Forcing turn-out and sore, swollen knees?

[WendyMichelle]

Everyone in my class goes for that "perfect" turnout. I've noticed some of the girls rolling in on their front foot when in fifth. One of our teachers gave one of the "best" girls a correction this past Tuesday about her turnout and actually told her to turn in a little bit because she couldn't maintain what she was trying to do throughout the exercises.

 

I can very easily get 180 degree turnout. No problem. When I am working at my own pace my knees track directly over my toes. However, in the class environment, when the music is fast with a quick detourne to the other side and immediately starting the second side with no time to get yourself settled, I'm finding that my knees are killing me and, particularly my right knee, is swollen afterwards (the left knee isn't much of an issue.........I ripped the medial meniscus out of it 9 years ago ). It gets to the point where it feels like my knees literally don't want to bend anymore and grabbing my foot and doing a quad stretch actually feels good on the KNEES, not the quads. I asked one of the other girls who sometimes teaches our class what was going on. She said she would have to watch me throughout an entire class to try to see what the problem was, but it sounded like I was turning out from the knee or ankle. She asked me to show her my turnout and do some exercises and she said that didn't appear to be the case (of course, this was also at my own pace). She then said I could be going down too far in my grand plies.

 

So yesterday we had this guest teacher. The very first thing she had us do was go into first position, then lift up our feet so that we were on our heels, rotate our feet straight forward (on our heels), then rotate back to first (on our heels), then drop our feet. I'm pretty sure this was an exercise designed to help you find YOUR first position. Mine actually was not that much different from what it normally is (maybe 5 degrees on each side). Some of the girls did this then immediately cranked their feet out to 180. She made those girls stop and keep doing this until they stopped cranking their feet. I took note of where my feet were and made adjustments in all positions (especially in fifth....I turned both the back and front feet in just slightly). I also did not go down as far in my grand plies. Surprisingly, I had no pain at all in either knee.

 

So......what was going on here? And should I not worry about "looking good" and go for what "feels good?" I also recently bought that book "Tune up Your Turn-Out" by Debra Vogel and she talked about how a lot of dancers will have what appears to be 180 degree turnout at the barre, but when they get to center they have to make adjustments. I have noticed that with myself as well. I can be very well turned out at the barre, but when I get to center I have to turn in to between 45-60 on each foot to feel stable. Vogel also said that once you get to the center that hardly anyone dances with perfect turnout?

 

Basically what I'm asking is.................am I making the right adjustments necessary for my body and abilities so that I don't rip out the right medial meniscus as well?

 

Also (I'm the Energizer Bunny today........I just keep going, and going, and going, and going....), I keep hyperextending my right leg. My legs are hyperextended anyways and I don't know what is going on or why this is happening (I was thinking that maybe it was from trying to have that pefect fifth position). Anyways, the muscle, tendon, ligament......whatever it is, right behind my right knee gets so sore that I limp a lot. I have to do some stretches on it in a certain way to make it feel better. This doesn't just happen with ballet, but just the least little thing seems like it will hyperextend it beyond what it already is and tweak it. Like I've had to rest my leg on ice before (days when I'm not dancing and even during those few months when I wasn't dancing at all this would happen).

 

Can anyone help?

 

WM

[Mel Johnson]

I've read Vogel on hyperextension and turnout, and she's right.

 

Far too many times, I've seen people who appear to have flat turn-out, and then when I look at their knees, there's a BIG discrepancy, like sometimes 40-45°! There is a little bit that the tibia/fibula assembly can lend to turnout, but really it's only about 5-10% of the total real turnout. Those bones and the knee weren't intended to move that way.

 

You can get more rotation out of the hip joint probably, but it's a slow, incremental process taking months. Even at my age, I was able to restore a significant amount of rotation when I started teaching again, after a very long time off.

[Victoria Leigh]

Sounds to me like the hyperextension, probably in addition to the over-rotation, is causing the problem. IMO, the very first thing you need to do is find the right alignment and weight placement so that the knee is not allowed to push back into that hyperextension. That IS something you can control, but it does take a lot of concentration and focus on doing just that, 24/7, NOT just in class! It's very important.

 

In the meantime, avoid ALL grand pliés except second position. ESPECIALLY fourth position. Just don't do it! Seriously, one can live (and dance very well) without grand pliés! Once the meniscus is gone, it's even worse to try and do those. Second should be okay, as long as you don't go down below the knees with your derrière. Skip the others and just do demis. You will be fine, and after a day or two, will never miss them. (I have not done a grand plié except second since my [hyperextended] knees went bad about 18 years ago.)

[WendyMichelle]

I've noticed that I can get down in fourth position, but the coming back up part is, um.........difficult. ;p The hyperextension also happens with the right knee just walking at work, etc. So it's not just in dance class. What do I need to do keep from pushing back all the way?

 

In the meantime, I probably need to say something to my teachers about not doing grand plies, right? How should I approach that situation....or just do demi's until they say something and then tell them my knees can't handle grand's?

 

Thanks Major and Ms. Leigh!

WM

[Victoria Leigh]

If they question you, explain that your knees have been bothering you. Any teacher who pushes you into doing grand pliés when your knees are bad should be banned from teaching for life!

 

As to fixing the hyperextension, get your pelvis in the right place, keep your weight forward, and simply do not allow the knee to push all the way back. Who is in charge of your legs, anyway? Seriously, it is not simple to remember all the time, but it really is a simple fix. Just don't do it. Take control of what your own knee does.

[WendyMichelle]

Apparently my leg is in charge of my leg! *lol* I think I need to have a talk with it about serious repercussions if it continues to misbehave.

 

Seriously though, I will try to be more aware of the simple things.......like walking. Who knew that walking would take such concentration?

[Jaana Heino]

Wendy, I am struggling with knees and hyperextension too, and have one bad meniscus knee (my left). My turnout is way worse than yours, but otherwise I could have written your story, complete with the teacher giving the heels-down excercize!

 

I am not even up to practicing walking yet, I have been told to practice standing! And as Miss Leigh says, I apparently need to practice 24/7... One teacher says I am to stand in relaxed first or third position, not only in class while I am waiting for others to go, but all the time waiting for bus, in elevators, and so forth, and to feel those muscles directly above my knees engage and my legs "straight but not pushed back".

 

(Moderators please correct if the above does not make sense, I might have very well misunderstood something. I have huge issues figuring out the whole straight knee thing.)

[Victoria Leigh]

No, you are correct, Jaana. When the problem is severe, you do have to relax the knees a bit and learn to control them from the quads. The problem then becomes getting them straight all the way when the leg is the extended leg and not the standing leg! This is one of the reasons that hyperextension is both a blessing and a curse!

[Balletismykidslife!]

>>>Sounds to me like the hyperextension, probably in addition to the over-rotation, is causing the problem. IMO, the very first thing you need to do is find the right alignment and weight placement so that the knee is not allowed to push back into that hyperextension.<<<

 

I have a question about hyperextension, and if there are 'differences' when using that term. Lets see if I can be somewhat clear here! My dd refers to hyperextension on many occasions, and she is usually talking about how 'pretty' it is, and how beautiful the leg looks etc.....Then she will at times refer to HER leg and say "Mom look my leg looks a tiny bit more hyperextended...do you see it?" And I just look as say..."Yeah looks good to me" Balh blah blah........

 

So my question: Is hyperextension something that just happens to certain dancers? Or do some dancers work hard towards making the leg more hyperextended? Or is it a bad thing like some of the previous posters have been talking about with it affecting the knees....?

 

One of the reasons I ask is because a lot of professional dancers do have beautiful (?) hyperextended legs, like Patricia Barker for instance. Is there a positive side to hyperextended legs because of how 'pretty' the leg is, and can you work to improve hyperextension if it is a positive thing...?

[Mel Johnson]

Hyperextension is an anatomical term. It refers to any joint, fingers, knees, elbows - which come to full travel ("lock") in back of a straight line. A lot, and I mean a LOT of students think that hyperextension means "sticking the leg WAY up in the air." That's not hyperextension from an anatomical standpoint. From a technical standpoint, it is a HIGH extension, 120° and above. It is only a coincidence of language that makes hyperextended legs a basis for high extension, as the hamstrings are elongated from the additional stretch between hip and knee and the abductors made unusually strong, just from natural getting around!

[Balletismykidslife!]

Oooops maybe I was not clear. Yes I do know that hyperextesnion is what you described. I am indeed referring to the leg from her knee down. I was not talking about 'great extensions'. Somehow I made that confusing. That is one reason that I mentioned Patricia Barker. She is a great example of hyperextended legs! So.....now that is clear...so what is your personal opinion on my question that I posted in my original post? Thanks!!!

[Jaana Heino]

When the problem is severe, you do have to relax the knees a bit and learn to control them from the quads. The problem then becomes getting them straight all the way when the leg is the extended leg and not the standing leg! This is one of the reasons that hyperextension is both a blessing and a curse!

 

How funny! I did just notice that some of my standard "straight supporting knee" corrections seem to have been replaced with "back leg straight in arabesque"...

 

To answer to the parent (please delete if this is not appropriate by the board rules), "hyperextension of the knee" when used anatomically correctly refers to the bone structure being such that it allows to knee to travel further back than the straight position. Someone who was not born with it should not forcefully try and push their knees to there, it does nothing in the best case and could cause injury in the worst. And really there is no need to wish you were hyperextended if you are not, as a natural straight position is just as pretty when used right, and easier to stand on! Sometimes ballet kids use "hyperextended" to mean "completely straight" when speaking of their knees (at least Finnish kids in the dressing rooms seems to), however. This could be what your daughter is talking about, but I would check that she is not e.g. doing splits forcing her heel of the floor with phonebooks or some other insane things the kids sometimes come up with. ;)

[psavola]

Not exactly on topic, but being hyperextended myself, I thought to share some things I've found helpful. This may or may not be useful to people without hyperextension.

 

First, I've found thinking about length instead of straightness in the legs seems to work well for me in finding the right position for the joint - straight but not sinking back.

 

The second is that this correct positioning of the leg joints is a process, not a position. Dance is essentially movement; a position is just something a dancer goes thorough. Leg straightness is a process because it is something that must be maintained, not just something briefly displayed.

 

As an another example, rotation is also a process - starting a combination from a position of perfect turnout does not guarantee perfect turnout during the combination. The only way to maintain rotation during the combination is to rotate all the time. The only way to maintain leg straightness during dancing is to straighten the legs all the time.

 

Päivi

[hart]

Mr. Johnson and/or Ms. Leigh,

 

Regarding the 5-10 degree rotation from the knee and ankle thing, do you agree with Vogel's assessment that if a student has pronounced tibial torsion, it is better to allow them to work with their natural body alignment rather than expecting perfect knee-over-toe alignment? My weight tends to be on the outside of my feet to begin with; when I try to correct my tibial torsion my weight is even further out, forcing my weight distibution backwards. It also hurts my knees. I have taken Ms. Leigh's correction to turn-in a little to manage sickling the working foot, due to my tibial torsion. With regard to the supporting leg, is it better to allow for the tibial torsion for the sake of better weight distribution or does alignment trump weight distribution? You would think ideal alignment would lead to ideal weight distribution, but it doesn't seem to work that way with my body, even when I am pulled up on my suppprting leg.

[Mel Johnson]

I generally allow that to continue, as a starting point, and encourage knee/toe tracking gradually as a goal. It's a slow process, but tibial torsion can be corrected with attention over a fairly long period of time. The problem is that the student may go back to it if it is not constantly reinforced. It was one of the reasons that Natalia Makarova's performing career was relatively brief. Nobody was looking for that particular defect in a ballerina of her stature.