IADMS Miami 2000   [back to the Category]

Gait Development in Young Ballet Dancers   [read the french version]

Author :   Jarmo Ahonen, P.T.

Author: Jarmo Ahonen, P.T., Finnish National Ballet, Helsinki, Finland

Classical ballet training has often been blamed for young dance students loosing their normal biomechanical functions as for example the normal gait patterns. The thinking behind this is that external rotation of the hip joints (i.e., the hip turn-out) is so emphasized in ballet training, young dancers form a habit of exaggerating the turn out in everything they do, including normal, everyday walking.
When comparing hip turned out walking to the normal gait patterns in the gait cycle, there are several things that do change based on the laws of the closed kinetic chain function in the upright position. In this presentation normal gait is used as a guideline. Young ballet dancers’ walking habits are compared to the normal biomechanics. The possible effects based on misalignment and poor posture caused by improper biomechanical control are also discussed.
In normal gait, feet are placed on the ground quite parallel. The position may vary by about 5 degrees in toward adduction or out toward abduction without causing much problem in the gait. When the feet are parallel, the lower extremity forms a structure that may function in normal alignment when walking. The foot’s three functions, 1) shock absorption, 2) adjusting to the surface/ground, and 3) forming a sturdy lever for terminal stance and pre-swing do work well as long as the feet are parallel
In ballet dance training the normal foot-leg alignment is emphasized in all basic foot positions. The young dance students should be educated to appreciate that alignment in all activities in the studio as well as outside of the studio.

Phases of Gait

Initial contact (0 to 2 % of the gait cycle)
In normal gait, initial contact occurs as the heel of the foot strikes the ground. The contact point is a little lateral from the foot’s mid line on the heel. When the feet are parallel the initial contact foot may start its rolling motion in to normal pronation. In dance walking, the toes contact the ground first and the whole extremity is turned out. If the feet are kept in turned out position and every day walking is continued in that manner, it will lead to excessive pronation and misalignment of the whole lower extremity.

Loading response (2-10 % of the gait cycle)
When the body is transferred forward in gait the leading foot is receiving the whole body weight. This movement has a pivot point at the heel where it touches the ground. The axis is called “the heel rocker.” In loading response the knee is bent 15 to 20 degrees to function as an efficient shock absorption system. The knee has to bend in straight alignment on the top of the foot. However, many dancers, young ones as well as older ones prefer to skip this phase by letting the knee stay straight. This leads to excessive hip adduction and internal rotation as well as hyper pronation of the foot/ankle. The alignment of the lower extremity is also false. Poor hip joint stability leads to poor pelvic control and the spine will compensate with uncontrolled movements.

Mid stance (10 to 30 % of the gait cycle)
If the previous phase, loading response, is skipped, mid stance will start too early and the center of gravity of the dancer stays too far behind and the dancer has a tendency to lean back too much. In normal mid stance the progression is quite prominent. The axis of the forward motion is in the talo crural joint (TC) or upper ankle joint. This is called “the ankle rocker.” It is important that the foot points forward when the tibia is pivoting around the TC joint. If the foot points out too much the axis of the movement is turned out as well. This will lead to compensation in the subtalar joint (STJ). Also movement around the oblique mid tarsal joint (OMTJ) and longitudinal mid tarsal joint (LMTJ) will be exaggerated with excessive rolling of the foot as the result. When a dancer is training ballet he/she is very much aware of “not letting the foot to roll in.” So it is of utmost importance that this is not happening in daily walking patterns.

Terminal stance (30 to 50 % of the gait cycle)
In the terminal stance there is a short moment when the entire body’s weight is on the ball of one foot, on a very small area. If the foot points straight forward the weight is distributed evenly on all metatarsal heads and the loading of the joints is straight and even. In normal alignment re-supination is also started at this phase. However, if the foot is flaring out, the weight is transferred too early to the medial side of the fore foot. At this point if there is too much foot flare out re-supination has not started yet and the fore foot finds itself in a very vulnerable position. Excessive load is placed on the medial side of the first metatarsal head and the big toe causing the IMT to deviate medially and the latter to deviate to lateral direction forming the basis for the formation of hallux valgus or bunion. The second metatarsal is carrying too much weight and is prone to stress fractures. Also muscles trying to prevent the abnormal function are over worked and their tendons react causing tendonitis or tendovaginitis.

Pre swing (50 to 60 % of the gait cycle)
Pre swing resembles the ballet movement demi pointe on the toe function and instep. In pre swing the foot is rolling forward while the body weight is been transferred to the opposite foot. In normal gait this movement is done around an axis that runs transversally on the fore foot through the joint of the big toe. This is called “the fore foot rocker.” In this phase the weight is distributed to the first and second metatarsal heads and the whole lower extremity is rotating externally while STJ is supinating. If the foot is flared out there is still an STJ pronation going on and the external rotation of the whole extremity could not have started. This leads to severe misalignment and puts a lot of stress on the foot/ankle, knee, and hip. If a dancer would do his/hers demi pointes in this way it would obviously catch the teacher’s eye and would get corrected. More so, it is important to maneuver even this phase in gait with good skills and normal functions.

This is the abstract of a paper presented at the Tenth Annual Meeting of the International Association for Dance Medicine and Science, held 27-29 October 2000 in Miami, Florida, USA. All rights are reserved by the individual author(s).