Organizing a Dance Conditioning Program

On this week’s episode of The Dance Docs I sit down with Dr Emily Noe PT to discuss a listener’s question on organizing a conditioning program, we dig bit deeper into why we tend to focus on deep muscle activation before the superficial muscles, and how both concentric and eccentric training do not cause bulky muscles and are a great addition to any conditioning program.  

Listener question:

I am a retired dancer and Pilates teacher that works with dancers and sees a lot of injuries of all types that I have tried to solve with my limited means and understanding, and I realize that I have never really thought in terms of power, endurance, or the means to these things. Pretty much my entire focus has revolved around watching muscle patterns, and I have often found a need to help alter patterning following fascial lines. So often one muscle(eg the gastrocs) will become dominant and one needs to encourage other less dominant muscles to do their share of the work(eg the peronii and the tibialis posterior)to solve achilles tendonitis, or the rectus abdominis, quads and glutes are overpowering the length provided by the hamstring/psoas connection. I would be interested in a segment that discusses the organization of one's training routine. In other words, would you recommend starting with deeper lines and then working outwards towards the more superficial muscles?(Kind of the reverse of how one stretches-outer to inner). If so, what would that look like? 

Also, because ballet dancers tend to worry a bit about the size of muscle, and because we often hear that training muscles eccentrically to their full length creates long, strong muscles, how does that compare to concentric muscle training? When do you work one way, and when do you work another way? 

  • Everyone brings their own unique experience to treating or working with individuals.  I have worked with Pilates instructors who see movement dysfunctions that I don’t.  

  • My goal has always been open to all practitioners because there is no one size fits all, and we all have something to teach.  

  • What you are doing sounds right in targeting the deeper muscles first and then transitioning to the more superficial muscles.  Lets focus on breaking this down into the more scientific components and why this process works well for most dancers or clients that you may be working with.

  1. Use of deep muscles/superficial muscles- Motor control/coordination before strength training

  2. Muscle size development- long vs bulky muscles and eccentric vs. concentric training

  3. What would a program actually look like

Motor Control and coordination before introducing Strength training

Definition of motor control- 

  • Motor Control is defined as the process of initiating, directing, and grading purposeful voluntary movement. 

  • In other words- which muscles fire when. 

Definition of coordination- 

  • Coordination is the ability to select the right muscle at the right time with proper intensity to achieve proper action. Coordinated movement is characterized by appropriate speed, distance, direction, timing and muscular tension. 

  • the ability to perform a motor task in an accurate, rapid and controlled manner


Think of your body as a giant road map, and you have the main highways that are built to withstand traffic and regular use, then you have the side roads that are traveled, and can handle some wear and tear, and then you have the backroad that are not traveled on often.  Now imagine there was a crash on the freeway and need to get to the studio for your dance class so you get off the freeway and take the side road or a backroad.  And you were able to make it in time for class.  The next day as you are getting ready to go to class you realized that the day before you got to the studio in the same amount of time using this new route and so why not continue taking that route even though the freeway is now clear.  This happens in the body all the time, you find a shortcut that gets you to the end result that you want, but it is not as efficient.  This is what we want to watch out for and why we stressed that in determining the 1RM we are looking for perfect form.  


When PT’s look for motor control we often test how certain muscles fire:

  • Examples of this would be the posterior chain pattern. 

  • When lifting one leg behind us, as in arabesque, there is a certain muscle firing pattern that is considered ‘normal’. This is opposite then same side lumbar extensors, hamstring, then gluteus maximus. 

  • This is an easy test test that can be used to assess if motor control is a factor in someone with lumbar or hip dysfunction. 

When we look at coordination we are watching movement, seeing if it looks “right.”

  •  A very common example of this is watching the position of the knee when someone is lunging. 

  • Is the knee going forward over the toes, is it tracking inwards, outwards, or is it in line?

    • Need to determine where the loss of control is happening.  

    • Gluteus maximus may not be working to control the hip but to stabilize the spine

  • Does a dancer hike their hip when going into passe or do they shift their trunk forward or back. These are all examples of what we define as coordination. 

Being able to complete complex motions, strength or power training requires the systems of the body to work together to achieve optimal force production or strength.  This requires the brain to send the signals out to keep you on the main highways, and then coordinating the motion like the orchestra conductor. The motor control and coordination systems work together to create strength and power for complex movements.

When we discussed strength and the 1 RM is a skilled motor task, where the whole system recruits with the proper patterns to allow the muscles the greatest amount of force production.

  • Many people can perform strength activities with poor motor control. This is why, in my opinion we must screen for and address motor control and coordination prior to dosing for strength safely. 

Reps and sets (Dosage) 

  • is really based around the clients coordination and motor control

  • Begin with easier exercises and if they can show efficient movement patterns then we can progress them into more complex movements or begin to add weight, to increase the force production of a muscle

  • Often times this can happen within one session of training. 

    • An example would be testing someone’s extensor pattern, seeing that their glute isn’t “firing” well and then training for this a bit. 

  • Dosage for motor control is high rep low load. 

  • The load is entirely based upon getting the correct pattern and can be adjusted accordingly. 

  • Once the pattern seems to normalize then you can jump right into training something like endurance or even strength in the same visit. 


Retraining motor patterns:

  • Sensory rich environments helps the body to connect the brain to the target area

    • Tapping, rubbing, vibration all help to increase the connection

  • Challenge your patients to solve a problem that they encounter

    • Many times I ask someone to complete a movement, add some external restriction cues and let them figure out how to complete the movement a few times before I cue or correct them

  • Make your sessions fun

    • Use a twister mat or dots on the floor to have your patient reach out to

    • Use a images to externally cue rather than just internal cue or anatomical cues

  • Understanding motor control can help you train an individual to advance from a novice to a skilled performer throughout their lifespan


Superficial vs. deep muscle work

  • Must have stability before you can have mobility.

  • Deep muscles are more of your stabilizers- in most cases you want to demonstrate proper control of the stabilizers before moving onto the superficial muscles

    • Examples of deep muscles:

      • TrA

      • Multifidi

      • Rotator cuff

      • Psoas

      • Tib posterior/ peroneus longus in foot

      • Foot intrinsics

  • Muscles that support the skeleton and are used for postural support during activities even as simple as sitting or standing. They are almost like guidewires for movement, or help to fine tune the motion

  • Once we can see that these muscles are working to stabilize then we can move on to working some of the larger more superficial muscles, begin working on larger more dynamic movements

  • All of your muscles need to work together not just in isolation.

 

Muscle Size development

  • Concentric strength training will make you bulky… fact or fiction

    • concentric training does not make your muscles bulky.

  • Both the concentric and eccentric portions of exercises contribute to building muscle, but in different ways.

  • For the most part, people have always tended to focus on the concentric portion for building muscle. This could be due to the fact that concentric training is more measurable in terms of improvement.

  • Concentric contraction- shortening of sarcomere

  • Eccentric contraction controlling the lengthening of the sarcomere

    • At the end of a eccentric workout you will not feel as tight due to the muscle being worked through the full opening of the sarcomere and not just the closing

  • Might feel tighter after a concentric workout, but that does not mean that you are actually building more muscle bulk.  

    • You will build muscle with either if you are dosing for strength because again, we are breaking down tissue to signal the body to lay down more. Health, injury prevention, and longevity are what we are looking for. 

  • Great Review of literature on Concentric vs eccentric muscle training and muscle hypertrophy (muscle bulk)


Language around muscle development

  • Muscle shape does not equal strength, health, or connected movement. 

  • It’s not about having bigger or smaller muscles it’s about being healthy, having good motor control, coordination and preventing injury. 

  • Can we begin to shift the ideal around the dancers body and focus on musculoskeletal health over a centuries old image. 


Building your plan:

  • You can incorporate the principles of strength endurance and power into a 15-30 minute workout before class to prepare you for the day, or do a much harder workout a few days/week.

Make a plan- set the intent of your workout: what are your goals? 

  • Warm-up and centering

    • Exercises that focus on motor control and coordination *possibly ones that a PT has provided and determined to be specific for you. 

    • Setting up the core

    • Want to get everything “warm” / blood circulating- I do a 5 minute warm up that is 1 minute jumping jack, 1 minute running in place/ butt kicks, 1 minute mini squat jumps, 1 minute kneeling pushups, and  1 minute single straight leg bicycle crunches. This can be repeated for a 10 minute warm up. 

  • Main set

    • increase the intensity of the exercise by adding resistance, or making exercise more complex to challenge the body

    • Increase ROM and rotation (squat + lift) 

    • Make sure that your client is using efficient patterning

  • Cool-down- 

    • Incorporate if you are ending your day or have a break before your next rehearsal, class.  If your day is continuing on you don’t necessarily want to add a cool down but can if you feel it is needed

    • Your cool down is like reverence in ballet class

    • If you are done for the day this is a great time to add some stretching since you are warm.

    • If you have another class or rehearsal to go to but you want to center and gather your thoughts at the end of your workout you can add a few roll downs with breathing.

Notes on program development:

Make your workouts interesting by adding variety, or setting a different intent for each one

Be ready to modify based on your clients

  • May need to make things easier or harder based on the clients patterning

  • This is not a one size fits all which is why finding a PT or instructor that spends the time to look thoroughly and create an individualized plan is so helpful. 

These principles are used to develop a cross training program. These workouts should be in addition to the classes and rehearsals you are currently doing, they should not replace class.

  • Exceptions would be if you are under the care of a medical provider who prescribes cross conditioning 2 days a week and class 3 days a week as you are returning from an injury. 

Remember that we are not in normal times, 

  • use this to continue building on what you have.  

  • When back to dancing 5 days a week and you will notice that you have a new underlying strength.  

  • Maintain cross conditioning programs 2-3 days a week when returning to a normal schedule or rehearsals or classes at the studio. 


Dr. Emily Noe PT, Weekly Plan:

Monday: warm up 10 min, strength 30 min, cool down/ stretch 10 min

Tuesday: cardio/ endurance warm up 10 min, class, stretch 

Wednesday: cardio/ endurance warm up 10 min, class, stretch 

Thursday: Rest

Friday: Warm up 10 min, strength 30 min, cool down/ stretch 10 min

Saturday: cardio/ endurance warm up 10 min, class, stretch

Sunday: class day or something more endurance based like a hike, bike, swim, jog, pilates

**Two days of rest per week is also an option and obviously this doesn’t include rehearsal or teaching times which may be spattered in. 


Dr. Kat Bower PT, Strength based conditioning circuit (~30 minutes)

  • I use an app called interval timer to keep pace during class.  It has a bell that alerts to the beginning end of each exercise

Warm up- (1 minute each)

  • Marching in place with high knees

  • Jogging in place

  • Arm Circles

  • Cross body punches

  • Side shuffles

Main set

Complete each exercise in the set for 30 seconds each with 10 seconds rest in between.  When you finish the set rest for 1 minute and then repeat the set one more time.

  • Core 

    • Chest lift

      • Basic crunch

    • Single knee to chest

      • Begin with both knees into your chest, head neck and shoulder curled up. Maintain hands on one knee and extend the opposite leg out, and alternate between sides

    • Double knee to chest

      • Begin with both knees into your chest, head neck and shoulder curled up, hands on knees.  Extend both legs and arms away from the center, and then draw both back in to the starting position.

        • Focus on maintaining neutral spine position, if the low back is arching bring the legs up slightly higher

    • Roll up

      • Begin with arms and legs extending away from the body and resting on the ground.  As you exhale curl up into a seated position, reach forward towards your toes, inhale draw up to a tall seated position, as you exhale roll down through your spine to starting position

  • Arms and Back

    • Prone arms W to Y 

      • Maintaining slight back extension with arms in a W position lift the arm up, extend them to a Y position then back to a W and lower the arms down

    • Prone arms 2nd to high 5th

      • Starting on your stomach extend the upper back with the arms in second, maintain that position raise the arms to high 5th, draw the arms back to second and then lower the body and the arms back down to the ground

    • Seated pull aparts (theraband or weights)

      • Holding onto a theraband with palms facing up to the ceiling, hands raised in line with the shoulders.  Open the theraband out to the side and then slowly return to starting position

    • Seated Overhead Press (theraband or weights)

      • Seated with knee bent and feet on the floor, loop theraband under your knees and hold the ends of band in your palms, arms should be in a W position.  Press the band up towards the ceiling and then slowly lower arms back down.  

      • Watch for rib cage/spine alignment; it should remain neutral throughout.  Common movement fault is to extend through the spine to achieve full overhead arm extension

  • Legs

    • Squat pulses (1 set hip, 1 set knee strategies)

      • Hip strategy- squat down ~50% sending your hips back and your trunk forward, trying to keep your knees in line with your ankle.  Do little pulses in this position

      • Knee strategy- plié position with the knee advancing forward over the toes, body can still have a slightly forward lead.  Do little pulses in this position

    • Theraband squats

      • With theraband around your knees, press out into the band slightly and squat down letting the hips reach back and your trunk lean forward.  Try to keep your knees in line with your ankles instead of forward over your toes

    • Side steps with theraband

      • In a mini squat position with a theraband around your knees take small steps to the side (make sure to alternate sides) maintaining the mini squat position

        • Monitor that your knee stay pointing forward throughout the exercise

    • Forward lunge

      • Starting in a standing position step one leg forward and lower down to the ground until your back knee is 2 inches off the ground.  Press off that front leg to return to a standing position. Alternating leg each time.

  • Full Body Plank Series

    • Plank knee taps (on elbows)

      • Begin in a low plank position on your elbows. Tap one knee down to the ground maintaining a neutral pelvis position and return back to neutral and repeat on opposite side

    • Plank hand taps

      • Begin in a high plank position on your hands.  Drive the hips up into a downward dog position and tap your hand to the opposite knee.  Return the hand down to the ground and press back into a plank position

    • Plank Knee Drive

      • Begin in a downward dog position, press out into a plank position driving one knee into your chest.  As you press back to downward dog position bring the leg back. Repeat on the opposite side.

    • Bear Walks

      • Begin in a quadruped position (hands and knees), lift the knees 2 inches off the ground, walk forwards with opposite arm and leg 3-5x and then backwards to your starting point.  

        • Try to maintain the knees floating off the ground and the pelvis low. 

Cool-down

  • Roll Down Push up x5

    • Begin in a standing position, roll down until the hands touch the floor.  Walk out to a plank position complete 1 push up (knees up or down- focus on good form with a long spine).  Walk back to a standing position and roll back up

  • 3 deep breaths in standing

    • Can add arms gathering up to high 5th and lowering down




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