California State University, Long Beach

Dancing Through the Pain

Dancers are graceful, strong and high-performance athletes. They also are flexible and resilient, but can break down over time because of repetitive stress on their bodies. Their feet can hurt, their ankles are often strained, and their hips ache from years of leaping and jumping motions that have taken a toll on their musculoskeletal system. But few dancers complain; the show, as they say, must go on.

A dancer’s reluctance to complain is one reason little is known about the exact extent of their injuries as well as how to reduce the number of injuries dancers sustain throughout their career.

Dr. Brooke Winder says dancers don’t focus on improving strength and conditioning, which could alleviate the risk of injury.

It’s a field relatively understudied compared to the field of sports science, a fact Assistant Professor Dr. Brooke Winder of the Dance department hopes to change. A practicing physical therapist, Winder routinely lectures on injury prevention and wellness for dancers, dance teachers, fitness professionals and health care providers as part of her field of study in dance science. She believes there needs to be more rigorous, high-quality research in this area.

“The unique opportunity here at Long Beach is that we not only have a wonderful dance program, but a wonderful physical therapy program as well,” Winder said. “The physical therapy program has been great and very interested in collaborating with our department.

“It’s a lovely place to bring in several different minds from the perspective of the arts and arts health, as well as fellow clinicians from within the physical therapy department to try to produce some new research that is elevating the level of dance science and going to inform not only dance but the physical therapy world.”

Winder is a full-time clinician, but she will focus on teaching and research. For years, she researched jumping and leaping mechanics and how they affected dancers’ lower extremities, but now she has refocused her attention on looking further “up the kinetic chain” to the low back and pelvis.

Dr. Brooke Winder helps dance students
Dr. Brooke Winder instructs dancers how to alleviate stress on their spines during warm-up exercises. Photo by Sean DuFrene.
Student Alex Rix leaps in air
Student Alex Rix demonstrates the demands dancers place on their spines when performing. Photo by Sean DuFrene

She said observationally during her research there seemed to be a connection between how the trunk and pelvis aligned and how the dancers used their lower extremity.

“These general observations, along with my clinical experience treating a lot of low back and pelvic pain, led me to want to focus my pursuits here (in partnership with the Department of Physical Therapy) on understanding more about contributing factors to injuries to the low back and pelvis in dancers, and how this can eventually be mitigated for dancers in the future,” Winder said.

Winder said that while low back pain has been widely studied in the general population, there are few high-quality published studies on that type of injury in dancers, particularly college-level dancers. Dancers, she said, place an incredible demand on the spine while performing impact activity, such as jumping and leaping. That also occurs with movements involving extreme ranges of motion into flexion, extension and rotation, and performing repetitive partnering and lifting.

Limited research has indicated that though dancers train at a high level, many do not possess the appropriate levels of strength, endurance and other measures of fitness required to do what they do.

“My goal is to understand how university-level dancers with, and without, a history of low-back injury may perform differently in measures of trunk and hip muscle activation, strength and endurance,” Winder said. “Understanding whether some of these differences exist in college-level dancers can help me to pursue other questions regarding low-back injury risk and injury prevention in the studio.

“Eventually, I hope to see how these measures may potentially relate to biomechanical strategies dancers use in movement as well.”

Dancers stretching
Dancers stretch before practice, a habit that could help ward off injuries Photo courtesy of university archives.

“I think we are trailing behind all the sports sciences, but the field is trying to get there,” she said. “We are trying to elevate the level of research and also the quantity of research that’s out there.”

Winder also aims to lengthen the professional life of a dancer through her research in dance science. Like football players who retire after a few short years from the abuse their bodies take on a weekly basis, dancers’ careers are cut short by similar problems.

“In classical ballet, it’s shorter because it is so demanding and people start (dancing) very, very young and start their careers in their teens,” Winder said. “So, it’s not uncommon for a dancer to be retired from professional performance in their middle or late 30s. It’s relatively short. So, anything we can do to extend the life of their careers I think will be so positive for the art.

“Another thing I would like to look at is not just keeping someone healthy for their performing career but how do you help someone that when they retire from dance and move onto other things, they can have the best health possible in their life.”