Monday, September 28, 2015

Patellar Femoral Syndrome - Part I

“When there is alignment and understanding, it is much easier to navigate forward together, ” - Karen Kimsey-House

          The knee is one of the most relied upon joints of the human body and is subjected to a great deal of force every day. During a simple activity like walking, the amount of force placed upon this joint is equal to anywhere from one-third to one-half an individual's body weight. When a person is climbing stairs the force placed upon the joint is equivalent to 3 times the individual's body weight, and when squatting, the knee must manage a force equal to 7 times the individual's body weight. When considering these facts, it is easy to understand that there must be a great amount of stress placed upon the knee in all kinds of dance. When the knee joint is functioning correctly, it is usually able to cope with this stress, however, when something is misaligned, and the knee joint is not functioning efficiently, the stress can be detrimental.

        Patellar femoral syndrome is a chronic condition in which the patella, or knee cap, is not correctly aligned. The patella is a triangular shaped bone that lies on top of the femur, or thigh bone. There is a groove in the femur which allows the patella to slide back and forth as the knee bends and extends. When the patella is not in alignment, it does not fit well into this groove, and the friction of the patella against the femur begins to wear away the cartilage found in the joint.

          When the knee joint is at rest, the patella is held in place by the capsule surrounding the joint, the ligaments on either side of the patella (the retinaculum), and the patellofemoral ligament, which connects the femur to the patella.

When the knee is actively bending or extending, the joint's stability is provided by the quadriceps (the four muscles located on the front of the thigh), the vastus medialis (which is a muscle that is found on the inner side of the thigh), the vastus lateralis (which is a muscle that runs along the outside of the thigh), and the iliotibial band, which runs from the gluteal muscle of the buttocks down the outside of the thigh.

          Dancers with patellar femoral syndrome will experience pain behind and around the kneecap during activities that require the knee to bend like squatting, jumping or climbing stairs. Occasionally, the dancer will also experience the knee buckling, or "giving way" when walking and may also complain of stiffness in the knee after sitting for a while.

          Any dancer experiencing these symptoms should rest the joint and use ice and anti-inflammatories to control the discomfort. The dancer should also contact a sports or dance medicine doctor to get a complete diagnosis. In most cases, once the cause is determined, physical therapy can help alleviate the symptoms and help realign the kneecap.

          Since an ounce of prevention is worth a pound of cure, my next post will focus upon the causes of patellar femoral syndrome and how to prevent this condition from occurring.

Tuesday, August 25, 2015

Exercises to Improve the Arch of Your Foot

         "The human foot is a masterpiece of engineering and a work of art." - Leonardo da Vinci

        All dancers strive to achieve the perfect foot. My last two posts detailed the anatomy of the arches of the foot and explained why a passive foot stretcher is not the most effective or healthy way to achieve that goal. 

         This post will provide you with healthy ways to work on strengthening and improving the arches. 

 * Slow, controlled elevés and relevés - Working the 
     muscles of the calf, the gastrocnemius and the soleus, 
     will help contribute to arch strength. Simple relevés and 
     elevés will work, but you can also vary the timing for an 
     extra challenge - going up on one count and taking three
    counts to gradually lower your heels or taking three counts 
     to rise and lowering the heels in one count.

* Forced arches  - In a parallel first position, bend your 
   knees. While keeping them bent, slowly begin to raise up 
   onto the ball of your foot to a forced arch position and then 
   slowly your heels to the floor. Repeat 8 times.


* Seated pointing and flexing  - Seated with your legs
   straight out in front of you. Point and flex your feet using a 
   theraband for resistance. You can wrap the theraband  
   around the ball of your foot and hold the ends in your 
   hands to provide resistance when pointing your foot, or
   loop the theraband around a chair leg and across the top of 
   your foot to provide resistance when flexing the foot.

* Domes - This exercise will work of muscles and tendons
   underneath the foot. Seated on a chair with your feet flat on
   the floor, keep your toes flat and do not allow them to curl 
   while trying to slide the ball of your foot toward your heel. 
   This movement is a small, subtle one but a slight dome 
   will form underneath your foot. Do 5-8 repetitions on each

* Towel gathering - Lay a small towel or scarf flat on the
    floor. Seated in a chair, place your foot flat on the towel and
   do not move your heel as you begin to slowly use your toes
   and the ball of your foot to gather and pull the towel toward
   your heel. The towel will only move a little each time. Be
   sure that both sides of the foot are working evenly, trying 
   not to use one side more than the other. Do 5 repetitions on 
   each foot.

Using these exercises will strengthen and improve your arches in a healthy way to achieve the aesthetic that dancers strive for while decreasing the risk of injury.