Rise Health Group – Blog

Written by our professional team at Rise Health Group – Key Health & Fitness Tips & Advice

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Here are the articles on this page:

  • Ankle Sprains: A common problem
  • The importance of calf strength in dance populations
  • Adolescents’ eating for performance and recovery
  • Foam rolling for Athletes & Dancers
  • Hydration for Dance Performance
  • Strengthening for Dancers – How should I be warming up?
  • Strategies to reduce risk of injury in dancers
  • Tips for getting a good night’s sleep
  • Off season
  • Knee pain in dancer
  • Foot and ankle

Ankle Sprains: A common problem

Ankle sprains are one of the most common injuries seen in sport and dance. An ankle sprain involves partial or complete tearing of one or more of the ligaments around the joint. Two major groups of ligaments can be found at the ankle, one on the inside of the ankle, the strong Deltoid ligaments, and the other on the outside of the ankle, the Lateral ligaments. Of these two groups, the weaker lateral ligaments are injured far more frequently, accounting for roughly 85% of all ankle sprains.

The lateral ligaments can be damaged when the foot rolls sharply inward and the weight of the athlete comes down on the outside of their foot, as seen on the right. This is called an Inversion injury. In contrast, the deltoid ligaments are damaged when the opposite movement occurs at the foot and the foot turns outward sharply. This is called an Eversion injury and it is far less common.

Sprains are painful, both immediately after the traumatic event, and for several days following the injury. If you suffer an ankle sprain, you may find you are unable to walk properly for a short period due to pain. This is normal. However, if you are unable to put any weight through the ankle, due to extreme, sharp pain, you should see a physiotherapist immediately, as there may be a fracture. Your physiotherapist will decide whether an X-ray is warranted.

Bruising and swelling is also common. The extent of the bruising and swelling is usually indicative of the severity. The more swelling and bruising in the area, the more likely a complete rupture of one or more ligaments has occurred.

If you sprain your ankle, there are a number of things you can do to manage the symptoms in the interim before you see a physiotherapist for assessment of the injury. You should ice your ankle as soon as possible following the injury. This will reduce the amount of swelling and bruising in the area and provide some pain relief. Ice for 20 minutes and repeat this process 2-3 times a day for the first 48-72 hours.

Application of a compression bandage and elevation of the injured ankle are also recommended to help reduce swelling. You should also try and normalise your walking pattern, putting as much weight through the ankle as you can tolerate.

Sprains can result in chronic instability of the ankle and recurrent sprains, so it is imperative that the injury is managed properly. Your physiotherapist will work with you to re-establish full movement of the joint, strengthen the surrounding muscles and put strategies in place to minimise the risk of reinjury and further damage.

Written by Stacey Cherry

APA Sports Physiotherapist & Clinical Manager

The importance of calf strength in dance populations

As the foot and ankle is the most commonly injured body region in dance, it is essential that dancers spend time on developing excellent strength, endurance and control of the calf complex.

What is the calf complex?

The calf complex consists of the gastrocnemius (the visible bulge at the back of the lower leg), and the soleus, which lies beneath it. The role of these two muscles is to lift the heel off the ground allowing such tasks as walking, running, hopping and jumping to occur. The calf complex also plays an integral role in maintaining the alignment of the many joints of the foot and ankle.

What role does the calf complex and strengthening have in dance?

The calf complex plays a significant role in dance, as a dancer requires significant calf endurance to perform tasks such as demi-pointe in ballet or to balance on their toes during point. Whilst the calf’s ability to generate a high amount of force allows a dancer to perform many different jumping variations, leap with great height and to perform complex diverse movements with both control and power.

When dancers have a greater control of their movements, in particular during a hypermobile position, calf strength offers greater support to the joints making for safer landings, effortless movement whilst decreasing the likelihood for soft tissue and joint related injuries.

Strength training has also shown to have a physiological response on a muscle ability to lengthen, with a targeted program having the ability to improve the range of movement of a joint and the flexibility of a muscle. Therefore, making it easier to achieve such positions as demi-pointe.

Do dancers undertake strength training?

Unfortunately, strength training is often neglected for flexibility and skill based practice, with a recent study showing that only approximately 25% of dancers regularly engage in strength training even though approximately 80% of dancers admitted that is was “very important”.

Muscular strength plays a vital role in the success and longevity of a dancer when incorporated in a safe and effective manner. Are you currently lacking appropriate strength training from your training?

Written by Stacey Cherry

APA Sports Physiotherapist & Clinical Manager

Adolescents’ Eating for Performance & Recovery

While the readily accessible Australian dietary guidelines provide suitable advice for adolescents who participate in general physical activity, those who have a high level of participation in sport require more specific guidance. Adolescent athletes must meet the nutritional requirements associated with daily training and competition, whilst also ensuring that their diet caters to the added demands of their growth and development.

Whilst determining exact energy needs of adolescent athletes can be difficult; monitoring growth, weight and overall health can help to determine if their energy intake is appropriate. Athletes should be encouraged to plan eating around exercise demands. This means to consume larger, carbohydrate based meals and regular snacks to meet increased energy demands on training/competition days. The duration and intensity of the exercise should also guide intake.

Both protein and carbohydrates are important for recovery after training and competition. Examples of appropriate recovery foods include:

Muesli with yoghurt and fruit
Pasta with lean meat
Lean meat and salad roll
Meals containing legumes or sweet potato
Consuming these foods helps to:

Appropriately refuel and rehydrate the body
Promote muscle repair and growth
Boost adaptation from the training session
Support immune function
Proactive recovery nutrition is especially important if you complete 2 or more training sessions in 1 day, or an evening session followed by an early morning session the next day. The body is most effective at replacing carbohydrates and promoting muscle repair and growth in the first 60-90 minutes following exercise, so it is beneficial to try to consume a snack or meal within this time frame following exercise.

Failing to consume the required foods following exercise can result in:

Increased fatigue (during training and at work or school)
Reduced performance at your next training session or competition
Suboptimal gains from the session just completed
Increased muscle soreness
Reduced concentration and motivation following the session
It is important that eating habits and food selection during adolescence reinforce a positive body image, and promote long term health. If you or your child have any concerns regarding their nutritional intake, it is recommended that you consult a sports dietitian for some individualised advice.

Written by Stacey Cherry

APA Sports Physiotherapist & Clinical Manager

Foam rolling for Athletes & Dancers

You may have seen athletes and dancers with a large foam cylindrical structure, this is a foam roller. Foam rollers are a fantastic tool for athletes to perform self myo-fascial release which is a technique that releases tight muscles or knots and also improves blood flow to the muscles.

Why should dancers foam roll?

Dancers often have over-worked muscles due to the extremely repetitive nature of the technique. These overworked muscles and fascia become tight because the nerves that connect them to the brain begin to fire overtime and create tension. The connective tissue of the muscles then tightens up, pulls on the tendon, which in turn pulls a little extra hard on bones. This creates a muscle imbalance leading to greater risk of injury/ pain. Tight muscles or joints due to overuse can also limit your ability to reach positions that are required in dance (ie. Back extension, leg kicks) leading to poor technique. Continued practice of muscle release will allow your muscles to work at their best by normalising the length of muscle and improving blood flow.

How to roll:

Apply your weight on top of the roller and roll back and forth along the length of the muscle repeating this slowly about 10 times on each muscle. If you find an extra tight, tender spot, you can rest on the spot for a few seconds, rocking back and forth.
You can safe to foam roll any muscle of the body, but you should NOT roll over your joints (knees, ankles etc.)
Dancing is a whole body activity and will benefit from rolling all muscles of the legs and spine.
Foam rolling before activity gets the blood flowing and assists muscles to work optimally. Foam rolling after activity helps to relieve muscle tightness which can lead to pain. It is therefore recommended to roll before and after activity.

If you haven’t already, add foam rolling to your daily conditioning routine to help you get the most out of your body!

Written by Stacey Cherry

APA Sports Physiotherapist & Clinical Manager

Hydration for Dance Performance

Drinking water during exercise is essential to maintain blood volume, regulate body temperature and allow muscle contractions to take place. The body’s way of maintaining optimal body temperature is by sweating, which results in a loss of body fluid. Drinking fluid during exercise is necessary to replace the fluids lost in sweat, and reduces the risk of heat stress and dehydration, maintains normal muscle function, and reduces the effects of dehydration on performance.

Dehydration has a negative effect on both physical and mental performance. When you are dehydrated, your heart rate and body temperature increase, and your perception of the difficulty of exercise increases. According to ‘Sports Dietitians Australia’ loss of fluid equal to 2% of your body mass is sufficient to cause a detectable decrease in performance. So if you weigh 50kg, a loss of 1kg of body weight is enough to reduce your dance performance. Additionally, loss of more than 2% of your body weight increases your risk of nausea, vomiting, and other gastrointestinal problems during and following exercise.

So, how do I prevent this from happening to me?
Measure your fluid losses

Weigh yourself before and after exercise
Your weight change (if any) reflects your total fluid loss, ie: the difference between your sweat loss and fluid intake
Remember that weight loss during exercise is primarily water loss (not fat loss) and needs to be replaced soon after finishing exercise.
What should I be drinking?

Water is an effective drink for low intensity and short duration exercise (of less than 90 minutes duration)
Sports drinks are ideal for high intensity or longer duration sessions (of greater than 90 minutes) as they more rapidly replace fluids and electrolytes lost in sweat and help to
replenish glycogen stores.
It is recommended that you drink small amounts of fluid often; before, during and after exercise.
Aim to match the amount of fluid lost with the amount of fluid you are consuming.

Written by Stacey Cherry

APA Sports Physiotherapist & Clinical Manager

Strengthening for Dancers – How should I be warming up?

The days of stretching your muscles before dance or sport are over. Want to become more flexible? Strengthen. Muscles feel tight? Strengthen.

Want to minimize your risk of injury? Strengthen.

The days of holding prolonged stretches to prepare muscles for activity are over. Stretching a tight or sore muscle it is like scratching an itch; it may feel good while you are doing it but the effects are minimal. In fact, dancers who spend long times stretching their muscles may actually be weakening the muscle; reducing its propulsion and making it more susceptible to injury…

Conventional wisdom says that in order for you to do the splits or go on pointe you need to stretch and stretch and stretch; whereas strength training will cause bulky muscles that will not appeal to an audience on stage. This is not the case! Strengthening will not only help improve muscle “tightness” and flexibility, but it will also dramatically decrease your chance of injury.

It’s all in the way we strengthen. High loads (weights) with high reps builds muscle size, therefore dancers should be aiming for high loads with low reps (to increase strength) and low loads with high reps (to increase the muscle’s endurance). This combination will give the muscles the ability to support and protect your body as it moves through the extreme ranges of motion that dance requires.

Still not sure? Since the early 2000s, The Australian Ballet Company has removed ALL stretching boards from their rooms and has ALL dancers on strength and conditioning programs. This is the model we should be following!

So the question is: “if I shouldn’t be stretching what should I be doing?”.
Warm up for dancers should include multiple routines; light jogging to warm the muscles, taking the muscle through range dynamically (with continued movement) and engaging the major muscles that will be used.

Your warm up may look like this*:
– Get the muscles warm with a light 5-minute jog or bike.
– Controlled leg swings (forwards/backwards and side-to-side), calf pumps, walking pretzel stretch and walking lunges
– Squats, glute bridges, calf raises off a step, prone holds and some controlled single leg jump and land activities

Remember, strengthening you muscles is the most effective way to increase your flexibility and decrease your risk of injury. Stretching may be a hard habit to break, but we promise your body will thank you for it later.

*This is a general warm up only. Individuals should see a Physiotherapist or Exercise Physiologist for specific strengthening and warm up routines that will increase their flexibility and decrease injury risk.

Written by Stacey Cherry

APA Sports Physiotherapist & Clinical Manager

Strategies to reduce risk of injury in dancers

Dance is a physically demanding activity that involves repetitive movements for several hours a day. This places dancers at high risk of overuse injury to the lower back and lower limb regions. Risk of injury increases with age, so it is important as a young dancer to implement good habits to reduce risk of future injury. Below are 5 strategies that dancers’ can use to reduce their risk of overall injury, with a specific focus on the hip region.

Always warm up before training or competition
Warm up improves joint range of motion and muscle flexibility, which is important due to the large range of hip mobility required for dance.
Warm up is also important for psychological preparation which helps to promote technique and performance, and thus reduce risk of overload injury.
A good warm up includes dynamic exercise, muscle activation and joint mobility exercises, and should be tailored to the style of dance to be performed; ensuring that all muscles and joints are addressed.
Ensure adequate rest between classes
Evidence has shown that dancing for more than 5 hours a day increases risk of injury
It is recommended that dancers have at least 2 days off from dancing per week to allow adequate healing and recovery, sleep is also very important for this.
At the end of the season, a 3-4 week recovery period is also recommended. Unlike other sports, dance has no specific ‘off season’, so this often needs to be implemented by the dancer themselves
Avoid overstretching
Whilst the hip needs to be mobile for dance, it also needs a large amount of stability in order to support the upper body and stabilise the lower limb, particularly during high impact, plyometric activities such as jumping and leaping.
In the hip joint, overstretching, or being forced into extreme ranges of motion can damage the structures that support the hip joint, including the labrum and ligaments.
In young dancers whose bones are not yet fully developed, it can also damage the shape of the hip socket, or create stress fractures.
An extremely mobile, and unstable hip joint is at increased risk of overload and injury both when young and later in life.
Strength training (global and stability)
Strength training has been consistently shown to reduce risk of injury in all sports people including dancers
Strength training is especially important for dancers due to the large range of motion that their joints are required to work through. Excessive mobility in any joint requires fine, coordinated control of stabilising muscles in order to reduce joint pain.
Pilates can be a great way of training this due to its low impact nature and ability to promote both global and local hip strength and stability, and overall postural control.
Eat well, and stay hydrated before, during and after class
Proper nutrition is important for dancers of all ages
Written by Stacey Cherry

APA Sports Physiotherapist & Clinical Manager

Tips for getting a good night’s sleep

Stick to a sleep schedule of the same bedtime and wake up time, even on the weekends. This helps to regulate your body’s clock and could help you fall asleep and stay asleep for the night.
Ensure your room is not to hot or cold. The ideal sleeping temperature is 21 degrees.
Adopt a sleep routine– take some time to wind down, do something relaxing and have the same routine each night before bed.
Switch of devices and stay away from TV at least 1 hour before bed. These devices stimulate your brain and have lights which can interfere with your ability to sleep. Have some quite time before bed to let your brain and body relax.
Written by Stacey Cherry

APA Sports Physiotherapist & Clinical Manager

Off Season

Throughout the year it is often difficult to get on top of injuries and niggles that present as we try to maintain the balance between rehab and continuing with training/competition. The constant demand of training and competition on the body depletes our ability to heal and recover. The “off season” presents an excellent opportunity to reduce training loads and focus on preparing the body for when the next round of competition or training will take place or “on season”. There is always a temptation to stop training all together in periods outside of the lead up to a competition or a performance. However, while having periods of rest is essential for mental health along with preventing injury and maximising performance, like all things this must be approached with balance.

Providing the body with sufficient rest time in the off season will allow the natural healing processes of the body to take place and often many of the aches and pains that are experienced in season appear to resolve. Once this has occurred the key to preventing these issues from reoccurring in the future is to identify the cause of them and then address the associated risk factors. Identification of areas of weakness, poor mobility or simply poor conditioning then allows development of a program to address these factors.

By spending time in the off season working on improving strength and fitness, the body also does not experience the same deconditioning that can otherwise occur. This is one of the most effective ways of preventing injury and improving performance throughout the year when training loads and competitions increase.

Written by Matt Timmers


Knee pain in dancer

Among the injuries or causes of pain regularly seen in dancers knee pain is one that is presents quite commonly. While there are many causes for knee pain, research has suggested that 29% of all injuries in adolescent dancers is accounted for by patellofemoral pain syndrome (Smith et al, 2015). Furthermore it is suggested that 75% of all injuries in this age group is accounted for by “overuse” type injuries.

To reduce this chance of injury there are 2 factors which can be controlled. The first is related to the individual’s biomechanics or how they move. The most common issues typically include poor strength around the muscled on the outside of the hip and/or a flat (pronated) foot type. The second factor is load management. This refers to the total amount of exposure that someone has to their provocative activity and this goes beyond just what is done in the dance studio. Total dance hours, other sports the individual may participate in and even things such as having to go up and down stairs regularly or having to walk up a big hill to school each day need to be considered in order to treat this presentation.

To effectively manage this condition both parts of the problem must be equally addressed. Even the strongest professional athletes have a limit on how much activity their bodies can tolerate before they start to get injured. Similarly if someone controls their loads well and their symptoms disappear if nothing is done to change the biomechanics the chances are that symptoms with return as soon at the load increases again.

Written by Matt Timmers


Smith, P. J., Gerrie, B. J., Varner, K. E., McCulloch, P. C., Lintner, D. M., & Harris, J. D. (2015). Incidence and Prevalence of Musculoskeletal Injury in Ballet: A Systematic Review. Orthopaedic Journal of Sports Medicine, 3(7), 2325967115592621. http://doi.org/10.1177/2325967115592621

Providing the body with sufficient rest time in the off season will allow the natural healing processes of the body to take place and often many of the aches and pains that are experienced in season appear to resolve. Once this has occurred the key to preventing these issues from reoccurring in the future is to identify the cause of them and then address the associated risk factors. Identification of areas of weakness, poor mobility or simply poor conditioning then allows development of a program to address these factors.

By spending time in the off season working on improving strength and fitness, the body also does not experience the same deconditioning that can otherwise occur. This is one of the most effective ways of preventing injury and improving performance throughout the year when training loads and competitions increase.

Written by Matt Timmers


Foot and ankle

The foot and ankle complex is a common problem area amongst dancers. Dancers regularly subject this area to high amounts of force as they repeatedly jump, land, twist, spin and in particular perform on pointe. This results in high amounts of force being transferred through this area and with such a complex function it is not surprising that it can end up being an area of concern.

Just like the rest of the body, completing a regular strengthening program that targets the foot and ankle can better prepare the body for coping with the demands of a high dancing load. This means trying to include exercises such as calf raises a couple of times per week along with balance and foot specific type exercises. Most dancers should aim to be able to complete 30 single leg calf raises in a row to indicate a good level of calf strength. The foot itself tends to be one of the areas which can be easily forgotten about. While doing rises to work on the big muscles of your calf are fantastic, the smaller intrinsic muscle of the foot can require attention too. These muscles, while only tiny in size, are critical for maintaining strength in the arches of your feet and play an important role in balance. Bare foot balance exercises are a good place to start when working on intrinsic muscles however more targeted exercises can be considered if required.

Written by Matt Timmers