In a space of 1 week, I have seen 2 subluxations that happened during different dance/movement training sessions. Seeing it happen on 2 occassions and speaking with people it happened to, I noticed some similarities in history of injury and some common predisposing factors. The traumatic event like subluxation or dislocation can make a dancer extremely apprehensive in their pursuit of having a successful and challenging dance career. But, don't worry, there is definitaley a lot of light at the end of the tunnel! There are ways in which you can train your body to decrease the reccurance of losing stability in your joint to the point you end up with subluxation or in worst case - dislocation.
Firstly, let's look at the most common predisposing factor that may lead to subluxation or dislocation.
Hypermobility
According to Hypermobiliy Syndromes Association, approx. 30% of global population is affected by hypermobility. The condition is mostly present in women and children, commonly found in Caribbean and Asian populations. Gymnasts, dancers, athletes and musician are some of the most affected.
The most common type of hypermobility is Joint Hypermobility Syndrome (JHS). People with JHS often present with below:
greater than average ranges of motion, especially passively
history of frequent ligament sprains, strains, subluxations and/or dislocations
lax ligaments and other soft tissues including (in some cases) decreased muscle tone
poor proprioception
easily bruising
soft, stretchy skin
For more symptoms visit Hypermobility Syndromes Association.
Most common way of diagnosing hypermobility is Brighton Criteria.
Hypermobility is not a sentence, it is often seen as an advantage, especially in dance. However, without a proper training consideration it can lead to series of unfortunate events and injuries.
Subluxation vs Dislocation
In the article by Jason Parry, he explains the key differences between Subluxation and Dislocation. The most basic one is the range in which the joint gets misplaced. Dislocation is a full disconnection of a joint (e.g. in your shoulder, the head of your humerous completely comes out of its socket - glenoid cavity), in a case of subluxation, the structures that hold your joint in place get loose and disengaged or engaged inapproprietly which can cause a misplacement of one of the bones but that misplacement is not complete, subluxation is often referred to as 'partial dislocation'. The event of dislocation and subluxation is accompanied by muscle spasms which make it harder to relax and let the structure find its way back in.
For advice on immediate management of dislocation/subluxation please visit Ehlers-Danlos.
Photo source: Gillette Children's
Based on key factors contributing to occurance of subluxations/dislocations here are 3 ways in which you can improve your life with hypermobility:
STREGTH TRAINING
Starting from functional strength, it is not about being able to lift extreme weights, it is about activating the right muscle groups while doing so.
You can go back to read on the kinetic chain in the previous article to start building the functional chain of activation.
Your training should incorporate isometric as well dynamic strength exercises. In here going step-by-step is the key. You want control. You don't just want to blag through the movements, you need to feel the strength and its lack.
2. PROPRIOCEPTION
Most important yet often overlooked element of training in a case of hypermobility. The abilty to precisely sense the position of your joint is essential in hypermobile dancers and movers. Training precision and reaction time should also be built in blocks. Gradually building those skills will allow for a healthy and long career without/wth minimal reccurance of subluxation and/or dislocation.
3. PROGRESSIVE ACTIVITY SPECIFIC TRAINING
The key is once again - PROGRESSIVE (gradual, step-by-step, built in blocks). Don't jump full-on to the training session after a long period of not training. Give your joints, muslces, soft tissues a chance to re-adapt.
Another key is ACTIVITY SPECIFIC - make sure you build towards the activity. If it's a specific style of dance you are about to return to, start with drills that make up the core of that style. Think about the more advanced way of performing a step/move and think backwards. What can you take away to start with and then gradually increase the difficulty of that step/move,
e.g. if you are a waacker that needs to be able to do a fast up and down roll, you can start with a motion that doesn't include a roll but you solely focus on placement of your arm, then you increase the speed, then you add roll, then you may add some wrist weights, then you may start adding a direction change, etc.
Those are suggestions to improve your lifestyle dealing with hypermobility in your dance/movement training. You should seek a professional care to look at the individual case and adapt the methods in the rehabilitation programme that best suit and serve you.
If anything mentioned in this article seems familiar but you have never been tested for hypermobility, feel free to reach out about an assessment and professional care.
With love,
Angie
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