Ballet-specific dietary/orthopedic recommendations?

[Yaffa]

Are there any specific health recommendations for symptom-free ballet students and/or retired ballet dancers? I don't mean the general recommendations which everyone should follow (good diet, sensible shoes, exercise etc) - but ones unique to the particular way that dancers have used their bodies?

 

Yaffa

[drdance]

Hi Yaffa,

There is a lot of research being published at the moment regarding vitamin D deficiencies in dancers so that might be something to consider. Combined with that I would recommend ensuring calcium intake is high too. 

[Picturesinthefirelight]

Good supportive, well fitting street shoes? Dd has a natural tendency to pronate so we try & avoid shoes like ballet flats.

[Yaffa]

Hi Yaffa,

There is a lot of research being published at the moment regarding vitamin D deficiencies in dancers so that might be something to consider. Combined with that I would recommend ensuring calcium intake is high too. 

 

Thanks,  any thoughts on how the research would translate into protocols for prevention when there are as yet no visible symptoms? For example, regarding bone health:

 

-  Should routine bone scans start at an earlier age than normal for former dancers?

- If so, should this apply just to former professional dancers? Or also for dancers who gave up ballet in their teens?

-  Might scans of particular limbs give an inaccurate picture of general bone health in former dancers (e.g. wrist scans of men who have done a lot of lifting, or ankle scans of female dancers)?

 

What about health of joints?

 

And about the recent discovery of a structural change in the brains of professional dancers who've been doing pirouettes - What happens to this difference as they age? (I believe that at least some of the changes in taxi-drivers' brains are reversed when they stop working.) Are former dancers better or worse than the general population at avoiding falls and conditions related to dizziness? Does their training make it easier for them to adopt particular strategies for fall prevention?

 

Yaffa

[edited to correct typo]

Edited September 22, 2014 by Yaffa

[drdance]

Unfortunately I'm no longer based at the University where they were doing a lot of the work on Vit D deficiencies - have a look online though as I'm sure some of the work has been published, with recommendations. I think the scanning was whole body but again I'm not an expert in this field.

[Anjuli_Bai]

Women who spend many years dancing and/or other vigorous physical activity may find that the metabulism has changed especially when it comes to hormonal changes later in life.

 

Since - especially later in life - the body stores estrogen in fat, generally speaking, women who have been slender all their lives may find the body is lacking in estrogen, doesn't store it well and this produces - or exacerbates - all sorts of problems.

[Lifeafterballet]

At Dd's vocational school girls are voluntarily taking part in a 5 year reasearch program into bone density and vitamin D deficiency in ballet dancers ! Dd has had to record diet, wear an exercise monitor, have a bone scan and give bloods. We willingly signed up for it ! Hopefully the findings will help dancers of the future to adjust their training/diet etc so not to become so fragile in later life !

[Tulip]

Yes central students are voluntarily taking part in a study, looking at the effect of elite training on the human body. My daughter has had to fast, exercise and have bloods taken up to now.

[LinMM]

It's interesting as generally exercise is considered good for bone density but there must be some point where the amount of exercise starts to affect the bones in an adverse way.

 

I think any body over the age of 55 should take some extra vitamin D supplement whether they are/were dancers or not.

 

When my bones were being checked (because of several breaks) I had a Dexter scan.....hope Ive spelled that right! They looked at one leg and hip and the spine with this scan. This seems to be how they measure bone density. Obviously for other checks on bone health a whole body scan may be used.....though I think this is used more when looking for cancer cells rather than bone density.

 

The problem is that it's quite complex in the end and it's often how your body deals with calcium rather than the amount you actually gain from your diet eg you may have sufficient calcium but the body doesn't metabolise it properly.

Sometimes it's linked with thyroid function especially in older people.

[LinMM]

There is a very good book by Dr. Marilyn Glenville called Osteoporosis. ......how to prevent,treat and reverse it.

 

It may be generally aimed at slightly older people but it is invaluable for anyone wanting to understand bones and bone health.

 

Perhaps with younger people either in full time ballet training or are already professional dancers because of the sheer amount of exercise on a daily basis protection of bones should be undertaken earlier than in the general population.

[Yaffa]

Thanks, I'm familiar with some of the Vitamin D research.. wonderful that British ballet students are still contributing.

 

From speaking with colleagues in the medical field and  friends who did ballet in the past, there already seems to be a huge amount of knowledge from research and ballet teachers etc. which often isn't getting where it's needed. Doctors in many countries now have to spend huge amounts of time on bureaucratic paperwork and must restrict the time they spend with patients. So they might not think of ordering an early bone scan for a lady who went to a vocational ballet school twenty years ago.

 

It would be nice if a reputable body could put out a checklist of riks/recommendations which former ballet dancers could download and, if appropriate, discuss with their doctors, before symptoms arise.  

 

Yaffa

[sarahw]

I think the issue with dancers and osteoporosis is because of low body weight/fat. This can lead to reduction in oestrogen production in the body which may go with an absence or reduction of periods due to interference with ovulation. If the body does not have enough fat to sustain a pregnancy you may stop ovulating. Peak bone mass is achieved late 20s/early 30s I believe so for some dancers a lot of this time they may be underweight.

 

Smoking exacerbates the problem.

 

I think if dancers have had prolonged lengths of time at low body weight or not having periods they should certainly discuss the need for a bone (DEXA) scan with their GP. Realistically in the cash strapped NHS with GPs firefighting all the time they will not have time to approach ex- dancers - you will need to initiate.

[drdance]

The issue also comes from vitamin D deficiency - vitamin D being the 'sunshine' vitamin. Dancers typically work very long hours indoors so don't get a lot of sunshine!

[Piccolo]

There's also a price to pay in later life for having long, fine boned limbs. In older people, this category is most at risk of fractures.

[taxi4ballet]

The issue also comes from vitamin D deficiency - vitamin D being the 'sunshine' vitamin. Dancers typically work very long hours indoors so don't get a lot of sunshine!

Perhaps the same also applies to actors, musicians etc as well as dancers. 

[Anjuli_Bai]

...and the dermatologist says stay out of the sun.....

[Yaffa]

I believe cartilage problems are also a major risk factor in former dancers.

 

Darcey Bussell described in a Daily Mail interview the great impact of her dancing on her body (contributing to her retirement):

http://www.dailymail.co.uk/health/article-430672/After-years-ballet-hips-crumbling.html

She said:

Damage to the hip joints is progressive, but with a good diet, supplements such as glucosamine (which reduces inflammation) and chondroitin (which slows cartilage breakdown), plus gentle exercise, I just pray I will be able to avoid the surgery.

 

Should other former dancer take supplements, beyond which are recommended for the general population?
 

BTW there's an interesting website: http://www.dancerships.com, written by a physician, acupuncturist and former ballroom dancer, with observations about the dance-specific aspects of hip replacement.

 

Yaffa

[edited to correct typo]

Edited September 24, 2014 by Yaffa