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Home > Technique

Hip Health

The Tao of the hip:
The hip joint is a remarkable rotator. Mechanically, it is a large ball-and-socket arrangement. The acetabulum is a deep, cup-like socket on the outside of both sides of the pelvis into which the head of the femur (thighbone), the longest and strongest bone in the body, fits to form the stable and strong hip joint. Aided and surrounded by a family of contributing muscles, the neck of the femur angles down, giving the hip it’s capacity to rotate the leg inward and outward, side and back.

When these muscles are in balanced strength and properly interactive, they stabilize the pelvis while the dancer is working, particularly on the supporting side. A stable supporting side permits the working leg to nestle and relax sufficiently in the socket to produce fluidity of action. If the pelvis is not held in a stable and lifted position with the lowest spine bones “dropped”, the legs are not free in the hip socket to turn out or move with ease.

Healthy Hip

Hip Health

Ever since our dance ancestors discovered that by turning out at the hip joint they could have greater freedom of movement, turnout has been obsessively cultivated. The extent of a dancer’s inherent turnout is controlled by the interaction between the hip’s external and internal rotators, connecting ligaments, the hip cavity and tension in the muscles controlling the hip’s movement.

All of these elements can be strengthened, stretched and developed until about age 11, although some changes can occur in the ligaments and musclotendinous structures until age 15. Turnout forced from the floor up results in an arched lower spine, twisted knees or rolling inward at the feet. In short, it does nothing for the turnout and causes knee, foot and ankle damage.

From the side, a perfect turnout has the midpoint of the kneecap aligned over the long axis of the foot, while the torso remains vertical and the arches of the feet are maintained. The knees face directly side so a straight line is formed to the ankle.

Few dancers inherit or can safely force a perfect 180-degree turnout. Boys, in particular, if they start to study at a later age, suffer frequent hip injuries from forcing turnout. A simple test for the extent of the natural degree of turnout has the dancer standing in parallel position and while maintaining straight knees, rotating the thighs outward as far as possible.

Injured Hip

Inner thigh muscles are vital for stabilizing the pelvis. If those muscles are weak, other muscles may be injured trying to compensate for the lack of function. Strengthening exercises should be a part of regular barre or cross training. “Tight” hips are congenital configurations and should not be forced. No manipulation, exercise, therapy or compensation in the knee or ankle will change the rotation in the hip. Work to balance the entire muscular structure to increase and maintain technical proficiency.

Some dancers begin their classes by “popping” their hips because it feels good. The theory is that the tendons snap across the front of the pelvis, or each other, as they change position and make a clicking noise. If the hip is snapped enough, it can become irritated, swell and develop tendonitis. Pain can also be the result of ligamentous injury, muscle strain, dislocation or a bone spur in the hip socket. All pain in the hip should be investigated.

The list of famous dancers with hip replacements may have inspired the media-induced myth that dance eventually results in overuse injuries and replacements. Dancing does not cause the arthritic condition that eventually requires hip replacement. The culprit is osteoarthritis, a degenerative disease that is almost universal throughout the world in the general population.

Cartilage wears down and the lining of the joint becomes inflamed, leading to cysts, joint destruction and pain. Each year, 200,000 Americans benefit from hip replacements because of wear and tear, destruction of the joint surfaces within the fatique-prone hip area, congenital inheritance, inflammatory arthritis, a back problem or deterioration cause by unequal leg length.

When necessary, replacements do permit the older dancer to teach, direct or even, as in the case of William Starrett of Columbia City Ballet who had bilateral hip replacements, to dance leading roles!

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