Wednesday, July 27, 2011

Should Runners Learn to Dance? Physical Therapy and Performance Implications (Part 2)

In Part 1, we discussed several observations involving the sports of running and dancing.  These observations lay the groundwork for this post, so if you have not read Part 1 yet, I suggest you at least skim it.

Now....some of you may be asking yourselves, "What do these observations mean to me as a runner!?"  Today I'd like to delve deeper into one of my methods for developing functional single-leg stance (adapted for runners from the Selective Functional Movement Assessment).  Remember, this method also applies to the early rehabilitation of dancers, so if you run by day and dance by night, listen closely!

First, let's take a look at dysfunctional single-leg stance:

Front view                                                      Back view

Do you see how this runner is leaning away from the leg on which he is balancing?  He is unable to stabilize his body through his trunk and lower extremity.  So, if you exhibit dysfunctional single-leg stance like the runner above, how should you go about developing a functional one?

As a sports physical therapist, my first goal is to help teach my patient the feeling of functional single-leg stance.  In other words, I use inexpensive tools to encourage the body to activate the required stabilizing muscles.  Check out the picture below.

                        Single-leg stance with trunk musculature activation**

**Take note of the 90-degree angle at the L hip and knee as well as the upright trunk position....think of trying to stay pencil-straight from your stabilizing (planted) leg to your head.  Proper positioning of the band involves hanging it around an object like a weight machine or a tree and pulling it towards your body with palms down.  Make sure that you have enough tension in the band.

I am having the patient use a band (can be a piece of Theraband or other stretch-like material) to facilitate activation of the trunk musculature.  One of the main reasons runners display dysfunctional single-leg stance is because they are not able to engage the trunk in concert with pelvic stabilizing muscles and the respective lower extremity.  If you utilize a band as illustrated above, you will notice that you can more easily maintain the single-leg stance position.  At that point, you are beginning to teach your body proper muscle activation patterns, which are extremely important for injury-free running.  How long should you maintain this position?  Enough time to challenge yourself.  Build up to 4-5 sets of 45-second bouts.  When you can maintain functional single-leg stance with the band for 45-seconds at a time repeatedly, retest yourself.  I'll bet that your once-dysfunctional single-leg stance is now functional = minimum of 10-seconds maintaining proper form without losing your balance.  Obviously, additional progressions for this functional movement exist, but the exercise illustrated above is the BASE for more advanced sequences.

Following development of functional single-leg stance, a series of low-level plyometrics is often initiated, beginning with double-leg hops and progressing to single-leg hops.  This portion of the exercise prescription following a running-related injury can be quite tricky and is best completed under the guidance and supervision of a physical therapist who specializes in treating runners.

If you have any questions or comments regarding the information just presented or a personal running-related injury question, feel free to contact me at or via DoctorJunes on Twitter.  I would be happy to help you in any way that I can.  And please, don't be like one of the dance accidents in the YouTube video below!

Wednesday, July 6, 2011

Should Runners Learn to Dance? Physical Therapy and Performance Implications (Part 1)

Runners and dancers -- two completely different types of athletes, right?  Think again.  Although formal dancing often occurs in an upstairs studio and running is performed anywhere from treadmills to trails, the two disciplines share some startling similarities.  Personally, I do not have any formal dance training unless you count the 5th grade ballroom dance lessons...thanks Mom and Dad!  I have much more experience working with and treating runners.  But as a physical therapist, I have worked with several dancers over the course of my career thus far, and I have made the following observations involving both sports:

1.) Dancing is a form of exaggerated running.  Running is an activity in which an individual is always in single-leg stance (one leg on the ground at a time) on one extremity.  In other words, one leg is on the ground while the other is in the air.  Dancing commonly involves leaping from one foot to the next; therefore, like in running, development of functional single-leg stance (see pictures below) is an extremely important element of a physical therapy plan of care for a dancer.

Front View                                                       Back View

2.) Development of the foot and ankle musculature and proprioceptors is vital to success.  A dancer who is weak in her foot and ankle complex will not be able to safely land while leaping.  Sports physical therapists see a fair amount of dancers with ankle sprains as a result.  The same principle applies to runners, particularly those who compete in off-road/track events like cross country and trail running.  Those readers who regularly run on trails can identify with this statement...strong and agile ankles can mean the difference between navigating that rock on the trail or sitting down on it afterwards with a bum ankle.

3.) From a performance standpoint, runners and dancers are always attempting to develop more powerful strides or leaps, respectively.  For runners, a powerful stride combined with an effective metabolic system is a deadly weapon.  Have you ever seen a professional dancer leap across the stage?  What a graceful display of true athletic power.  Should you be performing exaggerated running aka bounding as a part of your comprehensive training program?

Just a few casual observations to consider.  Runners can learn from dancers and vice versa.  Actually, I have known a few individuals who have excelled at both disciplines throughout adolescence.  In addition, I will go one step further and state that a common paradigm exists for treating running and dancing injuries.  Will the final stages of rehabilitation be different?  Absolutely.  But many similarities will exist in the earlier stages in terms of functional exercise.  In my next post (Part 2), we will explore how some of these observations and concepts relate to the treatment of running and dancing injuries.  These implications will be useful for all runners who desire to decrease their incidence of future injuries.  Check back for more!