{"id":7984,"date":"2018-08-16T18:18:11","date_gmt":"2018-08-16T17:18:11","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=7984"},"modified":"2018-08-16T18:19:27","modified_gmt":"2018-08-16T17:19:27","slug":"what-is-dance-medicine","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2018\/08\/16\/what-is-dance-medicine\/","title":{"rendered":"What is Dance\u00a0Medicine?"},"content":{"rendered":"<p><em><strong>Dr Nicky Keay\u00a0<a class=\"ProfileHeaderCard-screennameLink u-linkComplex js-nav\" href=\"https:\/\/twitter.com\/nickyKfitness\"><span class=\"username u-dir\" dir=\"ltr\">@<b class=\"u-linkComplex-target\">nickyKfitness<\/b><\/span><\/a><\/strong><\/em><\/p>\n<p>Traditionally dance medicine has been somewhat the poor relation of sports medicine. Why is this the case? There is no doubt that dancers, of whatever genre, require the physical and psychological attributes of athletes. However, dance involves an additional artistic component where ultimately performance on stage is judged not according to a score card as in aesthetic sports, rather on the ability of the dancers to forge an emotional connection with the audience.<\/p>\n<p>As with athletes, injuries are always an important topic for dancers: how to recognise the aetiology of injuries and thus develop prevention strategies. Dance UK have published two reports on national enquiries into the health of dancers. Dance UK has now evolved into the organisation\u00a0<a href=\"https:\/\/www.onedanceuk.org\/health-practitioners-directory\/\">One Dance\u00a0<\/a>which includes the National Institute of Dance Medicine and Science (NIDMS). One Dance provides delivery of the Healthier Dancer Programme (HDP) whose talks regularly engage 1500+ dancers and dance professionals per year and which will be a part of the One Dance UK conference at the end of November, an overarching event for the entire dance sector. One Dance holds a list of healthcare professionals with experience and expertise in dance. One Dance is an especially an important resource for independent dancers who will not have access to the provision for those working in larger dance companies.<\/p>\n<p>However, beyond injury management, there are important aspects of the health of dancers which need to be considered, highlighted in an information booklet \u201cYour body, Your risk\u201d from Dance UK. The female athlete triad is well established as a clinical spectrum comprising of disordered eating, menstrual dysfunction and impaired bone health. Indeed impaired bone mineral density many persist even after\u00a0<a href=\"https:\/\/bjsm.bmj.com\/content\/31\/2\/143.short?utm_source=TrendMD&amp;utm_medium=cpc&amp;utm_campaign=BJSM_TrendMD-0\">retirement in female dancers<\/a>. The recent evolution of the female athlete triad into\u00a0<a href=\"https:\/\/blogs.bmj.com\/bjsm\/2018\/05\/30\/2018-update-relative-energy-deficiency-in-sport-red-s\/\">relative energy deficiency in sports (RED-S) provides an important clinical model<\/a>. RED-S includes male athletes\/dancers, involves multiple body systems and crucially, evidence of detrimental effects on athletic performance is being researched and described. In other words RED-S is not restricted to female dancers\/athletes with bone stress injuries.<\/p>\n<figure id=\"attachment_7985\" aria-describedby=\"caption-attachment-7985\" style=\"width: 655px\" class=\"wp-caption alignnone\"><img loading=\"lazy\" decoding=\"async\" class=\" wp-image-7985\" src=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2018\/08\/Picture1-2.png\" alt=\"\" width=\"655\" height=\"491\" srcset=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2018\/08\/Picture1-2.png 1093w, https:\/\/blogs.bmj.com\/bjsm\/files\/2018\/08\/Picture1-2-300x225.png 300w, https:\/\/blogs.bmj.com\/bjsm\/files\/2018\/08\/Picture1-2-768x576.png 768w, https:\/\/blogs.bmj.com\/bjsm\/files\/2018\/08\/Picture1-2-640x480.png 640w\" sizes=\"auto, (max-width: 655px) 100vw, 655px\" \/><figcaption id=\"caption-attachment-7985\" class=\"wp-caption-text\">Integrated periodisation of training, nutrition and recovery support performance<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p>The fundamental cause of RED-S is low energy availability where nutritional intake is insufficient to cover energy requirements for training and resting metabolic rate. In this situation the body goes into energy saving mode, which includes shut down of many hypothalamic-pituitary axes and hence endocrine network dysfunction. As hormones are crucial to backing up adaptations to exercise training, dysfunction will therefore have an effect not just on health, but on athletic performance. In dance,\u00a0neuromuscular skills and proprioception are key for performance. Hence, of concern is that these skills are adversely impacted in\u00a0<a href=\"https:\/\/insights.ovid.com\/medicine-science-sports-exercise\/mespex\/2017\/12\/000\/reduced-neuromuscular-performance-amenorrheic\/13\/00005768\">functional hypothalamic amenorrhoea<\/a>, which together with impaired bone health from RED-S, greatly increases injury risk.<\/p>\n<p>Low energy availability can arise in dance and sport where low body weight confers an aesthetic and\/or performance advantage. There is no doubt that being light body weight facilitates pointe work in female dancers and ease of elevation in male dancers. Thus, low energy availability can occur intentionally in an effort to achieve and maintain low body weight. Low energy availability can also be unintentional as a result of increased expenditure from training, rehearsal and performance demands and the practicality of fuelling. This situation is of particular concern for\u00a0<a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC1756110\/\">young dancers in training<\/a>, as this represents a high energy demand state, not just for full time training, additionally in terms of energy demands for growth and development, including attainment of peak bone mass.<\/p>\n<p>Despite the significance of RED-S in terms of negative consequences on health and performance, as outlined by the IOC in the recent consensus update, further work is required in terms of\u00a0<a href=\"https:\/\/blogs.bmj.com\/bjsm\/2018\/05\/30\/2018-update-relative-energy-deficiency-in-sport-red-s\/\">raising awareness, identification and prevention<\/a>. Fortunately these issues are being addressed with the development of an online educational resource on RED-S for athletes\/dancers, their coaches\/teachers\/parents and healthcare professionals which is backed by\u00a0<a href=\"https:\/\/www.basem.co.uk\/membership\/basem-blog_detail.healthy-hormones.html\">British Association of Sport and Exercise Medicine (BASEM)<\/a>\u00a0and with input from One Dance and NIDMS. In terms of research\u00a0to facilitate the proliferation of evidence base in dance medicine, One Dance lists calls for research, whilst NHS NIDMS clinics provide access to clinical dance medicine. The importance of the application of this growing field of dance medicine and science for the health and performance of dancers was recently outlined in an article \u201c<a href=\"https:\/\/www.theguardian.com\/stage\/2018\/jul\/15\/raising-the-barre-how-science-is-saving-ballet-dancers\">Raising the barre: how science is saving ballet dancers<\/a>\u201c.<\/p>\n<p>On the international stage, the\u00a0<a href=\"https:\/\/www.iadms.org\/page\/2018\">International Association for Dance Medicine &amp; Science (IADMS)<\/a>\u00a0strives to promote an international network of communication between dance and medicine. To this end, IADMS will hold its 28th Annual Conference in Helsinki, Finland from October 25-28, 2018. In addition to extensive discussion of dance injuries, there will be presentations on \u201cSleep and Performance\u201d and \u201cDance Endocrinology\u201d.<\/p>\n<p>So maybe Dance Medicine and Science is not so much the poor relation of Sports Medicine, rather showing the way in terms of integrating input between dancers, teachers and healthcare professionals to optimise the health of dancers and so enable dancers to perform their full potential.<\/p>\n<p>***<\/p>\n<p><em><strong>References<\/strong><\/em><\/p>\n<p>Fit to Dance? Report of National inquiry into dancers\u2019 health.\u00a0Fit to Dance 2 Dance UK<\/p>\n<p><a href=\"https:\/\/www.onedanceuk.org\/health-practitioners-directory\/\">One Dance:\u00a0<\/a>Your body your risk. Dance UK,\u00a0Fit but fragile. National Osteoporosis Society<\/p>\n<p><a href=\"https:\/\/bjsm.bmj.com\/content\/31\/2\/143.short?utm_source=TrendMD&amp;utm_medium=cpc&amp;utm_campaign=BJSM_TrendMD-0\">Bone mineral density in professional female dancers<\/a>\u00a0BJSM<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bjsm\/2018\/05\/30\/2018-update-relative-energy-deficiency-in-sport-red-s\/\">2018 UPDATE: Relative Energy Deficiency in Sport (RED-S)<\/a>\u00a0Dr N Keay BJSM 2018<\/p>\n<p><a href=\"https:\/\/insights.ovid.com\/medicine-science-sports-exercise\/mespex\/2017\/12\/000\/reduced-neuromuscular-performance-amenorrheic\/13\/00005768\">Reduced Neuromuscular Performance in Amenorrheic Elite Endurance Athletes\u00a0<\/a>Medicine and Science in Sports &amp; Exercise 2017<\/p>\n<p><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC1756110\/\">Dancing through Adolescence<\/a>\u00a0Dr N Keay BJSM<\/p>\n<p><a href=\"https:\/\/www.basem.co.uk\/membership\/basem-blog_detail.healthy-hormones.html\">Healthy Hormones<\/a>\u00a0Dr N Keay BASEM 2018<\/p>\n<p><a href=\"https:\/\/www.theguardian.com\/stage\/2018\/jul\/15\/raising-the-barre-how-science-is-saving-ballet-dancers\">Raising the barre: how science is saving ballet dancers<\/a>\u00a0The Guardian 2018<\/p>\n<p><a href=\"https:\/\/www.iadms.org\/page\/2018\">International Association for Dance Medicine and Science<\/a>\u00a0Medicine &amp; Science in Sports and Exercise 2017<!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dr Nicky Keay\u00a0@nickyKfitness Traditionally dance medicine has been somewhat the poor relation of sports medicine. Why is this the case? There is no doubt that dancers, of whatever genre, require the physical and psychological attributes of athletes. However, dance involves an additional artistic component where ultimately performance on stage is judged not according to a [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2018\/08\/16\/what-is-dance-medicine\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":7985,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[16090,16068,16069,3040,1858],"class_list":["post-7984","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-dance","tag-featured","tag-featured-list","tag-red-s","tag-sports-and-exercise-medicine"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>What is Dance\u00a0Medicine? - BJSM blog - social media&#039;s leading SEM voice<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2018\/08\/16\/what-is-dance-medicine\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"What is Dance\u00a0Medicine? - BJSM blog - social media&#039;s leading SEM voice\" \/>\n<meta property=\"og:description\" content=\"Dr Nicky Keay\u00a0@nickyKfitness Traditionally dance medicine has been somewhat the poor relation of sports medicine. 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Why is this the case? There is no doubt that dancers, of whatever genre, require the physical and psychological attributes of athletes. 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