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Overuse Injuries in Dancers

Chapter: Types of Dance: Steps and Positions

Edited by: Antonios Angoules

Published Date: March, 2016

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Types of Dance: Steps and Positions

Elpidoforou Michail*
BSc-Ed, PT, dip. Physical Educator - Sports Scientist, Physical Therapist, Dance
Educator
Corresponding author: Elpidoforou Michail, BSc-Ed, PT, dip. Physical Educator -
*

Sports Scientist, Physical Therapist, Dance Educator, E-mail: elpidoforou@poetic.com

Abstract
Dance could be described as a performance art form in which the basic tool is the
body and its purposefully selected movement in an intentionally rhythmical and culturally
pattern with an aesthetic value and symbolic potential [1-3]. Human has been using the
body and its movement as a tool to express feelings and desires since prehistoric times
[4] and continues until now. As important moments in the history of Western dance have
been marked the birth of ballet, the evolution of modern dance and the revolution of the
post-modern movement in dance. In parallel, other dance types have developed from the
20th century, such as the jazz dance, and the promising “Hip-Hop culture” from which
many special dance styles have been born. The theatrical, generally, dancer is a unique
combination of athlete and artist [5] and dance is, without any doubt, a form of physical
activity [6] with great physical demands during the dance class, the rehearsal, and the
performance, which can all lead to injury [5], especially overuse injury, which seem to cover
the majority of injuries in dance [7,8]. The purpose of that chapter is to give a brief origin of
dance, noting the essential types of Western dance, to associate dance as a form of physical
activity with a high presence of injuries, and finally present photos showing the correct and
the incorrect alignment on very basic positions of classical ballet, which are considered as
common faults in the daily dance practice.

Keywords: Dance; Dance Injuries; Dance Positions; Dance Types; Western Dance
Introduction
Dance is one of the essential forms of human’s expression and communication [4].
People seem to dance for a variety of reasons from its birth, and have developed different
dance types as different forms of expression, as members of a socio-cultural community, an
aspect which forces the role of dance as a particular form of social interaction and brings
to dance the character of a culturally determined “program” where social, historical and
environmental factors fit together with the physical, psychological and mental features of the
individual [9]. Dance has developed different types throughout its historical path. However,
dance as a form of physical activity entails great physical and psychological demands; thus,
it often drives to high rates of injury [7,10].

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Discussion
Anthropological aspects of dance
Sachs [11] starts his book noting that dance is the “mother” of the arts, while music
and poetry exist in time, painting and architecture in space, but dance exists in both time
and space and in that special form of art the creator and the art piece are the same thing.
Dance is characterized as a multi-faceted phenomenon that includes, in addition to what
we see and hear, an underlying system which seems “invisible”, which is affected by the
socio-political context and function as a structured (movement) system of knowledge for
each community [12]. It is remarkable that dance is inextricably linked to the historical,
religious, philosophical, literary and scientific knowledge of each person who practice it [13].
Since prehistoric times, the human race has developed non-verbal forms of communication
and he has used the body and its movement as a tool to express feelings and desires. It
has been stated that before the invention of written languages, dance was a primary part
of the oral and performance methods of passing stories down from generation to generation
[4]. Thus, dance associated with each community as a body of historical evidence and
traditions, racial feelings and traits of a whole nation. Each community has developed a
unique approach towards dance as a means of expression and communication, as well as
a form of both physical and aesthetical education. A traditional dance to which we could
refer is a ceremonial African dance from the Acholi called “Larakaraka”. It is a special type
of courtship dance, which is performed in weddings by young people who are interested
to meet partners. It is referred that the best dancers only will get partners and the poor
dancers seem to die as bachelors [14].
The dance as a term
Generally speaking, it is difficult to define the difference between movement and dance.
Rudolf Von Laban [15] said that we move in order to satisfy a need. Dancing – in comparison
with the movement in everyday life – does involve the emotions, which may be the reason
as to why so many people are reluctant to let themselves go. Dancing could be described as
an emotional extension of ordinary movement, just as singing is an emotional extension of
speech [15]. More specifically, dance is a performance art form in which the basic tool is the
body and it’s purposefully selected movement in an intentionally rhythmical and culturally
pattern with an aesthetic value and symbolic potential [1-3].
Dance origins
Ancient civilizations, such as the Greek and the Egyptian, had a significant development
of dance as a form of artistic expression, religious rituals and educational method [16,17].
As far as the ancient Greeks are concerned, Lawler [16] has written that for them dance was
a truly social activity. They tended to express all their feelings by dancing and dance itself
was marking all the great social events.
The end of the ancient period has found Europe in the midst of changes at all levels.
The art was impregnated by social movements and uprisings, and the “Dark Ages” of the
Middle Ages preceded the periods of Renaissance and Enlightenment during which dance
had a development similar to the process in each society. During middle Ages we find only
two forms of dance expression: the laity dances (“danses des sociétés populaires”) and
the courtier dances (“danses de cour”). The period of Renaissance transformed along with
philosophy, art, and religion, as well as dance in Italy and then in France setting the stage
for the birth of classical dance [18]. Classical dance could be defined as a form of Western
academic dance using a dance technique known as “danse d’ école (the classical school). A
key role in the construction of Ballet played by Louis XIV and this type of Western academic
dance has developed in Russia in a more virtuosic style during the latter half of the 19th
century [19].

2
 The term of Modern dance has been used to describe the type of dance which has been
historically placed in the early period of the 20th century and it is not based on the academic
school of classical ballet. On the contrary, the first pioneers of modern dance, such as
Isadora Duncan, Ruth St Denis, Martha Graham and Doris Humphrey, have created dance
pieces rejecting the structural formality and sometimes the thematic frivolity of classical
ballet. Until the 60s, (modern) dance has been inspired by Zen, Indian philosophy, the
Theosophists and artists of the East [20].
Post-modern dance as a term has been firstly used by Yvonne Rainer in the early 60’s
including all kinds of experimental dance. Judson Dance Theatre was the first place where
people like Rainer, Steve Paxton and Trisha Brown have developed radical new ideas about
choreography rejecting conventional chorographical attitudes. They were more interested in
a vocabulary of minimal everyday movements based on structure than on spectacle and on
virtue than on virtuosity [19].
The term of “post-modern” dance coincides with the completion of modern dance (for
many the starting period of anti-modernism) while in other arts is the end of the modern
movement and the beginning of eclecticism and historicism. The postmodern dance,
which as a term especially in Europe seems to have the same meaning with the term of
“contemporary” dance, has been moved in 60s to other places such as galleries, stadiums,
streets, forests, churches and became more austere and abstractive, and in the absence of
music but in the presence of “everyday movements” [21]. Merce Cunningham was one of
the forerunners of this movement working with the musician John Cage. They used to put
innovative elements in dance, such as the randomness in movement and the experimentation
with the conceptual dipoles of “movement-no movement” and “sound-no sound” [22]. Along
with the development of modern dance, a remarkable growth of other dance types arrives,
such as the jazz dance, during the 19th century. Historically speaking, many Africans [23]
were taken by the early 17th century from their homeland and were driven by force to other
countries, including the United States of America. The population of African “slaves” (as
they used to be called and used) brought with them their cultural characteristics and after
the conquest of their liberty, in the middle of the 18th century, they started to embody
elements of the “new” American culture. Jazz dance, which combines characteristics of
African dances, classical ballet, and modern dance, created amazing art myths of the past
century, from which some of them still exist, such as the Broadway Theater and the Alvin
Ailey dance company [24]. Jazz dance has been characterized as “commercial” dance,
because of its large social impact and its promotion by media. During the mid-1970s Hip
Hop culture originated as an integrated series of live community-based practices, including
particular types of dance, dress, art (such as graffiti), and music [25] and it still grows up
worldwide with associated different dance types (such as the break-dance, the locking, and
the popping) [26,27].
Dance as a form of physical activity
It is remarkable that sports have many common elements with dance as athletes with
dancers. It often arises between the dance and the sport community the question about
the correlation of terms such as dance, exercise, fitness, and physical activity. Physical
activity is defined as any movement of the body made by contraction of skeletal muscles
and results in energy expenditure, and as exercise is characterized any physical activity
which is being organized in a planned and structured way and has a focus to improve or
at least maintain one or more components of physical fitness, which is a set of correlating
components to the ability to perform physical activity [6]. Thus, dance is considered as a
means of physical activity and it depends on the personal goal of the person who practices
it whether it would be characterized as an exercise form or just as a physical activity with
artistic or recreational purpose.

3
Dance and Injury
It has been often suggested that dancers may not be enough prepared for the demands
of the physical activity they do. Physical activity is stated as low in youth dance classes [28]
and the structure of dance training programs it is suggested to enrich by types of physical
training that practice other elite athletes [29].
The theatrical dancer is a unique, we could say, combination of athlete and artist. The
physical demands of dance class, rehearsal, and performance can lead to injury [5]. In
the literature, there is a great amount of research that has been published about ballet
dancers who have been described as both artists and athletes [30,31], performing complex
artistic routines that require a high level of athletic ability because of the extreme bodily
demands placed on them [32]. As a consequence, ballet dancers are at a high risk for
injuries that can potentially disrupt their performance and restrict their career [32,33], and
generally most dancers of all types have noted that they have experienced injury during
their careers [7,10,34,35]. It has also been noticed that ballet is a highly demanding activity
that requires a unique balance between “athleticism” and artistry [36]. In contrary to the
typical professional or collegiate athlete, the classical ballet dancer – as many dancers of
other types - is an artist who frequently leads a solitary life of 6-7 days per week strenuous
physical activity, which may begin from the age of 4-6 years of age and in order to create the
appearance of grace and beauty, forces his or her extremities into abnormal (in physiological
terms) and non-anatomical positions which are potentially dangerous [37].
Hamilton has noted that dancers, even if perfectly conditioned and trained and
psychologically prepared for the rigors of the dance life, will experience injuries, simply due
to the nature of the movement demands [38, 39]. Most ballet dancers will suffer at least one
injury per year. Many causes have documented by numerous researchers as risk factors.
Anatomical characteristics, medical and menstrual history, fatigue and dance experience
are some of them, while nutrient intake, stress and levels of physical fitness have recently
received the same amount of attention [40].
Starting period of pointe shoes
A critical issue for a new dancer, doing practice in classical ballet, is that of the starting
period of dancing on pointe shoes. It is an issue that concerns dancers, dance teachers and
health professionals (such as doctors and physical therapists), who often try to find which
is the best time for each dancer to start pointe work.
“Dancers need their feet to be healthy and pain-free” [41]; thus, the kind of the shoe
dancers wear is very important and seems to have the potential to enhance or restrict
the dance performance and the general dancer’s body health [41]. During past decades,
often even now, many theories have been discussed among dance teachers. Recent research
shows that dynamic tests of motor control (the Airplane test, Sauté test, and Topple test) can
better indicate pointe-readiness than chronological age (12 years) alone or in combination
with static measurements of the musculoskeletal system [42]. Other elements that they
have to be considered are: the dance pupil’s stage of physical development; the quality of
her (or his) trunk, abdominal and pelvic control (“core” stability); the alignment of her (or
his) lower extremity (hip-knee-ankle-foot) (see at the Appendix); the strength and flexibility
of her feet and ankles; and the frequency and duration of her dance training. Students, who
meet all of the above requirements, began ballet training at the age of eight or later, and who
are taking ballet class at least twice per week, should take up pointe work in the fourth year
of their training. Students with poor core stability or hypermobility of the feet and ankles
may require additional strengthening to allow them to safely begin pointe training. For those
who are only taking one ballet class per week, or who are not truly “pre-professional”, pointe
training should be discouraged. Any student with insufficient ankle and foot plantar flexion
range of motion or with poor leg alignment should not be allowed to do pointe work [43].

4
Conclusion
Dance, finally, as an art form of expression through the body, has inextricable connections
to each society, thus it evolves by changing its expressive tools and types along with the
society it is part of. Ballet could be considered as a relatively “stable” type of dance, which
has not been changed at all for more than a century. We can find therefore the same steps
and positions with those they used to dance from the 19th century. Furthermore, ballet has
still a key role in the education and the everyday training of the majority of professional
Western dancers worldwide [44], even when they dance modern or jazz [45,46]. These are
the reasons for which in this chapter (appendix) we refer on steps and positions of classical
ballet, in which correct and incorrect alignment is easy to be observed.
“We should consider every day lost on which we have not danced at least once.” 
Friedrich Nietzsche

Appendix
Essential dance positions in classical ballet - Correct and Incorrect alignment

(a) (b) (c) (d)

Figure 1:First position.

(a) Front view (Correct alignment), (b) Front view (Incorrect alignment), (c) Side view (Correct alignment), (d) Side view
(Incorrect alignment)

(a) (b)

Figure 2: Second position.

(a) Front view (Correct alignment), (b) Side view (Incorrect alignment)

5
 (a) (b) (c)

Figure 3: (a) Third position frontal view (correct alignment), (b) Forth position frontal view (correct alignment), (C) Fifth
position frontal view (correct alignment).

(a) (b)

Figure 4: (a) Pointed toes in proper alignment, (b) Pointed toes in improper alignment for pointe shoes.

(a) (b)

Figure 5: (a) Fifth position on pointe shoes (Correct alignment), (b) Plié on first position (Correct alignment).

6
 (a) (b) (c)

Figure 6: (a) Normal (neutral) pelvic position (Correct alignment), (b) Anterior pelvic tilt (Incorrect alignment), (c)
Posterior pelvic tilt (Incorrect alignment).

(a) (b)

Figure 7: (a) Correct good posture (Correct spine, pelvis & leg alignment), (b) Incorrect (sway back) posture
(Hyper-extended knees, forward shifted pelvis & head.

Acknowledgement
Special thanks to Marina Papanastasiou, Dancer and Dance Educator, and Alexandros
Tsiros, Photographer for the photos of Appendix.

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