Pilates for greater external rotation of the hip in dance Jenny Krude Oct 1, 2017 Costa Mesa 2017
The purpose of this paper is to identify and strengthen the muscles that will help a dancer in increasing his/her turnout in the hip joint, which is already a very stable joint. I will be identifying the muscles responsible for external rotation of the hip and learn how to engage and strengthen them resulting in a more opened turnout. An ideal turnout for a ballet dancer is a 180-degree rotation from both hips when a dancer is standing in first, second and fifth position. It can be very dangerous to try to force the turnout from the knees or ankles so we will be looking at ways to safely and effectively open up the hips. 2
Table of Contents Abstract 2 Table of Contents 3 Anatomical Description 4 Case Study 6 Conclusion 8 Bibliography 10 3
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As we look at the picture of bony landmarks of the pelvis we see that there are two main bones that make up the hip. Each bone is formed from the fusion of three bones which are the ilium, pubis, and ischium. These three bones come together to form the hip socket which is called the acetabulum. The pubic bone connects in the front by the symphysis pubis joint and the sacrum attaches to both ilium to complete the pelvis. The femur or thigh bone inserts into the pelvis by lodging the femoral head into the acetabulum. This is a ball and socket joint and is very secure. About 70% of the head of the femur is articulating with the acetabulum. The acetabulum is rounded and deep and suctions the femur into the socket like a vacuum. Karen Clippinger even found research (Smith, Weiss and Lehmkuhl, 1996) that talks about the great force required to separate the femur from the hip. She states, "In adult cadavers, 45 pounds (20 kilograms) of force was required to separate the joint 0.1 inch (3 millimeters), and in healthy adults, 90 pounds (41 kilograms) of force was required to separate the joint even when it was in a loose-packed position". This makes the hip joint the most stable joint in the body. The way that the femur fits into the socket creates an angle of femoral torsion. This angle is the relation of the angle of the head and neck of the femur and the shaft of the femur. A normal range is 8 to 15 degrees with anything over that being known as femoral anteversion and anything under that would be femoral retroversion. As a dancer you would be happy to have more of a femoral anteversion so that turnout would 5
come a little easier to you. This shows us that when it comes to our bone structure it is all up to our genetics. There are three ligaments attaching to the bones of the hip socket and joining them with the femur. They are the pubofemoral, ischiofemoral and iliofemoral ligaments. The iliofemoral is known as the Y ligament and is the strongest in the body. These ligaments are taut in hip extension, lax in hip flexion and stable when standing upright. We then look at our muscles since they are the movers of our bones. To externally rotate from the hip joint we use our large gluteus maximus and 6 deep external rotators that lay beneath. Those muscles are our piriformis, obturator internus, obturator externus, gemellus superior, gemellus inferior and quadratus femoris. The adductors are also used but more as the hip is extended, flexed, or abducted. I volunteered myself for this case study because it is a topic that I am passionate about. I am a healthy 34-year-old female with no injuries who has been dancing for only 4 years. Turnout is determined by bony, ligamental and muscular factors and because I started dancing later in life the positioning of my bones was already formed. Young dancers are able to manipulate the positioning of their bones until about age 11 or 12 and the acetabulum is really solidified by age 16. My goal was to see if by strengthening those external rotator muscles I could achieve more turnout. I had a friend use a goniometer to see what range I had before starting my training. I laid prone on the ground with both knees bent at 90 degrees while my friend placed a hand on one leg and started to externally rotate it from the hip making sure my pelvis remained in a neutral 6
position and my ASIS were in the floor. She then placed the axis of the goniometer over my patellar tendon with the stationary arm remaining vertical and the movable arm moved to match my lower leg and foot. 90 degrees in each hip would be a perfect turnout and my left side measured at 48 degrees and right side at 46 degrees. My mission now was to see if by strengthening my external hip rotator muscles I could rotate my femur in the hip socket and achieve a few more degrees of turnout. My conditioning program was: Roll Down WARM UP: Cadillac- roll up with the RUB, spine twist supine, mini roll up, mini roll up oblique, roll up top loaded FOOT WORK: Cadillac- including hip opener AB WORK: Cadillac- breathing and bottom lift with RUB HIP WORK: Cadillac- supine leg series SPINAL ARTICULATION-Cadillac- tower STRETCHES: Reformer- full lunge FULL BODY INTEGRATION: Cadillac- Thigh stretch with RUB ARM WORK: Reformer- Arms sitting LEG WORK: Wunda Chair- Hip opener and Frog Front Cadillac- Side lying single leg LATERAL FLEXION/ROTATION: Cadillac- Side lift with PTBar BACK EXTENSION: Prone 1 7
I chose to do my footwork on the cadillac because it allows you to get a nice stretch in your hamstrings as you bend and straighten your legs. The biceps femoris is a hip extensor and needs to be flexible to accommodate movement in a turned-out position. The hip opener was great in allowing me to connect with and engage my external rotators. I chose breathing with the PTBar and bottom lift because you get that extra element of spinal articulation with your ab work and the breathing is a very beautiful exercise that allows you to connect with the breath which is so important in letting the muscles relax and lengthen without tension. The hip work supine series on the cadillac allowed me to focus more attention on my left side which tends to follow my dominate right side. Tower is also a great exercise which engages the hip extensors and lets you get a nice stretch for the calves. The full lunge allowed me to get the largest range of motion in my stretch and the thigh stretch helped to open up my quadriceps and hip flexors. My arm work made me really work on my trunk stabilization and hip flexor strength and having a strong stable trunk is what will help support my hip positioning and movement. The work on the wunda chair really lets you connect with your external rotators which I found to be a favorite when performing the frog front and hip opener. The leg work on the cadillac was also great in isolating both sides and trying to keep the pelvis stable. After working out 3 days a week for 5 weeks I was excited to measure myself and was hoping for an improvement. After getting measured I was delighted to find out that my measurements had improved from 48 to 50 degrees in my left hip and 46 to 48 ½ in my right. These exercises have now strengthened my external rotators and have given me the knowledge to find them and use them while dancing. Before I 8
started this training program I didn't have much strength in this area and it was hard for me to find these muscles and engage them. I plan to continue this program and see if I am able to get additional rotation. I also know that it's strengthening my whole body and allowing me to continue on with my love of dance and pilates. 9
Bibliography Clippinger, Karen. Dance Anatomy and Kinesiology: Principles and exercises for improving technique and avoiding common injuries. Champaign, Il: Human Kinetics, 2007. Clarkson, Priscilla and Skrinar, Margaret. Science of Dance Training. Champaign, Il: Human Kinetics, 1988. Greene Haas, Jacqui. Dance Anatomy. Champaign, Il: Human Kinetics, 2010. Wilmerding, Virginia and Krasnow, Donna. Turnout for Dancers: Hip Anatomy and Factors Affecting Turnout. www.danceeducation.org, 2011. <citraining.com> 10