The Développé. Improving Ballet Extensions Through Pilates. Jazel Tricia Serate. January 15, 2018

Transcription

1 The Développé Improving Ballet Extensions Through Pilates Jazel Tricia Serate January 15, 2018 Pacific Palisades, CA/South Pasadena, CA

2 Abstract Utilizing the BASI Block System, this study aims to discover the effects that Pilates training has on strengthening and increasing ranges of motion in hip flexion for ballet dancers. This research focuses on improving the technique, stability, and range of motion for a ballet dancer s ability to perform a développé devant. Développé devant is a ballet move where the dancer s ending position is turned out, in hip external rotation, standing on one leg while the other leg is ideally above 90 degrees of hip flexion. Although hip external rotation is critical for the aesthetics of this position, the study focuses primarily on the hip flexors. An assessment of both passive and active range of motion (ROM) in hip flexion is measured with external rotation before and after the program. 2

3 Table of Content Page 1 - Title Page Page 2 - Abstract Page 3 - Table of Content Page 4 - Anatomical Description Page 8 - Introduction Page 9 - Case Study: Sophia Piedi Page 11 - BASI Block System Lesson Plan Page 12 - The Conditioning Program Page 14 - Conclusion Page 15 - Bibliography 3

4 Anatomical Description In order to understand how to improve a dancer s technique in a développé devant, we need to analyze and understand the bone structure of the hip, the muscles needed to be engaged or stretched, common hip alignment deviations through linked movement patterns, and physical limitations of the movement. The bone structure of the hip joint is a ball and socket joint that consist of the pelvic girdle and femur. Due to the unstable nature of ball-and-socket joints, the hip is surrounded by strong ligaments, tendons, and muscles that offer support for the weight bearing on the hip joint and allow for stability during locomotive movements. The pelvic girdle is formed by the two os coxae with the sacrum and coccyx in between. All together they form a bowl-like shape which cradles and protects some of the body s vital organs. Each os coxae is made up of the ilium, ischium, and pubic bones that fuse together in adulthood. The right and left anterior superior iliac spine (ASIS) of each ilium bone are used to observe for a lateral tilt of the pelvis, while the placement of the pubic symphysis, between the pubic bones, determine the degree of an anterior or posterior pelvic tilt. In Pilates, we find a neutral pelvic position, while standing, by leveling all three points on one flat, vertical plane. A neutral pelvic position in développé devant ensures that the spine remains long and that the proper muscles are used to lift the leg. The femur bone is the longest bone in the body. At the superior end of the femur, we find the smooth, round femur head, which is the ball that sits deep within the socket of the acetabulum. The femoral neck of the femur connects the head to the long femoral shaft. Lateral to the neck is the greater trochanter, which is an important site of insertion for hip abduction and external rotation muscles as well as an important landmark used in observing a client s plumb-line. Performing the elegant quality of a développé devant not only requires that you need skill to balance on one leg, but that the muscles need both strength and flexibility. The muscles that 4

5 need to be strengthened are the back extensors and abdominal muscles; the hip extensors, abductors, adductors, and external rotators of the standing leg; and the deep hip flexors, hip adductors, hip external rotators, knee extensors, and plantar flexors of the moving leg. In addition, a dancer must have significant range of motion in the hip external rotators, as well as flexibility in the hamstring muscles in order to increase the height of the moving leg. All of these physical tasks must be done while maintaining balance, lengthening the spine, and remaining soft in the face and finger tips. In this study, special attention will be given to the hip flexor muscles, which involve the rectus femoris, sartorius, and iliopsoas group. The iliopsoas group consists of the psoas major and iliacus, which originate on the spine or on the iliac bone and attach to the lesser trochanter of the femur. The rectus femoris is a large thigh muscle which allows for hip flexion up to 90 degrees, but the small, deep iliopsoas is the most important hip flexor for ROM above 90 degrees of hip flexion (Clippinger). The hip flexor muscles also include the hip adductors as they assisting in hip flexion in the lower ranges (Clippinger). The hip adductors include the adductor magnus, adductor longus, adductor brevis, pectineus, and gracillis. Understanding the linked movement patterns of the pelvis and spine are helpful to correct poor alignment and execution of a développé devant. Closed-chain pelvic movements tell us that an anterior pelvic tilt is linked to spinal extension, and a posterior pelvic tilt is linked to spinal flexion. In a développé devant, the standing leg is in a closed-chain position, so when the leg is raised, there is a tendency for dancers with short hamstrings or weak iliopsoas muscles to posteriorly tilt their pelvis while lifting the leg above 90 degrees. Since pelvis is tucked, the lumbar spine naturally draws into spinal flexion which disrupts the long line of the spine. Due to the extreme ROM of a développé devant, there are physical limitations that can keep highly trained dancers from reaching their desired leg height. An interview was conducted 5

6 on November 1, 2017 with Dr. Roy E. Kohn IV, who is a physical therapist at HealthMasters Hand & Physical Therapy Center in El Paso, Texas. Expounding on how to increase hip ROM, Dr. Kohn stated that it takes 6-8 weeks to even begin to see any changes in the length or mass of a muscle (Kohn). Although, Dr. Kohn also stated that ROM has less to do with the length of the muscle, but rather how sensitive the nerves that run throughout that muscle are when put in an unfamiliar position (Kohn). Specific exercises, such as sciatic nerve flossing or femoral nerve flossing, can be given to desensitize neural tension in the hips and legs. The reason why professional dancers are able to move in extreme ranges of motion is due to the amount of time they have spent desensitizing their nervous pathways and familiarizing their nerves to a wide variety of movement patterns (Kohn). 6

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8 Introduction Pilates training has long been known for its numerous benefits as a cross training method for ballet dancers. The mind-body aspect of Pilates encourages mental awareness to strengthen and stabilize muscles as well as simultaneously lengthening and stretching muscles. Being able to understand and master even the most fundamental Pilates exercises takes years of practice. This mind-body approach to fitness training appeals to ballet dancers whether they are recovering from injuries or fine tuning their technique. The grace and effortlessness of a ballet dancer creates an etherial world that audience members are captivated by. This type of movement quality requires great strength, fluid coordination, and extreme ranges of motion which often results in moving through or balancing in exciting, grandiose poses. Ideally, these dance poses are performed balancing on the toes standing on one leg, while the other leg is in the air well-above 90 degrees from the hip joint. Amateur dancers train vigorously to achieve this aesthetic and often end up compensating their form for the height of the leg. Since ballet dancers are constantly striving for extreme ranges of motion, they tend to lack stability and strength with the deeper muscles of the body that will help them achieve their aesthetic goals. This study aims to discover the effects that Pilates training has on ranges of motion in hip flexion for ballet dancers. 8

9 Case Study For this study, I recruited Sophia Piedi. She is 17 years old with no major physical limitations. She is an advanced level ballet student in the pre-professional dance company, El Paso Ballet Theater, and she has extensive performance experience in a variety of dance styles. Before we began our sessions, I evaluated Sophia s plumb line for any postural deviations, took note of her injury history, and measured the ROM in her hips. Sophia has a tendency to supinate her ankles and hyperextend her knees. She does not have scoliosis, but has a minor degree of lumbar lordosis, where the pelvis tilts anteriorly and the lumbar spine extends more than a normal curvature. Sophia has had no injuries to the hips. Although, she has a history of having Achilles tendonitis during strenuous performance seasons. She also has had a minor fracture to her right ankle, which has since completely healed over the past 6 years. Working with Sophia, she has shown to have excellent articulation in the spine and has a strong, athletic build from all of her dance activities. I met with Sophia for one-hour sessions 3 times per week for a total of 6 weeks in hopes to improve her dance technique as we progression through each session. Before beginning the lesson plan, I measured Sophia s hip external rotation as well as her passive and active range of motion (ROM) in hip flexion. To measure her hip external rotation, Sophia laid prone with one knee bent at a 90 degree angle. She laid in neutral spine position with her right and left ASISI and pubic bone against the floor. I held Sophia s right ankle and externally rotated her hip while making sure her pelvis maintained in neutral spine position. Once I was unable to rotate any further, I held the body of the goniometer to the anterior aspect of her patella directing the fixed arm perpendicular to her hip line and the moving arm running along her tibial crest. The angle between the fixed arm and moving arm for Sophia s right hip was 65 degrees. We repeated the process on her left side and found her left hip external rotation measured 50 degrees. 9

10 To measure Sophia s hip flexion, she laid supine with her left leg on the floor maintaining hip external rotation in both legs mimicking the position of a développé devant. I assisted Sophia into her passive ROM by raising her right leg to the ceiling. Sophia maintained neutral spine position while relaxing the muscles around her hips and legs. I drew Sophia s straightened right leg toward her chest until her muscles reached their maximum length. I then placed the axis of the goniometer against her greater trochanter. The goniometer s fixed arm was perpendicular to the floor, while the moving arm was pointing toward Sophia s right lateral malleoli of her right ankle. The maximum passive hip flexion, with external rotation, on her right side was 135 degrees. We repeated the process on the left to measure 130 degrees on her left side. Sophia s active ROM was measured in a similar manner, the only difference is that Sophia drew her leg into the extended leg position using her own muscles. I cued Sophia to maintain a neutral spine and neutral pelvis position as she raised her leg. Once she could not flex her hip any further, I measured her active hip flexion, with external rotation, on her right side as 125 degrees and her left side as 110 degrees. With the knowledge of Sophia s right hip having more ROM, I kept that in mind as she did any exercises and watched out for any deviations, such as tilting or rotating, in the pelvis trying to compensate for the lesser ROM in the left hip joint. Desired Results After this conditioning program, we are aiming to increase Sophia s passive ROM in her hip joints as well as increase the height of the moving leg by strengthening her hip flexor muscles. We are also hoping that she gain abdominal and back extensor strength, as well as strength in her hip extensors, abductors, and adductors to stabilize the standing leg. 10

11 BASI Block System Lesson Plan Before each workout, we began the session with the Roll Down exercise for Sophia to warm up the spine and for me to observe her alignment and ROM. Since Sophia demonstrated satisfactory articulation by moving evenly throughout the spine, she was given an intermediate level warm-up series. This lesson plan began on the Cadillac, which then was followed by the Reformer apparatus after Abdominal Work. Warm-up: Cadillac Warm Up Series - Roll Up with RUB, Spine Twist Supine, Mini Roll Up, Mini Roll Up Oblique, & Top Loaded Roll Up Foot Work: Parallel Heel, Parallel Toes, V-Position Toes, Calf Raises, Prances, Single Leg Heel, Single Leg Toes, & Hip Opener on Cadillac Abdominal Work: Bottom Loaded Roll Up, Breathing with Push-Through Bar & Teaser 1 on Cadillac Hip Work: Circles Up, Circles Down, Extended Frog, & Reverse Extended Frog on Reformer Spinal Articulation: Short Spine & Long Spine of Reformer Stretching: Kneeling Lunge Stretch on Reformer Full Body Integration: Stomach Massage Series: Round Back, Flat Back, & Reaching on Reformer Arm Work: Sitting Arm Series - Chest Expansion, Biceps, Rhomboids, Hug-a-Tree, & Salute on Reformer Leg Work: Single Leg Skating on Reformer Lateral Flexion/Rotation: Side Over on Box on Reformer Back Extension: Breaststroke Prep & Breaststroke on Reformer 11

12 The Conditioning Program Since I knew Sophia s movement background and previous training, this specific program was tailored to challenge Sophia s strength and abilities. The exercises were organized to maintain flow throughout the session as we worked from the Cadillac to the Reformer. Beginning with the intermediate level Cadillac Warm Up Series, stress was applied to Sophia s core as she worked deep into her abdominal muscles with the assistance of the top loaded Push Through Bar. Sophia struggled flexing her thoracic spine from a supine position. Thus, the Mini Roll Up and Mini Roll Up Oblique exercises were an excellent way to strengthen her abdominals, get more flexion and rotation in the upper spine, and lift her shoulders off the mat. Foot Work on the Cadillac was chosen for this lesson plan since the work challenges the iliopsoas and pelvic stabilizers, which aim to maintain a neutral pelvic position with flexed hips. The Hip Opener exercise was utilizes as a way for Sophia to discover her deep hip external rotators. As the position mimics a développé to the side, Sophia was able to focus more on externally rotating the thigh bone and dropping the hip into a neutral pelvis position and activating the back of the leg to pressed straight. Moving onto the Reformer, the Extended Frog and Reverse Extended Frog exercises were chosen for Sophia s Hip Work to improve pelvic stability while strengthening her true hip external rotation. Often times dancers are tight in their hips from constantly forcing their natural turn out. In these exercises, I wanted Sophia to take the time to find the disassociation from her pelvic and femur bones while focusing on using her deep external rotators, as opposed to the large, exterior hip muscles. For our Spinal Articulation Block, I cued Sophia to maintain neutral spine position as long as possible as she flexed her hips in the Short Spine exercise. Sophia had a tendency to lift 12

13 her hips too early while bringing her legs overhead. I guided her by holding the hips down and cueing her to relax her gluteal muscles while dropping her tailbone into the mat. From there, I instructed her to use her lower abdominals to scoop her hips up to roll onto her shoulders. I utilized the Kneeling Lunge Stretch to improve Sophia s flexibility in the hamstrings in order to limit antagonizing muscle activation of the moving leg in a développé devant. For our Full Body Integration Block, the Stomach Massage Series on the Reformer played an integral role in developing the dancer s strength to co-contract the abdominal and back extensor muscles. Creating the C-shape with the spine allows for deep engagement of the iliopsoas and the transverse abdominis, the deepest abdominal layer. As the back straightens out for Flat Back and Reaching, the back extensors are increasingly challenged to maintain the lengthened position as the carriage is moving. Simultaneously, stress is put on the deep hip flexor muscles each time the carriage is drawn in, as the exercise is nearly impossible to perform while gripping in the quadriceps. Cueing to refrain from gluteus maximus contraction, which causes a posterior pelvic tuck, is also given to keep the lumbar spine long. The Sitting Arm Series was chosen to increases stability and strength in the lower back extensors needed for a développé devant. As the leg raises into hip flexion in développé devant, there is a tendency to posteriorly tuck the pelvis and flex the lumbar spine. I utilized the Sitting Arm Series to strengthen the intrinsic muscles of the vertebrae, which keep the spine long and lengthened. In a développé devant, a strong, stable standing leg is essential to increase the height of the moving leg. Thus, the Single Leg Skating on the Reformer was instructed to improve hip abductor and adductor strength. As the knee presses into extension, we took the time to increase awareness and engagement of the gluteus medius, a major hip abductor and hip internal rotator that also helps prevent lateral tilt of the pelvis while standing on one leg. 13

14 A great deal of strength throughout the posterior chain is required to perform a développé devant. These same muscles are needed to perform the Breaststroke exercise on the long box. Ideally in a développé devant, the spine should remain upright even as the leg lifts, but the weight of the lifting leg tends to draw the upper body forward unless the muscles of the posterior chain remain engaged. By lying prone demonstrating the Breaststroke exercise, the muscles along the posterior chain strengthen the trapezius, latissimus dorsi, and spinal erector muscles to lift the upper body, while strengthening the hamstring muscles that lift the legs parallel to the floor. Conclusion After the 6 weeks, I once again measured Sophia s passive and active ROM in hip flexion. For passive ROM, we found a 10 degree improvement in her right hip and a 5 degree improvement in her left hip. For active ROM, we found a 10 degree improvement in both hips. Sophia reported that she felt more ease lifting her leg in développé devant, she can find her balance quicker, and she is much more stable balancing on one leg. Observing Sophia throughout our Pilates sessions, she shows to have grown in her understanding of her body and has begun to correct herself before I adjust her. Through this research, the BASI Block System has proven to be a well-rounded program targeting each muscle group through multiple planes of motion. Prior to this study, I was skeptical about conducting a program that focused on strengthening the hip flexors if fear that it would create tightness in the joints. The specificity and mindset of Pilates has shown that increasing self awareness for each exercise can target specific muscles without unnecessary tension in other areas. Without a doubt, Pilates can improve strength and range of motion in hip flexion for ballet dancer. 14

15 Bibliography Betts, J. Gordon, et al. Anatomy and Physiology. Houston, Texas: OpenStax College, Bib lioboard. Web. 21 Sept Clippinger, Karen S. Dance Anatomy and Kinesiology. 2nd ed., Human Kinetics, Ellgen, Pamela. Psoas strength and flexibility: core workouts to increase mobility, reduce injuries and end back pain. Ulysses Press, Haas, Jacqui Greene. Dance Anatomy. Champaign, IL: Human Kinetics, Isacowitz, Rael. Study Guide: Comprehensive Course. Costa Mesa, California: Body Arts and Science International, Isacowitz, Rael. Cadillac: Movement Analysis Workbook. Costa Mesa, California: Body Arts and Science International, Isacowitz, Rael. Reformer: Movement Analysis Workbook. Costa Mesa, California: Body Arts and Science International, Isacowitz, Rael, and Karen S. Clippinger. Pilates Anatomy. Champaign, IL: Human Kinetics, Kohn IV, Roy E. Personal interview. 1 Nov Photos Anterior View, Deep Muscles. Développé devant. Musculature Deep Hip. 15