Ballet News Reviews |Anatomy, Dance Technique and Injury Prevention by Justin Howse & Moira McCormack
This book was first published in 1988 and is now on its 4th edition. It’s an indispensible, detailed account of your body as it relates to ballet.
Written by Justin Howse (Consultant Orthapedic Surgeon with experience in the performing arts, especially dance. Howse was Orthopedic Consultant to The Royal Ballet and English National Ballet (company and school) and others) and Moira McCormack (Chartered Physiotherapist working with The Royal Ballet).
It’s not a science textbook, but it’s not chick-lit beach reading either! The medical terminology is explained very well and there are so many practical suggestions backed up with photographs, drawings and even x-rays that really help you to understand the longer, perhaps unfamiliar words.
There are 5 sections :
Anatomy & Physiology (the skeleton, joints, muscles, nervous system, skin, cardiovascular system, alimentary canal & digestion, respiratory system, excretory system, functional anatomy relevant to ballet)
Injuries (patho-physiology of injury, types of injury, causes and complications, treatment, prevention, nutrition and unexplained underperformance)
Specific injuries (ankle sprains & ruptures, subluxation of peroneal tendons, fracture of lateral and medial malleolus, osteochondral fracture of the dome of the talus, Achilles tendinopathy, stress fracture of metatarsals, cuboid subluxation, plantar fascial strain, corms and callosities, calf muscle tears and cramps, groin strains, hip impingement, sacroiliac strains, lumbar disc prolapse and many more)
Technical faults and anatomical variations (discrepancy in shoulder level, rib injuries, over-turning, restriction of turnout at the hips, weakness of adductors, quadriceps insufficiency, tibial bow, swayback knees, tight calf muscles and more)
There is also a brief glossary of ballet terms (though I’d refer you to The Technical Manual and Dictionary of Classical Ballet by Gail Grant for an industry standard full glossary.
The forward to Anatomy, Dance Technique and Injury Prevention is written by Dame Ninette de Valois (founder of The Royal Ballet) where she says that the book is, in her opinion, food for thought not only for dancers, students, teachers, repetiteurs etc but also for choreographers. In the same way that a composer has to keep within range of a singer’s voice, so should a choreographer, ideally, keep in mind the limitations of the dancer.
So many young ballet students and their parents put their trust entirely into the hands of their teachers. Often there is nothing wrong with this, but there is also nothing wrong in arming yourself with knowledge of your anatomy and physiology as it relates to ballet, and this book does just that. Ballet is a discipline where you have to learn the terms; learning how your own body works with this training goes hand in hand.
The text is accompanied throughout with clear drawings, photographs, x-rays – even basic information showing the difference between a well pointed foot and one that isn’t, is covered. Yes, it’s detailed, but if you don’t understand proprioception, how well-informed are you ? (Proprioception is derived from proprius (one’s own or self) and receptor (something that receives) and is the body’s ability to sense the position of the body as a whole and its individual parts, in space). So it’s pretty important in relation to ballet.
The clear photographs of dancers easily demonstrate, for example, a badly balanced pelvis in turn-out, or a ‘flat’ turned-out first position. Can you passively dorsiflex the 5th metacarpophalangeal joint 90 degrees right and left ? The nine-point Beighton Score (an observational aid to score hypermobility) and accompanying photographs will show you what that means. (Hypermobility means how much further than ‘normal’ your joints stretch).
The section on pain and pain control, including the analgesic (pain) ladder introduced by the World Health Organisation covers some interesting facts about the perception of pain and it’s importance in well-being, as well as how to manage pain through basic paraecetamol to hydrocortisone acetate, oral steroids and on to operations.
Prevention is everything, of course, and this section covers some ground; for example avoiding tar, nicotine & carbon monoxide to maintain cardio-respiratory fitness. Everyone knows this makes sense, but how many dancers take steps to avoid these substances as they have a direct impact on performance ?
How to work out your optimum daily water consumption is covered, along with the importance of hydration, especially whilst exercising, along with good nutrition.
It’s no surprise given the pedigree of the authors but I’m disappointed to note that there is no mention of misalignment when talking about bunions and the chiropractic treatment available. The advice in the book regarding congenital metatarsus primus varus (a splaying out of the first metatarsal bone that joins to the big toe that you are born with) which produces a secondary hallux valgus (the bunion) is a corrective operation in the mid-teens (not later) and I’d like to see later editions cover the chiropractic, non-surgical option particularly as the book makes it clear that operations on older feet or on the feet of working professional dancers is inadvisable – what are they to do, then ?
This congenital disposition towards a splaying out of the first metatarsal bone that joins to the big toe that predisposes it towards the development of bunions, is exactly where your ballet teachers have a lot to offer. Ask yourself, when does your ballet teacher ask to look at your bare feet in class ? Every six months ? Never ? Every three months would be a good guideline and though I appreciate that if you arrive for class always dressed in the same way that this might be a nuisance, the disruption just once every three months is justifiable. If your feet are always clad in shoes with either socks or tights then it’s impossible for the teacher to educate in the correct placement of the whole foot, not just the big toe. It’s completely possible that a child born with this deformity and who has the correct ballet training, will never develop bunions. So ask – it’s in your interest!
I’ve reported before about the length of time a dancer could take off work to recover from infected/inflamed bunions without addressing the underlying problem and how unnecessary, inconvenient, (not to mention costly and painful) this can be. Chiropractic treatment is worth considering and the earlier the better. I’ve written an article based on an interview with a qualified Chiropractor where you can find some helpful advice, and of course there are other treatments such as osteopathy (physiotherapy is covered in the book as McCormack is The Royal Ballet’s physio).
The black and white photographs in the very important strengthening exercises section aren’t as clear as they could be and I hope in future editions they will be updated. They are a little too dark and too blurry and they date the book unnecessarily. There are some colour photographs in this section (some taken by The Royal Ballet’s Ryoichi Hirano, and some of the dancers will be familiar) and that seems to highlight the discrepancy between the clarity of the colour and the indistinction of the mono even more. Still, seeing the difference between the correct way to do basic sit-ups and the wrong way, along with many other exercises, makes the inclusion of the photographs vital. There are four pages of photographs explaining the various techniques for taping your feet, which is extremely detailed and helpful.
A working dancer can’t really afford to be without this book and I’d recommend reading it during the training years for optimum performance and injury avoidance later on.
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