Expert: Dianne M. Buxton - 7/25/2007

Question
QUESTION: I read one of the question/answers on turn out, and like all of my teachers and the reply answer said, it all comes from the hip.  
I have great turn out at my hips when I'm doing the "butterfly" pose laying on my back and/or stomach, and my knees go down all the way, but I can't comfortably stand in first position or get the preferred heel to toe in fifth position that teachers want.  Another turn out issue is my tendu devant.  I can't get my leg to turn out, especially on my left side.  I understand that each hip flexor is different, but if it's taken me years to capture my right side's tendu devant turn out, is it true that there's hip turn out but there's also foot turn out?  
What I mean is, for example, my friend has very bad hip turn out, yet she has no problem with her first and fifth positions or tendus from devant which I have been so desperately fighting for even when I have close to 180 degrees turn out.
I hope all of this babbling makes sense to you, and I guess my most important questions are: 1. is there such thing as foot turn out? 2. Why do i struggle with turn out if my hips are so very flexible in the "butterfly" pose, yet someone else with bad turn out can perfectly turn out her leg in almost all positions? 3. How can I increase/help my turn out for a better fifth and tendu devant safely without injuring myself?

Thank you soo much!   I will appreciate it alot if you ca help me. =]

~ Rachel

ANSWER: Here is a truer test for turnout than the butterfly or frog position, where your hips are flexed and turnout will look like more than it really is.

Lie on your stomach with your legs straight. Here your hips are in an extended position. Bend one leg to a 90 degree angle. (If your hip comes of the floor, then you need to stretch out your quadriceps and iliopsoas muscles, as in doing a runner's lunge.) You could have someone gently hold your hip down on the floor if you like. Then allow your bent leg to angle down toward the straight knee. Where the leg stops, this is the correct degree of your turnout.

Doing the frog position on your back or stomach is not good for your knees even if you are flexible that way.

Now more importantly, how to hold the turnout that you do have....if you watch dance movies carefully you will see that the most brilliantly artistic dancers in the world are not necessarily born with a lot of turnout - and it doesn't matter! That is the good news.

Your lateral rotator muscles are your prime turnout muscles, specifically: Piriformis;Obturator Internus;Obturator Externus;Quadratus Femoris; Gemellus Superior; Gemellus Inferior. These muscles lie underneath your gluts. When they contract your thigh rotates. If your leg is behind you, the gluts and hamstring muscles also help to hold the rotation.

The balance and tone of any muscle comes from its ability to work, and its ability to relax when not working. So having lateral rotators that clench to rotate, and don't relax in between exercises, do not have the strength they could have. Turning in during class, in between exercises is a good habit to have.

If you have an illustrated dictionary and can see all these muscles, and feel them working and relaxing, you will become a local turnout expert!

For example, when you tendu devant, if your hips remain in placement and your thigh is moving freely on its own, you should be able to rotate to your full natural turnout, even if you cannot always hold it. You may have to practice this with your gluts released, to isolate the rotator muscles. Gluts don't increase your turnout.

If you sit on the floor, legs straight out in front of you, relax your gluts on the floor. Then just engage your rotator muscles and turn your thighs out without your gluts working. This will help you isolate the rotators. If you can raise the legs, one by one, an inch or two off the floor, and hold this turnout, you'll feel the rotators holding against the flexion action. If your hip comes up too, then you are not isolating the leg from the hip completely.

Standing in first position, you want to open the legs by contracting the rotator muscles, but not clenching the gluts at this point. It's good to be able to tighten and hold the gluts when you need to, but not at this moment. Whatever position you end up in, that is your turnout. Same for fifth, with the extra challenge of having one leg slightly behind your pelvis and the other in front. This requires more strength.

While many teachers would not allow this, I would encourage them to have many students working in third position for much longer than they usually feel is "normal". It's not that far to fifth position once the muscles are strengthened. Advanced students and professionals do different things to compensate for not having that perfect fifth position. If they have good teachers, they learn to do this minimally and without injury. But they are doing it very deliberately.

Some people's thighs are in a different position in their hip sockets, that allows more turnout. This is the way they are born. So don't look at anyone else and compare. Also some people have tibial torsion, which means their leg from the knee down is rotated outward. It can lead to other problems, but will give their feet a turned out look, while their knees and thighs may not be able to achieve the same turnout.

Another exercise to strengthen the turnout is as follows: lie down on the floor on your back, feet in first position, flexed as though you were standing. Pressing the back of the legs into the floor can help you feel the rotators. Move the legs, feet still flexed, about half an inch outward toward second position. Keep pressing the back of the legs into the floor, and don't let your back arch. You may only be able to go an inch , - but you'll feel those turnout muscles! Do that ten times every day and you will be much stronger standing up and doing the regular class movements. You won't regret investing time in this exercise. Be sure to relax the rotators afterwards.

Rachel I hope this helps. Please let me know if it isn't clear in any way.

Recently I watched a movie of William Forsythe's company. He says in the initial interview "Well, ballet is not anatomically correct". Understatement!

---------- FOLLOW-UP ----------

QUESTION: Thanks again for the advice.  I still have some questions about the hip.

What should I do if I can't get the perfect turned out foot in class, and that's what the teacher expects?  Is it bad to force the turn out because sometimes if I try really hard, I can make it turn out nicely, but if that's not safe I don't want to risk any injuries.

I plan on taking your advice and my old physical therapist's advice on stretching the hip in a lunge in between combinations.  I also have tendonitis in my hip, and I think that helps it by stretching.

Thanks,
Rachel
ANSWER: Hi Rachel. I'm sorry for the delay. I had an answer ready to send last night and when I hit "send" I realized I had lost my Internet connection. I just got it back, and I lost my answer too, so here I am starting again.

Since I don't know how old you are and how long you've been taking ballet, I'm going to answer as though you were at least 12 years old, and you sound like you've been taking it for more than a few months.

I'm concerned that you have tendonitis. This indicates that you are moving from an incorrect standing position, which would require more tension to hold in place. If so, then your muscles are tense, not correctly toned, and not as flexible as a result, before you have even done anything. Then it is more difficult to isolate your turnout from your pelvic position, so it is harder to turnout.

Or, if you were starting your movements from a posture of good alignment, but were straining to get to a position that your anatomy doesn't allow, the strain would come from that.

Either way, you have inflammation from a compensation in your positions or movements, that is hurting your body.

Turning your feet out more than your thighs would hurt you. Just don't do it. If your teacher expects a perfect fifth regardless of your natural ability to do it, then she expects the unreasonable.

You can be born with a hip joint that allows you to turn out more - or not. Don't look at other dancers because they may have lucked out in areas where you didn't - and vice versa.

A professionally trained teacher knows how to teach each individual student a)the ideal  b) how close you are to it  c)that it doesn't matter in most cases  d) how to fake it when you are advanced enough and strong enough - meaning, safely.

Recently I watched Gillian Murphy in a movie of Swan Lake. I don't remember what her turnout is really like. Her presentation and dramatics were way too good for me to examine where her standing leg was, turnout-wise. And it doesn't matter. I did notice that she doesn't have highly arched feet. In fact if she had auditioned at the school I went to, in a crowd of several hundred others, she may have been refused.

Some schools don't pick children to train who are not close to the ideal physique (and there are many opinions about that too) because they don't know HOW to train them. So a lot of talent gets deserted. In smaller studios anyone who wants to can take a class. Hopefully the teacher can handle the variation in physiques.

For example, your teacher could allow you to work in third position instead of fifth, until your hip tendonitis is gone. It may be a couple of years. But the day that you can do a fifth position, (and your pelvis may move slightly to allow this), you will have strong thighs and a strong back to allow for the adjustment in placement, safely.

Talk to your teacher and tell her you can't do the proper position right now, and maybe never. I'm hoping that she will review your standing position and figure out what your physique needs to do do get trained, develop strength, and accomplish the safest compensations.

I think all but the knock-kneed have enough turnout to do ballet.

I remember my first year of professional training. I had some physical limitations but I could turn out almost 180 degrees. Five years later I didn't have that turnout. Only when I studied anatomy did I realize that I had degraded the tone of my lateral rotators with too much tension.

I also never discovered that I had a deep demi plie and could really jump high until I studied modern dance where the emphasis was on other things and I learned to relax a little more as I was dancing.

Sorry for the digression - I'm just trying to put things in perspective.

I hope that helps Rachel. Please talk to your teacher and see if she can help you.

And for the tendonitis, try icing after every class, and at least three times a day-a soft gel ice pack applied for 15 minutes at a time, and then wait 45 minutes before doing it again, really helps an inflammation.

All the best, and fell free to pursue this further with me, Dianne

---------- FOLLOW-UP ----------

QUESTION: Don't worry, your answer was in perfect timing, since I just got back online from ballet.  I'm 14, going on 15, and I got snapping tendon almost 2 years ago this coming Septmeber.  

That year was my first year of proper ballet training with better teachers and peers.  I traveled Friday through Sunday to a school in CT and that's where some of the best training is and the most amazing girls I've ever seen.  During the week I went to my in-town studio where students' focus was on tap and jazz, but the ballet teachers were great (they teaught in the other school I went to in CT).  I was progressing from barely doing a turn en pointe to a clean single at the end of the year, however this quick change in training was both strenuous and an experiance I'll never forget.  That winter I injured my hip so badly because I didn't warm up before class, and I was actually limping for a day or two, and couldn't do the simplest ballet moves, so I took off a week or two and it got better.  However after this recovery, my snapping tendon syndrome got the smallest bit worse.  After that I began "cracking" my hips in order to get it into a posse or a la seconde.

The director told me to see the school's therapist, but I never got to until summer.  Then she made me lay on my back with one knee propped up onto a foam roller, and she sort of "rolled" my bent leg from right to left for ten minutes.  After that my hips felt very open and well flexible it felt like I could do anything.  She said to do that everytime before class, however I never really could because of time's sake and there wouldn't be any volunteers to roll my leg for ten minutes.  However I stretched my hip in between combinations in the lunge position as she also suggested.

Then this year began and instead of traveling out of state on weekends, I started going to New JErsey Ballet daily.  My hip was still the same however, hurting in posse and anything going past a la seconde (whether in seconde, roun-de-shaum, or bat-ma) --sorry for bad spelling--.  The director noticed my hip problems and the habit of always cracking it, and told me to go to therapy.  I couldn't get to a dance therapist, so I went to the local physical therapy place.  My therapist there helped me to strengthen the muscles around the hip area.  I never quite understood how it would help, but slowly it did, and I slowly stopped my "cracking" habit.  

Then this summer came, and I stopped therapy for a break before the intensive started.  I took open classes once a week, and whenever I did, my hip hurt more than ever.  One day I was actually limping because it hurt.  Now that the intensive has started, it is still the same and hurts alot.  I ice my hips for ten minutes after class and then shower and ice again for ten minutes (that's what I'm doing right now).  I'm also stretching in the lunge position during class, and I'm not doing anything that hurts my hip.

Well that is my hip injury story, and maybe if you have any more advice on more stretches?  My old therapist at the first school suggested getting a foam roller, is it worth getting?

I appreciate your advice very much.
Thanks,
Rachel

Answer
Rachel, would you mind if I forwarded your last question to Deborah Vogel? You can read about her at http://www.thebodyseries.com. She is a kinesiologist and anatomy teacher. I have talked to her by e-mail a few times and have a high regard for her. She is a master teacher and teaches at universities and teacher trainings. I feel she could give you the best feedback right now. She may publish your question and answer (just this one) in her next dancingsmart newsletter. You can look at her archives and see what they look like. Let me know, Dianne