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Animated Edition - Issues 1996 - 2001
Speaking two languages
Animated Winter 1999. Delegates from 18 countries converged for the International Association of Dance Medicine and Science Conference held in Connecticut, USA. Here Rachel Rist captures some of the issues emerging from this significant event

I was invited to present two papers during the conference. The first of which was on The Challenges of Implementing Fitness Training for Professional Dance Students - a programme devised by my co-presenter and Arts Educational School and British Olympic Athletic Team Physiotherapist, Mark Buckingham, and highlighted our progress on overcoming staff and student resistance to the notion of fitness training for dancers.

There is a perception that dancers are generally very fit because they are flexible, strong, have good endurance and work long hours in the studio. To test our students fitness levels we used the well-recognised fitness indicator known as the 'Bleep' test. The results proved quite revealing when, to our amazement, some of the drama and music students faired better than their dance counterparts. (Although this was to become a useful motivating factor in the long-run.)

Over a period of 12 weeks we were able to effectively improve the dancers fitness levels. Initially, we introduced three 20 minute sessions (increasing to 30 minutes as the dancers grew fitter) of dance based movement similar to an aerobics session. After a couple of weeks we noticed some shin splint and lower leg problems occurring so took the radical decision to introduce circuit training. To our surprise the students really enjoyed this and, with some imagination and creativity, we were still able to do this within a dance studio setting. Students were tested again after six weeks and all showed an increased score on the 'Bleep' test, which added to their motivation. By the end of term, the students performed in eight performances of an extremely demanding dance show. (One section alone required 45 minutes of non-stop jazz dancing and, followed by an interval, a further 40 minutes of classical ballet.)

Although some staff had initially been reluctant to give up valuable teaching time to incorporate the fitness training, it became apparent that instead of having to 'rehearse in' the stamina required through endless repetition, the students proved fit enough to cope with the nature of the work, so enabling staff to concentrate on the artistic and performance aspects of the choreography.

The rather controversial decision to put fitness training into the timetable and sacrifice some class time was a hard one. Initially, the students were so tired at the end of the training sessions that they were unable to participate in normal classes immediately afterwards! Also, the students themselves were surprised at how difficult they found it to cope with the extra physical demands and were not at all keen to move into this uncomfortable zone. However, after the first four weeks, the dancers could actually feel some improvement and the fitness training took on its own distinct atmosphere. Indeed, some students began to enjoy it so much that they increased their training and could be seen running around Tring Park before breakfast! To any one contemplating setting up fitness training sessions, I would urge them to go ahead and weather the first month, as from then onwards students discover for themselves the value, and the end results are certainly worthwhile. Seeing our students on stage at the end of the dance performance still smiling and looking confident were evidence enough for me.

My second presentation formed part of the Teachers Day and focused on The Need to Re-structure the Nature and Content of Dance Classes During the Growth Spurt Years. The increase in the length of the long bones, without the strength in the muscles to control an increased height, can put tremendous stress on vulnerable parts of the body. The growth spurt can also be a time of dramatic hormone changes and this, added to a perceived loss of ability during these changing years, can be very stressful for adolescent dancers.

The rest of the lectures were from orthopaedic surgeons, therapists, scientists and teachers, showing the diversity of the International Association of Dance Medicine and Science (IADMS), which comprises some 60 per cent medical practitioners. This necessitated some presentations being scientifically based and somewhat challenging for dance practitioners to follow. Others, although medically rigorous and aimed at physiotherapists, were useful for dance teachers helping our understanding of, for example, the complexity of the knee joint and the importance of correct diagnosis of knee injuries. But it was not all one-way - the more dance based presentations proved invaluable, in terms of educating the medical community about particular aspects of dance training.

At the moment, 'core stability' is an important focus in dance medicine. This relates to the need to aim for control of the centre of the body, rather than pure strength. Unlike most aspects of dance training, this is not something that can be improved upon with one single exercise endlessly repeated, but rather, of continuous good body use in a functional role. It is typical of a dancers mentality, that "if one sit up is good for you, then 100 must be great for you!" In this case, there is no magic exercise that will provide a quick fix for strength - the assimilation of good use of the centre of the body is performed by a series of abdominal, hip and spine muscles working in a coordinated and continuous way.

Kitty Daniel, Director of Dance at Cornish University, Seattle, presented a wonderful example of the principles of dance medicine being put into good practice, in her workshop Applying Principles of Stabilisation to the Ballet Barre. Her approach encourages students to focus on finding a 'neutral pelvis' and correct positioning of the thoracic and cervical spine of the upper body right at the beginning of class. This is then reinforced throughout the barre with careful attention paid to the execution of the simple movements of plie and releve in the correct pelvic and spine alignment in order for the body to engage correct use of the abdominal muscles to support the centre.

Perhaps one of the most significant benefits of the communication between dancers and the medical profession is in a shared use of the language of dance and anatomy, however, it does mean that if someone does not understand the anatomical language, they may not entirely follow the debate and miss out on valuable information. I think that as so many physiotherapists and doctors speak 'dance' now, there is a real need for dance teachers, dancers and choreographers to learn to speak 'anatomy'. The dance community most not consider itself too elite and above taking on the language and knowledge of the muscles, joints, tissues of the body and the use of the body in action. It is important to have a good working knowledge of what is happening inside the body during dance training. Now, an understanding of anatomy and physiology will enable someone involved with dance, to communicate with those who are helping dancers to dance longer and stronger. So much of the focus of Dance Medicine is in preventative work, that it is right to assume that a better knowledge of anatomy, will make a better dancer.

Many of the medical community who treat and look after dancers are dance trained, some have even performed at a professional level. This must be of great comfort to an injured dancer seeking help to know that they are being treated by someone who understands the problem and speaks their dance language. One of the first questions always asked by an injured dancer is: "When can I return to class?" With an understanding of the pressures that a dancer is under to make a speedy return to class, rehearsal, or performance, a therapist can also act as a mediator between the dancer and management. A therapist who understands dance will be trusted to make the right decisions for both the dancer and the company.

There are obvious gains to be made in attending a conference of this sort where the leaders and pioneers of Dance Medicine are lecturing. Of equal importance and value is the time spent networking and exchanging ideas and information with conference delegates.

At the well-attended IADMS business meeting a productive discussion on the need to attract a variety of experts to the conference was held with sometimes differing opinions on the content of the lectures, as delegates, and indeed the membership of the organisation, is from such diverse backgrounds. Many, orthopaedic surgeons desire more input from fellow doctors, likewise the physiotherapists and body conditioning teachers need to have presentations that will be of value to them. It was unanimously felt however, that the merit of such an organisation lies in the sharing of information at all levels.

In 1999 the IADMS conference will return to the UK to the Arts Educational School, Tring Park (it was here in 1997 that the UK's growing interest in Dance Medicine was really able to flourish). The superb studios, beautiful Rothschild mansion and parkland are ideal, and will enable delegates to spend valuable free time networking and exchanging information with one other.

Personally I am looking forward to the challenge of implementing some of the ideas gleaned. As dance teachers, most of our lives are spent in giving out to others - it was wonderful to have input. As always, I came away feeling that in making changes to training methods by implementing ideas, one is contributing to the artform. I fully believe that the great teachers of the past, given access to the same information that we now have, would have applauded the progress of the profession. It is by evolving that we can teach our dance students to succeed.

Rachel Rist, Head of Dance, the Arts Educational School,Tring Pack. She is on the Board of Directors of the International Association for Dance Medicine and Science, Chair of the Board of Governors of the Royal Academy of Dancing and on the Advisory Panel for Dance UK's Healthier Dancer Programme.

Rist gratefully acknowledges financial support from the Lisa Ullmann Travel Fund Scholarship without which she would have been unable to have attended the conference.

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Animated: Issues 1996 - 2001