 

Older students and even adult students can benefit from this visual as well, incorporating how the use of turnout can impact alignment (demonstrating the need to re-align when turning out) and the adjustments that need to be made when turning out.

Author: Jacqui Davidson

Photo by Bruce Monk.