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Interviewer: Three common dance injuries and how to avoid them. That's next on The Scope.

Announcer: Health tips, medical news, research and more for a happier, healthier life. From University of Utah Health Sciences, this is The Scope.

Interviewer: Trina Bellendir is a physical therapist in the Dance Clinic at University of Utah Orthopedic Center. And today we're going to learn about three common dance injuries and how to avoid them. So let's start with number one.

Trina: So that would be an ankle injury. That's sprain, strains, twists, turns of the ankle. Most of those from the ankle being dropped or pronated. People should work on lifting their arches up. They'll hear the terms short arch, arch ups or a suction cup, using the tripod of your ball of your foot on the first and fifth toes and your heel as your tripod and suctioning that down onto the floor.

Interviewer: And is that a good exercise just to do, just to keep those strong to prevent injuries?

Trina: It is. You should do a lot of toe exercises just in general. Toe and foot, that's one thing that we don't typically go to the gym and work out, our toes. We just put our shoes on and away we go, but over time your arches tend to drop and the ligaments stretch.

Interviewer: Gotcha. And doing those kind of exercises is not as fun as dancing.

Trina: Of course not.

Interviewer: But you'd recommend that people work that into their routine daily?

Trina: At least once a day they should be doing, watching where their arch is on a daily basis, whether they're a dancer or any other athlete or person that walks.

Interviewer: Gotcha. Common dance injury number two and how to avoid it?

Trina: Probably, the second most common one is a knee injury, not typically having a lot of ligament tears, but they do get a lot of pain around their knees from their knees falling in. This also can be caused because of the arch dropping, but also because of weak hip external rotators and abductors. So if you work on strengthening your abductors of your hip, most of the time your knee pain will go away.

Interviewer: Yeah. And then isn't that interesting how it originates up in the hip and you notice it in the knee?

Trina: The knee is just the symptom guy, but he typically is not the cause.

Interviewer: Gotcha. So do those daily hip exercises as well, your probably gluteus medius, I would imagine?

Trina: Good job.

Interviewer: Yeah. I don't know if minimus plays into that as much.

Trina: Glut minimus, glut medius both play into that, yes.

Interviewer: Gotcha. All right. Dance injury number three and how to avoid it?

Trina: Next one is the low back. People tend to have a lot of low back pain. Dance choreography is typically one sided towards one direction, usually the strong side. So just making sure that whatever you do going one direction you do going the other direction as well. And also really stretching your hip flexor out. That doesn't mean you get a bigger curve in your back, stretching that ileus soleus muscle.

Interviewer: So if you're a little bit older and a dancer, you probably have this type of discipline built into your routine, but if you're the parent of a younger dancer, it might be hard to impart upon them how important these exercises are for the longevity in their sport. How do you help convince somebody that might not be convinced?

Trina: It depends on if you're talking about an older dancer or younger dancer.

Interviewer: Yeah. Let's go with the younger dancer.

Trina: Okay. The younger dancer, I just tell them that I see these people over and over again, I would work with professional dancers, I work with the University dancers, and the best way to continue a long dance career is not to get injured at a young age.

Interviewer: And the best way to avoid doing that is being aware of these things as they arise and then strengthening the appropriate muscles to prevent it, yeah.

Trina: Yeah. Dance is expensive, so for the parents, if the person wants to dance, then they need to do their exercise.

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Interviewer: Learn more about the dance clinic and how it can help you if you're a young dancer, or a dancer that's been doing it for a while. We'll talk about that next on The Scope.

Announcer: Health tips, medical news, research and more for a happier, healthier life. From University of Utah Health Sciences, this is The Scope.

Interviewer: Trina Bellendir is a physical therapist in the dance clinic at University of Utah Orthopedic Center, and today we're going to learn more about the clinic. It's a resource for you as a dancer that hopefully you'll use before to prevent injuries, and if you do have an injury, it's also a place you can go to have that taken care of. So first of all, who is the dance clinic for? Is it just for amateur, professionals, both?

Trina: It is actually for both. Anyone that has an injury or would like to prevent an injury, or they know that there's some dysfunction, or their dance instructor has told them, "You need to work on this," that's what I'm there for.

Interviewer: Okay. So that's a good trigger word, right? If your instructor says, "This is something you need to work on," and you're not able to do it, that would be something you can help them with. Tell me about a typical visit. Who is that person?

Trina: I've had a few that came in with, "You need to work on your arch supports and lifting up your arch," and them not knowing how to attain that arch. So my job is to teach them which muscles to use, how to show them their points on their feet to get those activated.

Interviewer: Got you. Can you give us some other examples?

Trina: Knees over the second toe. Dancers tend to let their knees fall in, so we'd like to have them knees always in line with their second toe to help prevent some of the chondromalacia patella and knee dysfunctions.

Interviewer: And a lot of those dysfunctions, is this true or false, are caused by some sort of a muscle strength imbalance or a flexibility imbalance that you can help with?

Trina: It is. Most of them are muscle imbalances and we just need to do some minor exercises to help them rearrange those.

Interviewer: Got you. So it's for professional dancers as well as amateurs, young and old?

Trina: Young and old. I've seen them up to 50 or 60 and as young as 8.

Interviewer: Got you. And your typical patient, I would imagine, is somebody that comes in that has hurt themselves at some point, and maybe has ignored it for a while because they're hoping it would get better. You would hope to have fewer of those and more people that are coming in more proactively. Talk me through how somebody might know that they should actually come and visit the clinic.

Trina: Any time you start getting just the basic strains, pains type of thing that doesn't go away after you've iced it and rested it for a day or two, those are the type of people I'd like to see in there, preferably before they are unable to dance and the show is tomorrow.

Interviewer: And then for those that come that actually have some sort of a chronic issue, how do you normally work them through that?

Trina: Well, I treat the chronic issue first mainly by treating, getting their symptoms under control. Then we'll look back and see what caused the issue. Not just the ankle, but does it even arrive at the hip or at the back. We need to make sure the entire body is working well together and those muscle balances are correct.

Interviewer: Do you have any sort of technology or tools that helps you analyze dancers? I've been to a runner's clinic before, and I loved the fact that they filmed me. I learned so much from that.

Trina: So I am in a fairly unique position working at the university, that we have a motion capture system that we have in the clinic. We have a force plate that is actually brand new that we can test their ground reaction forces with. We have isokinetic machines for strengthening and testing, as well as what's called a foot mat. It does the pressure sensitive areas of your foot so they know where they're putting the pressure.

Interviewer: So a lot of kind of cool tools.

Trina: We have lots of fun toys over there, yes.

Interviewer: Yeah, to really help somebody through whatever particular issue they might be facing. So if somebody comes in for a visit and they're in the situation, either I guess. Let's talk through both of these. They're looking to do something that they're not able to at this point, or they have hurt themselves and they're looking to rehabilitate. How often does somebody usually have to come back before they start noticing some results?

Trina: I like to see results after the first visit.

Interviewer: Really?

Trina: That doesn't mean that I've got them completely better, but I want to make some changes day one. So maybe not better, but at least a change, so that way we know we're heading in the right direction.

Interviewer: I see. And does insurance cover this?

Trina: Insurance covers most of it. If we take your insurance at the University Orthopedic Center, then your insurance will cover the dance clinic as well.

Interviewer: So really, I mean, it's just great insurance against hurting yourself or being able to enjoy this thing that you enjoy for a long time.

Trina: It is. It's basically your co-pay versus a new pair of dance shoes, which can run anywhere from $50 to $150, $200. So your co-pays $25, $50 even, and it's worth it. I just would prefer to have people come to me early and have me say, "Well, it's just a little strain." I'd rather have that, give you a couple of exercises, treat some of the mechanics that you're doing early, versus waiting until it's a chronic issue and then it's going to take months to get better.

Interviewer: It's a lot easier to untangle that early on, so.

Trina: It is, and I try not to take you out of dance, because telling a dancer they can't dance is awful. So we try to keep you in your sport as long as you can, unless it's too bad.

Interviewer: So really, pay attention to what your body is telling you, and it's a great resource you can take advantage of that is fairly reasonably priced if you have insurance through the U.

Trina: Absolutely.

Interviewer: What about somebody that doesn't have insurance through the U?

Trina: People that don't have insurance through the U, we do take cash pay. We try to be kind with that, and if you pay upfront, it's a 30% discount.

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