Dancer Health

Pelvic Floor Dysfunction: This Major Muscle System Doesn't Get Enough Respect

"We think as dancers, 'Oh my gosh, if this thing isn't working hard enough, I have to work it harder.' In order for these muscles to work, they have to have a chance to relax, too." –Kathryn Maykish

As deeply familiar as dancers are with their bodies, there's one muscle group that can remain mysterious. You can't see it, and it can be tough to access, but the pelvic floor serves a major role in your posture and body function. Dancers and other athletes are more prone than the general population to dysfunction of the pelvic floor, and this can have major ramifications in dance and life.


The Anatomy

The pelvic floor is an interconnected series of about two dozen muscles that form a horizontal hammock (or sling) inside the pelvis. It anchors to the pubic bone in the front and the coccyx in back, as well as several points around the inside of the pelvis. The urethra, the opening of the rectum and the vagina pass through the pelvic floor. The bladder, colon, uterus, digestive organs and even the lungs and heart are supported from below by this sheet of muscle. Its contracting and relaxing control important functions, like going to the bathroom or holding it in, giving birth and enjoying sex.

Potential Problems

When dancers repeat high-intensity activities like jumping, the impact of landing stresses the muscles of the pelvic floor over and over again. Improper technique can make this worse. Dancers can ease the impact by rolling through the feet, ankles and legs into a plié.

Dancers can be dysfunctional breathers, says dancer, yoga instructor and doctor of physical therapy Kathryn Maykish. They overly tense their abs and fill the upper chest with air when they breathe, rather than allowing the stomach to expand on an inhale. As the chest pulls up, the pelvic floor comes up with it, keeping the muscles from fully releasing.

It's also common for dancers to compensate for overworked or weak abs, back, hips and inner thighs by squeezing or tightening the pelvic floor without even realizing it. Interestingly, because of the close connection between these muscles, pelvic floor dysfunction can sometimes play a role in lower-back pain, anterior hip pain and other issues or injuries in the groin and pelvis area.

Tight vs. Weak

There are two main kinds of pelvic floor dysfunction. One involves muscles that are too weak, which can cause incontinence: bladder or bowel leakage. Incontinence can show up as a sudden urge to use the bathroom that you just can't control in time. Or, you might experience a little leakage when you cough, laugh or land from a jump. Maykish says dancers may not realize that it's a health concern if they leak a little during petit allégro. "If you have a student who's always running to the bathroom before jumping," she says, "it's worth having a conversation."

The other type of dysfunction is when muscles are too tight. (And yes, it's possible to experience both types at once—tension doesn't necessarily mean the muscles are strong.) Dancers may feel the frequent extreme urge to pee—as much as 10 times a day or more—but only a little comes out. Tension in the pelvic floor can also make it difficult to use a tampon and cause pain during gynecological exams or sex. Or a dancer may feel a pain deep inside their pelvis that seems like hip pain, but they can't quite point to it.

Solutions

If you're seeing early signs of muscle weakness, practice gently engaging your pelvic floor when you land jumps. "It's not all about a squeeze," Maykish says. "It should be a gentle lifting sensation, like tightening up the ends of that hammock."

Practice Kegels, too, if incontinence is a concern. Don't overdo it, though, or you can wind up with the other problem—tension. "The common thing we think as dancers is, 'Oh my gosh, if this thing isn't working hard enough, I have to go work it harder,'" Maykish says. "In order for these muscles to work, they have to have a chance to relax, too." Engaging the muscles continuously won't make them stronger. Stretching with hip openers is helpful for both weakness and tightness. Consider seeing a professional, especially if symptoms change or worsen.

What to Expect With Treatment

A licensed PT with certifications in pelvic floor therapies can help you identify what exercises you need. The clinician should have a private room for pelvic floor therapy, and allow an adult to accompany a minor inside. They should always ask for permission before they do an internal exam and wear gloves for it. People can be a little apprehensive about pelvic floor therapy, Maykish says, but a good clinician will prioritize the patient's comfort. "Always my patient is in charge and can direct the exam," she says. An internal exam by a PT does not involve stirrups or speculum; just one gloved finger inserted into the vagina to feel for the muscles of the pelvic floor. "The therapist will go systematically to test the strength and range of motion of the muscles." They should be looking for the patient's feedback, and back off if something feels too uncomfortable. "I think most patients find their fear or anxiety about the exam is bigger than how it actually goes."

Dance Teachers Trending
Roshe (center) teaching at Steps on Broadway in New York City. Photo by Jacob Hiss, courtesy of Roshe

Although Debbie Roshe's class doesn't demand perfect technique or mastering complicated tricks, her intricate musicality is what really challenges students. "Holding weird counts to obscure music is harder," she says of her Fosse-influenced jazz style, "but it's more interesting."

Keep reading... Show less
Sponsored by Dean College
Amanda Donahue, ATC, working with a student in her clinic in the Palladino School of Dance at Dean College. Courtesy Dean College

The Joan Phelps Palladino School of Dance at Dean College is one of just 10 college programs in the U.S. with a full-time athletic trainer devoted solely to its dancers. But what makes the school even more unique is that certified athletic trainer Amanda Donahue isn't just available to the students for appointments and backstage coverage—she's in the studio with them and collaborating with dance faculty to prevent injuries and build stronger dancers.

"Gone are the days when people would say, 'Don't go to the gym, you'll bulk up,'" says Kristina Berger, who teaches Horton and Hawkins technique as an assistant professor of dance. "We understand now that cross-training is actually vital, and how we've embraced that at Dean is extremely rare. For one thing, we're not sharing an athletic trainer with the football players, who require a totally different skillset." For another, she says, the faculty and Donahue are focused on giving students tools to prolong their careers.

After six years of this approach, here are the benefits they've seen:

Keep reading... Show less
To Share With Students
Via @madisongoodman_ on Instagram

Nationals season is behind us, but we just aren't quite over it yet. We've been thinking a lot about the freakishly talented winners of these competitions, and want to know a bit more about the people who got them to where they are. So, we asked three current national title holders to tell us the most powerful piece of advice their dance teacher ever gave them. What they have to say will melt your heart.

Way to go, dance teachers! Your'e doing amazing things for the rising generation!

Keep reading... Show less
Sponsored by Alternative Balance
Courtesy Alternative Balance

As a dance teacher, you know more than anyone that things can go wrong—students blank on choreography onstage, costumes don't fit and dancers quit the competition team unexpectedly. Why not apply that same mindset to your status as an independent contractor at a studio or as a studio owner?

Insurance is there to give you peace of mind, even when the unexpected happens. (Especially since attorney fees can be expensive, even when you've done nothing wrong as a teacher.) Taking a preemptive approach to your career—insuring yourself—can save you money, time and stress in the long run.

We talked to expert Miriam Ball of Alternative Balance Professional Group about five scenarios in which having insurance would be key.

Keep reading... Show less
Studio Owners
Getty Images

Enrollment is an issue that plagues brand-new and veteran studio owners alike. Without a steady stream of revenue from new students coming through your doors, your studio won't survive—no matter how crisp your dancers' technique is or how well-produced your recitals are.

Enrollment—in biz speak, customer acquisition and retention—depends on your business' investment in marketing. How effectively you get the word out about your studio will directly influence the number of people who register. Successful businesses typically use certain tried-and-true marketing strategies to recruit and retain clients or customers. These four studio owners' tricks for kicking enrollment into high gear are modeled after classic marketing techniques.

Keep reading... Show less
Dance Teacher Tips
Thinkstock

Dance teachers are just as apt to fall into the trap of perfectionism and self-criticism as the students they teach. The high-pressure environment that is the dance world today makes it difficult to endure while keeping a healthy perspective on who we truly are.

To help you quiet your inner critic, and by extension set an example of self-love for your students, we caught up with sports psychologist Caroline Silby. Here she shares strategies for managing what she calls "neurotic perfectionism." "Self-attacking puts teachers and athletes in a constant state of stress, often making them rigid, inflexible and ultimately fueling high anxiety rather than high levels of performance," Silby says. "Perfectionistic teachers, dancers and athletes can learn to set emotional boundaries. They can use doubt, frustration and worry about missing expectations as cues to take actions that align with what they do when teaching/performing well and feeling in-control. Being relentless about applying a solution-oriented approach can help the perfectionist move through intense emotional states more efficiently."

Check out those strategies below!

Keep reading... Show less
Sponsored by Turn It Up Dance Challenge
Courtesy Turn It Up

With back-to-back classes, early-morning stage calls and remembering to pack countless costume accessories, competition and convention weekends can feel like a whirlwind for even the most seasoned of studios. Take the advice of Turn It Up Dance Challenge master teachers Alex Wong and Maud Arnold and president Melissa Burns on how to make the experience feel meaningful and successful for your dancers:

Keep reading... Show less
Dance Teacher Tips
Thinkstock

Since the dawn of time, performers have had to deal with annoying, constant blisters. As every dance teacher knows (and every student is sure to find out), blisters are a fact of life, and we all need to figure out a plan of action for how to deal with them.

Instead of bleeding through pointe shoes and begging you to let them sit out, your students should know these tricks for how to prevent/deal with their skin when it starts to sting.

You're welcome!

Keep reading... Show less
Sponsored by The Studio Director

As a studio owner, you're probably pretty used to juggling. Running a business is demanding, with new questions and challenges pulling your attention in a million different directions each day.

But there's a solution that could be saving you time and money (and sanity!). Studio management systems are easy-to-use software programs designed for the particular needs of studio owners, offering tools like billing, enrollment, inventory and emails, all in one place. The right studio management system can help you handle the day-to-day tasks that bog you down as a business owner, leaving you more time for the most important work—like connecting with students and planning creative curriculums for them. Plus, these systems can keep you from spending extra money on hiring multiple specialists or using multiple platforms to meet your administrative needs.

So how do you make sure you're choosing a studio management system that offers the same quality that your studio does? We talked to The Studio Director—whose studio management system provides a whole host of streamlined features—about the must-haves for any system, and the bonuses that make an excellent product stand out:

Keep reading... Show less
Dance Teachers Trending
Photo by Brian Guilliaux, courtesy of Coudron

Eric Coudron understands firsthand the hurdles competition dancers face when falling in love with ballet. Now the director of ballet at Prodigy Dance and Performing Arts Centre in Frisco, Texas, Coudron trained as a competition dancer when he was growing up. "It's such a structured form of dance that when they come back to it after all of the other styles they are training in, they don't feel at home at the barre," he says.

Keep reading... Show less
Dance Teachers Trending
Kendra Portier. Photo by Scott Shaw, courtesy of Gibney Dance

As an artist in residence at the University of Maryland in College Park, Kendra Portier is in a unique position. After almost a decade of performing with David Dorfman Dance and three years earning her MFA from the University of Illinois at Urbana-Champaign, she's using her two-year gig at UMD (through spring 2020) to "see how teaching in academia really feels," she says. It's also given her the rare opportunity to feel grounded. "I'm going to be here for two years," she says, which offers her the chance to figure out the answers to some hard questions. "What does it mean to not dance for somebody else?" she asks. "What does it mean to take my work more seriously? To realize I really like making work, and figuring out how that can happen in an academic place."

Keep reading... Show less

mailbox

Get DanceTeacher in your inbox