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Posts Tagged ‘Suzanne Martin’

A Better You | Wobble Your Way to Strength

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Give feet and ankles a boost with balance boards

By Suzanne Martin, PT, DPT

How do dance teachers stay sound and healthy enough to demonstrate safely after they stop dancing full time? It’s tricky business. We take for granted the flexibility and strength acquired throughout our performing and early teaching days. But all too often our bodies let us know that after all those years, they need more attention.

My rude awakening came when I stopped teaching about 20 classes per week in order to go to physical therapy school and subsequently, to begin the well-being program for Smuin Ballet here in the San Francisco Bay Area. Since I’m short in stature and the company was short on funds for things like massage tables, I agreed to work on the dancers on the floor. My flexible ankles became so unstable (from sitting on my feet and overstretching them) that they hurt when I went down stairs. I resolved to use my newly gained education to figure out what was wrong and what I could do to remedy the situation.

After X-rays ruled out arthritis and serious injuries, I set out to figure out the best way to strengthen and stabilize my ankles and came upon the wobble board, a flat, circular platform resting on a semi-sphere. It has kept me dancing (and walking), and a regular workout regimen on this piece of fitness equipment might help you do the same.

Types of balance boards

There are a few different types of balance boards, including the wobble board. All are essentially platforms resting on top of a smaller, raised surface that functions as a fulcrum. The user tries to balance on the platform as it rocks or swivels on its fulcrum. This forces the ankle to react quickly and mobilizes the important stabilizing muscles of the ankle and foot. Some balance boards resemble seesaws—long flat platforms placed perpendicularly atop cylinders or rectangles.

Because our ankles move in a circular fashion, I like the circular type. The one I have works for me because it has a wider base on the bottom side. Some have very high balls beneath the platform, which might result in a sprained ankle for people who are quite flexible. My wobble board has a small dot on the center that helps my clients and me line up the axis where the foot points and flexes. (It’s called “The Rock,” and it’s available from optp.com.)

A strengthening routine

Try this sequence to keep your legs shipshape. Even though the wobble board is meant for the feet and ankles, done properly, you’ll feel this set of exercises up into the pelvis.

• Stand squarely in front of a ballet barre or a piece of furniture with a high back. I use my Pilates trapeze table and hold onto the upright poles for easy support.

• Start with both feet placed on the farthest side points of the standing plate. Then rock side to side, allowing one knee and then the other to bend to create the motion, like a stair-stepper at the gym. Next, swivel the plate by pressing the edges of the disc down into the floor. Do about 6 clockwise and 6 counterclockwise actions. Again, allow one knee and then the other to bend to make the motion. These simple exercises loosen the muscles and tendons and oil the joints. As I like to say, “Motion is lotion.”

• Next, move on to single-leg work. Use your strong leg first; it will help the weaker leg to do better. First, find the axis point on your foot where it flexes and points. Place the web of your hand over the top part of the foot with your thumb on the inside of the foot and your fourth finger wrapping over the outside. Slide the arch you’ve made with your hand up the foot until it rests against your tibia. This is your axis point.

• Place that axis point across the inner dot (or, if there is no dot, the center of the pivot point), bisecting the circle evenly. Make sure the pelvis is over the foot; do not allow the hips to fall back behind the axis point.

• With the free leg, take a parallel coupé position. In this sequence, keep the knee as straight as possible. Perform the whole sequence on one leg first and then repeat it on the other leg. Begin by tipping the standing plate front to back, concentrating on making an up/down motion. Be careful not to pull yourself with your arms if you are holding onto furniture. Do about 10 repetitions. If your feet feel OK, then do some “pseudo-jumps”: rock forward, lifting the heel a few inches and rock back to center. Repeat 10 times. Next, make very small circles with the ankle. I call them “drills” because the circle is very small. I aim for making a swivel around the circumference of the small yellow inner dot on my platform. Perform these very briskly, doing 2 sets of 10 clockwise, and 2 sets counterclockwise.

• Next, do a passé sequence. Turn out both legs and passé front with the free leg. Place the little toe underneath the knee, pressing the thigh backward and tensing the rotators to intensify the position. Then rotate to parallel with both legs, pressing the parallel passé (inside of the foot) against the support leg. Continue alternating the passé, outward and inward, for 10 sets and end with passé turned out.

• This is the best part. Engage the inner thigh on a turned-out support leg (adductor magnus use) as you extend your free leg to a straight-knee, small fourth position on the floor in back, behind the wobble board, as in a pirouette preparation. Then press off the back foot and spring up, using the inner thigh to lead to passé (turned out) in front—pirouette position on a flat foot. Repeat 6 times, 10 if you are buff. When you’ve finished your reps, hold and intensify the passé position for 10 seconds.

The payoff

Strengthening your legs, or maintaining their strength, will reduce fatigue, make demonstrating pain free, and help prevent injuries. You worked hard for those legs. Now preserve them.

I have faith in you.

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A Better You | Fighting Fatigue

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A Better YouBy Suzanne Martin, PT, DPT

It’s no secret that dance teachers often have long, grueling hours. Handling your own fatigue when you’re faced with a barrage of personalities, minor emergencies, and classroom challenges isn’t easy.

Dancers are human, and humans have finite resources. Accepting that reality can be hard, but it isn’t all bad. Understanding your limitations can help you regulate your physical and emotional responses.

One way to cope on days when you’re foggy-brained and desperate for a nap is to make sure you’re ready for those days. How? By having a well-planned, well-regulated system in place. Think ahead. Know what to expect. Planning ahead allows us to mentally prepare for the stressful parts of our lives, which means we can summon the extra grit and discipline it takes to handle them as well as we possibly can. And then, once the difficult tasks are behind us, rest, sustenance, and emotional management can work wonders. Endurance comes when there is a balance between periods of stress and rest.

Choosing wisely when you’re considering which actions to take to make the day go better is key. That means making good choices about what you fuel your body with. Eating whatever is on hand and succumbing to junk-food–induced mood swings is not likely to benefit you or anyone around you. And we all know about the countless quick-fix survival products that claim they’ll propel us through our busy, exhausting days.

Take energy drinks, an increasingly popular “solution” to fatigue and overbooked schedules. These drinks work in the short term, but their energy boost comes with a price (see “A Better You: Super-Charged Caffeine,” July 2010). Excessive amounts of caffeine aren’t good for your body, and neither are the up-and-down swings that result, similar to a sugar rush. There are healthier options now, so instead of revving up on drinks containing mostly caffeine and sugar, boost your energy with drinks made of organic and natural ingredients, such as ginseng and ginger. But none of them is effective in the long run. Even “naturally” elevated energy levels are destined to come back down again, often with a thud.

Dance teachers can’t afford such volatility. Coping with long days and juggling an array of personalities and tasks take our full concentration—and discipline—to not only survive but actually enjoy the ride.

If you can’t break away from class or office tasks, do refresh yourself. Water is essential. According to the Journal of the American College of Nutrition (October 2007), foggy thinking starts at just 2 percent dehydration. Thirst makes concentrating more difficult and can deceive us into thinking we’re hungry. If you are truly hungry, stave off the accompanying crankiness with smart choices that will give you an energy boost with staying power. Low-glycemic foods such as blueberries, strawberries, and apples can give a quick pick-me-up; with a high water content, they will keep your blood sugar even until you can get to a meal.

One of the best ways to get through a seemingly endless day is to simply set your mind to “coping mode.” Most people don’t realize that they actually have a choice about how they approach the day, meeting, class, or whatever it is. You can dread it, or you can take a “can-do” attitude.

Some strategies for managing this emotional obstacle include tackling the most difficult tasks early in the day, or whenever you’re at your best, if possible. Avoid difficult situations or decisions that could be done on another day, when you’re fresher.

And delegate. If you can’t reschedule something that’s challenging, or if a difficult situation such as a parent acting out arises unexpectedly, ask a trusted staffer to handle it. If you can’t delegate whatever it is, remove yourself mentally. Being too wrapped up in a situation we can’t control adds emotional fatigue on top of physical exhaustion.

Here’s how: attend to the parent, but make an effort to remove yourself, as if you were watching the scenario from another physical viewing point. Imagine that you’re looking through a one-way window at the environment. Note the positioning in the room of the key players as well as body language. Who is involved and who seems to be holding back? Note whether anyone’s personal space is too crowded, or if the other person adopts a retreating stance. Is there a sense of dominance, such as a touch or a strong forward stance? Simply stepping back a few inches can deflate a charged situation. Plus, changing mental perspectives can help you see something new about the person or situation you’re dealing with. And people often solve problems more creatively when they imagine they’re solving it for someone else.

Distancing yourself without appearing to be inattentive, apathetic, or condescending takes practice, but is a highly effective negotiating and coping tactic. To avoid appearing disinterested or condescending, be subtle (a simple, non-dramatic step back will do), maintain soft eye contact, turn a listening ear, and nod your head to show that you’re still engaged.

When you’re exhausted, allow yourself to stop, slow down, turn the switch to off. In my 24/7 practice, I’ve learned that the work often doesn’t end, even after a big event or deadline. You might rejoice that it’s done, but more is just behind it. Going the extra mile is what creates success for most of us, but prioritizing what can wait is what keeps us sane and physically healthy. Take a cue from Scarlett O’Hara in Gone With the Wind and say, “I’ll think about that tomorrow.”

Also, set reasonable time limits for routine activities; doing so might just buy you time for a quick nap or an earlier going-home time. For example, a meeting will last as long as you schedule it to. Often we can accomplish the same thing in a 30-minute meeting as in one that lasts two hours if we stick to the agenda and act decisively.

Even bedtime needs to be approached deliberately in order to maximize the chances of a good night’s rest. For example, when I come home at 11pm from a performance, no matter how tired I am I take 15 or 20 minutes to bathe, sip some tea, and do some light reading. That transition time helps me get some true rest and good sleep.

The take-home message here is really one about knowing our personal boundaries—our physical, emotional, and mental limitations. We don’t need to please everyone. It’s taken years of trial and error for me to understand that certain people will not like my style, my office setup, or the fact that I have multiple clients and jobs. And that’s OK. You want to care for your clients, but you also need to care for yourself. It’s a reality.

Fighting fatigue means investigating your sleep habits, work routines, and emotional coping style—and the options you have. Being truthful about what works for you, devising strategies that incorporate these realities, and sticking with them will help make your life, and those of your family and clients, a lot happier.

I have faith in you.

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A Better You | The Post-Dancing Diet

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Take a smart approach to maintaining your weight

By Suzanne Martin, PT, DPT

Dancers, whether students or professionals, pay close attention to their bodies, and that doesn’t change when they stop dancing or taking class. Dance teachers don’t need to be super-thin anymore, but it’s hard not to keep asking, “What happened to that soloist’s body? Why am I gaining weight?”

If you’re like most of the teachers I know, you’re good about encouraging young dancers, especially girls, to adjust their perceptions and preconceived notions of the “right” dance body and accept and celebrate the body they have. But when it comes to yourself, I’ll bet you pay more attention to your mirror, in which every figure flaw is magnified, than to your own advice. Time and biology may make maintaining a good body weight trickier than anticipated.

Young dancers often expect a definitive answer when they ask what they are supposed to weigh, but that question is never easy to answer, especially for teens. Better guidelines exist for adults, whose bodies are not undergoing the rapid changes of adolescence. The basal metabolic index, or BMI, is the quick and easy way to determine whether anyone over age 18 is within the range of a basically healthy weight.

During routine check-ups, your physician can tell you where you fit in the BMI range, and it is easy enough to look up the parameters online. During the years when you’re dancing daily, you tend to be at the bottom of the normal BMI range. That changes when you’re injured, take time off to have a family, or move into the less active role of teaching. It’s common to ease up on a gym or Pilates routine because you’re tired of the grind. Plus, now you can kiss strict dieting goodbye—or can you?

This time of transition can be critical for a dancer once the fine-tuning of performance is no longer essential. Do yourself a favor and run, don’t walk, to another form of physicality. It may take some experimentation to find out whether you like being a gym rat, a Pilates maven, or a tennis nut, but do something. Make a pact with yourself to enjoy a month or so of taking it easy, and then get active again.

A lapse of more than a year in physical activity can undo years of training. (Think of the football player whose muscles turn to mush upon retirement.) Don’t be lulled into thinking it will never happen to you. The weight gained in the middle years does tend to hover around the abdomen. Keep your metabolism tuned up by participating in a physical activity such as bicycling or light weight training once or twice a week, in addition to taking dance class. Cross-training will add aerobic or strengthening work. Your activity of choice should make you moderately huffy-puffy and last for about an hour.

Another consideration in dealing with midlife body changes is that we need to revise the way we eat. As we age, our insulin, the hormone that regulates circulating blood sugar and fat deposition, may become less efficient, mostly due to inactivity. Eating regular meals, especially breakfast, is important. A good breakfast jumpstarts the metabolism and helps regulate blood sugar levels throughout the day.

What’s a good diet strategy to follow? A modified Atkins diet, which concentrates on protein consumption, keeps metabolism on track. There are similar regimens, such as the South Beach Diet, which replaces “bad” carbs and fats with “good” ones, and the Paleolithic diet, which is based on fiber and protein. What they all boil down to is the fact that we need fewer starchy carbohydrates as we age.

Be careful not to take these diets to the extreme. Carbohydrates are essential for energy and give the feel-good high of a serotonin release. A rigorous high-protein, low-carb strategy (in which you eat only a few carbohydrates per day) is guaranteed to backfire. One of my clients was on a medically supervised 600-calorie-per-day liquid diet for four months. Thankfully, she is not a dance teacher because she went through physical changes that would have made teaching difficult if not impossible, suffering from both fatigue and muscle pulls during the last portion of her program. Under-nourished and under-hydrated body tissues are fragile, so people whose dietary practices are extreme tend not to be very hardy or robust.

Another consideration in dealing with midlife body changes is that we need to revise the way we eat. A good breakfast jumpstarts the metabolism and helps regulate blood sugar levels throughout the day.

This patient entered a ketotic state (in her case, medically induced) during which the liver breaks down fat, bone, and muscle to keep the blood sugar stable. We are all in a state of ketosis when we wake up in the morning, and that’s why breakfast is very important. It doesn’t have to be a big meal, but it should have some staying power. Oatmeal, yogurt, eggs, and fruit are all good choices.

Most people can lose or maintain weight simply by avoiding regular consumption of starchy carbohydrates such as white potatoes, breads, pastries, and pastas. Whole wheat and gluten-free flour products are better but will still add pounds if you’re not careful.

Also, many adults tend to lose their tolerance for gluten. Again, this part of reaching adulthood is linked to the need to decrease the amount of breads and pastas we consume as our digestion changes over time. Basically, these body changes signal the need to simplify our diets on a daily basis.

Dairy products can be good choices since they provide both protein and carbohydrates. For those who are lactose intolerant, good alternatives are soy, almond, and oatmeal milks. Do check the fat content on dairy and alternative products because you may be consuming more fat than you’d like—never good for your heart. A completely fat-free diet is not recommended, but bear in mind that heart disease is still the number-one killer in the United States.

Think: all things in moderation. Julia Child was reported to have eaten everything she wanted to, just not in big portions. Social eating, fatty cheeses, and alcohol are part of “the good life” but can quickly add pounds. One teacher friend of mine has come up with a smart solution: she eats whatever she likes one day each week, which keeps her on track health- and weight-wise but also lets her enjoy the good things in life.

Another teacher I know said her perspective on dieting changed radically when she started concentrating on what to eat rather than what to restrict. As you move through the decades, this perspective will make maintaining a strong, healthy body as easy as (low-fat, vegan) pie.

Concentrate on eating several portions of protein each day. You can get protein from nuts, dairy, and full-grain products like oatmeal. I eat a half an avocado for lunch almost every day, not only because it’s a source of good fats and fiber but also because it has the most protein of any fruit. Eggs, chicken, and fish are good alternatives for people who want to avoid heavier meats.

Select root vegetables like beets, turnips, and yams because of their fibrous starches. Then add colorful vegetables like bell peppers, squash, and greens. Bring in fruits like papaya for digestion, watermelon for kidney health, and apples and blueberries for blood sugar regulation.

The big-picture goal? Make your routine simple, modify the trendy diets to healthier protocols, and embrace change.

I have faith in you.

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A Better You | Headache Help

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Don’t let migraines and more ruin your day

By Suzanne Martin, PT, DPT

If you suffer from frequent or severe headaches, here’s one more reason to be glad you weren’t around in the not-so-good old days: one treatment in centuries past was a technique called trephining, which involved cutting little holes into the skull to relieve pressure. But there are more civilized options. If you feel like someone’s drilling into your head on a regular basis, here are some tips to help you control your headaches and get relief.

Headaches come in various kinds, but migraines are the scariest. These typically involve intense pain in one area of the head, accompanied by nausea, vomiting, and extreme sensitivity to sound and light. Attacks can last as long as three days. Migraine sufferers may see flashes of light or experience blind spots or tingling in an arm or leg, either before or during an attack. Warning symptoms—neck pain, irritability, constipation, diarrhea, hyperactivity, and food cravings—may precede attacks by a day or so. As many as nine out of 10 migraine sufferers have a family history of the problem.

Women are three times more likely than men to have migraines, which can be set off by monthly female hormonal fluctuations. Many women suffer attacks immediately before and during their periods, when their estrogen level falls sharply. In some women, oral contraceptives can induce attacks. Migraines can also result from a trigger allergy, often to things in your daily diet such as red wine, chocolate, aged cheeses, and monosodium glutamate (MSG). If you suffer from migraines, chances are that you already know which foods can set them off. Intense exertion, mental stress, and loud sounds can also be triggers, so the risk factors you face in a studio are numerous.

Some dance teachers I know get migraines very intermittently, two or three times a year. Another has migraines so severe that she has to take medication that leaves her incapacitated for a day. For severe cases, triptans are the prescription drug of choice for relieving pain, nausea, and sensitivity to light and sound. They include sumatriptan (Imitrex), rizatriptan (Maxalt), almotriptan (Axert), naratriptan (Amerge), zolmitriptan (Zomig), frovatriptan (Frova), and eletriptan (Relpax). Bed rest and aspirin with caffeine may be enough for milder cases, while dimmed lights may be enough to ease others’ symptoms.

Many dance teachers prefer to go the natural route and avoid medication, but once your doctor has identified the source of the migraine as a hormonal or inflammatory response, it’s best to use the medication. These responses are biochemical cascades, meaning their cycles take time to resolve. It’s like blowing on a dandelion puff and watching the seeds disperse into the air. Each seed that starts pain, inflammation, and swelling will cycle until something stops it. Medications interfere with these cycles and stop them mid-stream. The sooner you can intervene, the sooner the headache will diminish.

Non-traditional therapies such as acupuncture, massage, and chiropractic treatments may be helpful in reducing the frequency or severity of migraines. According to the Mayo Clinic website, biofeedback “appears to be especially effective in relieving migraine pain.” In a biofeedback session, electrodes that are hooked up to specific muscles help patients identify tension-holding patterns in the face, neck, and head areas that contribute to migraine pain.

If you feel like someone’s drilling into your head on a regular basis, here are some tips to help you control your headaches and get relief.

Be aware, as you consider medication options, that if you take over-the-counter or prescription headache medications frequently or in high doses, you could induce what are called “rebound headaches,” in which the medications are causing your pain, not relieving it. Caffeine can make such headaches worse. Treatment may involve weaning you gradually off the medications, stopping them outright, and in some instances hospitalization.

If your migraines are unusually frequent or severe, you should discuss preventive medications with your doctor. These drugs usually don’t eliminate attacks completely, and some have serious side effects, but they can be helpful in some cases. They include beta blockers, certain antidepressants (useful even if you don’t suffer from depression), anti-seizure drugs, and Botox injections.

Other headaches
Other common types of headache are tension and cluster headaches. With tension headaches, you may feel pain on both sides of your head (as if a metal band were squeezing your skull); sometimes symptoms include neck pain and fatigue.

Cluster headaches involve severe pain on one side of the head, sometimes accompanied by nasal congestion and tearing from one eye, usually the one on the same side of the head as the pain. These can last from 15 minutes to three hours and can strike more than once daily during clustered attacks (hence their name).

Some headaches are physically induced. For part of my work in getting my doctorate, I focused on the spine’s influence on head pain. Physical therapists evaluate clients to determine if their pain is originating from the cervical spine or thoracic spine. By listening carefully to the client, as well as using our hands, we can investigate the pattern of a certain pain area. For instance, if head pain is experienced upon awakening in the morning, the pain may be caused by an incorrect or prolonged sleep position. Sleeping on one’s back with a rolled-up hand towel placed under the arch of the neck can be helpful. (This is a good sleep technique in general.)

Also, you can buy bed pillows equipped with a little roll that fits under the neck and eases the pressure of the head’s weight. The same roll is good for side sleeping. Try to keep the head level with the spine and avoid using high, stiff pillows that push the head forward when you’re on your back. An arc-shaped neck roll is useful for plane flights and for reading in bed.

The typical physical stresses of teaching, plus being “on” and speaking for hours, can produce tight muscles. Even a stiff rib cage area can produce neck and head pain. Since musculoskeletal symptoms can overlap with the inflammatory type of headache caused by periods and allergies, reaching an accurate diagnosis can greatly aid in easing your pain. If you suspect you are getting head pain from stiffness in your rib cage or upper trapezius area, wear a liniment patch such as Tiger Balm, Tylenol, or Salonpas (made with red pepper). Sometimes all you need is a little direct menthol action or plain pain relief.

Play detective
Use your dancer’s ability to analyze what’s going on in your body to tease apart the various elements—hormonal, musculoskeletal, sleep position—that cause pain in your head, neck, and shoulders. They all go together. Figure out which element needs what for relief. You’ll be happy you did.

I have faith in you.

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A Better You | Health Care How-Tos

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What to do when health insurance isn’t the answer

By Suzanne Martin, PT, DPT

Do-it-yourself health care is a part of life for many dancers—and dance teachers. Over time you’ve figured out how to tame that tendonitis and soothe strained muscles, so you might be one of those people who often delay seeking medical attention.

And nowadays, there’s another reason for delay: times are tough, job security is precarious, and you’re giving every dollar a harder look before you spend it. If you don’t have employer-provided health insurance, the cost of individual coverage can be prohibitive. Here’s some guidance on your double dilemma: what health problems can you safely handle yourself, and how can you get professional care when you need it without blowing your budget?

As a teacher, you can certainly avoid using a body part that is painful or locked up. But be careful: one problem I often see is the injured dancer who doesn’t quite go all the way into full dance movement again, creating a chronic condition. It’s sad when a dance teacher writes off a movement or position when it would have been possible to go a bit farther with treatment to regain full use.

A good rule of thumb is that if something is painful for more than a week and isn’t getting better despite your home remedies, seek medical care. There are a few exceptions to that rule, starting with obvious fractures and other impossible-to-ignore injuries. Also, if you run a fever of 100 degrees or higher for more than a couple of days; if you have persistent abdominal pain that prevents you from performing routine activities; or if a body part is red, swollen, and sore for more than two days, see a doctor.

You also need to keep your vaccinations current, including an annual flu shot—especially useful if you’re teaching preschoolers—and your once-per-decade vaccination against tetanus, diphtheria, and whooping cough. Don’t forget your regular Pap tests, especially if you’re sexually active. And if you have a family history of breast cancer, heart disease, or other diseases in which heredity plays a role, regular checkups are a must.

Dancers should pay particular attention to their therapeutic musculoskeletal care. Build your care team before you hit a crisis. You’ll need passive types (professionals who do hands-on work on you) and active types (who help you learn how to fill in your weak links). Passive care requires that you sit back, relax, and receive. Masseuses are a good resource for referrals of passive complementary care such as massage, acupuncture, and chiropractic. These specialists address the aches and pains we associate with working too hard, “throwing our backs out,” and general fatigue.

Active types of medical care come from physical therapists and movement specialists when retraining, rehabbing, and guidance into a full return to dancing can be achieved. Physical therapists can provide corrective manual therapy as well as guide someone into full dance use through rehab via Pilates or other movement forms. Seek out a therapist with dance experience; sports clinics may be a good resource for referrals.

Surprisingly, even the gold standard of premium health insurance, meant to cover urgent medical necessity, often won’t cover complementary or maintenance health care, which is what a dance teacher needs. Many of my clients now carry only catastrophic coverage, with deductibles ranging from $4,000 to $5,000, which prohibits use for everyday complaints.

To find affordable care, start by identifying your region’s resources. Don’t ignore your local free clinic, usually run by the city or the county. One resource in finding care is the national Artists’ Health Insurance Resource Center (ahirc.org), which is using a grant from the Doris Duke Foundation to counsel dance professionals—including teachers—about their health insurance options and available subsidies pending the arrival of national mandates in 2014.

“Dancers are notoriously uninsured—even more so than actors or other people in the arts,” Dan Kitowski, AHIRC’s director of health services, Western region, told Dance Studio Life. “We go one-on-one with people who are uninsured or losing their insurance and see what their options are.”

AHIRC is not an insurer and doesn’t provide care. Instead, it steers callers (323.933.9244, ext. 32 in Los Angeles or 212.221.7300, ext. 265 in New York City) to free or reduced-cost options where they live. No proof of dance affiliation is required.

If you live in a major city, you may find clinical care tailored for dancers’ needs. In San Francisco we have the Dancers’ Free Clinic, located in the ODC Dance Commons complex and staffed by volunteer physicians, physical therapists, and other health professionals. Anyone who takes dance or movement classes and has a dance-related injury is eligible for its care. In New York City, the Harkness Center for Dance Injuries at the NYU Hospital for Joint Diseases offers free and subsidized services, including orthopedic and sports medicine clinics, physical therapy, and injury prevention workshops. Also ask about health resources at the reception desk at local dance centers.

To find affordable care, start by identifying your region’s resources. If you have no insurance, don’t ignore your local free clinic, usually run by the city or the county.

Do you have the drive to start a free dancer-wellness program in your area? Orthopedic physicians, chiropractors, and physical therapists often want to become more involved with health care delivery to dancers. Make a lunch date with a health care professional and explore the possibilities. Private-practice MDs and chiropractors may welcome the marketing boost of community exposure. Even setting up a health fair at your studio will fast-track you into a whole new world of wellness.

Also, check out local professional schools in fields such as acupuncture, podiatry, physical therapy, chiropractic, and massage. I got my first orthotics at a school and massages at the local holistic institute. As the lead physical therapist for Smuin Ballet in San Francisco, I have contacted the administrators of some of these schools to get volunteer help on-site at the ballet’s rehearsals and in the theater pre-performance.

The upside is that these people are being scrutinized by their teachers and are learning the most current methods of treatment. Most schools charge a low, flat rate. Volunteers for a study or for a student project often get free care. The downside is that you might get a light massage, or a half-hour instead of the one-hour massage that you’d like. And of course, students graduate, affecting continuity of care.

Bartering works, too. Smuin Ballet provides acknowledgement in its concert programs as well as free tickets in exchange for the services of the therapists who help us. I have exchanged my services for such things as housecleaning, chemistry tutoring, and landscaping. Who needs private dance lessons in your area? Look around.

Need urgent care in a pinch? Check your local mall for the walk-in clinics that fill the growing needs of those who have lost their jobs and their employer-paid health insurance. For many, such clinics are the first line of emergency care, and they’re considerably more affordable than a hospital ER. Plus, you won’t be turned away. One dancer I know, in need of emergency antibiotics, reported that the doctor at such a clinic spent 45 minutes with him and that he was very pleased with the service.

Wondering if you might enter the house of medical school rejects? Maybe not. There are reasons why a physician may opt for a job in a mall clinic. Current private medical practice is difficult. Many physicians are stressed and disappointed as insurance reimbursements shrink. Also, an insurance company usually dictates which procedures a physician may perform.

So don’t let the lack of marketing and extras fool you. I also operate on a mom-and-pop level, limiting the number of clients I see in my home office. Described as a “concierge” therapist, I don’t take insurance, but I’ll definitely take care of you. Since I run a small operation, I am one-on-one accountable to those I serve.

Also, remember that MDs, chiropractors, and physical therapists are licensed by and accountable to your state’s consumer board of affairs or other licensing body. Do contact and file a complaint with this bureau for any questionable experience. Also, check whether the health professional working with you is board-certified, meaning he or she has two to six years of training beyond med school and has been rigorously tested.

Not all situations and conditions require “the best” in care. I can’t tell you how many people tell me their medical histories and maintain that they have been treated by the “best” in their fields. How many bests are there? Are they all comparable? If I’m going to the McDoc for a cold, will I not believe her if she only ranked tenth in her class? Medical school is only the beginning of the lifelong training required in the health field. I’ve logged more than 700 hours of continuing education since I received my doctorate.

Think twice and be discerning. And be creative. You have options in your health care.

I have faith in you.

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A Better You | Say Goodbye to Smoking

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Here’s why—and how—to quit

By Suzanne Martin, PT, DPT

What’s that smell? It’s unmistakable and controversial—the smell of cigarettes. So much has changed nationally and internationally in the last 10 years in terms of restrictions on smoking in public. Wrapping up the photo shoot for my book in London in 2006, we were barely able to breathe in the pub where we went to celebrate. However, this past year the air inside the same pub was clear—even if you had to brave a gantlet of wafting smoke plumes to gain entry.

What’s the big deal? My last column about smoking (“Kicking the Habit,” March/April 2010) was geared toward adolescent dancers. Chances are that those of you who still smoke started as adolescents. One young dancer told me he started because he saw the principal dancers smoking. Female dancers often take up the habit in an attempt to control their weight. Others use a cigarette as a break-time goodie to relax their nerves. Yet others rely on its appetite-suppressant effect to get through long rehearsal and performance days without hunger pangs.

Then slowly but surely, other effects creep in. One teacher told me that she had to stop smoking when she realized she couldn’t make it through her sixth class at the end of the day because she was so out of breath. Another had to stop when she developed chest pain from smoking those long, chic, unfiltered cigarettes back in the ’60s. Another recalled being in a New York dance class and hearing this incredibly labored breathing. She looked around and was shocked to see that its source was the teacher.

True, times have changed. But what if you don’t feel, or perceive, the effects on yourself or others? The impact of tobacco on breathing, for example, can take years to make itself felt.

Then, of course, there’s denial. Teachers who have stopped performing and are no longer worried about their weight may feel fatigue and general dissatisfaction and think: I’m just out of shape. Also, because of tobacco’s combined physical and psychological addiction, a teacher may resist quitting until smoking stops her from doing something she wants to do.

Why stop smoking if you like it? Here’s why: the number-one killer in the United States is heart trouble, and smoking causes coronary heart disease. Cigarette smoking causes reduced circulation by narrowing the arteries. Also, nicotine can increase the level of “bad” cholesterol in the bloodstream, setting you up for heart artery blockage.

Then there’s cancer, a close second to heart disease as a cause of death in this country. Here, smoking strikes again: lung cancer is the top U.S. cause of cancer deaths, claiming nearly 157,000 lives last year, the National Cancer Institute says. Smoking causes an estimated 90 percent of all lung cancer deaths in men and 80 percent of such deaths in women, according to the federal Centers for Disease Control. It also is blamed for nine out of 10 deaths from chronic obstructive lung disease. A graphic image from my years in physical therapy school has remained with me: a deceased smoker in the cadaver lab, with lungs as black as black could be.

You may be on the fence. Or maybe you’d like to stop, but withdrawal looks just too difficult. And besides, isn’t it true that people gain weight after they stop? These are valid concerns for a dance teacher, but please don’t stop there. Addictions have to be tamed.

The addictive payoff of nicotine may be unnoticeable to you if you’re a longtime smoker. Nicotine addiction is particularly insidious because it has strong mood-altering effects as both a relaxant and a stimulant. Withdrawal is not life-threatening as it is with drugs like alcohol. But nicotine also stimulates the reward center in the brain, giving a sense of near-euphoria. How do you give that up?

Try adding up what you have spent in your lifetime on cigarettes, and keep that number posted on your fridge for motivation. Add to that the amount spent on breath fresheners and dry-cleaning so that you don’t smell like an ashtray.

One practical motivation to quit is the sheer expense of the habit. Teaching dance generally isn’t a get-rich-quick scheme; think how much fatter your wallet would be if you weren’t coughing up the price of a daily pack of cigarettes (ranging from nearly $11 in New York City to about $4.70 in West Virginia). Try adding up what you have spent in your lifetime on cigarettes, and keep that number posted on your fridge for motivation. Add to that the amount spent on breath fresheners and dry-cleaning so that you don’t smell like an ashtray, and yes, you have a big number.

Mark Twain said it’s easy to quit smoking; he had done it hundreds of times. The dirty fact is, you’re going to have to work at it. Making a decision to quit may be momentous. Managing a decision like this takes true grit. Set your mind, but first create your strategy.

A number of weaning aids do indeed help. Nicotine gum, nicotine skin patches, nicotine lozenges, and nicotine nasal spray all work by helping you to stave off cravings while lessening your nicotine dosage, and they are all approved by the federal Food and Drug Administration. However, the FDA remains concerned about the e-cigarette, which allows smokers to inhale nicotine in a vapor. Regulators have raised concerns about the product’s marketing and quality control.

Thanks to the Internet, access to smoking cessation coaches is easy and affordable. As a longtime smoker, you may not realize the effects that nicotine has had on you, so do get some support and help. While you may see some weight gain, it will be temporary as your body resets its metabolism to life without nicotine.

This is a lifestyle change, a big one. You might be surprised to learn how many friends and relatives have long wished you would quit but were too polite to say so. Talk about it, and get others to encourage you and rally you on to your goals. Keep a log or a journal of your feelings and the days of ups and downs. In general it takes about 21 days to form a new habit. Give yourself a good amount of time to make the change permanent. One teacher told me she considered herself a non-smoking smoker for 10 years; she carried a pack of cigarettes in her purse for the first year, just in case.

’Fess up. We all have a habit to kick. Make this one your project. Think of all the people who depend on you; your family, your students, your colleagues, and most important, yourself. You’ve been around the block in the dance field. Now go around one more time feeling great.

I have faith in you.

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A Better You | Beating the Blahs

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Don’t let seasonal affective disorder get you down

By Suzanne Martin, PT, DPT

Do you realize how the seasons affect you? Weather affects mood. Dance teachers aren’t immune, especially since many studios, looking for a steady income stream, offer summer and holiday camps that keep their faculty teaching through all seasons.

Winter may seem to last forever. A number of people get a case of the blues that comes on gradually in autumn, lingers through the winter, and lightens when spring brings more sunlight. Though it’s more common in the fall and winter, seasonal affective disorder (SAD) can strike at other times, depending upon your personal preferences. If you’re the cool-weather type, you may experience an endless summer, just barely tolerating the heat and blazing sun until fall comes around.

Which weather pattern matters to you most as a dance teacher, and how does it affect your teaching? Here are some tips to understanding which season affects you most and how to manage that impact.

There is no known test for SAD, yet we can be proactive. Just noticing how the ebb and flow of the seasons affect you can be worthwhile in understanding your moods. Dance teachers need to be “people people,” gregarious enough to show interest in our students. When we enjoy ourselves while teaching, others notice, and the result is infectious. We need to draw people to us to ensure the success of our classes. While class content and teaching competence matter, the reality is that people also return year after year because of our personalities.

SAD is considered a type of depression. The typical symptoms of a full-blown depression—such as taking too long to perform simple administrative tasks, increasing isolation, persistent irritability, and just plain apathy—are easy to spot. Nobody wants to be around Debbie Downer. But SAD starts slowly and may progress to true depression before we realize it. Noting the effect of seasons can be critical in maintaining a teaching career.

Because I am a morning person I love the summer months, when it can be light enough to walk out to the beach at 5:30am. As much as I love the light of summer, here in the coastal Bay Area, summers can be foggy and cool. (The quote long attributed to Mark Twain, “The coldest winter I ever spent was a summer in San Francisco,” is apocryphal but nonetheless accurate.) How do I cope?

First off, there’s light therapy. Apparently the diminishment of outdoor light can be off-putting to our circadian rhythms. I replaced most of my overhead light bulbs with natural light spectrum bulbs. They usually last a whole year, longer than regular incandescents, and they don’t have the green cast and vibrating light of fluorescents. They’re easy on my eyes, don’t give me headaches, and help my mood.

Since dance teachers spend many hours indoors, it is cost effective to get the type of lighting that will work for you. If bulb replacement in your facility is not an option, try some at home or even consider light-box therapy. Sit in front of a light box for about 20 minutes a day. The additional light influences the circadian rhythm and lifts mood.

Do you prefer the dark and cold of winter to summer heat? I grew up in the South, and I love a warm and sunny day. However, I was amazed at how much easier it was to dance in the more moderate humidity and temperatures in the San Francisco area. Heat can be oppressive and lower frustration thresholds. It’s no wonder that more crimes are committed in hot weather. Ceiling fans and air conditioning can be indispensable.

As part of a program to promote well-being, I helped the ballet company I work with establish a protocol for limiting or canceling rehearsals on the occasional days when the studio temperature exceeds a certain limit. (Not many studios here have air conditioning because hot weather occurs so infrequently.) We eliminate all overhead light. Keeping cool drinks on hand and giving periodic mandatory movement breaks can help the dancers avoid heat stroke as well as the deadening sensation of inescapable misery that unrelenting heat can produce. The dancers were reluctant to stop rehearsing even when given the option to stop, so making a stringent policy of when to cancel class or rehearsal can be helpful.

There are more options for avoiding negative seasonal feelings. Decor is one place to start. One reason why the end-of-the-year holiday time can be fun is that it’s an excuse to dress up the workplace and be silly. It puts everyone at ease, creates excitement and interest, and is a great social elixir. Remember that decor can be what you are wearing as well as what’s hung on the walls or dangling from the doorways.

As goofy as it sounds, mixing things up with monthly or occasional themes—something as simple as having all the girls wear blue ribbons one day or decorating the lounge with colorful dried grasses or flowers—can lift the day for you and your students. Having a Plan B for an oppressively hot day, such as watching a dance DVD or sharing your own dance history, will surely delight your students.

Another strategy is to think opposites. Switch the season psychologically by showing clips from a cool-inspired dance classic like Anna Karenina in a summer month, or a vibrant piece like Paul Taylor’s Esplanade in a chilly month. Choose bright colors for yourself in winter and wear more subdued tones in the studio in very hot months.

Keep a tab on yourself. That’s one reason why journaling can be helpful; it identifies your own internal trends. Life’s inevitable disappointments and losses, in combination with seasonal mood shifts, may transform a subtle seasonal sadness into something larger. Women tend to be better at recognizing and voicing difficulties, so men should especially take heed of warning signs.

The signs of depression can include feelings of worthlessness and feeling overly guilty for things that went wrong or were out of your control. Studio owners and teachers will always grapple with artistic, management, and business issues as they strive to meet yearly goals and expectations. Keeping a log somewhere of these issues can help to maintain a larger perspective. Other signs include changes in sleep patterns such as sleeping too much, having trouble falling asleep, or awakening too early. Of course, the ultimate red flag is thoughts of death or actual contemplations of suicide.

The good news is that most people can be treated for depression. Dancers may worry that they will be rejected, criticized, or ridiculed if they admit to feeling depressed. That’s why seeking out a third party can be useful. Options include finding a competent counselor through a health care provider or religious organization. Anonymity can then be guaranteed.

Be proactive throughout the year in safeguarding your emotional health. Dance is about joy, which is the basis of our emotional health.

I have faith in you.

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A Better You | Mood Swings, Menopause, and Men

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Dealing with hormones—in the classroom and in life

By Suzanne Martin, PT, DPT

Hormones. You can’t live without them, but sometimes it’s hard to live with them, and that includes when you’re on your feet all day, teaching and dealing with teens who are as temperamental as you feel. How to cope? Being aware of what’s happening and being kind to yourself are good places to start.

Women may suffer from PMS (premenstrual syndrome), an often trying time of bloating, moodiness, and irritability that typically occurs about a week before the menstrual cycle. Not only is it is a tough time for you to be in a leotard, it may lower your patience threshold quite a bit. Mapping out your monthly emotional cycle is well worth the effort. By keeping tabs on when you need to be vigilant about politeness and decorum, you might avoid snapping at a client or coworker—or worse, a student. Simplicity can work here. Just mark on your calendar the days when you feel up, down, sad, impatient, or bloated. Then consciously work to sync a lighter demeanor or whatever is individual to you, such as smiling more, on those days. Keep logging data; it may take several months to see the pattern.

The premenstrual time is often when women crave sweets and fat. By using your monthly pattern cues, you can make a pact to designate one day of giving in to the cravings instead of trying to use willpower, and then possibly failing the whole week with uncontrolled eating. Stress-reduction techniques such as working out (hard enough to sweat) by walking, running, and jogging can also help if you start before, or right at the beginning, of your bloated period. You can reduce bloating by lowering your intake of salty foods, and even by reducing food intake for the day. And take heart. Bloating is usually not as obvious to others as it is to you. If you feel like you need a boost, wear more makeup or use jewelry or scarves to draw attention to your face and upper body.

Being nice to yourself can also go a long way. Along with bloating and general discomfort, many women experience migraines and cramps once their period hits. Use mood-lifting music, take a few minutes to yourself, or sit down more and let others demonstrate. Maybe even take a day off. When you’re feeling irritable or in pain, it’s time to tune in to what you need, both physically and emotionally.

But what if you’re past that point, and instead, you’re fanning yourself in a studio that seems to get hotter and hotter? Do you feel an intense desire to shed more layers although you’re already in a leotard and tights? Find yourself long on irritation and short on patience? Lucky you. Menopause is waiting in the wings, watching. The stages of life are inevitable, but there are pros along with the cons for the change of life.

First, the good news. Periods have lost their power over you. While perimenopause may last for a good 10 years when you go in and out of having a period, it will eventually end. Once you reach full menopause, your period and its difficulties are gone. But you’re exchanging one set of symptoms for another. You may lose the discomforts that accompanied your monthly cycle, only to learn firsthand about the discomforts of hot flashes.

Again, there’s more good news. Hot flashes often don’t continue past the first part of true menopause, and there are ways to mitigate them. Adding just a bit of cardio work, such as 20 minutes of brisk walking or jogging, can help regulate the master gland, the hypothalamus, to regain temperature control. Younger dancers, often being slight in build and body weight, are no strangers to feeling cold a great deal of the time. Now warmth is easier to maintain.

Regular exercise also helps with other menopause symptoms such as irritability and impatience. Repetitive-motion exercise such as cycling, elliptical training, walking, running, jogging, and swimming all give a good dose of serotonin that helps to maintain a positive, stable mood.

It’s important for women to recognize the significance of the less obvious symptoms of menopause: mood swings, irritability, insomnia, depression, feelings of worthlessness, fatigue, and crying spells. Women sometimes worry, “Am I losing my mind?” when these symptoms occur. It’s important to see a doctor to rule out other causes, but if menopause is the culprit, you might want to consider treatment, such as hormone supplements.

Estrogen supplementation does work in early menopause for the regulation of hot flashes and mood swings. If you’re dealing with menopausal discomfort, find a gynecologist who has a lot of patients going through menopause and who has kept up on research in the field. Every woman’s case is different. Some are more willing than others to put up with the hot flashes, irregular sleep, and other baggage of menopause. Some women have family histories of breast cancer or heart disease to take into account.

Bear in mind that if you decide against hormone replacement, you’re not without options. Another excellent way to relieve menopausal symptoms, in addition to exercise, is to watch your diet. Taper off on caffeine, chocolate, red wine, and spicy foods, which can increase the frequency and severity of hot flashes. The Mediterranean diet, which is richer in fruits, vegetables, fish, and olive oil and lower in saturated fats than the typical American diet, is a good way to provide optimal nutrition that will help support your body as it goes through menopause.    

Declining estrogen production contributes to the loss of bone density in post-menopausal women. Dancers in particular are vulnerable because the risk of osteoporosis is greater for women who weigh less than 135 pounds and who may be low in vitamin D because they spend their days teaching indoors, away from direct sunlight. But the good news for women who teach dance is that spending long hours on your feet in the classroom helps to retain bone health. I encourage you to attempt to keep your legs and feet conditioned to jump, even if it’s minimal, because impact gives the most bone density.

Men are not immune from the ups and downs of emotional life, even though society tells them (unfairly) that they aren’t allowed to show weakness or signs of depression. Testosterone makes men virile, true—but if you’re a guy, remember you’re human too. That wonderful testosterone, helping you to achieve, can also be a downfall. Male teachers, in showing others how things are to be done, may overshoot their abilities, even while marking. Men are well advised to pick and choose what to demonstrate and to be confident in their pedagogic roles.

There are benefits for both men and women once the hormones start to fade. Freedom from birth control allows you to nurture a healthy sex life, which works wonders on serotonin release, giving a cardiovascular lift and a glowing complexion to boot. Menopause may seem like a loss of femininity, but can actually be turned into a feminist experience. This is the time of life when delegation and work satisfaction can finally yield some “me” time for both sexes. Most of the small children running around your feet are your students, not your own.

Remember, too, that you are not alone, even though you may not have a partner at this time. (Divorces and spousal passings are prevalent at this time of life.) Participate in life. No matter what life stage you are in, expand your world by challenging yourself to try one new thing each year. Going to conferences can help you find new friends and foster new avenues of pursuit. Keep making plans for your personal future. Create your bucket list and go after it.

And finally, acknowledge the signs of hormonal highs and lows and face them head on. This is not a rehearsal. This is your life, and life has one command: to live. Your students will love you for it.

I have faith in you.

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A Better You | Down in the Mouth

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Jaw problems can be a pain in the neck—and elsewhere

By Suzanne Martin, PT, DPT

Take a test. Look at your face in the mirror. Open your mouth, make a fist with the knuckles held vertically, and see how many knuckles you can fit in between your teeth. This is called the “freeway space.” Are you able to fit the normal amount of three knuckles? The major muscles used for eating are among the strongest in the body, and so they generate an enormous amount of force. When life gets tense, we also tend to tense up our jaws. The jaw muscles work in coordination with muscles around the ears and at the base of the head. A domino effect is often created, resulting in ear, head, face, and neck pain. Check yourself.

Now feel for tenderness. There are two little muscle groups in the back of the mouth where the molars meet. You can feel their action if you stick the tips of your index fingers into your ears and gently press the pads to point forward. Is this area inside your ears a bit sore? Then open and close your jaws to feel the action of the jaw joint. Is it smooth or crackly?

Then there is a big vertical muscle on the lower jaw that pulls up into the cheekbone. Run your fingers along the bottom of your cheekbone and notice whether it’s tender. The last muscle of this group is located just up and back past your temples. Rub your scalp in this region and notice if either side is tender in this area. The muscle tenderness and jaw-opening quality and distance tell a lot about how you’re doing in more ways than one. Problems in these areas may be a major culprit in face pain, jaw pain, and headaches.

Your students’ body language also may reveal problems with jaw tension. Aspiring dancers may not realize they are clenching their jaws when attempting particularly difficult moves and often need coaching to let that habit go.

But what does it say about the teacher or studio owner who displays a stern jaw and just can’t relax? Make a note of where your tongue lies when not in use. The rest position for the tongue is with the tip on the roof of the mouth, just behind the teeth, not on the bottom. An out-of-position tongue may indicate wearing of the temporomandibular joints, where your jawbone meets your skull on either side of your head. And such wearing can cause headaches and neck pain.

The jaw is the top of the line of the biomechanical chain that starts from the feet and works its way up. Tensions, misalignments, and imbalances from below will affect the positioning of the head on the neck. Then, when you add the emotional content of facial expression, you have a recipe for ear, face, and head pain, as well as such symptoms as ringing in the ears, dizziness, and eye pain.

To compound the problem, symptoms may go untreated because oral health care is often one of the first things to go when people are forced to cut back on medical expenses during a prolonged recession. The well-being of this area of the body doesn’t loom large on most dancers’ radar anyway. We rely on our legs and feet mostly, so it only seems reasonable to neglect mouth and jaw pain until it becomes unbearable. Besides, dancers are good at managing pain. We’re proud of it.

So what can a cost-conscious dance teacher do about head, neck, and face pain? Here are some tips to help you to mind your mouth, in a good way.

First, recognize that there is a direct relationship between stress and head and mouth pain. When times are this tough, even your own success can cause stress (and when businesses are struggling to survive, just putting on a recital within budget and without a hitch may count as a major success). And if you’re doing well, you may feel awkward, guilty, or sad when so many of your neighbors are hard pressed.

Stress is best met head-on. Once you’ve set your priorities and assessed your stressors, organize your time but listen to your body. Just like our students, we show the mark of stress in our faces. Keep breathing, get enough sleep, and try these exercises.

Let the backs of your hands rest on your thighs in these exercises.

1. The Lion Exercise: Sit tall. Smile and lift your eyebrows along with your top lip. Press your tongue against the bottom teeth and push the tongue outward in a rolling action, as if

you were trying to push open a drawer from the inside. Stay and breathe 3 times and relax.

2. For the next exercise, gently move your lower jaw from side to side. Now, while keeping your head still, shift your eyes to look from side to side. Then put it all together by moving your jaw in one direction while you shift the eyes to the opposite direction. Slowly reverse the directions of the jaw and eye motion, and repeat the whole combination 4 or 5 times.

Next, tilt your chin toward your Adam’s apple and imagine you’re pressing the back of your head into sand at the beach. Feel the back of your neck lengthen and gently let your bottom jaw go slack. Stay for 3 breaths and release.

End the sequence by placing the tip of your tongue on the roof of your mouth and open your teeth to about an inch apart. Take a deep breath in for 6 counts. Exhale with an audible “ahhh.”

As an added precaution, assess your posture habits. “Forward head” is a term applied when a person carries her head forward of the center of the shoulder, causing the upper body to drift backward to compensate. This can be seen in the widespread swayback posture. Even if a dancer has a forward head, she often can make it look good. Yet adopting this posture daily can exacerbate head and neck symptoms.

Remember that the weight of the head is like a bowling ball on the long stem of the neck. Slumping at one’s computer can cause increased strain in the upper neck and jaw. Stress-relieving activities, such as knitting or watch a movie, can cause strain if you’re sitting in a deep couch and craning your neck forward, with the upper neck getting crunched as the eyes zero in on their target. Be sure your low back is supported in its natural slightly arched curve and that your head is over the pelvis as much as possible. Hold the lower neck steady and try to tilt only the head (moving only the upper neck) for vision precision. Every so often, sit forward, roll the shoulders backward a few times, and squeeze between the shoulder blades. Yawn, and open and stretch the mouth and tongue.

Next, examine your oral habits. What you do with your mouth can reveal a great deal about your anxiety level. Do you find yourself clenching your teeth at times, night or day? Grinding one’s teeth while sleeping is often an anxiety habit that cannot be broken, but we can check ourselves and consciously allow freeway space of an inch between the teeth and be mindful to allow the tongue to float to its rest position at the roof of the mouth.

Also, chewing gum occasionally is fine, but continuous gum-chewing can tighten the jaw muscles. (And nervous chewing on pens, pencils, straws—or one’s fingernails—is not a great stress-reduction method.)

Another key to head health is paying attention to your gums. A good offense is the best defense when it comes to a healthy mouth, even if you’re worried about the expense. Dental schools are easily accessed for exams and cleaning if you’ve had to give up your dental care provider.

Look at your habits. Keep flossing. Breathe. Let your body get a whole new outlook by taking control of your mouth.

I have faith in you.

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A Better You | Surviving Hard Times

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Don’t let rough economic seas throw you off course

By Suzanne Martin, PT, DPT

It’s always amusing when someone greets me by saying that they’d like to do exactly what I do for a living. At such times I think: be careful what you wish for. Those of us in the dance field who manage businesses, offices, and studios know that the work is 24/7. Not everyone is suited for the self-employment lifestyle, and even those who succeed at it may endure some bleak moments—myself included.

A number of years ago when I was in the early throes of menopause, starting a new private practice and a ballet company wellness program, and becoming a writer, I became—to put it mildly—cranky. As anyone who has put together productions and run a studio at the same time knows, there are a million details that at some point just cannot be delegated. Any dancer soon becomes skilled at multitasking as she deals with maintaining her technique, staying fit, and handling rehearsals and finances, and she brings those skills to bear when she decides to open a studio.

Being conscientious in front of a class and creative in basic production values are vital skills, but they may not be enough to survive the added anxieties of a national financial crisis that shows no signs of ending. Every day’s news is a litany of grim unemployment figures, foreclosures, and jittery financial markets. Even if you’ve been relatively unscathed, you’re rare indeed if the turmoil hasn’t touched the people you care about. What’s a studio owner to do to stay stable and on course through unstable times? Here are some tips on identifying when attending to business goes past the due-diligence level into true anxiety and how to handle the stress of uncertainty.

First, examine your muscle patterns. Are your muscles tense, aching, or sore? Do you find it hard to relax when relaxation time comes? (Notice that the question isn’t, “Do you find time to relax?” That’s always a challenge for teachers and studio directors, but it’s one that you can’t bypass safely.) One telltale hint I’ve noticed in my practice comes when I am fully holding someone’s body part. If I have to ask the person repeatedly to let the body part go limp, especially when it’s being cradled, that’s a sure sign of underlying tension. Check it out for yourself during your next massage.

Other physical symptoms of anxiety include shakiness, cold and clammy hands, and a racing heart. Even dizziness, faintness, and difficulty breathing can point to anxiety. A number of my clients, including dancers, have experienced such severe physical symptoms that they were sure they were having a heart attack. Another thought her chest pains and panting were signs of an asthmatic attack. Yet another thought her severe abdominal pains had to be appendicitis. Others might have recurrent migraines or digestive disorders, and so anxiety might go unsuspected because the symptoms often appear to point to those existing problems.

Next, be honest with yourself: Do you suffer from the perfectionism that is often necessary to excel? Has the onstage performance anxiety familiar to every dancer crept into your offstage, post-performance life? Detachment is hard when the subject is yourself, but it’s necessary in order to see clearly how past disappointments, obstacles, and choices affect your present outlook.

What about the rest of your emotional life? In general, do you feel good about yourself and like spending time with yourself? Recently a longtime dance teacher and former professional ballet dancer told me about a rural sabbatical during which she felt aloneness for what seemed like the first time. She’s a popular teacher who thrives on constant attention from students, and she explained that she hadn’t really paid attention to herself, but instead focused on her classes and family. She seemed a bit amazed at the inner life that her sabbatical revealed to her.

Taking care of your physical well-being is crucial as well. Dancing is indeed physical, even if you are just standing and marking rehearsals and classes. Remember to strategize your eating schedule, eating some form of protein every few hours to keep blood sugar stable. Keep plenty of water on hand to keep your mind fresh, and work to get in that seven to eight hours of rest every night. The tedium of the daily grind can add to your fatigue, so plan and consider those outside professional development days well in advance. I find that conferences and other meetings with colleagues keep me stimulated with new ideas, provide a much-needed distraction, and help me gain perspective on my own day-to-day issues.

Renewal, restoration, and realization that this is just one more trial can help you weather the current storm and keep day-to-day worries and irritations at a sub-meltdown level. We all need daily encouragement to remember that this day will end, this crisis will resolve. Make a habit of encouraging yourself. Self-talk is a great strategy to get through that one taxing day, that one I-can’t-stand-this minute.

Worry can be a tremendous obstacle to problem-solving. Taking responsibility is one thing; endless ruminating is tiring and self-defeating. It takes discipline to turn away from a problem, but you can convince yourself to do what you can with an issue and then rest while you await the next development. One of the biggest lessons I’ve learned in my practice is that all my work won’t be finished in one day. Just like Scarlett O’Hara in Gone With the Wind, I’ll think about it tomorrow.

Get good at triage. Prioritize the multiple projects on your agenda. Focusing on the task at hand can get you working one step at a time instead of freezing at the thought of what the entire project year means. Learning to bring the focusing and mindfulness found in meditation practices into your daily work life will ease mental strain and help lessen stress levels by creating actual enjoyment of dealing with each bite-size piece of your workload as it comes. Practice your self-talk and convince yourself that you can enjoy every task at hand.

It is prudent to recognize that even very stable people may need to seek professional help from time to time. In our business lives we readily accept the input of trained advisors who can help us get past the details of the trees to see the whole forest, but admitting that we need help finding peace of mind can be harder. It’s not a moral failing to get a good evaluation from a cognitive behavioral therapist, and it can be an important and necessary step.

I’m sure that many of you will agree that it’s a marvel that our businesses do keep going. Those of us in dance are truly married to the profession, for better or worse. Let’s all look forward to our fiftieth anniversaries.

I have faith in you.

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A Better You | Osteoporosis and You

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Give your bones a break—so they don’t give you one

By Suzanne Martin, PT, DPT

Why should dance teachers worry about their bones? Osteoporosis is basically an epidemic. About 10 million Americans have this bone-weakening disease, with another 34 million at risk, the National Osteoporosis Foundation says.  The American College of Sports Medicine has warned that women in all athletics—and dance is nothing if not athletic—are at risk for osteoporosis, amennorhea, and eating disorders. It also pointed out that eating disorders and malnutrition are both detrimental to the formation of bone.

Two years ago I attended a continuing-education program given by the Foundation for Osteoporosis Research and Education, where endocrinologists explained that osteoporosis isn’t diagnosed until the patient suffers a fracture. In women, the first fractures begin in their 50s at the wrist, followed in their 60s by fractures in the thoracic spine vertebrae, with hip fractures usually occurring in their 70s. (Because estrogen is critical to bone formation in women, they tend to lose more bone after menopause.)

Think of a dancer’s typical life trajectory. Dance students, especially in ballet, face the challenge of staying lean while mustering the strength and stamina to fulfill their performance goals. When I conducted an informal survey of 15- to 17-year-olds in my nutrition lectures at San Francisco Ballet School, a surprising number of dancers said they wished they could keep the weight and body shape that they’d had at age 14. This may reflect the popular misconception that thinner is always better, but remember that when you lose weight, you don’t just lose fat—you also lose bone and muscle.

Also, it’s no secret that young dancers in the midst of early bone formation are more susceptible to lower-extremity and spinal stress fractures when their periods are delayed or absent because of their rigorous exercise and low body fat. Low body weight means low lean muscle and low skeletal weight as well as low body fat. Growth generally is accomplished by about age 20. The stresses and strains endured by young dancers during their pre- and early professional years set up the skeletal frame they will have for the rest of their lives.

The dancer who goes on to pursue a teaching career, then, may think she’s out of the woods: she can pay less attention to diet because she doesn’t face the energy demands of performance, or an audience’s expectation of ballerina-slim dancers. But think twice. Bone growth (geometry and density) peaks by about age 35. The goal then becomes keeping the baseline bone amount steady until old age.

How can you ensure that a formerly stressed skeleton can stay strong for a lifetime? Here are some dos and don’ts that you can tape to your bathroom mirror.

First, eat wisely. We all know about the necessity of daily calcium, and I’ve written about the importance of Vitamin D supplements (the new recommended daily allowance, or RDA, is 1,000mg/day). Sitting out in the sun for 20 minutes a day with arms, legs, and chest exposed may give you good Vitamin D, but watch out—wearing sunscreen, inconsistency, and distance from the equator all interfere with exposure to UVB radiation, which means you might not really get your daily Vitamin D dose that way.

Make sure your diet has enough protein—it’s essential for aging bones. The RDA for adult women is about 0.4 grams per pound of body weight, and protein sources are easy to research online. We may not need as much as when we were performing, but I know I have to push to get enough since I eat lightly. My typical breakfast of hot cocoa, oatmeal, and flax seed meal gives me about 25 grams. The protein helps to stabilize my blood sugar and the starchy carbohydrate gives me satisfaction until lunchtime.

Protein is also necessary to counteract sarcopenia, the muscle loss experienced as we progress from middle age to old age. Bones and tendons depend on the pull of muscle to increase bone density. Almonds, oysters, and leafy green vegetables such as collard greens add variety and natural calcium to the diet, as do the tried-and-true dairy products of milk and yogurt.

Next, stay strong with resistance exercise. I use light weights—from 3 to 10 pounds, depending on the exercise. You won’t bulk up, and some upper-body weight work will keep your neck happy.

  1. Stand in parallel with your feet just less than hip-width apart. Hold a 5-pound weight in each hand and make shoulder rolls (backward only; we already round forward too much) about 10 times.
  2. Place the weights at either side of your thighs. Slide the weights up and down the sides of your thighs for about a 6-inch excursion. Open the elbows sideways as if a puff of air were opening the armpits as you slide upward. Do about 10 repetitions.
  3. Hold a 1- to 5-pound weight at each end with your arms fully extended toward the floor. Lift the weight to chin height while winging the elbows up and out. Feel as though your core is lifting the weight as it slides up past the front of your body to the chin. Do 1 to 3 sets of 10 repetitions.
  4. Keep holding the weight in both hands and place it overhead, toward the back of your head. Elbows point upwards. Lift the weight up toward the ceiling, straightening the elbows, and then lower the weight again. Do 1 to 3 sets of 10 repetitions.
  5. Bent-over rows are helpful to keep the thoracic spine strong.
          a. At the barre, take a 5-pound weight in each hand and stand in a flat-back position. Be sure to hold your abdominals. Lean your forehead on the barre (a folded towel will lessen the pressure).
          b. Lower the weights toward the floor, then exhale and lift them to the sides of your chest. Lower slowly in 4 counts. Do about 10 repetitions
  6. Planks front, side, and back are the best way to protect the three danger spots of wrists, mid-back, and hips.
          a. On your hands and knees, in a flat-back position, engage the abs, back, and pelvic floor. Reach the feet back and lengthen out into one long line. Hold for 20 counts. Repeat once.
          b. Lie on your side with your forearm on the mat and your legs in parallel with the feet dorsiflexed so that the toes are pulling back toward the  shins. Exhale and elevate the hips. Hold for 4 breaths and lower. Do 4 repetitions.
          c. In a seated position, put your hands on the floor behind you with the fingers pointing toward the pelvis. Lengthen the legs in front of you.   
              Again, dorsiflex the ankles. Exhale and elevate the pelvis. Keep the elbows bent. Breathe 4 times and lower. Repeat once more.

Research with osteoporosis patients as far back as 1984 has shown that extension exercises offer the most protection against fractures. The Pilates swim is an example. Lie on your abdomen. Imagine there’s an ice cube under your waist so that you lift the abdominals. Exhale and lift the head (keep looking down), and then lift the arms and thighs an inch off the floor. Gently paddle the arms and kick the legs for 20 to 30 counts.

Keep jumping. Bone growth is stimulated by stress, and impact offers the greatest benefit. Keep your relevé strong so that you can still jump a bit in class. Some judicious jumping will keep those hips strong. Remember the Magic 25? (See “A Better You: Better Balance,” May 2011.) Just stand at the barre in parallel and make 25 brisk elevés. Hold the last one and fully engage every muscle fiber you can muster.

Get outside. Walking and hiking are great for dancers. Jogging and full-out sprinting may be hard on longtime dance legs, so it might be best to save the big jumps for sprung floors.

Protecting our bones means job insurance. Eat smart, move smart, be smart.

I have faith in you.

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A Better You | Helping Your Hands

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For pain-free hands, look to your neck and arms

By Suzanne Martin, PT, DPT

As a teacher, think how many times a day you use your hands. As a dancer, consider the beauty of a delicate hand in a port de bras. Our hands are priceless, yet we don’t always think of protecting their health.

While we hear plenty of stories about injuries to feet, knees, hips, and backs, hands can also land in harm’s way. One dancer I know developed arthritis of the thumb after a partner squeezed her hand so hard that it was severely sprained. Another dislocated her thumb and fractured a nearby bone while performing a finger turn with her partner.

Most school owners do a considerable amount of desk and computer work, which can lead to hand pain. And those of you who are mothers might complain of hand and arm pain from handling children.

People often suspect carpal tunnel syndrome—a high-pressure problem due to swollen nerves and tendons—when their hands, wrists, or forearms ache, but that’s not the only possible culprit. Nerves run from the neck all the way into the hands, and tightness or irritation can cause pain anywhere along this route. Most hand pain comes from overuse and not traumatic injuries.

Body connections
Hands, neck, and arms go together as one unit. To have happy hands, you must have a properly aligned neck that allows you to breathe into the area above the collarbone. Letting your head jut out in front of your body’s center of gravity often leads to problems with the arms and hands.

The neck vertebrae are unique in that the bones can actually telescope forward like a giraffe’s neck. Watch someone giving a lecture or teaching—often, she’ll push her face forward as she works to engage her audience. The more animated the speaker is, the more this forward pressure tends to happen.

Proper head alignment is needed when you’re dancing, such as in spotting. But as teachers, you mark combinations more and dance less, which means that your neck alignment is sure to go if you’re not vigilant.

Nerve pain and pathways
Arms and hands are susceptible to pain from tight nerves. Nerves are encased in a sheath, and if they are tight they will not glide within that sheath as they are designed to do. As a teacher dances less and loses neck flexibility, her cervical (neck) nerves may become tighter and lose their glide. The nerves wind from the back of the neck down through the scalenes, which line the sides of the Adam’s apple, forming what’s called the brachial plexus network above the collarbone and ending in the armpit or arms.

Dancing and performing require a great deal of respiratory diaphragm use, and the scalene neck muscles work in opposition to the diaphragm, just like the biceps muscles in your arm works in opposition to the triceps. When the biceps flexes, the triceps has to relax (extend). The diaphragm and scalenes work in a similar fashion—if one is at work, the other will relax.

Because dancers spend hours holding their arms up or out to the side, the deep neck muscles (the scalene muscles) can become tight. Tightness in the scalenes can cause the major nerves of the arms (all the way down to the fingers) to experience pain or tingling. Working the diaphragm can help to lessen the tension on this area.

To have happy hands, you must have a properly aligned neck that allows you to breathe into the area above the collarbone. Letting your head jut out in front of your body’s center of gravity often leads to problems with the arms and hands.

Dancers tend to have a tight thoracic outlet (a small area above the collarbone where the scalenes are; if you lift your arm in port de bras, you’ll feel these muscles tighten). Teachers work these muscles a lot. They hold their arms up demonstrating, pick up small children in class, do hours of computer work, pick up barres, and sweep the floor. And because dancers often have loose joints, their forearms and wrists often aren’t very strong, so other muscles pick up the slack.

Taking steps to healthy hands
We’ve discussed how posture, the muscles of the neck and collarbone, the tightness and gliding capacity of the nerves, and the full action of the respiratory diaphragm all play a part in healthy hands. Attention must also be paid to how the hands and wrists are used, and steps taken to protect them. Here are some ideas and tips to keep your hands happy while they work.

  • Think of your head as a bowling ball. Keep it over your center of gravity in the pelvis. Notice how you hold your head as you demonstrate or watch your students. Keep your jaw a bit slack and relax your tongue so that the tip slightly touches the roof of the mouth.
  • Stretch the sides of the neck. Reach behind your back and hold the elbow of the other arm. Gently tilt the head away from the side you’re holding and let the ear feel heavy while you take several deep breaths. Then open the collarbone muscles by lifting the clavicles and rolling the shoulders gently backward 4 or 5 times.
  • Stretch the front of the neck and chest by performing the “butterfly” off the edge of your bed. Lie on your back with your armpits at the edge of the bed. Keep your knees bent and press your back firmly into the bed. Clasp your hands behind your head and point the elbows toward the ceiling in a closed-arm position. Then gently arch backward and open your elbows, supporting your head. Open your mouth and breathe deeply 4 or 5 times. Close the elbows and curl up to come out of the position.
  • Lie down on the floor or bed and move your arms as if making snow angels, then cross your arms and mime pulling a shirt off over your head. Repeat the sequence several times.
  • Place your hands on the floor or a counter so that the third fingertips point to one another, about a foot apart. Gently move one shoulder toward the opposite hand, then move the chest past the midline and move the other shoulder toward its opposite hand. End by rounding up through the chest, making a big curve in the breastbone (as if drawing an oval in space). Repeat several times and then reverse the direction of the shoulder oval.
  • While standing, reach one arm up and the other down with the palms of each hand facing inward toward the body. Squeeze the shoulder blades together while simultaneously squeezing the front of the ribs. (Think about “making dimples” in the ribs below the breasts. This engages the upper abs to help balance the trunk in a correct posture.) Continue to reach up and down for 5 counts, then switch sides. Repeat several times.
  • If you have painful arms and hands, take a brisk walk. Let the arms swing gently and don’t hold anything. (Unfortunately, walking the dog doesn’t count due to frequent stops and leash wrangling.) Just 10 to 20 minutes a day of therapeutic walking keeps your diaphragm doing what it does best.
  • While sitting, try a simple roll of the shoulders, then squeeze the shoulder blades together.

Keep a light grip
Be careful how your use your hands and wrists. Use a light grip whenever possible, letting your palm and biceps do the work. The neutral position of the hand is a slight curve with a gently cupped palm. The back of the hand should form a straight line with the back of the forearm. Avoid a deep crease between the hand and the forearm while performing any hand work or computer use. If you use a laptop computer, rest your hands on its surface; for a desktop computer, try using a gel pad under your wrists for both keyboarding and mousing.

All that time on the computer, gripping a steering wheel, and juggling endless chores can catch up with the best of us. A little knowledge and due diligence go a long way to avoiding chronic hand pain.

I have faith in you.

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A Better You | Keeping Colds at Bay

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How to avoid catching your students’ sniffles

By Suzanne Martin, PT, DPT

Does it seem like you’re always suffering with a cold? Or do you remain relatively sniffle-free? The answer can depend on a number of factors. And one of them could be long-term exposure to your dance students. Yes, it’s true—teaching dance just might give your immune system a boost.

While an infant depends on its mother’s immunity to get by (babies receive sickness-fighting antibodies from the placenta and in breast milk), children can be hit hard until they’re old enough to have built up immunity. That’s one reason (along with behavioral and attention span issues) why some dance teachers won’t allow children under age 3 or 4 into dance classes. Dance teachers know that little ones with runny noses and coughs can cause big repercussions.

More than 200 varieties of the common cold, the rhinovirus, are known to exist. Take count. How many sniffling, sneezing students have you taught in your life? It’s likely that if you’ve been teaching a long time, you’ve been exposed to a large number of common colds and flu, all helping to build up your immunity.

Your immune system is fascinating, and far more extensive than most people realize. It plays defense by making antidotes, called antibodies, when it detects outside invaders like cold and flu viruses. Specialized cells surround and puncture things they don’t like, literally eating them up. Working on the offensive are organs and more specialized cells that keep out invaders and also detect and correct mistakes made by your own DNA. The list goes on and on.

But besides bringing hordes of new youngsters into your studio, what else can you do to prevent those I’m-too-sick-to-teach-but-I-will-anyway days? Here are some ways to keep those unwanted colds at bay.

Wash those hands
Our primary defense is our skin, the largest organ in the body, which keeps out unwanted bacteria, viruses, parasites, fungi, molds, and microorganisms—just about anything you can name. That’s why hand washing is so important.

Instead of antibacterial soap (which kills off good bacteria as well as bad), try shea butter or olive-oil-based soap. If these are too expensive or you want to go completely organic, wash with a dilute solution (50/50) of vinegar and water. Or go with a good, basic moisturizing soap like Dove.

Another easy defense is to wipe down the studio’s barres, doorknobs, faucet handles, and high-traffic surfaces during cold and flu season. Bleach is the best. Ammonia is also effective, but if you want a pleasant smell in your rest rooms, try Lysol. Straight alcohol, no dilution, is probably best for barres. It’s easy and cheap and has no additives that might cause trouble when touched by students with sensitive skin.

You can bolster your skin’s immune response by making sure you eat foods rich in vitamin A. In order to build collagen or antibodies, you need to start with protein, then add A vitamins, which help the body utilize the basic nutrient (protein). Foods that are orange in color (such as carrots, yams, and papaya) contain vitamin A, while eggs, cheese, and liver are all high in protein plus vitamin A.

How many sniffling, sneezing students have you taught in your lifetime? It’s likely that if you’ve been teaching a long time, you’ve been exposed to a large number of common colds and flu, all helping to build up your immunity.

Swish and brush
The mouth provides an easy entry point for undesirables. The head, face, and neck all are heavily endowed with another part of our immune system, the lymph nodes, which can get overloaded and swell from too much contamination. Remember to gargle on a regular basis during high-exposure times, and lessen the load on the nodes by simply swishing out your mouth or brushing your teeth. Even if you swallow some of the bad guys, your next line of defense—the acid in your stomach—will likely kill them off.

Vitamins and supplements
Try taking a multivitamin containing zinc, which helps immunity and the lymphatic system. A study by Noel Solomons in Nutrition Reviews, a journal devoted to keeping academic researchers, students, and professionals abreast of research in nutrition science, looked at the vitamin intake of older adults. A group that took an over-the-counter multivitamin got fewer colds. Pumpkin seeds, lean beef, and oysters are other good sources of zinc.

Herbal supplements can help, but do keep in mind that these are medicinal substances. It may help to take the herb echinacea during cold season, and the botanical golden seal is known to have properties that help fight bacteria that show up when our immunity is low.

However, there’s a caveat: a lot is not always better than just enough. One of the problems with herbals is that it can be difficult to understand what makes a therapeutic dose. You might want to get some help by consulting your general practitioner and a health adviser at a health food store.

It’s best to be up front with your medical doctor because herbal supplementation can strengthen or diminish the effects of any medications you might be taking. So start slow. Be suspicious and do your research. The National Institutes of Health is an excellent resource.

Homeopathic supplements can be used with caution. Homeopathy uses herbs and plants in very dilute solutions to have an effect on human biochemistry. The actual mechanism is quite esoteric, and of course, there have been no RCTs (randomized controlled trials) conducted by the FDA. It’s wise to use these concoctions sparingly so that our bodies will respond to them when we need them, perhaps at times when colds and flu are prevalent. Just as with many medications, taking a herbal supplement too often may decrease its effectiveness.

Even more important, we want to avoid an autoimmune response (when the body turns on itself). Persons with diabetes, lupus, and rheumatoid arthritis should avoid alternative supplements because the supplements could interfere with medications physicians are prescribing for these disease states. Teachers with arthritis or other inflammatory conditions should proceed with caution, as well, since stimulating the immune system will cause it to initiate the first stage of healing: inflammation.

Exercise more, stress less
In the right amounts, exercise can boost the immune response. It causes the blood to flow faster, which moves antibodies and specialized cells through the body and delivers them where they need to be at a quicker pace. But beware: too much exercise, such as in over-training, reverses the effect. That’s why dance teachers need to be proactive and rest in between bouts of intense exercise. A good rule of thumb is that if your muscles are tired when you wake up in the morning, you might be over-exercising. Difficulty sleeping is another symptom of over-training. After age 40, it’s a good idea to alternate days of cardio exercise and weight training to build in muscle recovery time.

Stress and fatigue are energy vampires. Without proper rest, we can run short on the energy resources we need to keep our basic body functions operating, including our immune response system. For example, the adrenal glands produce adrenaline. But those “fight or flight” responses are meant for brief spurts. With constant use the adrenals can begin to lose their function, making us more susceptible to a full-on invasion.

The antidote here is simple: rest, the great healer. It slows down processes like digestive activities so that all resources can be renewed. It may take discipline to forgo watching that late-night movie so you can get some extra sleep, or to say no to some invitations or activities and stay home and relax instead, but at times it’s well worth it. Our batteries need rest and relaxation time to get recharged.

Good effort, good health
In general, a healthy lifestyle pays off. Eating fresh fruits and vegetables, along with low-fat proteins, will ensure that you get the vitamins and minerals needed to bolster your immunity. Vitamins, minerals, and supplements help keep your body ready to fight illness.

So eat right, get enough rest, and eliminate stress. Keeping your school extra clean during high-contagion season may well keep students in class and you at your best. By staying healthy, you’ll feel perky enough to run your business or teach those classes with a smile.

I have faith in you.

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A Better You | Word Power

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Great teachers know it’s not always what you teach—it’s how you say it

By Suzanne Martin, PT, DPT

Dancers are constantly being evaluated and must endure comments from teachers, directors, critics, and peers. Those words have power. They can build dancers up or tear them down. Receiving comments about one’s physicality from teachers and directors is a natural part of the development process in any dance training. But what is really being said? Is it useful? Do the dancers understand the intent?

There’s not much we can do about the use of language in the greater dance world. Tactless reviews and bad press will occur from time to time. But in the studio, it’s another story. How teachers speak to their students matters, and it can make the difference between training students effectively, so that they can maximize their potential, and undermining the effects of good training. The message you need to convey to your students is important, but so is how you deliver it.

Careless comments
A couple of years ago, I watched a ballet class of mostly 14-year-old pre-professionals while waiting to give a lecture on nutrition. The teacher walked up to me and said—not very quietly and quite seriously—“What am I supposed to do with these bodies?” Perhaps without meaning to, she conveyed to those students that they were not worth her time and effort. Teachers need to be constantly aware of the damage they can do with thoughtless comments.

Words can have unintended results. I once worked with a very tall, well-trained dancer who told me that while in training, she was told she wouldn’t be transitioned from the school into the company because she was a “big girl.” Her roommate later showed her how to “fix” the problem by making herself throw up. It took years for that young dancer to overcome her bulimia and to see herself as statuesque, not overweight.

Words matter when dealing with students’ motivation, too. All teachers want their students to excel and reach their artistic potential. It takes knowledge and skill to push a reluctant student to a new level or pull more out of an underachiever. Children respond well to consistency and stability. Still, it’s understandable that a teacher might become frustrated by a student’s lack of drive or reluctance to experiment with a new way of performing an action. The late choreographer Michael Smuin once complained to me about a dancer who had great natural ability but just couldn’t seem to break out of her box. Sounds familiar?

However, the greatest failure may not belong to the student, but to the authority figure who doesn’t measure his words and actions. I learned this lesson during my medical internship when my clinical instructor received a bad review for correcting (and thereby compromising the authority of) another physical therapist in front of patients. Words matter, as one dance school found out when an African American teacher told a student not to dance like a “white girl.” The school is now dealing with a lawsuit.

A teacher’s duty
What’s a teacher to do? We have a duty to be outside observers and push our students to excel. We also have a duty, particularly in pre-professional schools, to encourage students who we think will succeed. Yet it is hard to predict who will exceed our expectations. Ugly ducklings have been known to become graceful swans.

When in doubt—or better yet, at all times—think. In all situations, take the time to pick the right words before speaking. Refrain from making quick comments that might be misconstrued by a naïve young dancer. Work on establishing criteria for levels of training at your studio so that expectations will be clear. If you have a policy of an annual progression based on years of attendance, you can still provide written information about skill requirements within those levels so that students know what to strive toward. Parent conferences are easier when a skill-set policy is in place.

Seek out professional speakers
If you have concerns about dancers who are overweight, underweight, or might be engaging in risky health behaviors, get help. These are tricky areas in which sensitive communication is essential. Don’t try to handle every situation yourself. Nutrition lectures or discussions on sports psychology topics can be enormously helpful to parents, students, and your studio staff. Chances are your local community has a few experts in these fields who would be happy to visit the studio once or twice a year to share their knowledge.

As a health professional, it’s easy for me to foray into forbidden areas concerning risky adolescent behavior in the context of a lecture. One studio invited me to lecture after a student fainted from low blood sugar. In another instance, I mediated between a mother and daughter who was told she had the professional “right stuff” but whose weight fluctuated due to her partying habits. Finding a professional who can intervene in cases like this could save your business.

Share your concerns and policies with your staff. Help them develop acceptable language for corrections. Always be sensitive about a dancer’s age, weight, race, and physical attributes. Make all your words constructive and respectful. It’s the right thing to do.

Words count. Be wise.

I have faith in you.

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A Better You | Better Balance

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How to retain the skills and strengths that keep you on your feet

By Suzanne Martin, PT, DPT

Living the dance life is a balancing act. Literally. How many hours have you spent teetering on demi-pointe or performing a challenging adagio on one leg for 64 counts? So much of our early training is spent in finding our balance, and then once we gain it we assume it will always be there for us. Unfortunately this isn’t the case.

Dance/USA, an organization of dance company managers, has developed a screening process by which companies can gauge the health and well-being of professional dancers and help them be more proactive about health issues. The screen contains balance tests, one standing still and one moving from plié to relevé. The first year I gave the “stand on one leg for 60 seconds” test to some professional ballet dancers, a surprising number “failed” the test. Take the test yourself.

  • Stand on one leg in parallel.
  • Lift the other leg into a loose coupé without touching the support leg.
  • Cross your arms and place your hands on your shoulders (elbows not touching the trunk).
  • Close your eyes.

Closing the eyes is the stickler. How many seconds can you balance for? The test has three indicators that point to how you might fall out of this position. Do your hips sway you off balance? Do you touch the other foot down to catch your balance? Or do you drop off like you’re falling to one side? Each of these indicates different aspects of balance.

Our body systems are amazingly redundant, intersecting to give nuances to life functions as well as serving as backup in case something falls short. The balance system is no different. Balance is accomplished through three components: vision, inner-ear neurological balance mechanisms, and joint perceptions, called proprioception. Proprioception is the perception of movement and orientation that arises from stimuli within the body—very important, for example, when a dancer is lifted off the floor.

So in the test above, if you fall off balance in any of the three ways, you might have a joint perception problem. Hips swaying off balance might indicate muscle strength or fatigue issues, while touching a foot down could be a sign of scoliosis and falling to one side may indicate an inner ear problem.

Health issues aside, the good news is that balance is very trainable. But as teachers transition from performing to demonstrating and choreographing, their balance may become rusty. People sometimes confuse rustiness with true balance disorders. How do you tell the difference? If you develop dizziness that makes the room spin and the feeling does not go away after you stop moving, or if you lose your balance badly enough that you have to grab onto something or repeatedly fall over for no reason, it’s time to get checked by a health professional.

Certain conditions mimic rustiness in balance training. Low blood pressure, common in physically fit people such as dancers, can make you feel lightheaded when you lie down quickly or get out of bed or up from the floor quickly. (Blood pressure is normally higher while you’re lying down, and the sudden ascent into a standing position can lower the blood pressure too quickly.) And physically fit dancers tend to have higher metabolisms than the general population. That means when you’re famished, the combination of low blood sugar with the low resting heart rate and blood pressure typical of well-conditioned people might produce some dizziness with level changes.

 Having stamina is vital for teachers and studio directors, especially those who handle most of the business operations or teaching duties. You can enhance your capacity to endure those long workdays by making sure your blood sugar doesn’t get too low and by adding in some cardio exercises. Even just taking the stairs or walking instead of driving during errands will help enhance your stamina. It’s also important to develop a good eating pattern that keeps some blood sugar circulating. Snacking on energy bars, apples, or juices can help throughout long workdays. A little goes a long way, and judicious bites can help maintain an even flow of sugar to the brain, which is needed for concentration.

If you want to keep or improve your balance ability, don’t forget your ankles and knees. As a teacher, you may be standing up more, but you are probably not as physically conditioned as when you were dancing full-time.

It’s true that if you don’t use balance skills, you will lose them. Ever notice how chaîné turns and quick spotting are harder for your students after vacations and breaks? If you want to keep or improve your balance ability, don’t forget your ankles and knees. When researchers studied how subjects reacted to the sudden start of a treadmill, they noted that the first parts of the body to act to regain balance were the ankles and then the knees. That tells us that it never hurts to beef up leg strength.

As a teacher, you may be standing up more, but you are probably not as physically conditioned as when you were dancing full-time. To strengthen your legs, follow this regimen.

  • Sit on the floor and relax your feet.
  • Hold one heel in the palm of one hand and hold onto the sides of the ball of the same foot with the other.
  • Keeping the heel steady, gently twist the forefoot (the ball) from side to side several times.
  • Loop a stretchy band around the ball of the foot, and anchor the free end around the other foot.
  • Move the looped ball of the foot sideways, winging the foot without turning the leg in and out. Do 20 repetitions.
  • Now point your foot and pull the band around the tops of the toes, covering them. Wrap the free ends behind your waist and hold them on the same side as your exercising ankle. Pull your wrapped toes back toward the shin. (This strengthens the ankle and toe extensors.) Do 20 repetitions.
  • Repeat with the other leg.

Don’t forget standing exercises for the side of the hip. (The hip abductors are responsible for stabilizing the pelvis in a one-legged stance.) These two exercises are good for keeping fast-twitch muscle fibers activated and ready. I use a Pilates long box, which is about 16 inches high, but a kitchen stool will do.

  • Stand on a straight leg and place one foot flat on the prop, in parallel.
  • Press and point off the foot on the floor in a brisk, springing action, like a mock jump. (Don’t stop at half-toe—make sure you roll off the entire foot and toes.) Repeat 10 times.
  • Repeat in demi-plié. Concentrate on using your muscles to break your connection with the floor. Do about 10 of these as well.
  • Repeat both exercises on the other leg.

Last, try the “Magic 25,” also known as calf rises. According to Susan Mayes, principal physiotherapist at Australian Ballet, after insisting that AB dancers do at least 25 (or, preferably, 30 to 35) of these rises every day after barre, the company saw a marked decrease in ankle injuries.

  • Stand on one foot in parallel.
  • Keep your knees and hips straight as you elevé up to half-toe and down. Repeat on the other leg. Do the “Magic 25” repetitions and you’ll be good to go.

Protect your balance skills by doing the standing-still balance test from time to time. Keep doing your chaînés to keep your spotting strong, and then beef up those feet, knees, and ankles. It all works.

I have faith in you.

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A Better You | Help for the Hypermobile

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When flexibility crosses the line from aesthetics to ouch

By Suzanne Martin, PT, DPT

There’s good news and bad news about hypermobility: it helps dancers achieve beautiful, extended lines, but it comes with health issues and concerns—some that might even keep a person from dancing at all.

This was a hot topic at the International Association for Dance Medicine and Science (IADMS) conference last October in Birmingham, England. The day’s discussion was led by Dr. Rodney Grahame, an esteemed rheumatologist and medical professor at University College Hospital, London, who has created a test to see if a person’s hypermobility tendencies are benign or indicate the presence of a true hypermobility syndrome.

Try the test yourself. Can you put your palms on the floor? Can you press your little finger back into a 90-degree extension or press your thumbs to the inside of your forearms? Do your knees extend backward past a straight vertical line by 10 degrees? Can you similarly overextend your elbows? If you pass four of these trials, you rate a “yes” (i.e., positive) and would fall in the benign hypermobility range.

Problems with hypermobility
To have true hypermobility syndrome, you must also meet other criteria, such as having three or more joints that are painful for more than three months. Often dancers and teachers do not consider their “cranky” joint issues as symptoms because they are so accustomed to the discomfort.

In a study of English ballet professionals and students reported in the Journal of Rheumatology in 2004, more cases of hypermobility were found among corps members than principals, perhaps because hypermobile individuals lack the strength and coordination necessary to perform principal roles. Yet naturally flexible individuals find themselves drawn to dance, and they may face a lifetime of chronic pain, even when dancing.

If dancers don’t understand the importance of protecting their joints once they lose the strengthening benefits of daily class and rehearsals, they could experience a cascade of joint problems. When ballet dancers stop putting so much effort into pulling up and turning out, they (the hypermobile ones in particular) lose the benefit that comes from working on their postural muscles every day. Their lax ligaments then start to cause more joint problems, such as ankle sprains or knee problems.

An ounce of prevention goes a long way. That’s why it’s important for teachers to understand how excessive flexibility can affect their own spines in the long term.

Flexibility without strength
Aging dancers usually find that their arabesques and turnout aren’t what they used to be. In an effort to retain these prized accomplishments, they may cause themselves more physical problems. That’s what happened to a ballet teacher who came to me with “kissing spine” after performing the Snow Queen role in her school’s production of Nutcracker. Yielding to the pressure of her students and their parents, she donned a tutu and—because she was busy tending to the details of running a show—performed sans warm-up.

X-rays showed an inflammation on her spinous processes, the bony dinosaur bumps on the vertebrae. She danced, but she also bought herself six weeks of recovery. Apparently she still had the flexibility but not the strength or muscle memory to properly perform those extensions and arabesques.

A few years back at the IADMS conference, Dr. Peter Lewton-Brain, a doctor of osteopathy and former dancer, displayed two MRI images of his own back: one where he hinged into an arabesque and one where he engaged his trunk muscles to lengthen into an arabesque. The second image showed that it’s possible to avoid compressing the vertebrae during extension. The trick is to stretch all parts of the spine independently so that the back doesn’t simply hinge at its most naturally flexible points.

Stretching the neck
The neck is very flexible. If it weren’t for the limiting effect of muscles and ligaments, it could almost do a full rotation à la The Exorcist. Hypermobile people often crack their necks repetitively—not the best of habits, since the “crack” will occur where there is least resistance, not necessarily where it will best allow the neck to function. The lower neck can telescope out like a giraffe’s, which is what most people do when they’re working on a laptop.

For proper vertebral alignment, hold the lower neck back and balance the head over the body’s center of gravity. In looking down the head should simply tilt forward on the ear-to-ear axis rather than hang forward.

Here is an excellent exercise to keep the neck healthy.

  • Lie on your back on a bed with both armpits aligned along one side of it so that your head extends off the bed. Support your head with your hands, as if you were holding a cantaloupe.
  • Bend your knees, keeping the soles of the feet on the bed.
  • Keeping the elbows tucked down and in, engage your abdominal muscles as you arch the upper back, allowing the head to sink toward the floor.
  • Breathe three or four times.
  • Keep the elbows tight to the torso as you curl up and out of the position.

The chest area
The thoracic spine, the section housed by the rib cage, is well suited for rotation due to the length of the beaklike spinous processes. Unfortunately, hypermobile dancers often splay the ribs or are often trained to over-arch the thoracic spine in a neutral standing position, which over time can lead to flattening of the normal spinal curve and stiffness.

It may seem counterintuitive, but it can be helpful to roll on a foam roller from the nape of the neck to the waist while curving the upper body in a modified crunch position. This mobilizes the vertebrae to lessen the stiffness. (Be sure to support the head with your hands.) Or try this exercise, which keeps the back and ribs supple.

  • Lie on your back on the bed.
  • Using the fingertips, press the sternum (staying above the armpit line to avoid the pointy xiphoid process) toward the floor.
  • Exhale and feel the sternum drop, then stay there and gently press the sternum three or four more times, going a bit deeper.

The next exercise will help keep the back muscles strong and counter swayback.

  • Lie face down on a firm bed or padded bench with your breasts just over the edge.
  • Anchor your pelvis by tucking under and lifting your abdominal muscles as if you’re avoiding an ice cube at the navel.
  • Bring your arms to your sides. Let your upper body drape off the edge of the bed or bench. Exhale.
  • Press your pelvis against the bed and lengthen horizontally bit by bit, starting from the waist, until your head is straight out and you’re looking at the floor.
  • Hold this position while you inhale. As you exhale, slowly lower, starting with a chin tuck and rolling vertebra by vertebra through the upper neck, lower neck, and shoulders.
  • Repeat once or twice every couple of days.

Another exercise for a healthy back is to bend back over a large therapy ball or Pilates arc, engage the abs, and breathe for a minute.

The low back: a danger zone       
The lower (lumbar) part of the spine is most vulnerable where the moveable vertebrae transition to the fused vertebrae of the sacrum, around the middle of the back of the pelvis. In this part of the back, hypermobile people are at risk for herniated discs.

The shape of a woman’s pelvis and sacrum—more deeply curved than a man’s to accommodate a baby—and nature’s monthly allotment of a hormone that increases general flexibility (to aid in childbirth) also play a part in low-back problems. Dancers may get stress fractures here or the vertebra may slip forward into the bowl, causing severe sciatica (irritation of the sciatic nerve, which manifests as shooting pain through the buttock and down the leg).

Recognizing hypermobility
Core exercises are essential, but recognizing that you tend toward hypermobility (and thus are susceptible to injury) is even more important. Every once in a while ask someone to check your arabesque to see if you are shifting sideways. If you are, it’s a sign of hypermobility in one or more ligaments on one side of the spinal column, which can pull that vulnerable lumbar area out of its supportive proper alignment.

A good way to check for this shift is to position yourself on your hands and knees in front of a mirror. Slowly lengthen one leg behind you, trying not to shift even one iota. First keep the top of the foot on the floor, then elevate the leg. Ask your spotter if you’re lifting one side of the pelvis or if there’s any rib shift. It’s harder than you might think to hold square without shifting.

Maintaining a healthy back means attending to all the components of the spine. Flexibility doesn’t have to disappear completely as you age, but it takes diligence to avoid potential pain and problems.

I have faith in you.

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A Better You | Needy Knees

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Preventive care can keep “middlemen” joints at their best

By Suzanne Martin, PT, DPT

When a dancer has to stop dancing prematurely, it’s often the knees that are to blame. Sometimes those pesky joints lay dancers low in a dramatic mid-performance injury, and sometimes it’s just daily knee pain that leads a dancer or teacher to quietly end her career. Some teachers just struggle along, like my own beloved ballet master, who takes an anti-inflammatory and wears split-sole jazz “tennies” in order to continue to teach with bad knees.

When I taught a course called “Issues in Dance Medicine” at San Francisco State University, I gained some wonderful thoughts on knees, courtesy of my successor. Her students would line up in front of a mirror with their tights pulled up their legs and study the various knee types before them. Some knees looked like squinting eyes. Some were arrowhead-shaped. Others were rounder and undefined. Looking at knees is like visiting the zoo—we’re all different animals.

As a physical therapist, I treat many people for mid-life knee problems. (Most originate from pesky IT band tightness: see “A Better You: Babying Your IT Bands,” DSL, August 2010.) Yet knee problems hit at every age. Even if you are in your 20s or 30s, it’s never too late to promote good knee health by starting on a knee “sparing” program. Bottom line: we all want to keep doing what we love, and we need our knees to do that.

A complex system
It’s important to understand that knees are just the middlemen. They are completely vulnerable to what’s happening above (at the pelvis) and below (at the ankle and foot). The knee is a complex joint, created when four bones meet. Like a domino, the knee will react to situations that originate at the waist or the foot (such as a misalignment). The knee operates in a number of directions. It bends and straightens but also rotates, and that rotation plays a part in turnout.

Recently, I treated a 10-year-old girl brought in by a teacher concerned that the girl’s turnout was greater on the right side than the left. This wasn’t due to her hips—both hip sockets were equal in range. It appeared that the girl’s body had compensated over time for some weakness, perhaps in the lower back; from a very young age (perhaps six months to a year) she had favored sitting in positions that stressed an inward rotation of her hips. This girl was fortunate that her teacher was observant and cared enough to push her to take care of this problem early in her training, while it was still fixable.

It’s difficult to detect problems such as knock-knees in ballet students, who are constantly standing in turnout. Older dancers might have the benefit of a good trainer or company master who meticulously checks their alignment. But over time, our natural inclination toward misalignments can lead to wear and tear on the knees. I’ve had clients waiting for joint replacement surgery say they wished they had known enough to have corrected their mechanics years ago, thereby avoiding surgery.

Yet it’s never too late. Here are some exercises to get you started on good knee health.

Look for misalignment
Stand barelegged in front of a mirror, feet in parallel first position. Draw an imaginary vertical line through the center of the kneecap and down to the second toe next to the big toe. Do one or both knees knock toward the other? See how your kneecap makes a triangle shape—which way does the lower point of the triangle point? Do your knees bow outward?

Now draw a line from the second toe to the heel. Can you place your feet so that they are “drawing” two parallel lines on the floor? Do your heels try to pull toward each other? Are your ankles rolling in or out? This is all good information.

Knees are just the middlemen. They are completely vulnerable to what’s happening above (at the pelvis) and below (at the ankle and foot).

Now try the dynamic test. Step far forward into a lunge. Did the action make your knee hurt? Can you keep your knee aligned with the hip joint? Quickly return to parallel first. Could you return to the perfect parallel lines? Try the other leg. Don’t be surprised if one shows better alignment—that’s typical.

Now that you have some information, here are some exercises designed to strengthen those aging, overused knees. Remember—paying appropriate attention to preservation will help you keep dancing for years.

Exercises for knee health
These exercises help the kneecap to glide smoothly by increasing the amount of synovial fluid in the inner knee joint, which “oils” the joint as it hinges.

  • Lie on your back. Bend both knees and place the soles of the feet on the floor, about three inches apart in parallel first. Lift one thigh and gently hold the back of it. Softly straighten the knee and flex the ankle, then bend the knee and point the foot. Repeat six times.
  • Keeping the metatarsals on the floor, lift and bring the heels together. Open the knees into a gentle turnout. Lift and support the thigh from underneath. Repeat on both sides.
  • The next exercises use a stretchy band. This band series helps joint perception as well as training to handle “perturbation,” or when something knocks us off balance.
  • Loop the band around a leg of heavy furniture. Facing the anchor, stand in parallel first and place the free end of the band around one heel. Press the knees together and hold the tailbone down. Bend the knee in a hamstring curl and then straighten it. Do 6 to 10 repetitions.
  • With a straight knee, press the heel to the back several inches without tilting the pelvis. (Try this without holding on, which works both sides of the body as you try to balance.) Do 6 to 10 repetitions. Then, keeping the heel behind you, balance for 10 to 20 counts.
  • Move the band behind the knee and step back about one foot. Place the heel of your free foot on the floor in front of you. Demi-plié, straighten, and elevé slowly on the banded leg. Do 6 repetitions, then balance.
  • Place the band just below the knee. Turn 90 degrees and repeat the demi-plié/elevé sequence, keeping the free leg in front or an easy coupé. Turn 180 degrees to face the opposite direction. (This is the hardest direction.) Repeat the sequence.
  • Repeat all exercises with the other leg.

Knees have many needs
After strenuous teaching days it helps to ice the knees. I like to sandwich my knee between two gel packs, wrap it, cradle it on a little pillow or towel, and go to sleep. Cooling the packs in the refrigerator instead of the freezer will provide “sustained cooling,” rather than freezing the joint (which might be necessary with a recent, large traumatic injury such as an ACL tear).

Don’t forget that what benefits feet also benefits knees. Footwear today has better cushioning, and new foot products are available, such as items that absorb the stresses related to prolonged standing. Look at catalogs for companies such as FootSmart, Hapad Inc., and Dr. Scholl’s for creative ways to keep your feet (and knees) happy.

Depending on your individual knee condition, braces may or may not help. Your orthopedist can help you make that decision and also let you know if you have enough cartilage left to benefit from taking supplements such as glucosamine and chondroitin, which work toward cartilage health. Omega 3 oils stem inflammation, and enzymes may help to diminish scar tissue caused by chronic injury, surgery, or overuse. Eating foods such as salmon, mackerel, sardines, and berries helps aging joints. Extra hydration is necessary as we age, so it’s a good idea to drink at least six glasses of water a day. For external hydration, I recommend Epsom salt baths (about half a cup per four inches of water in a bathtub) several times each week to keep the connective tissues supple in the thighs and lower legs.

“Oiling” the knees through exercise (motion is lotion, as we physical therapists like to say), improving mechanics, and challenging their balance, along with good ergonomics and daily restoration, are the orchestra tickets to success.

I have faith in you.

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Sign Up for Pilates Continuing Education Seminars

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January 31 marks the end of the “early bird” registration period for summer 2011 Pilates Therapeutics Specialization Programs in Scoliosis Management and Breast Cancer Rehabilitation.

The courses, to be led by Suzanne Martin, PT, DPT, a doctor of physical therapy and Pilates expert, are designed for certified Pilates teachers. Each course has been awarded 26 continuing education credits (CECs) for PMA-certified Pilates teachers by the Pilates Method Alliance.

Martin is an ACE-certified fitness instructor and cancer specialist and is certified by the American College of Sports Medicine, the Pilates Method Alliance, and St. Francis Memorial Hospital Center for Sports Medicine. She has been presenting scoliosis and breast cancer workshops since 2001 for professional associations and education providers such as the Pilates Method Alliance, California Education Connection, and Balanced Body University, and has written articles on both subjects for Pilates Pro magazine and other publications. She is also the author of the “A Better You” column in Dance Studio Life magazine.

Both four-day courses will be held at Pilates Therapeutics, Martin’s private physical therapy practice, in Alameda, California. Scoliosis Management will run June 23 to 26, and Breast Cancer Rehabilitation will run July 21 to 24. Both include two months of mentoring and follow-up.

For more information, visit www.totalbodgoydevelopment.com or email Martin at ptherapeutics@pacbell.net.

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A Better You | When Little Worries Add Up

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Don’t let bumps in the road send you into the ditch

By Suzanne Martin, PT, DPT

Stressed? Who isn’t, these days? Think about how your day started on the way to the studio. Do these thoughts sound familiar?

“Why did that car cut in front of me?”

“Do I have everything I need for today? Darn, I forgot that CD I wanted to try.”

“A teacher called in sick and now I have to teach four classes in a row.”

Then, when you got to the school, maybe the lock wouldn’t open, or there were 20 phone messages waiting for you, or the desk person was late, or the floor needed cleaning. The list goes on and on. Pressures and responsibilities sure add up for studio owners. On top of daily annoyances, you might be worried about your career’s overall direction. With every step forward the stakes seem to get higher and the juggling acts grow more complicated.

With all of life’s stresses and aggravations, is it possible to find happiness? One of my favorite quotes is by Abraham Lincoln: “Most people are about as happy as they make up their minds to be.” While in some cases life can throw a curve that is truly disheartening, most of the time we do have control over how we react to daily annoyances. We can choose to rise above them—or let them bring us down.

As life’s snafus multiply, our fuses tend to shorten. We feel frustration, yet all the life events that demand our attention keep going. How we react to these events, and to the people involved, is largely determined by personality.

Let’s take a look at three personality traits generally associated with happy persons—cooperativeness, self-directedness, and self-transcendence. (For more information on the connection between personality styles and happiness and satisfaction in life, visit anthropedia.org.)

Cooperativeness
Would your staff and clients say you are easygoing and cooperative, or disagreeable and contentious? What about your best friend? We tend to behave differently and set different boundaries with close friends than with business associates.

Think about how you interact in cooperative situations, such as working with colleagues on a mutual community project, dealing with your staff during annual events like recitals or opening days, or having a one-to-one conversation with a parent or student.

  • Do you always have to be the leader?
  • Do you do the least amount of work of anyone in the group?
  • Do you overwork the event, not only fulfilling a leadership role but also micro-managing everyone else’s efforts?
  • Do you run roughshod over others in an attempt to get things done?

Delegation is a delicate matter. Your attitude toward others sets the tone and determines how much work you will have to do to gain the cooperation needed to implement your vision.

Self-directedness
Many studio owners are not only concerned with making a living today but also eager to create a long-term dance legacy. A goal like this demands self-directedness from the owner—in other words, having a strong-enough inner drive that will allow you to keep moving forward even when the circumstances of owning your own business seem overwhelming. This drive will help you retain focus from the exciting first years through the long, sometimes difficult decades needed to grow the business you envision. If you are focused—you follow through on challenges, you don’t procrastinate, you deal with small problems before they become big problems—your staff will likewise be encouraged do the same.

For example, if a studio owner has a vision of the choreography she prefers for the annual recital, she must be focused and clear about her intentions. If her self-direction is strong, the teachers will follow her lead. If not, they may go off on choreographic tangents.

Self-transcendence
Now look at the last trait—self-transcendence. This is not a yoga meditation form or the desire to shave your head, don a saffron robe, and spend your days chanting about peace and love. Don’t think Dalai Lama. Instead, think win–win.

Most negative comments sting. But as painful as it is, confronting these hurts—intended or not, minor slight or major offense—is a good mental-health practice.

 If you give to others with a happy heart, in a truly selfless manner, you will gain happiness in return. The beauty of gift giving is that the action brings happiness to both the giver and the receiver. Self-transcendence means to go beyond one’s self—in today’s slang, to “get over yourself.” Allowing others the opportunity to bring their talents to the table and shine creates good feelings all around—and it’s also a way to relieve our burdens and lighten our responsibilities.

Happiness and good health
How we respond and react to others, and how satisfied we feel with life, have a direct effect on our physical health. Studies show that people who cultivate a kinder, gentler, and more mindful approach to interactions suffer from fewer heart and stomach problems.

Following that same reasoning, we should cultivate a gentle and mindful approach toward ourselves. Ferret out those inner dissatisfactions. Let them bubble to the surface where they can pop and dissipate into thin air.

Learn to identify which offenses are truly worth worrying about. True, most negative comments sting. But as painful as it is, confronting these hurts—intended or not, minor slight or major offense—is a good mental-health practice.

Take the time to process hurts. Simple hurts such as oblivious comments may be easily brushed off by counting to 10. It may take more work to put the larger ones—usually inflicted on us by those who know us best—into perspective. It helps to have a support team in place.

Any entrepreneur needs an advisory team to help with business-oriented tasks such as writing a mission statement, setting annual goals, or creating a public relations plan. But that team can also offer support when customers take aim with those slings and arrows. Working through disappointments, setbacks, and obstacles with others can help you focus on the real problems and divert useless anger and frustration away from your clientele. And yes, it will also improve your own health and protect your sanity.

Let go
One big life lesson we all must learn is how to let go of grudges. Life isn’t fair, period. But processing the hurts at least can get you to the crossroad where you can choose whether to carry past slights throughout life or move on without that baggage. It’s a personal choice.

Again, think “win–win.” Moving past the pain not only lowers our blood pressure and gives us cleaner arteries, but it also can bring us to a level of self-transcendence. Forgiveness is the ultimate moral gift. The person who stole our clients may not deserve to be let off the hook. But chances are, if we expend our energy on ourselves and our work—plus win the moral prize by taking the high road—we’ll prosper like nobody’s business.

Those of us in the dance world chose to give to the world through our art. As teachers, directors, and choreographers, we dedicated ourselves to service to others. Certainly, dance teachers pass more than dance knowledge down to their students. Think of all the hours you spend with your students. Whether you realize it or not, students are taking note of the values you display and example you set. We should never underestimate the impact we have on others around us, especially the impressionable youth in our care.

I have faith in you.

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A Better You | Get Hip to Health

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How to keep your hips pliable and pain free

By Suzanne Martin, PT, DPT

Hips—we love ’em in the dance world. They make life worthwhile by letting us kick, swivel, turn, jump, everything—you name it. We probably spend half of our dance lives cultivating the perfect demi- and grand plié. Yet more and more, dancers from my generation of baby boomers and even some Generation Xers are crowding the corridors of surgery centers on their way to hip procedures.

My husband, a former ballet boy, has had both hips replaced, and so has my sister-in-law, who is Graham-trained, with up-to-the-ears extensions. (My own chronically stiff and painful left hip hasn’t reached that point, but it was one of the big reasons I stopped teaching a few years back.)

I attended the IADMS (International Association for Dance Medicine and Science) conference about 10 years ago, when there was still a stigma attached to hip replacements. But with so many baby boomers out there today, and with so many of them requiring arthritis surgery, hip replacements have become almost commonplace and are no longer discussed in whispers by medical professionals. Dancers have also become more comfortable considering hip replacements as the procedure’s level of quality has improved and news spreads of people continuing to dance after undergoing such surgery. (Think Broadway divas Liza Minnelli and Bebe Neuwirth, and ballet dancers William Starrett and Wayne Sleep.)

Still, statistics on the frequency of hip surgeries are hard to come by. To my knowledge, neither the Arthritis Foundation nor the American Academy of Orthopaedic Surgeons can provide usable numbers. A few years ago I tried to gain access to the AGMA (American Guild of Musical Artists) membership rolls to ask dance professionals whether they had undergone hip procedures, but union privacy laws prevailed.

Why so many hip injuries in dancers? A joint that is used repetitively in extreme ranges of motion will wear out more quickly because the cartilage undergoes unusual amounts and types of friction. Couple that with the fact that dancers who have superb mobility in a joint tend to “showcase” that mobility (or flexibility) again and again—it’s what makes them stand out from the crowd. Hypermobile people often can’t feel when their joint is correctly positioned, but they can be taught what is correct via mirrors and by learning how the correct position feels. That’s why good dance training is so important.

Still, several questions spring to mind. How do dancers damage their hips so severely that surgery becomes the only option? Is there anything we can do to reverse this trend?

Dancer diagnoses
Three categories of dancers are most at risk for hip damage. First are the fortunate young “noodles,” dancers with super-flexibility and natural extension. This group may have shallow hip sockets and/or overly elastic ligaments (when the connective tissue that holds the bones in place is like a stretched-out waistband), which cause incorrect and repeated rubbing within the hip socket. (The thigh should move in the cup-shaped hip socket with precision and not jostle around like a bouncing ping pong ball.) There actually is some benefit to being a bit tight when beginning dance training and acquiring flexibility through proper stretching.

My own informal study of the hips of elite female dancers found that although these dancers display fascinatingly high extensions, the range of their hip joints is not very different from the general population. So where is a dancer’s range coming from? As the dancer overextends in one area, other parts of the body compensate to make it happen, which can strain numerous joints. Let’s look at a person landing from a petit allegro jump. The acceleration of gravity means the person lands with four times her body weight, which puts great force on the overextended hip joint as well as all the other joints down the line. This force is repeated every time she lands, and after too many landings, the system can fail.

The frightening thing is that, according to my favorite orthopedic book, Orthopedic Physical Assessment by David J. Magee, the hip endures two and a half times a person’s body weight with every step. Just think of what this means for dancers, with all that increased force of jumps. Eventually, this pressure causes the lining of the hip socket, as well as the cartilage covering the ball, to erode.

This “noodle” category also includes dancers who have a connective tissue disorder, which can be measured through blood tests. This condition, although relatively rare, is a type of arthritis and may not reveal itself until a dancer is in her 20s. Typically it starts with pain or stiffness in the hands, but bunion pain can also be a symptom. I know of one dancer in her 30s who suffered from this condition. She eventually underwent a “metal-on-metal” procedure, in which both the femur head and the socket were lined with metal caps. She is thrilled to be out of pain and with all her range intact.

Use and abuse
People do tend to gravitate toward dance if they are flexible. If they are not, they find ways to make their movements bigger and more spectacular. This group—dancers who perform such big movements that they injure a hip—is the second category of dancers at risk.

One frequent diagnosis is the hip labral tear. The hip ligaments that tie the thighs to the pelvis are outrageously strong. Yet one common movement in dance, grand battement à la seconde, promotes the loosest position of the thigh bone in the hip socket. This means that the potential is great for the thigh bone to come out of the socket during this movement.

I recently treated a dance teacher friend who had partially dislocated her hip. She was demonstrating a contretemps in a grand allegro combination and landed a bit off-center of her support leg. I managed to guide the bone back into the socket. Miraculously, she had not torn the labrum, the cartilage that lines the socket. (The femur head attaches to the socket with a loose ligament. In newborns, this ligament—ligamentum teres—holds the thigh in close proximity to the pelvis. Eventually, it may dissolve, but if it doesn’t, it can pull on the socket cartilage and cause a tear.) Labral repairs are becoming more common, but it’s better to avoid the situation by building strong hip and psoas muscles through exercise. Dancers who feel a snapping or clicking in the hips can learn how to hold the femur in the socket with specific exercises.

Last, there is garden-variety osteoarthritis. One hypothesis for the cause of this condition is that one hip gets more wear due to a body imbalance. (Treatment for this—by adjusting and balancing a pelvis—is my manual therapy specialty; I probably adjust three to five of these every time I work with a ballet company.)

Repetitive choreography, like sauté arabesque on the same leg or leaping only to one side, can create this kind of imbalance. We call these problems “laterality,” meaning doing too much to one direction. One side of the pelvis can dip down onto the thigh, causing improper bone positioning in the hip socket, which leads the pelvic socket bones to rub abnormally on the femur. Over time, this abnormal pressure can wear out the joint.

Keeping up with hip health
What can you do to avoid hip issues like these? A lot. Be sure to cross-train and break up repetitive patterns. When working on flexibility, make sure your effort is equal from side to side. Remember exercises such as the frog stretch—lie on the abdomen with the legs in second position; push up on forearms and tuck the pelvis. This gives equal pliability to the pectineus muscles at the very top of your inner thighs.

One great end-of-the-day pelvic balancer is the “constructive rest position” recommended by mind–body wellness pioneer Mabel Todd. Lie on your back with both legs bent at a 90-degree angle, feet flat on the floor. Tie the thighs together with something inelastic, like a yoga strap, to release the muscles. Stay and breathe for 5 to 10 minutes.

Also, work on your strength with some simple exercises like these: Get a stretchy band and tie a loop onto the leg of a heavy sofa or table leg. Stand and face the loop and slip one foot into it.

* Holding your knees together, bend the knee of the looped leg (think hamstring curl). Then straighten the knee and push the heel behind you (think parallel tendu derrière).

* Turn so the looped leg is on the side, away from the furniture anchor. Press the foot to the side with the leg in parallel.

* Turn 180 degrees and press the looped leg (same leg, but now close to the anchor) across the body in front of the support leg, again in parallel.

* In each of these positions, do 10 repetitions and hold the last repetition in a stretch for 10 counts. Repeat all on the other leg.

Nutrition also plays a part in joint health. Ligaments need adequate protein every day to stay strong. Make sure you are getting enough protein to meet the U.S. recommended dietary allowance of 0.8 grams per kilogram of body weight for adults. (In terms of servings, that’s about the equivalent of three packs of playing cards.)

Strong ligaments and muscles also depend on strong bones. Eat enough calcium-rich foods such as dairy products, almonds, and leafy greens to meet the RDA daily recommendation of 1,000 mg per day for ages 19 to 50 (or 1,200 if over 50), or take a daily supplement. Joint health supplements like chondroitin and glucosamine can, over time, have a positive impact on your cartilage.

The quest
Remember: dance is like golf. Proper body mechanics and good technique never go out of style. Challenge yourself to continue your quest for the perfect form. Your hips depend on it. The good news is that information about joint health is more readily available than ever. And if a surgical intervention becomes necessary, there are plenty of options to get you moving again.

I have faith in you.

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A Better You | Body Check

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Tips to keep your body going for the long run

By Suzanne Martin, PT, DPT

For dancers, pain is a way of life. And as teachers, after years of accepting the physical discomfort caused by rigorous training, rehearsal, and performance, we may end up with a skewed perspective on how much discomfort is acceptable. It’s time to rethink what’s acceptable for your body from a health-and-wellness point of view.

Every occupation has its physical pitfalls—office workers sit too much, waitresses stand too many hours, nurses lean over bed rails or lift woozy patients. But while those workers might, say, recognize and care for an aching back, a dance teacher might work through it, then forget about it.

Here’s a way to tally up some of the wear-and-tear on your body: add up how many hours you spent training as well as working. When will you be able to retire? Add your working hours until that date as well. (For example, I estimate I’ll have to work 15 more years before retirement. At 40 hours per week for 50 weeks per year, that’s 30,000 more hours!) Your lifetime total gives you an idea of the physical toll dance has taken—and will take—on your body. Now think—what does retirement mean to a dancer or dance teacher? Taking a seat? Doubtful. We aren’t exactly a population that likes to be inactive.

How can you get through a demanding career and still have enough physical stamina and working body parts to enjoy retirement? It all comes down to one simple word—maintenance. Here are some tips on how to maximize your physicality for the long haul.

Make yourself top priority
First off, don’t put your body’s health on the back burner. From family needs to business woes, there are many good reasons why teachers don’t get started on self-care and maintenance. But good reasons and excuses are two different things. “I just don’t have the time” is a major excuse. You’ll have plenty of time if you are forced out of work by health issues, “elective” surgeries such as joint replacement, or exhaustion. But that’s not a good strategy.

Other reasons for procrastination range from fear of success to fear of failure. (Yes, both play a part.) Others around you may not want you to succeed by looking better or feeling better than they do. Complainers and naysayers want you to stay stuck in your unhealthy patterns of behavior so that they don’t feel guilty about their own bad habits. Refuse to be controlled by peer and popular pressure, and stand firm for your own health and well-being.

Don’t look at your health as an “all-or-nothing” enterprise. Since most dancers are always striving toward perfection, you might be hesitant to start a well-being program if you don’t believe you can do it all, and at 100 percent, yet. In body maintenance, keeping an open mind pays off. How do we tame any overwhelming “Godzilla” ideas into a doable plan? By becoming a “Godzilla-whisperer,” gently and consistently nudging the beast with a bit of nurturing and stability. With a little thinking and flexibility, you can come up with a manageable healthcare plan.

Your good-health team
Don’t wait for a crisis to strike before you find a healthcare team, which should include a general physician, a gynecologist, plus any needed medical specialists. Above and beyond checkups, you also need complementary care such as fitness workouts and some sort of body work such as manual therapy from a qualified therapist or masseuse, or my favorite, acupuncture.

Teachers may not realize how much these healthcare modalities can help keep them pain free and functioning at top physical form. But seeing is believing. For example, the ballet company I work with has agreed to a multidisciplinary approach to meeting the well-being and healthcare needs of its dancers, and it sees that its investment is justified when dancers experience fewer injuries.

It’s the same thing with dance teachers or professionals in any physical occupation. One annual spa treatment is better than zero. But a consistent conditioning program, along with intermittent visits to a masseuse, movement specialist, or acupuncturist, can reap benefits and save money in the long run. To find a practitioner who matches your values, lifestyle, and health and fitness goals, ask around for referrals.

These complementary components may seem self-indulgent and expensive, but they can be surprisingly accessible in most communities. There is a free dancer wellness clinic at a dance center in the San Francisco area. Low-cost care is often available from interns at massage schools, acupuncture schools, or chiropractic colleges. I even got my first pair of orthotics at a reduced price from the local podiatry school.

Make time for yourself
No time? Be honest—you make sure to schedule your hair care visits or map out your activity planner for the school year. Give as much attention to your health care. Look ahead and pencil in your workouts and complementary care appointments. If you think others might perceive you as self-indulgent (or judge that your tuition could be lower if you cut out the extras), take a tip from my high-profile clients, such as physicians and lawyers. They tell others that they have a “medical” appointment rather than a massage or facial. Protect yourself. Self-care takes moral fortitude.

Be realistic: look for ways to give your body a rest every three or four months. I schedule conferences and other trainings specifically for this reason. Spa vacations on their own may not be doable, but you can add a spa service or two at these enforced getaways. And don’t forget the fringe benefits—one reason I get my nails done is because the nail clinicians give killer forearm and calf massages. And don’t forget to take advantage of last-minute cancellations or schedule changes that can provide much-needed mini-breaks.

Target neglected areas
Don’t be fooled that the movement you do while teaching class is adequate exercise. Dancers suffer most from overuse of muscles due to repetitive movements. To combat this, design a home exercise maintenance plan for busy days and for when you travel. Include movements from stretching, yoga, and general fitness that target body parts that you don’t work while teaching, perhaps your upper body or core. Include activities such as light joint mobilizations, Thera-Band exercises, or rolling your foot on a tennis ball on a regular basis. Concentrate on high-wear-and-tear areas like knees by strengthening hips and ankles. Remember: it doesn’t have to be a thorough hour-long barre. A little goes a long way. No perfectionism!

Protect yourself
Paying attention to ergonomics should not be limited to your time sitting at a computer. Be sensible. Find good footwear and allow yourself to sit intermittently during long hours of teaching. Protect your ears as well. I worked with one pianist who played so loudly that my ears hurt after class. Wear earplugs when you need them. Hearing loss can come at any time and any age.

How do you know when to seek help? First, any pain should get attention. Try what doctors refer to as RICE—rest, ice, compression, and elevation—and see if the body part will respond. The rule of thumb is that if the pain doesn’t go away in 7 to 10 days, seek medical attention. Most minor dings will respond quickly to home care, but don’t teach for weeks in pain without getting an outside opinion.

Be smart. Protect yourself. Stand firm. Every investment in your health today will pay dividends tomorrow. Think of it this way—if you go to the gym or a medical appointment, your family and friends might miss you for an hour. But if you take that hour, chances are they will enjoy your company for years to come.

I have faith in you. 

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A Better You | A Touch of Caution

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How to handle hands-on corrections in class

By Suzanne Martin, PT, DPT

As dance teachers, you probably find that you need to touch your students in order to make certain corrections. Dance is a visceral, physical tradition, and hands-on cueing and correctives are essential. Yet in today’s dance world—at least in the United States—let the teacher beware.

Beneficial versus inappropriate touch is big news. In our litigious society, it behooves teachers to know when, where, and how to give physical cues and corrections that are both meaningful and non-offensive. Our concerns about inappropriate touch aren’t universal, though. For example, in traditional Balinese dance, the teacher stands behind and makes full body contact with the students, helping them learn the feel of the art form.

Understanding the nuances of acceptable touch will go a long way toward creating a desirable and necessary level of comfort in your classroom, for you and your students. You can’t teach—much less sleep at night—if you’re stressed out about whether putting a hand on someone’s thigh or abdomen will result in accusations of sexual harassment.

The wrong way vs the right way
Years ago, I was minding my own business near the end of the ballet barre, when the teacher, who was not familiar with me, slid his hand underneath my à la seconde leg and thrust it up to emphasize the ballistic nature of the grand battement. I wasn’t happy. I felt the rip and pull on my hamstring. Stunned and unsure of the damage, I left the class early.

My husband, an ex-dancer, remembers a ballet master grabbing his testicles in an attempt to “correct” his inner thigh placement. Having trouble believing such a thing, I inquired if maybe the master was trying to help with pelvic floor pull-up. My husband assured me that the touch was indeed not a correction.

I also heard of a gymnastics coach who would pinch the girls when they incorrectly performed a move. After a number of complaints, he was legally barred from working as a coach.

On the flip side, I remember how a ballet teacher held my waist as she positioned my à la seconde leg into the hip socket so I could feel the seating of the thigh in an above-the-shoulder extension. It felt good and right, and her adjustment let me discover the placement I needed to strive for.

Dos and don’ts of cueing with touch
Teachers today work under the greatest liability risk in all of dance history. As a licensed physical therapist, I am legally allowed to touch patients, yet I am also fully aware of my own liability. For teachers, who lack the protection of that licensure, it’s an even bigger concern. One misinterpretation by a student who starts an inquiry into your competency as a teacher will clear out your studio clientele quicker than a swarming beehive in the middle of a yoga class. Let me give you a few tips on the dos and don’ts of tactile cueing.

Be polite
While it’s true that dance teachers need to be firm and in control of a class, remember not to get cocky. Yes, students know much less than you do. Helping them understand movement concepts and their matching physicality can be grueling and tedious work. But be mindful. Authority can be conveyed with seriousness, not domination. Be sure to keep respect in the forefront of your mind, no matter how challenging or insulting some students might be.

Don’t do what one teacher did during a studio performance. With a scary forced smile on her face, she told a confused child to curtsey and then pressed hard on the child’s head to prompt the movement. Apparently the parents watching were so taken aback that they laughed. But I can assure you this incident generated much discussion on the local parents’ chat lines.

Since any contact by definition is a violation or an intrusion into a person’s personal space, asking permission is always advisable.

That impatient teacher should have cued the little girl with an easy voice modulation, saying, “Look down. Look up. Smile!” Anything would have been better than forcing the girl’s head down.

Ask permission
Everyone has a different style. In my PT practice I sometimes use a bit of humor, perhaps hovering over the person I’m about to touch like a mad pianist about to pound on a Steinway. I explain that I intend to use manual therapy, then ask permission: “Now I’m going to put my hands on you. Is that OK?” This gives the person some control. During my hands-on therapy I check in often, asking, “Am I killing you?” or “Are you OK?” Since any contact by definition is a violation or an intrusion into a person’s personal space, asking permission is always advisable.

For example, a teacher might say, “Let me adjust your foot,” make eye contact, then say “OK?” to acknowledge that she is entering the student’s personal territory. The whole class can attest that the request was made before the physical contact.

You are the boss. Keep in mind that body language is transparent and self-control an important job skill. You have to rise above typical frustrations and be a role model.

Less is more
The amount and force of touch are also critical. The teacher who adjusted my leg in the battement used far more force than was necessary to get the point across. In fact, his touch was aggressive. Male teachers should remember the strength differential between a grown male and a student, even if the student is an adolescent male. When teaching passé to arabesque, a sweep of a hand upward along the abdomen to the ribs can help students understand the movement of the trunk as the leg moves backward. This gives them a chance to muster up their own strength and follow the motor pathway as outlined by the teacher. When working on pulling up, using your thumb to draw a line from just below the navel area to the ribcage can be just the thing to help a drooping core. It also will help students avoid over-tucking the pelvis.

Let’s face it. It’s old school and outright dangerous to force someone into a split or push a dancer’s shoulders and head into a deep backbend. While it is true that flexibility needs to be developed, success often depends on the amount of time students are willing to dedicate to the endeavor. Slow and steady wins the race.

Palpation: broad vs pinch
In general, it is good to develop a broad-handed touch. I learned this during my PT internship in hippotherapy (a form of treatment using horses). Patients with severe neurological problems were seated on horseback with blankets instead of saddles. I was so worried they would fall off that I grabbed hard at my poor patients’ legs and bottoms. I was shown how to use a broad palm to avoid pinching and hurting.

Cradle a leg or arm with your palm instead of clutching with your fingertips. You can easily guide rotation and elevation this way—plus it’s better for your own back. It’s noninvasive, as opposed to the probing, groping nature of specific finger pressure.

Fingertips are sensitive and personal. See the difference for yourself in this exercise: drum your fingers against your other hand, then softly clap your hands, noticing how the drumming creates a more specific action. Along the same lines, you’d probably agree that waving your hand at someone is friendlier than pointing.

Instead of touch, use descriptive imagery
Tactile cueing is essential, but imagery can be indispensable and at times more effective. Words and images stay with us and give quality and texture to rote movement, helping dancers develop that “something extra” that makes them more than mere technicians. Artistry depends on complexity, and the sooner it is ingrained, the better. I like animal images. When I teach variations of grand jeté, I use the image of darting sharks for low and small leaps and a gazelle flying in midair for high jetés with ballon. A teacher gesturing like a symphony conductor can help with timing and movement quality, transitions, and sequencing.

Imagery works well when touch isn’t an option, such as when the concept you’re teaching involves anatomic structures deep within the body. Try using this image when teaching elongated spine mechanics. Have the students sit in a slump like a deflated accordion, then feel the progression up through the spine as the accordion fully inflates.

The details do make the difference in the art of dance teaching. Getting clear on how your touch conveys meaning is well worth the trial and effort. It will make you a better teacher—and give you one less thing to worry about.

I have faith in you.

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A Better You | Letting the Sun Shine

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Banish negativity with mental and physical strategies

By Suzanne Martin, PT, DPT

Waking up tired and sluggish? Do you feel apathetic, indifferent, and numb at the studio? Have long days turned into long years, your attitude become “Been there, done that” as you anticipate every irritation that can happen in a day? Are you counting the days until vacation even though the dance year just started?

Wait a minute—what’s happening? You got into this profession because of passion and love—where did all that good stuff go? If these feelings persist or interfere with work performance or relationships, you could be dealing with clinical depression, so make sure you see a doctor. But if what you’re suffering from is a case of boredom and the blahs—no fun, but not nearly as serious—then help is on the way. Here are some mental and physical strategies that you can use to remove the negativity and restore the sunshine to your days.

Risk leads to reward
I recently attended a celebration of LEAP, or Liberal Education for Arts Professionals, which I participated in during its formative years in the ’90s. This degree program at Saint Mary’s College of California, in Moraga, assists dancers as they transition from a performing career to the next stage of life. Listening to ballet, modern, and musical theater dancers describe how they moved on to new careers was nothing less than inspiring.

Owners of dance studios have taken similar leaps—opening a studio is no small risk, period, and nobody said it was going to be easy. Programs like LEAP give encouragement to dancers who are making major life or career changes by pointing out that so many of the things that helped them become dancers—creativity, a killer work ethic, determination—will also help them thrive as entrepreneurs or business owners. With that in mind, celebrate your own bravery and give yourself a break.

Make decisions with confidence
Making decisions while juggling finances and staff, plus the never-ending work of attracting and retaining students, can seem monumental. All decisions involve consequences, and anxiety about finding the “right” choice can lead to procrastination, second-guessing, or self-doubt—all of which sap enthusiasm. An advisory council is always helpful in providing due diligence or for brainstorming. (But remember that seeking too many people’s advice can muddy your decision making, not clarify it.) Once a decision is made, commit to it. Give yourself permission to enjoy the consequences, even if they lead to more decisions and perhaps an alteration of the original plan. It’s all part of the adventure.

Practice effective detachment
It’s important to offer a kind ear to people in your work life who are struggling with problems or complaints. But absorbing their negative emotions will only compromise your day and interfere with your ability to maintain enthusiasm and emotional consistency. Detachment is one way to give respect to others while limiting your involvement. A simple “I’m sorry you’re going through this” can often suffice.

But beware. Detachment is not indifference. Let the person know you are listening by repeating some of his phrases or thoughts.

Often, people who are wrapped up in their own problems cannot see things in perspective. Discussing the problem in a neutral location—for example, at a coffee shop—can lead to fresh, new ideas. Resist the urge to dive into the problem with them. Bite your tongue. Sit on your hands. Count to 20. Let the person work it out. Both of you will be happier, I promise.

Gossip-fests can be enticing, so if you’re tempted to jump into one with a parent or co-worker, find something good to say, deflect the conversation in another direction, or have courage and end it politely. Even passive participation, such as listening to a group’s gossip, is no good for your own peace of mind.

Delegate
If you’re not good at delegating, learn. Sure, you can do all the tasks required, but do you want to or need to? Give staff, volunteers, parents—and yes, even students—a chance to participate. Figure out what you can let go, and don’t feel guilty if you’re not working on something every minute. Use that free time to schedule some balance into your days. In the end you’ll come out ahead by not scaring away clientele with cranky, irritable behavior caused by overwork.

Clear your mind with exercise
Daily restoration involves healthy eating, seven or eight hours of sleep, drinking about six cups of pure water, and cross-training. Try to develop a structured regimen that makes use of non-dance-related movements (to avoid overuse of muscles), such as Pilates, yoga, stretching, and light weightlifting. All provide solid conditioning, and the variety of cross-training will energize you and keep you feeling great.

Detachment is one way to give respect to others while also limiting your involvement. A simple “I’m sorry you’re going through this” can often suffice.

A 2009 study conducted by the Mayo Clinic found that outdoor activities such as gardening, team sports, walking or jogging, biking, and golf can provide a sense of freedom from work burdens. It’s a fact that pleasurable activity can help you move toward a positive attitude adjustment.

Smiling works
When looking to lift your mood, don’t forget your friends. A 2009 study conducted by the Women’s College Research Institute in Toronto, Canada, found that women in particular get a mood boost from positive interpersonal influences.

One more reminder: smile! Putting on a happy face does have a positive effect, according to a Department of Psychology study at the University of Missouri. People who frequently smile report that they find higher satisfaction and meaning in life, and their happy attitude rubs off on friends, family, and co-workers.

Battle bitterness with rest
Feeling trapped in an unrelenting schedule can lead to cynicism—suddenly, your valued clientele seems like a pitchfork-wielding mob of angry villagers. You may think you are hiding your bitterness, but people will hear it in your speech and see it in your body language, and it’s guaranteed to drive away the people you love and want around you. (It’s surprising how transparent we are.) It’s important to get enough rest and restoration so you can return to reality and recognize those challenging clients as part of your thriving business, not an uncontrollable mob.

Stimulate your mind
To keep yourself fired up, ramp up your professional development. When I started my private practice as the sole practitioner, I found that taking workshops and classes helped me expand my own thinking. I could see how my expertise and talents differed from others’, and I became open to other points of view. At conferences, I learned about new technology and the changing nature of my field. Look for conferences and workshops that will help you round out your training and exposure. If you’re tired of workshops, offer to present a workshop or class at a conference yourself. It’s amazing what you can come up with when a deadline is looming.

Don’t underestimate the importance of getting away from it all, for a lengthy vacation or only for an hour. When our workload is very high—and we all know how long the days are in the performing arts—it’s more difficult to relax during non-work hours. Be sure to schedule some quick, fun getaways in advance, such as a facial, massage or spa visit, or private Pilates session. If a spare hour unexpectedly pops up, go window shopping, read a book or magazine, or relax with a Sudoku puzzle. There are endless creative ways to recharge your mind and reset your coping gears.

Conquering burnout
Think losing the love of dance can’t happen to you? Negativity creeps up slowly, like a fog. We’ve all heard stories of executives who left high-powered careers or made other extreme lifestyle changes because job pressures ate away at their happiness. Dance is a passion. Entrepreneurship requires hyperdrive productivity. Don’t let either one consume you. With a little perspective, balance, and foresight, you can leap ahead, stay in the field you love, increase the positive and reduce the negative, and maybe even earn a lifetime achievement award.

I have faith in you.

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A Better You | Babying Your IT Bands

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Roll and stretch your way to pain-free legs

By Suzanne Martin, PT, DPT

My good friend was on the phone, distraught. She complained that the side of her thigh was going numb and she was rightfully concerned; numbness in a leg is not a good sign. A doctor’s examination and X-rays revealed nothing wrong, like a blown disc. She asked to see me, and even before she came into my office, I had a good idea of what the problem was. It was the notorious tight IT (iliotibial) band syndrome.

Sure enough, when I pressed on the side of her thigh, she winced. It was time to get to work. This kind of bodywork is not fun. On my website I specify that my manual therapy is corrective work, not a spa experience. Having an IT band worked on is definitely not for the faint of heart.

What is the IT band?
The IT band runs from the ilium to the tibia, hence the term “iliotibial band.” When you place the palms of your hands on your hipbones, what you’re actually touching are the iliac crests of the pelvis. The tibia is the shinbone.

Anatomically the IT band starts as a tendon from two muscles: the gluteus maximus (GM) in the back and the tensor fascia lata (TFL), a small muscle on the most forward part of the side of the pelvis. You can find the TFL by bending at the hip and feeling the strappy muscle that tenses up on the side. Of course, we try to minimize this in dance technique; its dominance means that it is compensating for the psoas.

From the tendons of the TFL and GM, the band converges into a long, flat, beltlike structure on the side of the thigh. It converges even more at the side of the knee, causing kneecap misalignment when it’s too tight. Continuing past the line of the knee joint, it ends at Gerty’s tubercle (a bony prominence that sticks out like a bump) on the side of the uppermost part of the shin (the tibia). Thus the shin will outwardly rotate when the IT band is too tight, causing the knee to knock inward. A tight IT band results in a biomechanical cascade that makes you walk like a duck on one side and shortens the leg on that side.

The IT band is fascia, a connective tissue that gives structure to the body, and its consistency is like stiff cheesecloth. And it serves a function: when it tightens, it protects the knee from sideways movement. But when it gets too tight, it can make you miserable.

Professional dancers and athletes definitely have to grapple with this one, taking a proactive approach before tightness becomes a problem. Repetitive legwork tightens the band and using turnout increases its torque, compounding the problem. Dehydration (e.g., from excessive sweating) also tightens the tissues. Keeping hydrated and stretching regularly may allow dancers to sidestep pain and imbalance. However, aging athletes and teachers usually have to confront the IT band facts of life.

Tending your IT bands
Fascia needs to be softened more with age, and that means the IT band needs specific care and stretches to prevent or control the pains and imbalances that come with being right- or left-side dominant.

The best weapon against IT band tightness, imbalance, and discomfort is the foam roller. I recommend a six-inch-diameter roller that’s about three feet long. Different structures need different strategies in order to stretch them with precision. Since the IT band is predominantly fascia, it softens with compression.

Rolling
First lie on the roller at your hip creases and hold yourself up on your forearms so your abdomen is off the floor. Roll from your hip creases to your kneecaps.

Next, roll your sides. Place the roller on the side of the thigh and roll toward your knee; stop just before the knee. Remember that the thigh is circular on the side and that the IT band originates from both the front and the back of the pelvis. So for best effect, roll in three strips along the side of the thigh. Roll along the front of the side, then directly on the side, and then along the back portion of the side. Make four or five passes along each strip. Thoroughness will pay off.

Finally, if you don’t have any active knee problems, roll on the muscular portion of the shin area. This is a hard region to get to, so be patient. Bend your leg at the hip and knee and fold it under you with the muscled part of your shin (anterior tibialis) on the roller, holding yourself up on your hands. (It’s like a modified child’s pose in yoga.) Gently roll four or five times on that area.

Stretching
I recommend both standing and supine stretches.

  • Sawing stretch: Lie down and place the soles of your feet on the floor. Lift your right leg and hold onto your ankle. Keeping your pelvis anchored on the floor, press the right ankle toward the left shoulder. Make a small sawing motion several times, going across your body, breathing with each one.
  • Figure 4 stretch: Next, lift the left leg and cross the right ankle over the left thigh. Lace your fingers behind the left thigh and pull it forward while gently pushing the inside of the right knee away from your face. Breathe about 10 times as you gently rock side to side in this position. Repeat on the other side.
  • Standing doorway stretch: Stand with your right side toward the door frame. Cross your right foot in front of the left, keeping most of your weight on the left foot. Hold onto one side of the door frame with one arm slightly higher than your head and the other arm lower. Bend over to the right, tightening your hips and pressing the pelvis forward as you lean your hips toward the left. Breathe several times to feel the stretch. Reverse the stretch to the other side of the body.
  • Standing barre stretch: Stand in fourth position turned out (with your feet aligned as in fifth position, not in an open fourth) and place your weight primarily over the front foot. Cambré forward, keeping your weight on the front leg, and remain inverted as you breathe six times. Slowly roll upright. You can also do this stretch in a parallel first position (feet about 4 inches apart).

Side-of-the-body stretching will pay off royally. Even if you can’t commit to a half an hour at a time, five minutes per day could be the ticket to keeping you balanced, happy, and on the dance floor.

I have faith in you.

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A Better You | Oh, My Aching Back!

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Here’s how to tame the pain

By Suzanne Martin, PT, DPT

Got an aching back? You’re not alone. It’s estimated that 80 percent of people will experience low back pain at some point in their lives, and why wouldn’t dancers be included? They endure long hours standing in classes and even longer hours delegating, directing rehearsals, and doing grunt work during performance crunch times. Most teachers have reveled in their back flexibility, perfect pull-up, and posture, but how long can those nobly acquired attributes hold up? Here are some tips to help tame those aches and pains.

Relievers
One of my favorite dance books—it has gone in and out of publication since 1937—is Mabel Todd’s The Thinking Body. Todd invented something called “constructive rest” for dancers. Clinically, I find this is a great exercise for the back in general. Todd claimed that dancers overuse the hip flexors and jump around all day in asymmetrical positions, which can torque the pelvis and back.

Try this for an end-of-day reliever. Lie on the floor with your legs elevated at a 90-degree angle at both the hips and the knees. Then tie the knees together with a bathrobe belt or yoga/stretch strap. Just getting into this position for 10 minutes lets gravity release the muscles and straightens out the pelvis and spine.

Heat, or what we call “neutral warmth,” can be a yummy treat for the back at the end of the day. Just a bit of warmth, not too hot, is enough. For an at-home spa experience, try heating your jammies in the dryer before putting them on at night. For a special treat, try lying in constructive rest with a heated hand towel folded flat beneath your waist. If your back is seriously tweaked or inflamed, then treat it with the RICE (rest, ice, compression, elevation) formula instead.

Motion relievers include sacral circles and knee rocks. Lie on your back and lift your knees up over your hips. Hold onto your knees and make a circular motion, as if you were tracing the rim of a saucer with the back of your pelvis. If you have soreness on only one side of the back, try rocking the folded knees gently toward the side opposite the discomfort.

Doing daily duty
It’s important to nip back discomfort in the bud whenever possible. The rationale is that the back has deep structures that have a high threshold for discomfort because the spine is a big structure like a tree trunk that can endure lots of stress and strain. The downside is that when the pain threshold is achieved, it can take hours for the ache to subside. That’s why preventive steps are so important. You’ll have to summon up a little discipline to turn this exercise drill into an automatic routine, but you’ll become addicted before you know it. Try this series of three maneuvers when taking a bathroom break or getting up from your desk.

First, roll your shoulders up and back 10 times. (Don’t repeat in the other direction because most of us already round our shoulders into a slump really well.) Be sure to feel like you’re moving the collarbone up and off the rib cage, the primary purpose of the roll. Next, make a fist with each hand and press them into your low back while you also roll the fists upward, making a rolling, arching motion. Imagine you’re trying to knead bread dough upward toward your head. Do this about five times, starting from the lowest point at your pelvis and ending up around where you feel your ribs. This motion literally moves the soft disc material back into proper position. Then, reach one hand up straight toward the ceiling and the other down by the side of your thigh. Find your form. Lift the groin muscles toward the head and squeeze your ribs together in front, while also squeezing the shoulder blades together. Really pull the hands away from each other, one up, one down. Breathe three times and repeat to the other side.

One great daily barre exercise is the daily double (squat and arch). Face the barre, placing your toes to meet the wall. Lean back and straighten your arms. Then tuck your chin to your chest and round your back as you squat, bringing your hips toward your heels. Exhale and press your feet down (toe, ball, heel) and tuck your pelvis under to start rolling up the spine, and end with an arch while you’re leaning away from the barre. Tense your abdominals, then gently lift your head and tuck your chin into your chest to start reversing the arch. Look at the wall in front of you and repeat two more times.

If your back is regularly sore by the end of a long teaching day, consider wearing split-sole, padded jazz shoes.

Another great daily exercise is done while seated. Sit forward toward the edge of your chair, with feet about hip width apart, or a small second in parallel. Turn to the left and hold the back or seat of the chair with your left hand. Take your right hand, place it on the outer side of your left thigh, and pull with the left hand to intensify the back rotation. Go easy. Turn your nose to the left. Now, turn your eyes to the right (yes, the right) and breathe three times. Then, without moving your head, look toward the left and breathe three times. Untwist back to the forward facing position and repeat to the other side. This twist is actually more effective if you first rotate toward the easier direction of rotation and then do your harder side. One set of rotations will do.

Good vibrations
Another method for relieving pain is vibration. Physical therapists use a technique called TENS (Transcutaneous Electrical Neuromuscular Stimulation), in which electrodes are used to send pulsing stimulations into bodily tissue. TENS diverts the brain away from unpleasant sensations.

In lieu of TENS, you can do your own vibrations. One of my favorite exercises is meant to imitate a happy dog—the one whose leg moves when you rub his tummy. I do this one every morning. Lie on your back and press your back into the floor. Bend one knee and place the sole of the foot on the floor, and then lift the other leg with the foot sole flat toward the ceiling. Tightly vibrate the lifted leg by pushing the heel repeatedly toward the ceiling. (This takes practice.) Then do the other leg. Follow this exercise with the flops: Reach both feet and hands upward and loosely shake them in an easy motion for eight counts. Next, relax your limbs and let the hands and feet flop downward for two counts (this involves bending of the shoulders, elbows, and wrists, and optimally the hips, knees, and ankles as well) and then reach to the ceiling for two counts (flop, flop, and stretch; flop, flop, and stretch). Repeat this once more. Feels good!

Bracing power
Another useful technique is bracing. Any joint—and your back has many—loves bracing when it’s feeling tired and cranky. If your back is regularly sore by the end of a long teaching day, consider wearing split-sole, padded jazz shoes. You’ll be surprised how extra padding in the shoes can help an aching back. Also, check whether your legs are getting enough support. Wearing Supplex tights, or even double tights, or a Spandex unitard can brace you in from the waist down. Sometimes outerwear such as bike shorts can help under a skirt if the very low part of your back (where the pelvis starts) tends to get sore.

End-of-the-day attention also can pay off. Try wearing a generic back brace, available at most drug stores, during the ride home—or when you get there. Even elastic ankle braces, the generic kind that you slip on like a sock with the toes and heel exposed, can provide back relief. It’s surprising how bracing the ankles—bolstering the foundation—can give stability to the sacroiliac joints at the back of the pelvis. If your back is really cranky, consider the intermittent use of Kinesio tape in an X pattern on the low back.

Take control of your back. By applying relievers, giving daily attention, making use of simple techniques, and lessening back stress through bracing, you, too, can enjoy a long-lasting, functional back. And when the inevitable strain does happen, you can have confidence that you have tools to transition out of it.

I have faith in you.

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A Better You | What’s in a Word?

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ABetterYou2What you say, and how you say it, are as important as what you do

By Suzanne Martin, PT, DPT

Having a nice day? As teachers and studio owners, you’ve probably noticed that the quality of your day has a lot to do with the people you deal with. Dance education means lots of face-to-face interaction, and that means running the gauntlet of myriad personalities and their varying emotional states. When customer satisfaction is a necessary goal for survival—as it is for anyone involved in teaching dance—it’s important to work toward positive outcomes in both business and casual interactions.

It’s easy to forget that clients and employees often have their own agendas, which might be different from your own. All of us can learn from Mahatma Gandhi, the premier model of self-control in extremely difficult human relations. In one story I heard, when Gandhi was anticipating potential violence with soldiers as he held fast to his civil disobedience, he said he trusted that the soldiers would behave as what they were—soldiers. He didn’t expect them to act or behave any differently than as they were trained to do: to follow orders and provide military defense when instructed. True story or not, it’s a good example of the kind of thinking you should strive for.

If you don’t think like Gandhi—in other words, if you trust that people will behave in a way that they probably won’t—you’re setting yourself up for problems. Unrealistic expectations can lead to faulty communication. Remember the famous quote by cartoonist Walt Kelly, “We have met the enemy and he is us.” Make sure that you’re not contributing to communication problems by expecting others to behave or think as you do, or as you think they should.

Communication should be a two-way street, but it’s often one-way instead, with more twists and turns than San Francisco’s famed Lombard Street. To help you recognize verbal volleys, take control of your words, and dodge and dart your way to having a nice day, here are some tips inspired by Oakland-based communications consultant Sharon Strand Ellison’s Taking the War Out of Our Words: The Art of Powerful Non-Defensive Communication.

Power of words
Words contain power, packaged as questions and statements. To shed some light on how convoluted communications affect us, let’s start with the simple question. Or is it so simple?

Questions
Questions can be loaded with hidden meanings, containing either intentional or not-so-intentional adversarial statements. Consider two seemingly benign questions. First, one for students: “Do you want to be a professional dancer?” Spoken in different ways in different contexts, the meanings could range from “You need to work harder” (showing irritation or unmet expectations) to a non-loaded inquiry about future plans: “Are you considering dance as a career?” Add tone of voice, body language, and qualifiers like “always,” “ever,” and “never,” and the question’s meanings become even more layered and judgmental.

Now, one from a parent: “When will Susie perform [insert coveted role]?” The meaning could range from a simple request for a chronological date to a not-so-veiled expectation that Susie should be promoted, and soon.

The most volatile questions come with multiple choices that offer no appropriate answer or are self-incriminating. I know someone who was asked in a job interview whether he would prefer to kill someone with a knife or a gun. The poor guy was so taken aback that he completely blew the interview. (Oddly enough, the interview team didn’t understand what the problem was.) Before asking such a question, think about how you would feel if you were offered only compromised answers to choose from.

“Why” questions, a common form from children, often make us feel like we’re being interrogated. Students, employees, and inquiring parents might have innocent intentions but are not always tactful. Some zingers from children: “Why don’t you wear less makeup?” and “Why are you so fat?” Even in the face of such outrageousness, think before you answer. It’s easy to laugh off a child’s lack of social skills, but when dealing with adolescents and adults, use the three-second-wait rule. That brief delay helps you avoid knee-jerk replies that may come off as defensive, sarcastic, or judgmental.

Make sure that you’re not contributing to communication problems by expecting others to behave or think as you do, or as you think they should.

Adults might not understand that they are overstepping boundaries by asking questions that are none of their concern (why the school is run the way it is, for example) or that are distracting. Two questions I’ve gotten are “Why do you work so hard?” and “Why are your eyes so dark?” These questions are particularly annoying when I’m giving a client extra time and attention. A momentary lapse of decorum on my part could mean losing the client—and even worse, my response could zip along the gossip hotline and cause ill feelings with many people.

Ellison advocates replacing “why” questions with “what” questions whenever possible. Instead of “Why don’t you pick up your children on time?” try asking, “What’s stopping you from picking up Susie on time? She was upset the last few times you were late. How can we work together to resolve this?”

Statements
Now consider the other primary mode of common speech, the statement. Statements seem straightforward, and that’s the problem. Statements define authority, but they can mislead as well.

Definitions of authority
Start observing three things: how others use inclusive pronouns, state their opinions as facts, and speak in generalizations. Analyzing these practices will show you how to exert authority with conscious skill.

Inclusive pronouns such as “we,” “you,” and “they” can suggest superiority; they distance the recipient. Saying, “We plié with the ankles first, then open the hips,” comes across as fact, whether it’s accurate or not.

Start taking note of how many people speak in generalizations, which can instantly turn opinions into “truth” (like “Everybody’s doing it, Mom”). The same thing happens when you use absolute verbs (“is,” “are”) to pass judgment (“Ballet dancers are dumb” or “Men aren’t flexible”). “They say” is a prime example of unsubstantiated authority (who are “they”?), as are unqualified percentages (10 percent of people think/do whatever) and the popular “Studies show [insert desired ‘fact’].” A simple “What do you mean?” can counter such empty statements.

Negative statements can be tough to counter. Try responding with a “why” question when someone says, “It won’t work,” or “I can’t do it.” But use one that rephrases the question in a positive way. Responses like “Why do you say it won’t work?” or “Why do you say you can’t do it?” suggest that a positive outcome is possible.

Although this kind of response allows negative people to be heard, they might not want to give more information. Ellison advocates allowing them to refuse to respond. Think about your own experiences. Coercing information out of someone can feel like theft or a violation.

Statements as predictions
Statements can become predictions, which hypothesize about a potential outcome. Parents often use predictions with their children; for example, “If you don’t stop by the time I count to three, you won’t get dessert.” However, beware the fake warning. Nothing undermines your authority like making a prediction you won’t carry out. If those parents give their children dessert even though the undesirable behavior continues, they lose credibility as authority figures. Even small children know the score on that one.

According to Ellison, predictions can be protective, foretelling, or neutral. They are protective when you give cautionary instructions, such as telling students to sew their elastics on their shoes (because using safety pins or staples would be harmful). Foretelling can be judgmental, as in “If you wear that, you’ll be on the worst-dressed list.” The best choice is a neutral prediction.

Being neutral means predicting only how you will respond to the potential choices the other person could make. You will offer two alternatives and you must clarify each choice in order to avoid having people make assumptions. For instance, if you tell a hysterical parent, “If you continue shouting at me, I will have to walk away,” and you stop there, the parent could assume that the conversation is over and there can be no positive resolution. However, adding an alternative, such as “If you stop shouting, then I will do my best to listen and find a solution,” offers a chance of a win–win resolution.

Accountability
Acknowledging your own verbal accountability—for how your words come out and how they’re received—is important in maintaining a non-defensive posture, even if the person you’re in conflict with refuses to do so. Remember that excellence is born in doing the right thing. And doing the right thing doesn’t necessarily mean it will feel good in the short term.

It will take practice to remain neutral in your questions, statements, and predictions. Start to notice your interactions, and then take your cue from Gandhi and take a non-defensive stance.

I have faith in you.

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A Better You | “Ouch” to “Ahhh”

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ABetterYou2Swollen, aching legs and feet are an occupational hazard—but here’s how to cope

By Suzanne Martin, PT, DPT

It’s one thing all dance teachers have in common: standing for mega-hours. I remember talking to a friend who had stopped teaching dance; she said the best thing about it was that her feet didn’t hurt anymore. And when I sympathized with a dancer caught in ridiculous traffic, a similar thing happened: She said she was so grateful just to be sitting down. Sound familiar?

Why do dancers’ feet and legs hurt so much? It’s true that most dance injuries occur in the feet and legs, but on a day-to-day basis, apart from actual injury, the cause of the discomfort is simple: overuse. Teaching is hard work. To have longevity in the field, your feet have to be constantly restored, daily. Here are some tips to help you turn your standing hours into happy hours.

Footwear
Take a close look at your footwear. Can tape, toe spacers, or ball-of-the-foot gel pads help you? It’s amazing how many great new products are available now that were not around only 10 years ago. Some of them, like Scholl’s products, are available in drugstores; others can be found in dance-specialty (Discount Dance Supply, Bunheads Dance Accessories) and foot-specialty (FootSmart, Hapad, Inc.) catalogs and websites.

What you wear in your shoes can definitely help you survive long hours on the dance floor. Most dancers get pretty savvy about all the helpers and inserts that can make huge biomechanical differences in their feet and ankles—but as teachers, it’s easy to forget that yours need the same care. It’s well worth the effort to find out what works, both in the studio and on the street. For instance, I double-padded the carpet in my Pilates studio, and I wear elastic ankle braces when doing lengthy standing work. I also wear Kinesio bunion tape when taking ballet class now.

Foot care
Routine maintenance can strengthen the feet and ankles. Have you transitioned into a managerial role, or into teaching from performing? Most dancers have shaped their feet as a rite of passage, aiming for flexibility and the status symbol of a beautiful foot. But once they move into teaching, often they don’t realize that though the shape and the skill are still there, the strength might not be. My transition from teaching 12 classes per week to sitting in physical therapy school and ultimately working clinically was more drastic than I expected. It was a big shock to find out how much day-to-day teaching had strengthened my feet and ankles and how quickly that strength was lost.

Exercise tools
Several quick and dirty tools can make a serious difference in day-to-day foot comfort. Number one is the tennis ball. Just rolling the foot firmly over the ball in the morning or before you teach can activate the four layers of muscles in the sole of the foot and begin to stretch the strappy connective tissue, the plantar fascia.

Next, get a Thera-Band. I keep one attached to the foot of my bed and religiously perform three exercises on each foot. Another helpful tool is a wobble board. I use the Rock Ankle Exercise Board, available from optp.com. (See “Exercises” for how to use both tools.)

Restorative practices
Feet appreciate having the toes stretched apart. Something as simple as placing one of those toe gizmos for keeping the toes apart when applying nail polish can provide a great end-of-day stretch.

Leg swelling is an often overlooked problem. Typical complaints include a feeling of heaviness and/or aching. I notice in my clinical practice that women tend to suffer more from swelling, likely due to monthly hormonal fluctuations and the natural flexibility they have in the pelvic and leg region for childbirth. Add to that a dancer’s flexible body and you’ve got a favorable scenario for more-than-usual leg swelling.

Most dancers get pretty savvy about all the helpers and inserts that can make huge biomechanical differences in their feet and ankles—but as teachers, it’s easy to forget that yours need the same care.

From exercise physiology, we know that blood travels from the trunk to the limbs during strenuous exercise and can pool there if not redirected. Do your socks leave a line on the shin? Check the amount of swelling in your lower legs by pressing the pad of your index finger into the soft tissue about 3 inches above the anklebone. Press front, sides, and back. Is there an imprint? If the finger indentation persists more than 5 seconds, it may be worth a doctor’s visit to determine whether a circulation problem exists.

How to tackle the problem of swelling depends on its severity. Compressive stockings and knee-highs are available from hosiery companies like Hanes. Compressive stockings can be immensely helpful during long flights, which often bring on quite a bit of leg swelling. New mothers will find that wearing bike pants, girdles, or slimming undies from companies like Spanx will lessen postpartum swelling and pelvic pain. Check out ballet tights that have Supplex added, which can provide helpful compression during class.

An end-of-day restoration can be particularly useful. A simple practice is elevating the legs above the heart. Lie down, place the legs on two bed pillows so that the knees are supported, and shake them vigorously with a vibrating motion to start moving the fluid out of the legs. A more aggressive and extremely beneficial practice is to do contrast baths before elevating the legs.

You’ll need two tall containers (try plastic trashcans) because the water needs to go up to at least mid-calf in order to have the desired effect. Place ½ cup Epsom salts in one and fill to mid-calf level with warm (not hot) water. What’s most important is the contrast between the two temperatures, not the absolutes of hot and cold. Pour cold tap water with perhaps only 5 ice cubes in the other. (I know a dancer who lost sensation in her skin by over-chilling her legs in ice water.) Place your feet and lower legs in the warm container, then in the cool one, for 10 minutes each. Repeat the cycle once (ending with the cool container) for a total of a 40-minute soak. Then, for optimal results, rub the lower legs and feet with a liniment or homeopathic salve such as Traumeel or arnica cream before elevating them above heart level for 20 minutes. Try this after your longest day and your legs will love you forever.

Payoff
Yes, it takes effort, but good leg and foot care will never let you down. The benefits are less irritability, more endurance and patience, and actually enjoying your days and nights in the field you love.

I have faith in you.

Exercises

Thera-Band

1. Loop the band over the leg of a bed or heavy chair. Sit with your right leg perpendicular to the loop of the band. (This should be the leg that’s closest to the bed or chair.) Place the right foot into the loop, extending the band over the top half of the foot and toes (on the big toe side). Stretch against the band to make it taut. Remember the motto “Meet it, don’t beat it,” giving a nice amount of resistance without overdoing it.

2. Now make a windshield-wiper action with just the foot; hold your knee to prevent thigh motion.

3. Circle the foot 20 times in each direction, working against the resistance.

4. Stay seated in the same direction and perform the same three exercises with the band looped over the little toe side of the left foot. Then rearrange yourself by sitting with the left leg perpendicular to the loop and perform the same three exercises with the band centered on the left big toe and right little toe, respectively. It might seem like too much to do in one sitting, but once you get it down you can knock it out in 5 minutes.

Wobble board

1. Stand on the disc, centering your stance with your feet in parallel about 4 inches apart. Tip the disc forward and back about 10 times, making sure to move your whole body up and down rather than making the motion with the pelvis. (A mirror helps.)

2. Next, swivel the disc, touching the rim along the floor, making the motion by bending the knees—first one, then the other. Go about 10 times in each direction.

3. Stand on the center of the disc on one parallel foot with the other in parallel passé. Keeping the supporting knee straight, touch the rim of the disc to the floor front and back 10 times. Then circle the standing foot so that the disc makes small swivels again, 10 times each way. Repeat with the other leg.

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A Better You | Frenzy Free

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ABetterYou2
Feeling overwhelmed? Here’s how to say no to others and yes to yourself.

By Suzanne Martin, PT, DPT

Everyone would agree that the year’s end is a difficult time. It usually involves frantic list making, wrapping up the fall season’s dance programs, and facing increased family and social commitments. And then there’s coming to terms with what did and did not happen in the business plan for the year. If that isn’t a recipe for hyperventilating and an impending sense of doom, I don’t know what is.

“Just say no” is a familiar mantra against drug use, yet how many of us are addicted to the adrenaline surge of deadlines and the endorphin rush of people-pleasing? As a businessperson, my goal has been to always give lagniappe to my clients. I learned this French concept from business owners in my native New Orleans. Lagniappe means “a little extra something.” That means giving your clients more service, more friendliness—to dote on them in a sincere manner. It’s a sure-fire win in business. But where does it stop? Here are some ideas on how to tend to business and still enjoy a rewarding holiday time. We’ll boil it down into boundaries and self-sabotage issues.

Boundaries
Boundaries typically fall into two categories: personal and work related. Unfortunately, in the arts world, where what I call “dual relationships” are common, these two often become intertwined. Dual relationships happen when we become friends with or emotionally attached to our employees, colleagues, and clients. We want to provide meals, rides, and chore relief for sick co-workers, or help with carpools and babysitting for special students.

The key here is to differentiate lagniappe from charity and responsibility so that a shift of dependence in others doesn’t become a burden to you. Learn to recognize potential conflicts of interest before the relationship starts. Know the limits of what you can realistically deliver, and if possible, make a written policy to avoid disappointing those who need your help as well as yourself. Email lists are helpful in keeping everyone posted about health news or when organizing an assistance network for a sick or heartbroken person. I admire the preschool rules I hear about from my clients, which fine parents for every minute they’re late to pick up a child. Preschools know boundaries.

Feeling guilty about not coming through for someone is like putting on boots of lead—sure to slow you down. Of course, in extreme circumstances, such as a death in the family or catastrophic illness, letting others into the loop can lessen your load enough that you can do those labors of love. For those non-catastrophic times, decide what your boundaries will be.

For instance, in my practice, I allow limited email and phone consultations outside of office times when necessary. However, sometimes a client doesn’t understand that I cannot be responsible for wakeup calls and hour-by-hour physical meltdown consultations. So I have a protocol: I often use practice advisors—friends and colleagues in similar private practice settings, or former clients who were mentors in my life and can offer me objective viewpoints—to decide how to approach clients who have unrealistic expectations of personalized medical care.

I encourage small business owners to use business advisors. They can lessen the frustration of dealing with needy clients and give a third-party perspective about what is feasible in terms of service. (A nonprofit, national organization that specializes in small business advising is SCORE—Service Corps of Retired Executives.) Sometimes just talking to an advisor can create a dynamic change that will then allow you to move into the next phase of untangling a mess.

Self-sabotage
Often the most misunderstood boundaries are the ones we hold with ourselves. We may prefer to follow the path of least resistance, avoiding unpleasant confrontations; consequently we do not set limits on what we will tolerate and take on. This behavior often leads to resentment because we fail to identify the true source of our distress. The perpetrators are not the “others” who force us to take on more and more responsibilities, but ourselves, when we refuse to set limits.

Often the most misunderstood boundaries are the ones we hold with ourselves. We may prefer to follow the path of least resistance; consequently we do not set limits on what we will tolerate.

And sometimes we are enthusiastic and exuberant, wanting to be everything to all people, which often leads to “time-debt.” Time-debting behavior is seen in people who constantly run late or don’t show up after making many promises to too many people. What starts as a promise turns into a series of disappointments. This is a potential career-limiting move, since others will move away from an unreliable you.

Both of these scenarios point to lack of understanding of how long things take to get done as well as the inability to acknowledge our own limits.

Solutions
Take heart—putting the reins on runaway overbooking doesn’t have to squelch your productivity and joie de vivre. I surprised even myself when I added writing books, producing DVDs, and earning a doctorate to my already busy life. But I did have to learn tricks. Learning the limits of self-discipline requires trial and error. No one is perfect, so give yourself a break.

Look in the mirror and repeat after me: “I can change only myself, not others.” But to change a behavior, first you have to identify it. This is the idea behind mindfulness. Spend a week—OK, four days since you’re pressed for time—noticing all the times you add to your to-do list without really being invested in those activities. The idea isn’t to promote the “I/me/mine” movement, it’s to fully engage in and commit to what we’re agreeing to do.

Being overwhelmed scatters us. It keeps us from focusing on what we need to do to achieve the success we seek. Getting a grip on overbooking behavior can mean the difference in coping in the short term and achieving our goals over the long term.

Once we’ve decided what is meaningful to us, prioritized our interest areas, examined our motives, and resolved to forgo the unnecessary, the question becomes “What’s stopping me?” In his recent book, Excuses Begone! How to Change Lifelong, Self-Defeating Thinking Habits, Wayne Dyer offers ideas to help put less-than-useful behavior in perspective and plant the seed of change. He lists 18 excuses that keep us from doing all that we can for a fulfilling life.

One technique he recommends is to recite affirmations to yourself just before you go to sleep, allowing the brain to assimilate the desired effect during sleep. We are often overwhelmed by fears of not accomplishing everything we’d like to and frustrated when we can’t find time for the things that are important to us. Dyer recommends identifying your excuses and reversing them with a positive affirmation. Stir up as much feeling as you can muster for best effect.

Going a step farther is author Noah St. John, in Permission to Succeed. He believes that success is more naturally driven than failure because in nature success is crucial to ensure the continuation of the species. He says the brain responds better to questions than to statements (the usual format for affirmations) and that the brain is very good at negative self-talk (“Why am I so dumb?”). He advises “re-forming” the brain through positive self-talk in the form of “why” questions, which he calls “afformations.” He states that “Why?” is a motivating question to the brain, a command to seek an answer. His afformations concentrate on strengths, even if imagined, rather than deficits, using questions such as “Why am I so attractive?” or “Why am I presented with so many opportunities?”

Examining and working on your boundaries and practicing positive self-talk may take some practice, but why not start now? By January 1, 2010, you could be A Better You.

I have faith in you.

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A Better You | Super Powers of Sleep

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ABetterYou2

Want to improve your day? Make sure your nights are spent slumbering.

By Suzanne Martin, PT, DPT

Missing a little sleep? Well, think twice about doing that, if you can. As someone who travels frequently across both national and international time zones on business, I can attest to the mental and physical challenges of sleep disruption. And judging from the plethora of commercials for sleep medication on television and in magazines, sleep—or more important, insomnia—is a national concern.

Freud made sleep important in 1900 with The Interpretation of Dreams, which maintained that dreams reveal one’s motivations. When I took an abnormal psychology course, one of my favorite parts of it was recording my dreams. (The best one involved marrying Michael Jackson!) Oddly enough, sleep wasn’t considered essential for physiological health until the 1950s, when it was discovered that sleep was an active mental state, not a passive suspension-of-life one as theorized by the scientists of Freud’s time.

Types of sleep
Neuroscientists now know that the sleep–wake cycle is a part of normal physiology and progresses through life from the frequent sleep periods of an infant, to the twice-a-day pattern of a napping child, to the adult’s circadian cycle of one sleep period and one awake period.

Technically sleep includes several phases of deep non-REM (rapid eye movements) sleep and the lighter REM sleep. Non-REM sleep is characterized by a very heavy, still period during which the sleeper is hard to awaken. The lighter, almost hyperactive REM phases are what we see in dogs when they twitch and imitate running while snoozing.

Sleep deprivation
Although sleep has been well studied, its exact physiological mechanisms remain elusive. However, numerous studies cite the effects of deprivation, even though we still don’t know exactly how it works. Of particular interest to dancers is the effect of sleep deprivation on muscles, metabolism, and mental function.

Not only is a sleep-deprived person unlikely to have the energy needed to get through a week; in addition, sugar may be deposited in the fat stores too quickly, causing weight gain.

Deprivation tends to lead to problems with blood sugar regulation. There are several possible reasons for this. One is that without adequate sleep, your body fails to store carbohydrates in the muscles as sugar (called glycogen, which is the major form of energy that dancers use). Because muscle sugar tends to become depleted over consecutive days of exercise, further depletion caused by sleep deprivation poses a problem for dancers, who often dance six days a week. So not only is a sleep-deprived person unlikely to have the muscle energy needed to get through a week, in addition, sugar may be deposited in the fat stores too quickly, causing weight gain. Sleep deprivation can also lead to an oversupply of circulating blood sugar, which is a big problem for diabetics, who must pay critical attention to their blood sugar levels.

What’s the big deal?
It’s easy to recognize that staying up all night, or losing sleep due to working the swing shift, or moonlighting due to the recession could be hard on a person’s health. Yet many of us justify losing a bit of sleep every night, thinking those small losses couldn’t possibly add up to much. Winding down after night classes and late rehearsals is a particular problem for many in the dance and theater set.

A study involving driving looked at the scenario of losing one hour of sleep per night (in a typical eight-hour night) over many nights. Expected effects were seen on cognitive functions such as judgment, impulse control, attention, and visual acuity. The frightening thing was that the study’s subjects weren’t aware of these deficits.

It gets even worse: In other studies, in which even more sleep was deprived over a week, the subjects’ thinking ability became comparable to that of stroke patients. The most common point between a little lack of sleep and severe lack of sleep was that the subjects were unable to recognize the deficits. This is proof that if you want to be in charge and perform at your best, then you have to take charge of your sleep habits.

SleepTaking charge
Here are some tips to make the most of your sleeping hours:

  1. Watch your alcohol intake. Dancers often use a “painkiller” to wind down at night and to ease aching legs and back. While one glass of wine may help you nod off initially, it actually disrupts the sleep stages, causing you to linger in the non-deep stages and making you awaken before you’d like to. Instead, try an Epsom salts bath (about ¾ cup in a tub of warm water) and a warm, calming tea like chamomile to slow down the churning wheels of body and mental activity.
  2. Do some aerobics. Nothing is better than oxygen. Getting cardio by walking, running, or biking about three times per week can aid sleep as long as you exercise at least 3 to 4 hours before bedtime. (Exercising too close to bedtime can disrupt sleep.) Dancers may be resistant to other forms of exercise or feel so tired at the end of the workday that more activity seems impossible. Remember that even 10 minutes done at several separate times of the day can count. Walk to the store or take the stairs—anything to get in more oxygen. Dancers use “spurt” energy instead of the aerobic type of metabolism marathon runners use. So it’s important for dancers to get aerobic exercise; the oxygen is a natural sleep aid.
  3. Work on your stress level. For busy studio owners, this is easier said than done. Try forming a habit of journaling, meditating, praying, or any other form of internal concentration. It will take discipline to get started, but you’ll succeed in setting the behavior if you persist for 21 days. Even if you feel you can’t devote an actual sit-down time to stress defense, try self-talk. Take a tip from principal dancers, many of whom help themselves succeed through self-talk. Encourage yourself during the day as you find yourself feeling frustrated or starting to fade. Reassure yourself that you only have so much time until the end of class or whatever task you have to do. It works. That way, at the end of the day you don’t have to process all the little (or big) annoyances and frustrations that happen in a normal business day.
  4. Create a bedroom sanctuary, a designated space for sleeping. Remove stimulating things like TVs and computers. Stereos are fine if you avoid loud, stimulating music; soft music can help produce that sanctuary feeling. And “white noise” (a low, static sound, like that of a fan) can help calm you.
  5. Allow yourself a wind-down period of about 15 minutes before you want to go to sleep. Light reading is the trick; don’t try to absorb detailed technical material. And save the whodunnits and bodice-rippers for daytime. Getting so involved with a novel or movie that you can’t bear to put it down or turn it off could give you double eye bags in the morning.

A positive approach
Another interesting finding in sleep-deprivation studies is that people who were not satisfied with their sleep actually may have slept a full eight hours and not recognized it. So just getting yourself to stay in bed is a good discipline. A common mistake is to get up and read or do work when sleep is interrupted, which only reinforces the insomniac pattern.

A better approach is to soothe yourself, with self-talk and pleasant sensations, just as you would an infant. Remember, we have an evolutionary hindbrain, a low-level primitive brain, as part of our total makeup. Rub your hands on your bedding and notice the texture; tell yourself how pleasant the sensations are. Listen to your breathing. Tell yourself, “All is well,” because at that moment, chances are that you really are OK. You can train yourself to focus on pleasant rather than unpleasant stimuli, a skill often used by patients who suffer chronic pain.

You spent all that time training yourself in meticulous dance skills. Getting your sleep patterns under control may seem like a daunting task, but with a little knowledge and effort, you can sleep well. And a good night’s sleep can make daily life an enjoyable event.

I have faith in you.

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A Better You | Maximizing Your Potential

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Look beyond your talent to find wisdom

By Suzanne Martin, PT, DPT

Got talent? Of course you do! If you didn’t, you wouldn’t be in the position you are with a dance studio. Is it a blessing that allows you to soar above your peers, or a curse that blinds you to the need to follow through with vision and passion?

In defining talent in the dance world, we tend to think of the extremes. For example, when I taught dance in the San Francisco Bay Area, I had a 9-year-old student who, in her first class, not only demonstrated perfect second position pliés but could do a développé à la seconde on the first try, with turnout, above her shoulder height.

But what’s more interesting is what people do with their blessing or curse. Take the real case of a boy who could perform multiple pirouettes and cover a full stage with jetés en tournant by age 11. In spite of his promising talent, self-sabotaging behavior ended his rise to the ranks of a major professional company. Unable to understand the precarious nature of his gift, he acted out by mouthing off to his teachers and finally succumbed to emotional problems and drug addiction.

These extreme cases bring to mind the highs and lows of talent. Often, we learn what works and what does not only in hindsight, and over time. Yet one thing is certain: It takes more than talent to stay the course. It takes drive and initiative.

Taking tips from Talent Is Never Enough by John C. Maxwell, a minister who has written more than 50 books, can help us address not only how to stay in the game but how to thrive in it. The disparity between what talented people expect from life and what they actually get (its realities) provides the friction of a perfect stress storm. Let’s look at some of the basic truths Maxwell expresses and consider how they apply to dance teachers.

  • Talented people often get frustrated with the mundane aspects of life such as paying bills and dealing with people; after all, focusing on their talent is so much more engaging.
  • It’s not enough to have knowledge; it’s what you do with it that counts. That’s called “wisdom.” Wisdom involves prudent decision making.
  • The biggest stress buster is acting with what Maxwell calls “wise thoughtfulness”: attempting to listen, allowing others to be heard, and yet allowing them to take the consequences of their actions, such as letting a student who waited too long to sign up for a class miss out on a performance.
  • Successful talented people don’t act alone; they value interpersonal relationships. We don’t live in a vacuum and we need other people to help us carry out our visions, serve as receivers of our talents, and mirror our contributions (the fulfillment of our talent) to others. Taking the help and admiration of others for granted may work for a while, but following the one-way streets of self-centeredness can send us circling in an eternal vortex. Making the most of your talent means developing enough strength of character to last past being the flavor of the month.
  • It’s important to find balance between the all-consuming, outward focus of using one’s talent and the inward focus needed for restoration. A busy life may not necessarily provide a productive life and can actually quell the development of a person’s full potential.

So what does all this mean to you?

Overcoming the mundane
Another helpful book, Your Own Worst Enemy, by psychologist Kenneth Christian, founder of the Maximum Potential Project, offers insight into how to reach the point of commitment, of not turning back on yourself and your goals. Christian asserts that gifted people often expect that they will breeze through an exceptional, almost magical life due to the ease and accolades they have grown accustomed to. As artistic souls, they may bristle at the thought of being ordinary or leading a structured life.

One of the pitfalls here is that boredom and lack of interest can create a tendency to skip the details that ultimately might lead to memorable work. Christian identifies the underlying problem as a fear of failure. Gifted people who realize their potential put themselves in the position of taking risks; they learn from trial and error, correcting themselves as they go. The price for avoiding details and taking the path of least resistance, he says, is a life of shallow activities and limited interests.

Finding wisdom
How do teachers and school owners demonstrate wisdom? With prudent decision making and by delivering messages without tarnishing their talent with bad manners. Being mindful not only of what you say but how you say it can create a make-it-or-break-it moment. The talented often forget that they do have choices in how they demonstrate their talent, which touches all areas of their lives.

Teaching and running a studio both involve many moments of interpersonal interaction—from registration days to the start of each class to year-end performances—which, when handled with wisdom, hopefully turn into years of ongoing relationships.

How many times have you seen talented people show, through their behavior, that they just don’t get it? Here’s one example: A studio owner friend of mine described a Pilates studio in which the instructor was militant, admonishing people (like my experienced friend) not to “cheat” by modifying a move. When the instructor asked my colleague why she thought the class was losing students, my friend cheerily answered, “Maybe you could try being friendly!” Ouch.

Wisdom means understanding that although you need to convey a message, it’s best to do it when you can add value to the relationship. Talented people are used to acting quickly and instinctively. In potentially confrontational situations, train yourself to take a couple of breaths or a few moments (or longer) before taking action. Reflecting before interacting can lead to a positive resolution instead of escalating tensions. Ask yourself: Will I be happy tomorrow with how I handled this situation?

Wise thoughtfulness
The wrong timing exacerbates difficult confrontations. Some confrontations call for privacy, an appropriate location. Taking into account the fatigue level of the person to be confronted and yourself can be a deal maker. On the other hand, thoughtfulness goes both ways. One responsibility of the talented is to be a good representative of what that talent gives you. If you constantly complain about how tired and busy and stressed out you are, why would someone want what you have?

We need each other to succeed. Take the example of a ballet studio owner whose senior ballet master wasn’t included in the studio transfer when she sold her business. He had had one personal drama after another, losing focus in his classes. Despite the man’s talent, the new studio owner wanted nothing to do with him. The ballet master needed the new owner’s acceptance to remain at his job, and he failed to get it.

Character formation
Character formation is critical to gifted people because it occurs through experiences over time, whereas their talent has probably been there all along. Will they have enough character, avoiding shady business or dubious shortcuts, to carry out the passion of their talent when life gets difficult? This goes along with acquiring a taste for the mundane details of life.

Carrying a vision to fruition means taking risks but correcting choices along the way, as well as developing a lifestyle that ensures lasting success. The paradox for the talented is that focusing on only the giving aspect of their talent may leave little time for the restorative necessities of life. They may try to avoid burnout by using drugs or alcohol—but that’s a choice; it’s not inevitable. Even the best thoroughbred has to be groomed and fed and rested.

Balancing inward and outward focuses
The introspective activities of thinking, reflecting, and meditating take time. Wise choices often come to us in times of introspection, and those choices play a big part in making a happy, fulfilling life. The gifted may need their eyes opened with the help of professionals, such as mentors, a business advisory team, or a therapist. I find that answers and direction often come intuitively through meditation and journaling. During my Stanford Hospital internship, years before I began to write professionally, I followed my 40-minute commute with a cup of tea and 10 minutes of writing. Only then did I turn to my patient load for the day.

Deflecting stress with words
While the talented love an artistic challenge, too much stimulation and stress can turn smooth sailing into choppy seas. One trick to ease the burden is to pay attention to language that gives personal power and that reverses negative statements. For instance, try replacing “I would like to get it done today” with “I am doing it today.” Say it out loud and notice the change in the tension in your chest. It works for dealing with mundane tasks as well. Try saying, ‘There’s still time to . . .’ in place of ‘It’s too late to . . .’ and again notice that the altered intention gives a bit of ease. It may take practice, but deflecting stress by simply changing the words you use can be a powerful ally in getting through those long days.

Staying the course
Christian offers one final exercise for staying on track. Try adding it to your meditations or to that final five minutes in bed before you begin your day. For just a few minutes, focus. Imagine yourself gathering the materials and resources you need for that day, or for a particular project. Then see yourself in your mind’s eye as beginning the work and then going on to complete it. Create a self-fulfilling prophecy, and meet the potential of your talent.

I have faith in you.

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A Better You | Rediscovering Your Core

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Going beyond the abs for true inner strength

By Suzanne Martin, PT, DPT

“Core? What is that?” I received this query from a French editor when she was translating my Better Back book into French. Today we have so much biomechanical research to answer that question.

It’s true that most dance injuries occur in the ankle and foot; however, overuse injuries are the hallmark of dance training, which is repetitive by nature. The biomechanical chain from the core downward is of crucial importance in helping dancers continue to dance. The top of this chain is, of course, the core.

Most people think the core consists of the abdominal muscles. But that’s only part of the story. The core is not only cylindrical (the abs) but also has a top and bottom. Think of this inner unit as Computer Central.

Training dancers in the concept and mechanics of the inner unit as Computer Central is the next wave in comprehensive career preparation. Core control separates the beginners from the advanced in terms of coordination and technical finesse; without it, limbs literally flail in partnering.

Parts of the inner unit
The inner unit has four elements. Located in the front are the deep abdominals (the transverse abs), which run from side to side, creating an abdominal “corset.”

Underneath a flat soft-tissue layer are the multifidi, each of which connects several vertebrae. These thin muscles, of varying lengths, stabilize the spine. These muscles work underneath the long, strappy muscles (the erectors) that run vertically down the back. The erectors stabilize the back in large orientation motions of the spine, such as the arch of arabesque.

At the top of the inner unit is the respiratory diaphragm, a circular muscle that moves up and down like a piston.

At the bottom is the pelvic floor, also called the pelvic diaphragm. It moves in a small, parachute-like motion, rounding up into the body to support the internal organs above.

Why inner-unit control matters
These four aspects of the inner unit must coordinate to protect and stabilize the low back and act as an anchor, or ballast, for the motions of the upper body. For my clients with scoliosis and especially for flexible women, teaching them to internally “hold” the center of gravity by coordinating the inner unit essentially gives them an insurance policy against severe low back injuries.

Boys and men have other reasons to pay attention to the precision of inner-unit use. They tend to have greater strength in general, laying on more muscle mass after the adolescent growth spurt. But this absolute strength can mask any deficits in the postural muscles. Also, boys who start dance late or progress into partnering before they’ve gained enough torso strength risk back problems.

Another key reason for control is that the inner unit must be stabilized in order for the psoas to properly work for leg elevation, e.g., développés. You just can’t get around it—the inner unit provides low-back protection, an anchor for upper-body and arm use, and a stable base from which the legs lift. Plus, it guides the knees and feet into optimal contact with the ground. The core does everything except cook your dinner.

Just like Joseph Pilates said in Return to Life, anything worth doing takes time to develop, so be patient in your pursuit of the consciously working core.

I have faith in you.

Visualize and Exercise

Finding the components of the inner unit in dance motion is the subject of much interest in dance medicine and physical therapy circles. Here are some tips to help you find them most effectively.

Visualize: Your center of gravity
Place one hand on your navel, then go 3 inches down and imagine going 3 inches inward. Place your other hand on your low back opposite the front hand. Your center of gravity is in this area. Feel your hands sandwiching this area. Bring your head weight over this area. Notice how the back relaxes when the center of gravity and head are aligned.

Exercise 1: Finding the inner unit
Transverse abdominals
Kneel on all fours in a tabletop position. Make a flat back, extending your head and tailbone in opposite directions. Keeping your back flat, lift your abdominals up toward the spine. To access the deepest abdominal muscle layer, visualize your abdominals as ‘smiling’ from hipbone to hipbone. Try pulling the muscles in and pushing them out without your breath initiating the action. Then pull them in and hold them while thinking of the diaphragm moving up toward your head and then down toward the tailbone four times.

Multifidi
Sit tall on the edge of a chair with a firm surface. Place your hands on your low back at the waist. Shift your ribs forward and feel the big, strappy erectors pop out. Then feel for the trough between the erectors and the spiky dinosaur bumps of the spine.

Now sit tall with your head and ribs in a vertical line over your pelvis (so you’re no longer shifted forward). Without changing the orientation of the back (no flexing or arching), feel like you’re pushing back against the muscles in the trough to tighten them. These are the multifidi. 

Pelvic floor
Think of the pelvic floor as diamond shaped, with the four points being the pubic bone in front, the tailbone in back, and the two sitz bones (ischial tuberosities) at the bottom. The diamond can be divided into two triangles, front and back.

Practice pulling up the muscles of the pelvic floor. Don’t grip them; instead imagine that an elevator is lifting them into your pelvis. Go easy.

Now squat in a wide second position, bracing your hands against your thighs. Practice lifting the muscles of the pelvic floor even though you are widening the bones of the pelvis into the squat. Stay there and breathe four times, working on keeping the pelvic floor muscles engaged in this wide position.

Respiratory diaphragm
Since the diaphragm is circular, let’s find it in several places. Place your hands on the front of the ribs. Now sniff briskly. The movement you feel in front is the action of the diaphragm. Now place your hands on the sides of the ribs. Inhale and see the sides of the rib cage expand; as you exhale, gently squeeze the rib cage.

Next, get a Thera-Band® and place it horizontally around your back below armpit level, making it tight enough to feel the tension (but not too tight). Breathe in and feel the rib cage expand and press against the band to the back. To fully fill the lungs when you inhale, think of filling two cones, one on either side of the body, from the base of the cone up to the tip, which reaches above the level of the collarbone.

Exercise 2: Straw exercise
(Imagine being sucked up through a straw. This is also a good one to do in a car while waiting in traffic.)

Sit on a surface that’s high enough to let your feet dangle above the floor. (In a car, simply keep your feet on the floor.) Slump down like a deflated accordion. Inhale, and as you exhale, gently pull your sitz bones together. Then press down on the sitz bones and feel an imaginary hand lift the skin of the low back so that you roll slightly forward. Elevate through the pelvic floor. Keep lifting the spine through the waist and lift the rib cage off the waist. Continue stretching up through the middle and upper back, thinking of going up through the rib cage. Then stretch the neck up like a giraffe’s neck.

Stay tall and inhale. Exhale and get taller; inhale and stay tall. Repeat. Exhale and get taller, then relax.

Visualize: Pelvic placement using the inner unit
Stand with your feet a few inches apart, toes facing forward in parallel. First feel the external muscles. Using the abdominals, tuck your pelvis, shortening the distance between the breastbone and the pubic bone. Then try tucking the pelvis by tightening the glutes (pulling the back of the pelvis down toward the thighs). Then arch the back by tightening the erectors, the big, strappy muscles of the back.

Now find a neutral pelvis with the hipbones lifted and the tailbone pointing down toward the floor. Experiment by moving the pelvis into a tuck and then into an arch only by changing the tightening of the pelvic floor. First tighten the front and notice the slight tuck. Then tighten the back and feel the slight arch. Train yourself to find a neutral pelvis and support the low back through the use of the deep muscles of the pelvic floor.

Exercise 3: Coordinating the inner unit
Take a tabletop position on your hands and knees with the knees 3 to 4 inches apart in parallel. Find a flat back. Reach behind you with the sitz bones so that the pelvis is neutral, without a tuck.

Feel the abdominals lift against the spine and an imaginary hand holding the low back flat, creating a sandwiching effect. Feel the width between the sitz bones as you lift the pelvic floor up toward the head without disturbing the orientation of the pelvis or back. Tuck the toes under. Inhale and exhale, then lift the knees about 2 inches off the floor. Stay there and breathe for four breath cycles, then lower the knees. Repeat.

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A Better You | Know Your Upper Body

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Combine anatomy and imagery to make port de bras sing

By Suzanne Martin, PT, DPT

Nothing is more beautiful or exhilarating than a port de bras. I love the saying “The legs dance the music and the upper body sings the movement.” But getting to the point where your dancing sings is not always easy. Often the problems are obvious to teachers, but what a correction really means or where the work should be happening might not be so evident to students. This month we examine some tools to guide corrections related to the upper body, and in the next few columns we will sequentially dissect the lower body and that all-important turnout.

A port de bras reveals much about a dancer. Wooden arms are a giveaway for lack of dancing expertise, no matter what the style. In my opinion, achieving the detailed perfection we expect from advanced dancers is far harder in the arms than in the legs. Arms should développé just like the legs.

An entire region of the brain is devoted to the coordination of the eyes, head, and arms. In a class on motor control I learned that for every degree of range of motion, it’s likely that 19 muscles are in action. Some of those muscles function as stabilizers and some as movers of the action. But how do you coordinate all that?

It helps to think of the upper body as three parts: the head and neck, the ribcage and its spine, and the shoulder girdle. An amazing fact is that the shoulder girdle (the breastbone, shoulder blades, collarbones, and arms) free-float on the ribcage (see Observe in “Visualize, Observe, Exercise”). The girdle attaches to the rest of the skeleton only where the collarbones meet the breastbone (sternum) in the sternoclavicular joint. This joint, among the strongest in the body, holds so well that in falls, the collarbones tend to break before this joint will become dislocated.

Musculature Stabilizers
We can categorize the deep muscles of the upper body by observing the surface anatomy of the body.

First find the stabilizers, what I call the “upper core.” These muscles balance and control the head and neck and anchor the shoulder blades. They can be visualized in the ribcage: Look at the bottom of the sternum. See how the ribs create an inverted V? By squeezing this V together and deflating the ribs below the breasts, you can activate the upper core.

The diaphragm, oblique abdominal muscles, and intercostal (between the ribs) muscles create a foundation for head balance and arm use. The action of the diaphragm, the big, horizontal muscle that divides the upper and lower portions of the body, is easy to observe: Simply place a hand just below the breasts at the midline and sniff a few times.

Strengthening the upper core prevents sway back, a very common dancer posture.

Shoulder blades
Learning to anchor the shoulder blades into the ribcage provides the leverage needed for optimal control of the arms.

A common complaint among teachers is that when students raise their arms past horizontal, they lift their shoulders. The shoulder muscles that attach at the ribcage in the back of the armpit area (the teres major, teres minor, and serratus anterior) work to anchor and elevate the heavy arm. You can find them by lifting your arm a bit to the side and reaching under the arm to feel around at the tip of the shoulder blade. To enhance the feeling, lift and lower your shoulders. Learning to operate the arms from this area prevents the upper shoulders (the upper trapezius muscles) from dominating the movement. Plank exercises, especially when done on the forearms, promote strength in this area.

Chest
All dancers want to appear larger than life onstage, and a big part of presentation is being able to project. When dancers hear the commands “Open the chest” or “Bring your shoulders back,” they may either splay the ribs in front or pinch the shoulder blades together. Accomplished dancers know to use the middle and low trapezius muscles, which essentially “tack down” the shoulder blades against the ribcage, opening the chest and lifting the face toward the light. (A sunken chest tends to pull the face down, away from the light.) These muscles are difficult to see or feel unless they are well developed (see Exercise 3, “Visualize, Observe, Exercise”).

Triceps
Teachers often tell students not to let their elbows sag, which results in “chicken arms,” but they need to teach them to engage the triceps, the muscles on the back of the upper arm. A common triceps exercise in fitness training is the kickback. The upper arm is held parallel to the floor, and the elbow is bent and straightened while holding a weight in the hand.

The kickback is not enough for dancers, who need to engage the long head of the triceps that originates in the armpit; that’s what gives that floating-arms effect we like. Two Thera-Band exercises (see Exercises 1 and 2, “Visualize, Observe, Exercise”) promote the use of the triceps in dance. Doing these simple exercises before class can enhance sensation in the arms and boost coordination in combinations.

Alignment of the face and neck
If the upper-core foundation is intact, the head and neck will float on top of the shoulders. Teachers may give the command to not look down, which is good advice since the rest of the body will follow where the eyes go. Also, for optimal mechanics in turns and elevation in jumps, the weight of the head must be over the center of gravity in the pelvis.

Communication
What we say to students makes a big difference in how corrections are implemented; see “New Ways to Correct” for new approaches. Take these tips into the classroom and you and your students will be exhilarated and inspired by the improvements in their port de bras.

I have faith in you.

Visualize, Observe, Exercise

Visualize: Arms développé
Imagine starting from one imaginary back hip pocket and breathing out into the opposite armpit, like you’re filling a balloon with air. Imagine a golden ring passing around the upper arm, elbow, forearm, wrist, and then the palm. You’re sure to see a beautifully shaped and elevated arm.

Observe: Free-floating shoulder girdle

Shrug your shoulders up to your ears. See how the collarbones create an angle and feel how your shoulder blades slide up on the ribcage.

Exercise 1: Triceps
Hold a Thera-Band with both hands, roughly 10 inches apart, at your sternum, with the elbows pointing straight out to the sides. Straighten one elbow so that the hand goes out to the side and then return the hand to the chest, all while keeping the upper arm horizontal to the floor.

Exercise 2: Triceps
Hold the Thera-Band overhead (shoulders down!) with hands about 2 feet apart. Pull one end down and sideways toward the hip. You’ll feel the stretch in the elevated upper arm, pulling on the long head of the triceps.

Exercise 3: Trapezius
To strengthen the middle and low trapezius, lie on your abdomen and slowly move the arms from high fifth to second position and down to first. Concentrate on making a V with the point reaching down the middle of your low back as you move your arms from first to fifth while keeping the shoulder blades wide.

New Ways to Correct

1.  Old school: “Press the shoulders down.”  New school: “Lengthen the turtle’s neck out of the shell” and “Breathe out from the armpits.” Pressing the shoulders down may incite a painful grinding action of the shoulder girdle on the ribcage. What’s really needed is to hold the upper core and hold the arms from the armpits, not from the shoulders.

2. Old school: “Hold your ribs.” New school: Encourage students to engage the upper core this way: Place one hand below the breasts and the other on the sternum and gently pull the flesh in opposite directions. Then lift up by imagining that a pole that runs through the ears is moving toward the ceiling.

3. Old school: “Open the chest.” New school: “Widen the back” and “Breathe out into the arms.” Telling dancers to open the chest may lead them to pinch the shoulder blades together or splay the ribs in a sway back. Instead, students should use the back of the shoulders to anchor the arms.

4. Old school: “No chicken arms!” New school: Ask your students to fire up the triceps by lifting their elbows.  Tell them to imagine that the arms, in second position, create a ring around the back, with a sloping line extending from the shoulder through the elbow, wrist, hand, and fingers.

5. Old school: “Don’t grip your jaw.” New school: It takes practice not to grimace or tighten the jaw during difficult exercises. Challenge your students to part the lips as they dance; doing so softens the face and neck and unlocks the jaw. Take it to the next level by telling them to smile softly through the eyes. The image helps them relax and open the line of the head and neck.

6. Old school: “Don’t be so wooden!”  New school: Imagine that golden ring (see “Visualize”). In an adagio, tell the students to breathe out from the spine in opposite directions and reach the arms to second position starting from the armpits. Tell them to imagine that a drop of water is rolling in a smooth motion down the top of the arm to the third finger.

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A Better You | Coping in a Crisis

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It’s mind over circumstance when times get rough

By Suzanne Martin, PT, DPT

Does art imitate life? The lively arts in America historically shadow the ebbs and flows of the economic life of the country, and those who practice them know all too well the pain of the current economic downturn.

How do we maintain our business and artistic visions in an economy that is predicted to slowly return to normal over the long haul? What we’re thinking and how we’re coping with economic fluctuations affect our well-being. We all know that diamonds are created under pressure. But what happens when the pressure doesn’t let up? Here are a few tips to help you turn that rough diamond into a true faceted jewel.

The power of thought
What we do and what we think on a daily basis are crucial in times of transition and crisis. Dr. Caroline Leaf, author of Who Switched Off My Brain? urges us to develop our thinking power. Artistic people are naturally curious; choreography and dance instruction require tremendous qualities of analysis and limitless amounts of creativity. But fear, the ultimate paralyzer, causes procrastination and poor decision-making, two undesirable behaviors for the artistically inclined self-employed.

Dr. Leaf offers a simple formula to quell anxiety and that overwhelmed feeling: Make a choice to ask questions, search for answers, and discuss the information that is being hurled from all directions. She explains that by disciplining our brains to focus and turning over ideas, we will deepen our thinking. Knee-jerk reactions come from the subconscious; higher thought functions require more processing.

This doesn’t mean you should hyperventilate with friends over the latest economic media blast. According to Leaf, this format is a license to give in to what you’re doing, actually slow down to focus on the reality of the situation, and depending on the issue, maybe even enjoy being in the moment by breaking the panic cycle and increasing the ability to cope. In this way, choice dictates our behaviors.

Obstacles to a positive attitude
Making conscious choices allows us to regain some or complete control of our circumstances. John Maxwell, author of The Difference Maker, reminds us that the one thing inside us that cannot be taken away is our choice of attitude. He calls attitude the “difference maker” because it can make or break a situation. He warns of the five obstacles to creating a positive attitude: discouragement, change, problems, fear, and failure.

This list is a great analogy to the practice of physical therapy. Clients often come in with an injury, a change, or a problem, which quickly disintegrates into discouragement, fear, and failure. Maxwell’s maxim for grappling with this common scenario warrants our attention across many professions and roles, from physical therapy, dance injuries, and body care to our status of employment or partnership.

Dealing with discouragement
Discouragement is often the number-one obstacle for my clients who have trouble recovering from an injury. Maxwell’s recommendations ring true for the physical world as well as daily life. He suggests finding the right perspective to get a grip on the situation. Hanging out with the right people and looking at the whole picture can be lifesavers in pulling out from the grips of discouragement. I love his story of the famous Colonel Harland Sanders, whose restaurant business suffered due to a freeway change. Sanders was driven to change his entire world, to look larger, and eventually founded Kentucky Fried Chicken (now called KFC), an American icon.

How many dancers have come back from what seemed an insurmountable injury? You too must have some stories of success that got you where you are today, complete with unpredictable twists of fate.

The effect of our decisions
Maxwell describes how the decisions we make, especially in times of crisis, can impact our outlook. Doing the right thing may not always be easy, but having to back up, make excuses, apologize, or experience guilt and resentment for inappropriate behavior saps our energy and positive outlook.

He suggests that the timing of decisions influences whether we will do the right thing. Making decisions to avert discomfort when things aren’t going well feeds fear and failure, the other obstacles to a positive attitude. He suggests a hill-and-valley model of decision making. It takes a great deal of clarity to get to the hilltop before making a decision, and yet many people forgo the perseverance period, the uncomfortable valley before the decision.

How do you know you’re on the hilltop of decision time? You will have more clarity about the situation and a feeling of moving toward something instead of running from it. The rationale for waiting for the right timing is that if others are involved, you’ll leave them on better terms, without burning bridges. Also, using positive instead of negative data will ensure a desirable pattern of moving from hill to hill instead of from valley to valley.

Coping day to day
What to do on a day-to-day basis? San Francisco Bay Area psychotherapists have some concrete suggestions. At the top of the list are exercise, rest, and eating healthful foods. This is great advice because we all know that when crisis and drama begin to happen, shifting into high gear can mean jettisoning the excess baggage of day-to-day stresses (like forgoing doctors’ appointments and canceling gym memberships). This strategy might work for a day or so, but in the long term it’s a surefire setup for failure.

Next on the list is talking to people. Again, good advice, but remember Maxwell’s recommendation to seek out positive company. The joke is that if you run with the dogs, soon you start barking like them too.

The next suggestion may come as a surprise: volunteer. I remember a client, a human resources manager and a great positive role model, who once asked what to do with people who are overwhelmed. The answer is to give them another thing to do! Helping others is an amazing antidote to navel-gazing at our own problems. Again, another analogy in physical therapy is that a major way to interrupt a pain cycle in the body is to distract attention away from it. Reaching out to others breaks the cycle of discouragement by encouraging others, offering personal contact, and relieving the pain of our own problems, even if temporarily.

Making the best of things
Although none of us choose to experience crises, they can also mean opportunity. We may have to discipline ourselves to find the silver lining, but with tools, and technique, and training, just like in dance class, we can do darn near anything.

I have faith in you.

Tips on Coping

  • Focus your thoughts: Ask, answer, and discuss.
  • Work on your attitude.
  • Seek out positive contacts and get a broader perspective.
  • Time decisions to your best advantage, not to your comfort level.
  • Exercise, rest, and eat well.
  • Look around to see who needs your help.
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A Better You | The ABCs on Vitamin D

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ABetterYou2
By Suzanne Martin, PT, DPT

Got sunlight? Of course. Well, maybe—depending upon the season, how far you are from the equator, and how much sunblock is in your moisturizer. We all know that a little sunlight can make us feel better, and most of us know that it’s a source of Vitamin D. Yet how many dancers do you see with a George Hamilton tan that’s not painted on? In my studio experience I’ve seen many a pasty face; even in Miami Beach, Phoenix, or San Diego, beaucoups hours of teaching, rehearsing and performing can keep even the most devoted sun-child indoors. And what about the ozone-layer scare? Most dancers with experience (read: age) tend to wear sunscreen not just for melanoma prevention but also out of vanity. We all want to stay wrinkle free as long as possible.

Why does Vitamin D matter? For starters, it plays an important role in bone density, especially in women. The American College of Sports Medicine and the International Association for Dance Medicine and Science have made groundbreaking statements about the incidence of amenorrhea, osteoporosis, and stress fractures in female athletes and dancers. It is now well known that dancers, especially the young, need to eat enough calories to sustain the energy level necessary to excel in dance and avoid the risk of imminent stress fractures and down-the-line osteoporosis that often accompanies low blood levels of estrogen. Now we have one more important piece in the well-dancer/strong-bone puzzle—Vitamin D—thanks to recent research spearheaded by Dr. Michael Holick and others at Boston University School of Medicine.

What is a vitamin, anyway?
Technically, a vitamin is a catalyst for necessary chemical reactions that make our cells and tissues function well. “Vitamin D” is a nickname because now we know that it is actually a full-blown hormone, a chemical messenger with functions that go beyond the all-important role of bone manufacture.

Sources of Vitamin D
Most people now know something about the so-called “sunshine vitamin.” The traditional belief was that we get enough Vitamin D from sunlight. But after health officials discovered Vitamin D deficiency’s link to bone problems in sun-deprived slum dwellers in Warsaw and London in the late 1800s and early 1900s, D began its roughly 100-year history as a food additive into such products as milk and juice. Severe deficiency creates undeveloped bones in children (rickets) and fractures in adults (osteomalacia).

According to Holick, in about 1930 U.S. government regulations slackened the requirements regarding Vitamin D as an additive; the problem was solved. But was it? Frightening research from Dr. Holick tells us it likely is not. His recent studies on human blood levels at various latitudes, the true amount available in milk and juices, blood-level findings across skin color, and the amount of sunshine that actually passes through glass are reason enough to pay attention.

Holick’s argument for Vitamin D supplementation to avoid deficiency is profound. The farther you are from the equator, the less D you absorb. Plus, you need a large amount of leg, arm, and facial skin exposure, for about 15 minutes 4 times a week, to get the minimum. The amount found in juices and milk often varies from the stated packaging. Dark skin colors and the filtration effect of glass block the beta ray exposure necessary for Vitamin D production.

Dancers at risk
Both baby ballerinas and seasoned masters appear to be at risk for a double whammy of shaky bone health. Young dancers run the risk of low estrogen levels and body weight having a negative impact on bone production and density; add the factors of geographic location, skin color, and limited exposure to the outdoors to create a tricky skeletal situation. Older dancers share those geographic, skin, and cultural issues, and those who are post-menopausal have a recipe for fracture if they don’t take preventative measures. In younger dancers, think stress fractures; in older dancers, think hip replacement. Add the fortunately going-out-of-style cultural behavior of smoking and/or consuming sodas to either demographic, and you’ve got a surefire recipe for disaster.

What if you don’t care about bone health? Isn’t that an abstract idea? Don’t those problems happen to other people? Not really. All dancers can relate to muscles. Muscles equal technique; muscles dictate control. Muscles determine how you look onstage and whether you have the strength to execute an entire variation. Yet the real zinger is that muscles can only be as strong as the bones they pull on. Soft, hollow bones mean little muscle strength. In the flexible body type of the typical dancer (called hypermobility), muscle strength translates into less joint pain, fewer sprains, and generally less body pain. And to have strong muscles you need strong bones.

How much is enough?
Are all dancers doomed? The good news is that Holick’s research caused other researchers to jump on the Vitamin D bandwagon, and they have some concrete recommendations. The recommended daily allowance has been bumped up to 1,000IU from its previous levels of 400IU for children over age 4 and 600IU for postmenopausal women. Another recommendation is to have your blood level of D2-OH measured; a minimum value of 40 ensures the bone strength necessary for good muscle tone.

An adequate amount of Vitamin D, along with the recommended daily allowance of 1,200 to 1,500 milligrams of calcium for adolescent dancers and post-menopausal dancers, respectively, is crucial to bone deposition. There is now evidence of Vitamin D’s influence on other important physiological functions that have an impact on cancer risk and immune disorders. That means that everyone, especially those watching their caloric intake, needs a multivitamin supplement for basic nutrition.

An often-asked question is how to get it naturally in food sources. The obvious ones are D-fortified milk and juices. Unfortunately Vitamin D occurs best in cod liver oil, not a favorite food for most of us. That’s why supplementation makes sense. Look for the D3 form in supplements and heed the 1,000IU level for a daily dose.

The farther you are from the equator, the less Vitamin D you absorb. Plus, you need a large amount of leg, arm, and facial skin exposure, for about 15 minutes 4 times a week, to get the minimum.

Still not convinced?
Dr. David Feldman of Stanford University School of Medicine’s endocrinology division tells us that Vitamin D is now recognized to have expanded activity beyond its traditional role in prevention of osteoporosis, rickets, and osteomalacia. Recent evidence points to its role in the prevention of autoimmune diseases such as fibromyalgia (considered a muscle endurance problem in physical therapy), and the development of certain cancers.

Feldman correlates distance from the equator with the incidence of breast, colon, and prostate cancers. This is good information for boomers, and especially to those of us in Northern California. Adding some D to the diet could decrease the usual cancer risk associated with our lack of sunlight and advancing age. Vitamin D promotes natural cell death, a problem with self-perpetuating cancer cells, and blocks the blood supply development needed by growing cancer cells.

What’s the bottom line?
Wear your sunblock when enjoying outdoor activities, but do try to get 10 to 15 minutes of sun exposure several times per week. Get your blood level checked so that you know your baseline. Take the recommended daily supplement to ensure a good blood level. Be sure to take calcium; D doesn’t work alone. All dancers should take 1,200 to 1,500 milligrams of calcium per day, coupling it with magnesium for maximum absorption.

The take-home message is that we all want to keep dancing, and we have enough information to know how. A strong infrastructure, our skeleton, is our insurance to keep dancing into the sunset.

I have faith in you.

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A Better You | On-the-Go Nutrition

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Food tips for a hectic lifestyle

By Suzanne Martin, PT, DPT

Staying healthy while being in a studio all day and eating on the run is one enormous challenge. And wouldn’t it be great to go beyond maintenance by achieving optimal health?

People who live the performing-arts life prolong their youth by being so active in their 20s and 30s. Yet what an effect it has on the body. Dancers who start at age 8 or 10 and pursue a teaching or performance career have packed in a lot of mileage by age 30. And just think about 40- and 50-somethings! So if you’re going to go into the sunset in your dancing shoes, how can you stay the course?

Any worthwhile project requires R&D, research and development. Knowledge is powerful. But a little knowledge plus the plethora of trendy eating diets, articles, and supplements can be dizzying. Thinking simply, life boils down to three physical requirements: water, food, and rest. How do you regulate, and enhance, all three while multitasking?

When it comes to being on the go, strategy pays off. One of the biggest pitfalls for even the most dedicated health nut is being caught off guard. Plan, plan, and plan some more, so that you not only have nutrients and water within your grasp but also time for rest. Let’s look at water and food. Being nourished and hydrated are two great ways to boost your energy level and keep up with a busy lifestyle.

All-essential water
Drinking plenty of water is one of best ways to stay afloat. Your body is 75 percent water; losing as little as 2 percent of that can cause foggy thinking. Physical performance starts to decline. Slowness can be dangerous when you need to be mentally alert: driving, crossing the street, bicycling. Slurring words impairs your ability to command authority and confidence. Slowed reactions make preparing a class, organizing, and doing analytical tasks take longer than necessary.

To make sure you get enough water in your busy day, drink one tall glass in the morning and one before bed. Have another glass if you get up during the night. In general the advice is to drink eight glasses per day, although the new thinking is that consuming water-rich foods such as fruits and vegetables contributes to this amount.

Try keeping a pitcher of water available with sliced lemons or strawberries in it for an extra lure. When traveling, fill your own big bottle or buy one after you pass security at the airport. We often mistake thirst for hunger, so next time you feel a hunger pang, reach for a water bottle before heading to the fridge.

Dancers lose a significant amount of water when performing under the lights, and they feel it in their legs. But it doesn’t happen only onstage—that heavy-leg feeling you sometimes get from teaching and rehearsing means you’re getting dehydrated. Another way to stay hydrated is to take Epsom salts baths. Mix about a half-cup of salts in a warm bath to hydrate and soothe muscles. They’re especially helpful after a flight.

We often mistake thirst for hunger, so next time you feel a hunger pang, reach for a water bottle before heading to the fridge. 

Hydrate and energize
Another quick energy/hydration tip for morning jumpstarts, afternoon lows, and jet lag is Emergen-C®. A combination of vitamins and minerals available in health food, drug, and grocery stores, each packet has 1,000 milligrams of Vitamin C. The Joint Health formula includes glucosamine, recommended for dancers because it may protect joint cartilage.

Emergen-C’s carbonated formula fizzes up in water, which gives it a quicker entry into the gut. (That’s why champagne gets you high so much more quickly than wine.) The minerals potassium and magnesium replenish electrolytes, which are essential to recovery after exercise. If you can refrigerate it, try adding it to a homemade carrot juice smoothie. The carrot juice stabilizes blood sugar and the fruit gives a quick jolt of energy.

Meals
What about solid food on the go? Again, it breaks down to three categories: home packaging, pre-packaging, and restaurant food. With food, there’s truth to the adage that if you want anything done right, you have to do it yourself.

Strategy pays off when you crave a meal. As I mentioned in the January issue, preparing food—chicken, salmon, or tofu for protein, plus veggies and a dressing—in containers for the upcoming week will ensure lean, healthful meals. Taking a salad with you is easy. Combine the salad and eat it with green tea, which contains antioxidants and is a safe metabolic accelerator (weight-loss agent). It also has caffeine for a boost of energy. If you can’t mix the ingredients on site, fix a single-serving salad in the morning and take it with you. Try cottage cheese, fruit (strawberries, papaya, avocado), walnuts, and low-fat crackers for a quick, easy-to-digest lunch.

Energy bars
What about the darling of pre-packaged food, the energy bar? There are a staggering 900-plus bars on the market, ranging widely in nutrient content, ingredient quality, and calories. Select a bar that has protein, carbohydrate, and fat in a ratio of, respectively, about 40/40/20. It should be high in fiber and low in saturated fat, with no trans-fat. A bar with 200 to 300 calories can substitute for a meal, especially when combined with a glass of dairy or soy milk and a piece of fruit.

But should bars make up most of your meals? Registered dietician Nancy Clark, in private practice at the Boston area’s Healthworks Fitness Center, has plenty to say about energy bars: Look for quality bars made from whole foods such as fruits, nuts, and fiber. Analyze the name—some bars may be dessert substitutes rather than healthful, compact nutrition. Remember, by law the first ingredient listed is the most plentiful.

Choose a bar that is as unprocessed as a processed food can be. My favorite does have a dessert name: “Cherry Pie” from Larabar. However, this brand is all fruit and nuts, with no added sugars, fillers, supplements, or flavorings. They are gluten- and dairy-free and kosher to boot. Even the most discerning vegan (but not those with peanut allergies) can partake of these raw bars. Clif® is another high-quality brand that is organic and trans-fat free, although it’s higher in fat content than others.

Another pre-packaged fast food I cannot live without is oat cakes (often confused with hockey pucks). I carry them on trips for an inexpensive breakfast or quick meal when stranded at airports. Listed as having 2 points in the WeightWatchers® system, they might be sweet for some tastes.

Variety: key to good nutrition
Clark cautions that eating bars on the run is one thing and good, wholesome nutrition is another. She advocates consuming 20 to 30 different foods per week. Variety ensures that we get the nutrients, vitamins, and minerals necessary for optimal functioning. And don’t forget those five portions of fresh fruit or vegetables each day.

Eating a variety of foods also ensures that we don’t develop allergies over time to cultural favorites like wheat. Counting on energy bars to regulate your caloric intake will get you into a nutritional rut, and eating them in lieu of desserts or whole foods will take away the skill of portion control when navigating social events and emotional highs and lows.

The restaurant trap
One surefire way to double your weight is to eat every meal in a restaurant; think the freshman 20, or as my relatives in New Orleans say, the Katrina 40. When you’re traveling, or even just busy, it makes sense to eat out—but restaurant fare can pack in all kinds of hidden calories, saturated fats, and other enemies of healthy eaters. Restaurants have improved their listing of heart-healthy meals, but they may add calories, salt, and sugar to enhance flavor. Another difficult ingredient is MSG, which provides flavor but can cause headaches and water retention.

The best strategy when dining out is to not eat all the bread on the table. Instead, order a bowl of soup—the warm liquid feels good in the stomach and the volume helps you feel full. Avoid cream soups unless you’ve really got to have that chowder on a wintry day. For entrees, choose grilled meat or fish and vegetables over combination foods such as lasagna, cream dishes such as fettucine alfredo, or even pizza.

What to eat when
The order in which you eat makes a difference in literally trimming the fat. Eat meat and veggies before baked potatoes, rice, and french fries. The starches are the fillers of nutrition, depending upon your caloric needs. If you are a farmer, or an endurance athlete like Lance Armstrong, you should eat pancakes, bread, eggs, bacon, and grits for breakfast—easily a 1,000-calorie meal.

Yet for most people, filling up on starches prevents you from eating the foods with the most nutritional value, such as fresh vegetables for vitamins and roughage, protein for building muscle and bone, and minerals. Another mind-blowing fact, according to performance researcher Dr. Clyde Wilson, is that the liver can metabolize only small amounts of food at a given time. The rest gets stored away for future use—read: fat.

Vitamin D
Next month’s column will focus on the crucial role of Vitamin D for a strong musculoskeletal system and in helping our bodies cope with cancer risk and autoimmune disorders. So stay tuned for more on Vitamin ‘D’ancing!

I have faith in you.

Quick Tips for Healthy Eating
  • Keep hydrated. Drink a glass of water first thing in the morning and again before bed. Aim for eight glasses a day. Make water more enticing by adding sliced lemons or strawberries. Try Emergen-C for an energy and nutrition boost.
  • Use energy bars sparingly, and choose those with a 40/40/20 ratio of protein, carbohydrate, and fat. Opt for the least-processed bars on the market, such as Larabar and Clif bars. Oat cakes are another good option.
  • Prepare healthy meals ahead of time to grab and go: Proteins (salmon, chicken, tofu, cottage cheese), nuts, veggies, and fruits make good salads and snacks.
  • In restaurants, choose lean meats, soups, and veggies. Eat the protein and vegetables first to avoid filling up on carbohydrates like bread and potatoes.
  • Take a good-quality multivitamin that includes 1,000 milligrams of Vitamin D.
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A Better You | Living With Stress

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Strategizing to make stress a manageable part of your life

By Suzanne Martin, PT, DPT

Stress is a fact of life. We can’t live with it when it gets overwhelming, and we can’t live without it because it motivates us to stage the next big project. I tell my clients to go for the “athlete recipe”: alternate stress with relief, stress with relief. 

Finding ways to modulate stress is crucial. Too much unrestored stress (stress that’s not countered with relief) leads to chronic headaches, high blood pressure, diabetes, ulcers, even loss of fertility. Many physicians believe that most major illnesses derive from unaddressed chronic stress. Note the words “unrestored” and “unaddressed.” The idea is not to get rid of stress but to learn strategies to cope with it, balance it, and keep it at bay.

In the December 2008 issue we discussed how to identify unproductive thought patterns that can blow stress out of proportion. This time we will reach for coping mechanisms that help to balance the inevitable stress in our lives. Let’s look at three categories: avoiding, reducing, and relieving stress.

Avoiding stress
Avoiding stress can be as simple as training yourself to get up at least 15 minutes earlier each morning. For me, it’s a sacred time when exercise, meditation, and reading set up the day. Another strategy is to prepare for the next day as much as possible by preparing coffee pots, clothes, and lunches the night before. On Sundays I often fill refrigerator containers with fruit, nuts, cottage cheese, and salmon so that I can quickly throw lunches together.

Many physicians believe that most major illnesses derive from unaddressed chronic stress.

One hidden stressor is wearing clothes that don’t fit or feel good. It’s better to chuck or donate pinching shoes and clothes with itchy materials and creeping waistbands. It’s surprising how a few user-friendly “uniforms” can take the stress out of a morning.
 
Rearranging your commute times by just 30 minutes at either the beginning or end of the day can mean avoiding traffic snarls and so decrease your frustration. 

Most people keep their calendars on handheld devices these days; if you don’t, use a planner. Never rely only on memory, because when the multitasking inevitably starts, some important appointment is sure to be forgotten. Having a central wall calendar to coordinate family appointments ensures that everybody knows where everyone else is. Use color-coded highlighters to keep track of people or recurring events.
 
Setting appointments a little ahead of time can be helpful in getting clients to show up and not waste your time. Let people know your time frame and ask them to arrive 10 minutes beforehand. Ending a conversation with a frank “I have to let you go now,” or “That’s all the time I have for today” is clear and respectful and keeps appointments on schedule. Giving a 10-minute warning of “Do you have any other concerns?” is gracious and keeps you both on track.
 
Practical matters can be less stress filled if attacked proactively. Simple things like scheduling routine maintenance on washers, cars, and heaters can keep you out of emergency mode. Making duplicate keys and exchanging them with a trusted friend can be a lifesaver at times. Buy essentials in bulk and keep an emergency stash of toilet paper, tampons, and toothpaste on hand; only dip into the supply when necessary so you’re never caught off-guard. Have multiples of frequently needed items; for example, I keep lipsticks upstairs, downstairs, and in my purse. Most important, make copies of all legal papers, such as birth certificates, Social Security cards, insurance policies, and car or house ownership records and keep the originals in a safe deposit or fireproof box. Do get that crucial durable power of attorney and living will notarized and stored.
 
And last, the biggest stress avoidance tactic is never to shop for clothes with critical teenagers, skinny friends, or anybody who is a perfect size 0.

Reducing stress
The art of reducing stress means going with the flow and detaching from the stress-inducing person or situation. As comedian Bill Cosby says, “You can turn around painful situations with humor; if you can find humor in anything, even poverty, you can survive it.”

Waiting in line at the doctor’s office or bank can try even the best of us. Counting your blessings instead of the minutes is a great way to keep things in perspective. Take several deep breaths and treat the waiting period like your own personal break instead of stewing about going nowhere. When waiting on the phone, multitask by reading emails or organizing your calendar.
 
What about those long-winded phone calls or coffee appointments with a friend who needs a sympathetic ear? Keeping engaged but detached is a self-preserving tactic to ensure that the crisis—and the stress—doesn’t get transferred over to you. Use a paraphrasing conversational technique (rephrase what she’s just told you) to show your friend that you hear her and you care. As she gives gory details of her husband’s infidelity, tell her it sounds like it must have hurt her badly. If you keep gently reinforcing what she says, she’ll feel understood. Of course, what your friend really needs is to empower herself, not just take other people’s advice.

One great way to foster self-preservation and keep other people’s problems at bay is a nightly Epsom salts bath (1/2 cup Epsom salts in a warm bath for at least 5 minutes). A therapist client of mine suggested it to me since I work so intimately with others; it’s a technique to discharge other people’s energy from me. As dance teachers, you too take on a lot of energy from others, so give it a try. Whether this technique is New Age hooey or based in science doesn’t matter—it’s become my ritual of creating a physical and behavioral boundary, to let go of the day and restore and refresh my muscles and my spirit.

A final way to reduce stress is to lower your standards. Keeping in mind the rhetorical question “How important is it?” can’t be beat when selecting which battles to fight.

Relieving stress
Relieving stress requires lifestyle adjustments. Physical contact is the greatest stress buster of them all. I call my pets my “hairy stress relievers.” Stroking a pet, holding hands, hugs—they’re all good.
 
Exercise is a top-notch reliever and is of concern to many tired dance instructors. Cross training is the way to go so that you put your mind somewhere else besides the choreography and class plans. I’m a Pilates devotee, but I couldn’t live without early morning walks. Getting even 5 minutes of fresh air, a sometimes limited resource for studio inhabitants, can be immensely restorative. Swimming, yoga—you name it; but do it. 
 
Giving yourself a chance to get things off your chest is crucial. Think of all the hats you wear, and find an ear for every hat. I’ve gotten practice mentoring from two important colleagues, business mentoring from others, plus three health advocates for my various health needs. Find and nurture your team before you are in a crisis. Everyone needs counsel; even King Solomon said that a man is only as wise as his counsel.
 
Finding your health advocates ties in with structuring time for yourself away from your business. Scheduling local getaways and healthcare appointments such as massage and acupuncture, even months in advance, will help you pace yourself and provide psychological relief in knowing that help is on the way.
 
Last on the list of stress relievers is your nighttime routine. Sleep hygiene is essential to restoration. Creating a nighttime pattern of unwinding, as hard as it is after nighttime classes and rehearsals and performances, is a must. Sleep is a restoration of the oxidation that the body and brain have experienced during the day. The fourth stage of sleep, the REM cycle, is where most of the body’s and mind’s healing takes place.
 
Now you know how to avoid, reduce, and relieve stress. It may take a while to create your own version of this template. Get started, and have patience. I have faith in you. 

Stress-Management Tips

To avoid stress:

  • Get up earlier.
  • Organize your calendar.
  • Arrive early for appointments.
  • Anticipate others’ time-management issues.

To reduce stress:

  • Go with the flow.
  • Practice assertive conversation closers.
  • Take warm baths with Epsom salts.
  • Ask yourself: “How important is it?”

To relieve stress:

  • Unwind.
  • Get worries and frustrations off your chest.
  • Exercise (something other than dance!).
  • View the entire forest. Take off the blinders; you know what you are doing.
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A Better You | Outsmarting Stress

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Mobilizing your brain to fight mental pain

By Suzanne Martin

When was the last time someone looked at you as if you were a bored housewife and said, “Well, at least you can work when you want to because you work for yourself”? When that happens to me, I resist the urge to kill, and in my best imitation of a syrupy Scarlett O’Hara, I smile sweetly and remember my company motto, “Smile and be polite.” Then I gently explain that when you work for yourself, every client is your boss and unfortunately, the hours are 24/7.

 As I write this, it’s Saturday at 7 p.m. After emailing advice and appointment confirmations, spending another half-hour leaving detailed voice messages on fees, directions, what to wear, what to expect (all of which is clearly spelled out on my website), I’m here to tell you that you can do it. After spending more than 25 years as an independent contractor in the field of teaching the art and science of dance, Pilates, and physical therapy, I’ve become an accidental expert.

After I graduated from PT school, gaining a second master’s degree and a doctorate, I hoped that I’d walk away from the dance world and settle into the gentle practice of healing. But soon I realized that dance had a grip on me that wouldn’t let go. In straddling the worlds of physical therapy, university teaching, and private practice, I’ve made an art of multitasking. I’ve also learned how real the stresses of teaching and entrepreneurship are, and now I’m here to pass on the information to you. This article is the first step in our shared journey toward increased wellness.

You, new and improved
What I’m talking about is not business information, although you need that too. I’m talking about something that’s more important—you. Very simply, no you, no business—end of story. Finding strategies to take care of yourself, and implementing them, is the only way you’ll survive.

Your mother wasn’t kidding when she said the dance life would be a hard one. Whether you’re a studio owner, a staff teacher, or a contractor who juggles multiple jobs, you face physical and emotional stresses every day. Step one is acceptance. Have you accepted your challenge, the one you probably didn’t fully understand when you chose a life in dance?

Acceptance is better than Prozac. For whatever reason, you chose this path, so it’s a good assumption that you’re good at it, or at least conscientious enough to learn what it takes to make it happen. So relax in that knowledge. Remember Shakespeare: “To thine own self be true,” even if you have to repeat it every day.

If you’re a school owner, essentially you’re a CEO. Did you know that CEOs typically schedule only about 50 percent of their workweek? The gaps allow time for unexpected daily crises, which inevitably crop up in any workweek. Borrowing that time-management concept, studio owners might be lulled into the idea that generally mornings can be used to organize and delegate. However, a big problem in the dance-school world is that it runs seasonally around peak performance times such as the winter holidays and the end of the academic year. What starts out as a well-oiled machine in September can quickly smell like burned oil come October. Certainly the schedule is relentless—but is it really the schedule that gives you the fingernails-across-the-chalkboard effect?

A new way of thinking
How do you prevent the daily grind from pulling you into the meat grinder? Put simply, by changing your way of thinking. It might not be so simple, but it’s a skill worth learning. The good news is that a behavior change that you can maintain for 21 to 28 days is likely one that will become permanent. Even better is the observation that one young pre-professional dance student made in one of my nutrition classes: He said that it might take 21 to 28 days to form a new habit, but a change of heart can be made in an instant.

Thanks to psychologist Albert Ellis and his theory of cognitive behavioral therapy, we have tools—our own thoughts—that can create that instantaneous change of heart or deflate our irritation levels. The first step is realizing the difference between your conscious and unconscious minds. Think of your conscious mind as a rider on the horse of the unconscious mind. It can recognize and identify feelings, but its primary role is to learn and give directions. Just as a well-trained horse can walk a familiar path without help from the reins, our gut responses are ruts in the ground that the horse has been trained to know and love.

Changing our gut responses from gut-wrenching experiences into productive interactions means identifying four not-so-productive thinking styles: “demandingness,” “I can’t stand it-ness,” “awfulizing,” and condemning/damning.

Demandingness
Getting overly upset indicates that you are demanding something. Basically it involves a belief that you are able—and intend—to run the universe. Running a studio does involve a confident decisiveness, but the fact is that, in all reality, you cannot control all people, places, and things. Demandingness is likely to happen when the outcome of an incident does not meet your expectations. Taking a hint from principal ballet dancers, self-talk promotes higher performance. In this instance, corrective self-talk states that the incident indeed should have happened because it actually did occur. Rate the event with 100 percent being the worst-case scenario. What’s an honest estimate of the damage? If it’s only x percent bad (and in all actuality you can stand x percent of grief), then you have deflated the situation.

“I can’t stand it-ness”
Can you really not stand it? It’s annoying, yes, but put that event scale to work. Simply verbalizing, “I can’t stand it,” imprints the idea that no solution, no relief is possible. Using the 1-to-10 pain scale (with 1 being no pain and 10 being “flopping off the table, give me morphine” pain), be honest now—what is the actual pain level?

“Awfulizing”
By learning to listen for words such as “terrible,” “horrible,” and “awful,” and using your event-rating scale, you can decide what has crossed the line of unacceptability and learn to recite the mantra “Nothing is terrible.” You cannot change a past mishap; perhaps it shouldn’t have happened, but it did. Decrease your stress level with a quick thought replacement of “I’d like it if . . .” or “It would be better if . . .” or “Next time I’ll . . .” Have patience; remember the 21-day habit-maker. It takes practice.

Condemning/damning
Next explore your self-esteem. One definition of self-esteem is tunnel vision plus dichotomous (black or white, good or bad, all or none) thinking. Our self-esteem becomes linked with how we think others perceive us (usually negatively). With tunnel vision, obviously, we look at only what is in front of us, who is “in our face.” It’s as if our horse suddenly has blinders. Dealing with many clients in close physical proximity makes this unproductive pattern all too easy to fall into, and it can take perseverance to correct.

Our passion for dance often encourages us to put on the horse’s blinders because we love the field and are enthusiastic about bringing others into the fold. But often this results in putting yourself down when students, parents, sponsors, board members, or promoters make their expectations or disappointments known (or you think that they are). But school directors and owners need “forest” eyes—they have to see more than the trees in front of them because there are many variables to coordinate, and their critics may not be aware of crucial factors that affect decisions.

Again, take a reality check. Be honest. Become a dispassionate judge in the trial of the committee accusing you of injustice. Does the sentence you are serving in your mind fit the severity of the crime of your accusers?

The zero effect
If you allow condemning/damning thinking to go on too long, you risk encountering the dreaded “zero effect.” The horse, your subconscious, is in charge of this line of thinking, which means that you believe you are a zero because someone doesn’t love you enough or treats you disrespectfully. And not only are you a zero now, but you’re doomed for life. Or if you’re not a zero now, you will be soon. And last but not least, you are bad, a zero, period, and deserve what gets dished out to you. Sound rational to you?

Accept the challenge
Identify those unproductive thought patterns, both in yourself and others. With detachment, a change of heart, and a 21-day goal, you can defuse the stressors in your life. You can do it. I have faith in you.

Next month we’ll explore more about how to learn to avoid, reduce, and alleviate stress by replacing negativity with positive tools.

Tips for De-Stressing

When you find your emotions escalating, stop and rate the true “awfulness” of the event. Where does it fall on a scale from 1 (best) to 100 (worst)? Chances are it’s something you can handle if you relabel it as “not so bad.”

Listen for negative words like “horrible,” “awful,” “terrible,” and replace them with thoughts that accept a less-than-perfect scenario. Then resolve to improve it next time. Use empowering thoughts like “Next time I’ll . . .” or “It would be better if . . .”

Have patience. It takes time to break old patterns of thought or behavior. Be kind to yourself while you’re working on developing new habits.

Have confidence. Don’t let those who see only the trees deflect you from your view of the entire forest. Take off the blinders; you know what you are doing.

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Common Ground: for teachers and students | Dancers’ Half-Dozen

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5 exercises for the body—plus 1 for the brain

If you’ve been thinking about spicing up your normal exercise routine, look no further. Dance Studio Life asked a range of practitioners, all of whom work with dancers, for their favorite stretching and strengthening exercises. So pick and choose, or try them all—you’re bound to find something that works for you. As a bonus, there’s an imagery exercise to get your mind in gear.

From Cyndi Lee, owner, OM Yoga, New York City

Model: Shawn Kane (Photo by Janna Coker)

Exercises that make you pull into the center are great for dancers because their bodies are so flexible. In yoga, when we say, “center,” we mean midline energy—everything pulling in and hanging onto the bones. It creates a strong container for all that fluidity and hypermobility. If you don’t have that, you collapse and get injured.

Exercise: Vasisthasana (side-inclined plane)

  • First, come into plank pose (a push-up with your arms straight and your legs all the way together like a mermaid). A main part of the exercise is feeling your legs strong together. Think of your outer legs pulling together, not just your inner thighs and gluteals. You should distribute your awareness and effort throughout your whole body. In yoga, we work with opposites to do that. In plank position you think of your abs and quads moving up into your back, softening your back down into your front so that they meet. That’s what makes the strong container.
  • Next, you shift over onto the baby toe side of the right foot so that the weight of the left leg is stacked on the right. Extend the left arm straight up. In this pose you reach down with the right arm and up with the left so that your weight doesn’t collapse down. The legs work the same way, drawing the right side up to the left. Often dancers find this difficult because they’re not used to their arms doing weight bearing, but it’s really about using the legs. If you lift up with the legs, it takes weight off the arms. Doing all that makes the abs engage.
  • Keep your body engaged in the position but relax your mind. Feel how you’re extending in all directions and that you’re very big and vast.
  • Come back to plank pose, light as a feather, and shift over to the other side.

From Marika Molnar, physical therapist; founder of Westside Dance Physical Therapy, New York City

This is my personal favorite core strengthener. Most dancers I have worked with have tight hip flexors, especially the tensor fascia lata. This may be a cause of the excessive anterior pelvic tilt that becomes their habitual posture, which can result in compression of the lumbar (lower) spine. Many core-strengthening routines are taught in supine position, which is very valuable in the beginning but must be translated to a standing posture to have lasting effects.

Exercise:

  • Stand with your back against the wall, heels about 3 inches away from the wall. Keep your legs and feet parallel (no turning out) and place your feet in a stance wider than your hips.
  • Next bend the knees slightly so that you are in a mini parallel plié, keeping the knees over the second toes.
  • Inhale into the posterior/lateral (back/sides) rib cage more than into the belly, and as you exhale contract your abdominal muscles so that your pelvis rotates back and places your lumbar spine (low back) flat on the wall. This is not accomplished by tucking the pelvis under; the abdominals should be doing the work.
  • Hold this position for 10 seconds and slowly try to straighten your knees while keeping your back flat on the wall. Take the full 10 seconds to straighten your knees.
  • If this is easy for you, move your feet an inch or two closer and repeat.

Perform this exercise 10 times to regain the motor control of your abdominals and stretch your hip flexors. Once you have mastered doing it with your feet totally parallel and under your hips, try raising your arms above your head. This gives the abdominals an extra challenge because they must work harder to keep the rib cage down.

From Suzanne Martin, freelance Pilates instructor; physical therapist, Smuin Ballet, San Francisco

It may not be obvious, but these two exercises are some of my favorite “core” exercises for dancers. Dancers spend about as much time kicking and lifting their legs as they do bending backward. These exercises train the body to use the core to support arabesques, extensions, and cambrés, as well as providing a release for the overused deep hip flexor, the psoas. Do them in order. Enjoy!

Exercise #1

Part 1:

  • Lie on your stomach and place your hands, one on top of the other, underneath your forehead.
  • Lift your abdominals off the floor, knit the ribs together, and lift your groin muscles toward your head.
  • Bend your knees and open the thighs about 1 foot apart. Make sure the thighs don’t go into a turned-out “frog” position.
  • Rock your feet side to side in a windshield-wiper action 10 times

Part 2:

  • Return to the starting position, then turn your head to the side and place your right cheek on your hands.
  • Spiral your body as you reach your right second toe back and behind you (like in an attitude position) until you see your foot.
  • Lower your body sequentially down through the chest, waist, hips, and finally the thigh. Be sure to first lift the second toe straight upwards, creating a “smile line” between your thigh and your buttocks. Hold this hip position, then reach backward for the attitude reach.

Keep your front core connected and the elbows firm against the floor throughout the whole move. Do this exercise six times on the right and then repeat six times on the left.

Exercise #2

  • Lie on your stomach with your hands on the floor above your head and your feet about hip-width apart in parallel (not turned out).
  • Lift the abdominals as if water is pressing up against you. Pull the tailbone downward toward the feet. Make “smile lines” delineating the hamstrings (back of thigh) from the buttocks.
  • Drag your forearms toward your waist, lifting up the front of the body into a sphinx pose with most of the abdomen slightly off the floor.
  • Keep the knees straight as you exhale and lift the feet off the floor 2 inches. You should feel as if your body is in a firm bow (arched) shape
  • Quickly reach your hands out in front of you and rock forward, keeping the torso stiff so that your feet go higher in the air. Then lift yourself up to “catch” yourself on your hands. Repeat the rocking motion 5 more times
  • On your last repetition, hold your head and feet up to intensify the position, then lower gracefully down.

From Debra Rose, former dancer with Alonzo King’s LINES ballet, GYROTONIC® master trainer, and executive director of San Francisco Gyrotonic; with Lisa Okuhn, freelance writer and former dancer with OCD/SF and Laura Dean

A deep and integrated psoas stretch is an essential tool for both dancers and non-dancers. A properly stretched psoas maximizes mobility in the front of the hip socket, relieves its pull on the lumbar spine, and creates a strong, open posture that allows a full range of movement. This flexibility and easy alignment in turn allows dancers to develop a strong, stable, well-aligned arabesque.

Exercise: Psoas stretch

This basic GYROKINESISÒ psoas stretch, which is done on a stool, allows the knee to lengthen downward, creating an arc that opens the hip and stretches the psoas gently and naturally. This is better than forcing the leg to stretch straight back, which can cause low-back strain.

  • First, sit on a stool facing forward. Rotate 90 degrees to the right. Position the back (left) knee toward the floor at a perpendicular angle, placing both hands on the front (right) knee for support, and making sure the back foot, ankle, and shin are aligned.
  • Lengthen the thighbone out of the hip downward toward the floor, creating space in the hip socket. Concentrate on allowing everything below the hip socket to descend and scoop back. At the same time, everything above the hip socket ascends and moves slightly forward.
  • Exhale and gently reach the heel backward and toward the floor. Remember to let your leg descend and scoop back, while everything above the hip socket ascends and scoops upward. Think of creating one long, continuous arc. Your knee will elongate but it might not straighten.
  • Repeat six times, slowly and mindfully. Turn to the left and repeat. Do two sets on each side.

When standing in first position, the dancer can mimic this elongation, feeling both legs descending and rooting into the floor. As the dancer moves through tendu back into arabesque, the standing leg lengthens into the floor while the pelvis and upper body elongate upward. The working leg lengthens, reaching down into the floor before curving up into arabesque. With a lengthened psoas, and using the concepts learned in the exercise, as the leg rises a dancer can maximize the extension in the hip before extending the lower lumbar spine (low back), and sequentially the rest of the lumbar and up into the thoracic (chest area) spine. The result is a stretched, unbroken arabesque line.

GYROKINESIS is a registered trademark of GYROTONIC® Sales Corp and is used with their permission.

From Mark Haim, artist in residence, University of Washington Dance Program, Seattle, WA

I love to do improvisational visualizations with dancers. I guide them through images and “stories” from which they move. They can move any way they want to but should continually concentrate on the images that are given to them. This exercise helps dancers clarify their relationship to the surrounding space.

Exercise: Exploring the Body’s Relationship to Space Through Imagery

  • Start by lying on the floor, relaxed, in any comfortable position. Close your eyes.
  • In your mind’s eye, travel up to the ceiling and see yourself from above. See your body’s arrangement on the floor, the clothes you are wearing, what each part of your body looks like.
  • Now imagine that the floor is glass and you can see yourself from below. Notice the same things you did from above. Do this from the right, the left, from any angle you wish.
  • Drop back into a point in the center of your body (whatever center you desire) and form a small bar of soap there. Let the soap lather up until the suds and bubbles expand through the entire body.
  • Let the bubbles move your body around, any way the image takes you.
  • Expand the suds image so that you are now made of bubbles and hiding in a big pile of soapy bubbles. Move in that pile, hidden from view.
  • Let the bubbles combine until that pile has become one big bubble.
  • Move within that bubble. Explore its shape; let its shape change as you explore it.
  • Turn the bubble into a cube, any size you wish, and move within that fixed bubble cube. See how your movement changes.
  • Alternate between the cube, the mutating bubble, or any set shape of a bubble.

Try doing this with others!

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