Analysis Of Pelvic Alignment In University Ballet Majors
Original ArticleAnalysis of Pelvic Alignment inUniversity Ballet MajorsJennifer L. Deckert, M.F.A., Sarah M. Barry, M.F.A., C.L.M.A., andThomas M. Welsh, Ph.D.AbstractClassical ballet technique emphasizesproper alignment of the pelvis to optimize dancer performance. A seriesof three experiments was conductedin a major university ballet programto determine: 1. the average degree ofpelvic tilt for freshman ballet majors,2. the degree of pelvic tilt acceptableto university ballet teachers, and 3.whether an individual tutoring intervention could improve pelvic alignmentin dancers who displayed a high degreeof anterior pelvic tilt. Experiment 1showed that anterior pelvic tilt for 17freshman ballet majors averaged 13.4 .Experiment 2 revealed a mean anteriortilt of 11.4 for photographs rated asacceptable tilt by ballet teachers at thesame university. Experiment 3 showedthat three dancers who participatedin six hours of individual tutoringimproved their pelvic alignment by3 to 4 , enough to move two of thedancers into the acceptable range. Thesestudies suggest that a moderate degreeof anterior pelvic tilt may be commonand acceptable for university balletmajors, and they show that dancerswith excessive anterior tilt can improvetheir alignment with as little 6 hours ofindividual tutoring.Dance is an art form whereperfection results from adelicate balance betweenartistry and physical skill. Classicalballet training focuses on perfectingalignment of the human skeletonin service to both purposes. Whatconstitutes ideal pelvic alignment fordancers has yet to be demonstratedempirically. While the logic of efficient biomechanics might suggest thepelvis needs to balance on the headsof the femurs,1,2 the relative positionof specific bony landmarks whenthe pelvis is balanced will probablyvary by individual dancer, and frommovement to movement. Research isneeded to clarify this issue. This studyfocuses on dancer pelvic alignmenton the sagittal plane.Kendall, McCreary, and Provancedefined neutral pelvic alignment asa point where the two anterior su-Jennifer L. Deckert, M.F.A., and Sarah M. Barry, M.F.A., C.L.M.A., completedthis study while MFA candidates at the University of Utah. Jennifer Deckert iscurrently in the Department of Theatre and Dance at the University of Wyoming,and Sarah Barry is in the Department of Dance at Florida State University. ThomasM. Welsh, Ph.D., is in the Department of Dance, Florida State University,Tallahassee, Florida.Correspondence: Jennifer L. Deckert, M.F.A., 263 A North Fifth Street, Laramie,Wyoming 82072; jdeckert@uwyo.edu.This study was presented at the annual meeting of the International Associationfor Dance Medicine & Science (IADMS) in Stockholm on November 5, 2005,and was the winner of the 2005 IADMS Student Research Award.110perior iliac spines (ASIS) are on thesame vertical plane as the symphysispubis.3 Fitt defined neutral alignmentas having the ASIS and the posteriorsuperior iliac spines (PSIS) on thesame horizontal plane.4 Using eitherconvention, possible misalignmentson the sagittal plane are tilting thetop of the pelvis too far forward(anterior tilt) or tilting the top ofthe pelvis too far backward (posteriortilt).3,4-8Excessive pelvic tilt, particularlyanterior tilt, appears to be a commontechnical fault among pre-professional ballet dancers, and may be causedby an imbalanced use of musclesthat control the pelvis and lumbarspine, tight hip flexors, or structuralanomalies. Several dance trainingauthorities suggest that misalignmentof the pelvis in dancers may lead tovertebral stress and knee, foot, andankle injuries due to compensatorymovements and excess muscle tension.4-6 Efficient pelvic alignment,on the other hand, may facilitateefficient movement in general andefficient specific action at the hip andlumbar spine.1,4 Learning to achieve amore neutral pelvic alignment mighthelp dancers succeed in the highlycompetitive field of ballet.Several studies provide a startingpoint for further research on thistopic. Gamboian and colleaguesanalyzed the effectiveness of somatictraining to improve pelvic alignment in university dancers.5 These
Journal of Dance Medicine & Science Volume 11, Number 4, 2007investigators found that techniqueclass alone did not improve pelvicalignment, however adding somatictraining did lead to improvementin some individuals. They recommended the use of repeated measurement across days and within-subjectresearch designs to accommodateday-to-day and between-subject variability. Welsh and colleagues useda repeated measure, within-subjectresearch design to evaluate the effectsof back strengthening on universitydancers.9 McMillan and associates7suggested that Pilates-based exercisecan improve posture and body control. They concluded that alignmentimprovements were probably attributable to increased motor control.Pelvic alignment measurementsystems vary across studies. Some useda two-dimensional kinematic analysissystem such as the Peak Performanceanalysis5,10 or Vicon kinematic system. 11 While lab-based measurement systems offer a technologicallysophisticated approach to assessingalignment, they place dancers in anunfamiliar environment that mayaffect performance and alignment. Afew researchers have used alignmentmeasurement approaches that areeasier to adapt to the dancers trainingenvironment.McLain and coworkers 8 placedreflective markers on dancers’ anterior superior and posterior superioriliac spines and videotaped them infront of a large grid. Expert judgesrated the dancers’ alignment fromthe videotapes. Fitt and colleagues12placed reflective markers on thesesame bony landmarks and took sideview, still photographs so the angleof pelvic tilt could be measured later.Independent of the measurementmethod employed, dance researchershave emphasized the need for repeatedmeasurements and within-subjectcomparisons to reveal and accommodate individual variation.We conducted three studies toexamine pelvic alignment in dancersin a professional training programin ballet at a major university. Theexperiments assessed: 1. the averagedegree of pelvic tilt for first-year bal-let majors, 2. the degree of pelvic tiltacceptable to the experts who teachthem, and 3. whether pelvic alignment could be improved throughindividual tutoring. Experiment 1was a descriptive study of the degreeof pelvic tilt in first-year dancers in auniversity-based professional trainingprogram in ballet.Experiment 1Participants and SettingSeventeen of 25 first-year, female ballet majors volunteered to participatein Experiment 1 in response to anannouncement made in their danceinjuries class. All were between 17 and20 years old and had been selected byaudition for the professional trainingprogram. Participants signed consentforms and the university’s Institutional Review Board approved allthree studies.First-year ballet majors were required to attend daily 110-minuteballet technique classes as well as50-minute pointe technique classesthree times a week, and a 50-minutecharacter dance class twice a week.The dancers had a variety of techniqueinstructors, each with their own intention and focus. None of these classesfollowed a specific, pre-formulatedballet technique. A diverse combination of classes is probably typicalof many dance programs in highereducation.MeasurementA measurement procedure was developed to assess each dancer’s degree ofpelvic tilt while dancing. The procedure was comparable to a radiographicapproach used by Crowell and colleagues13 as a criterion comparison forclinical assessments. We adapted theprocedure for use in an environmentanalogous to ballet technique class.All assessments were performed in theballet studios where the participantsattended daily classes. The measurements were conducted, one dancer ata time, always following ballet technique class to insure the dancers werewarm. The dancers were taught threeballet barre combinations. The firstcombination, pliés, included a phrase111of two demi-pliés, one grand plié, andport de bras combining torso and armmovements. The second was a tenducombination from first position combining a demi plié in fourth or secondposition with a demi rond de jambeand slow tendus into first position.The final combination was a tendufrom fifth position. This combinationutilized a transfer of weight throughfifth position, quicker movements,and a relevé in fifth position with achange of the feet. All combinationswere typical of a ballet technique classfor dancers at this level. While theywere conceptually simple, the combinations did challenge the dancersby demanding quick thinking andtransfer of weight.Three-dimensional reflective markers were placed by palpation on thedancers leotards at the anterior andposterior superior iliac spines (Fig.1). The first author placed all markers to minimize variability in markerplacement. Crowell and colleaguesfound inter-tester assessment of theASIS and PSIS alignments to vary asmuch as 5 , while intra-tester assessments varied by no more than 2 .13To match conventions adopted byseveral authors,4-6,11-13 pelvic alignmentwas measured along the sagittal planeand compared to horizontal, as 0 . Wedefined tipping the pelvis so the anterior superior iliac spines moved lowerFigure 1 Example of marker.
112Volume 11, Number 4, 2007 Journal of Dance Medicine & Sciencethan the posterior superior iliac spinesas anterior tilt and tipping the pelvisso the posterior spines moved lowerthan the anterior spines as posteriortilt. Accordingly, the dancer in Figure1 is displaying anterior tilt.A tripod-mounted video camera(Cannon GL1) was placed perpendicular to the dancer. The camera wasleveled and its height was adjusted sothe center of the lens was one meterfrom the floor, which was at hip levelfor most dancers. The degree of zoomwas set to marginally more space thanwas used by the dancers while performing the three barre combinationsto insure consistency across observations. A black drape was hung on thewall behind the dancers to provide aconsistent contrasting backgroundagainst which to record their alignment.The dancers performed the balletcombinations to pre-recorded musicwhile being video recorded. From thevideo recordings of each session, stillimages were taken from eight pointsin the combinations such that theyrepresented the range of movementincluded in the combinations wheredance teachers might expect thepelvis to be neutrally aligned. Threeimages were taken from the pliécombination, three were taken fromthe first tendu combination, and twoimages were taken from the last tenducombination. The specific locationsfor these stills were as follows:1. Bottom of demi-plié in firstposition,2. After coming up from thegrand plié in fifth position,3. After the circular port de brasin fifth position,4. After rond de jambe fromtendu back to tendu side,5. After the last quick tendufront,6. Top of the relevé in first position,7. Tendu side during first set,and8. Relevé fifth position right footfront after degage switch fromthe back.The eight still images were measured using image analysis softwareavailable in the public domain (ImageJ: rsb.info.nih.gov/ij/index.html).The software allowed an angle in degrees to be determined by comparing aline drawn between the two reflectivemarkers to the horizon. We assignedpositive numbers to degrees of anterior tilt and would have assignednegative numbers if any dancers haddisplayed posterior tilt.The measurements were summedand divided by eight to yield a meanfor each session. This provided an estimate of the degree of pelvic tilt eachdancer used when neutral alignmentmight be expected. The process wasrepeated once a week for three weeksfor each of the 17 participants. Themeans from each of the three sessionswere averaged to determine a threeweek mean for each dancer. An overallmean for all the participants was alsocalculated.To assess the reliability of the measurements, 79 of 700 still photographs(11%), were drawn at random and independently assessed by a second observer. Measurements were comparedphoto-by-photo and an agreementscored when the two measurementsdiffered by less than 2 . Reliabilitywas calculated by dividing the number of agreements by the number ofagreements plus disagreements, andTable 1Dancerconverting the resulting proportionto a percentage. Overall reliability was81%.Results and DiscussionTable 1 displays the individual measurements and weekly and 3-weekmeans for each of the 17 participantsin Experiment 1. The results showthat all participants had some degreeof anterior pelvic tilt. Individual measurements ranged from 7.8 to 20.5 .Three-week means for individualdancers ranged from 8.9 to 18.3 .The overall mean for all 17 dancerswas 13.4 of anterior tilt. Anteriorpelvic tilt was highest for 10 of the 17participants during Week 3.Pelvic alignment varied fromdancer to dancer and from week toweek for individual dancers. Thisvariation is consistent with previousfindings and supports the call for repeated measurements when studyingpelvic alignment in dancers.5,7 Possible explanations for the alignmentvariability might include changes inmuscular tightness, energy level, ordancer focus. Fatigue, a desire to impress the researcher, and settling intoold habits may have contributed to theincrease in anterior tilt for many dancers during the three-week observationperiod.Degree of Anterior Pelvic TiltWeek 1Week 2Week .211.59.8Group AverageMeanStd. 64.03.53.90.71.81.21.91.72.2*Dancers 2, 5, and 13 completed only two weeks of assessments. Since there was so littlevariation, we kept them in the sample.
Journal of Dance Medicine & Science Volume 11, Number 4, 2007Mean anterior tilt for dancers inthis study was consistent with priorresearch conducted with dancers,5,12and somewhat higher than ranges(4 to 16 ) recorded for other populations using similar measurementprocedures. 11,13,14 Experiment 2used the images from Experiment1 to determine the degree of pelvictilt that is acceptable to teachers ofballet.Experiment 2MethodFour university ballet instructorswith knowledge of dance scienceand proper alignment were askedto participate. Eighteen still images were chosen from Experiment1 based on the following selectioncriteria: the pelvis and alignmentwere easily seen against the blackbackground, they represented all ofthe eight recorded positions, and theyrepresented a range of pelvic tilt (7 to 19 ) that approximated the rangemeasured in Experiment 1. The images were modified to remove thereflective markers and blur the facesto disguise the dancers’ identity. All18 images were shown to the instructors in random order and they wereasked to place each image into oneof three categories—acceptable, borderline, or unacceptable—based onpelvic alignment. The mean degreeof anterior pelvic tilt was determinedfor each category by averaging theFigure 2 Judges ratings: box plot defining acceptable, borderline, unacceptablepelvic tilt with median values and interquartal range.measurements for the images placedin each category.Results and DiscussionFigure 2 summarizes the results ofthe ballet instructors’ assessmentsand they show a distinct differencebetween the mean degree of anteriortilt for the photos placed in each of thethree categories. Particularly notable isa 5 difference between the mean acceptable pelvic tilt of 11.4 (SD 2.95)and the mean unacceptable pelvictilt of 16.4 (SD 2.93). The mean forthe images rated borderline was 13.5 (SD 1.70).The results show that the averagedegree of anterior tilt revealed inExperiment 1 (13.4 ) nearly matchedthe mean (13.5 ) for the photographsjudged to be borderline in terms ofacceptability to the teachers (Experiment 2). In fact, 12 of the 17participants exceeded the mean anglefor the photos judged acceptable.These results suggest the need for anintervention to improve pelvic alignment in dancers with high degrees ofanterior pelvic tilt.Experiment 3The purpose of Experiment 3 wasto determine whether an intensive,multi-component, individualizedtraining approach could improve pelvic alignment for dancers with excessive anterior pelvic tilt and extensiveprior dance training. A within-subjectexperimental design was employed topermit the use of an individualizedtraining strategy, and to eliminateindividual alignment differences as apotential confounding influence onthe results.ParticipantsThree dancers from Experiment 1(Dancers 11, 15, and 16) were invitedto participate in an individual tutoringprogram designed to reduce anteriorpelvic tilt. The dancers were chosento participate in Experiment 3 basedon alignment tendencies revealed inExperiment 1. All had a high degreeof anterior pelvic tilt and, upon interview, expressed a strong desire toimprove their alignment. The danc-113ers had the same course schedule andeach was exposed to the same dailyclasses, corrections, and information.Background information was attainedthough preliminary interviews.Dancer 16 was 17 years old at thebeginning of the study and indicatedthat she was very aware of her needto improve her pelvic alignmentbased on repeated corrections giventhroughout her dance career. Herdance training began at age four andconsisted predominantly of ballet,although she also had some experience in modern and jazz techniques.She entered the study with a meananterior pelvic tilt of 18 . Dancer 11also said she was exceedingly awareof her misalignment and was becoming increasingly frustrated with herinability to fix the problem. She hadfocused on ballet training for the pastfive years and was 18 years old duringthe study. The results from Experiment 1 revealed a mean of 17 anteriorpelvic tilt. Dancer 15, 19 years old,had been training for 13 years in ballet and character dance, and spent ayear dancing professionally prior toattending the university. Her initialanterior pelvic tilt was 14 .Prior to intervention, all threedancers were presented for evaluationto a physical therapist to determineif their individual pelvic structuresrestricted alignment improvement.Dancer 16 showed tightness in bothhips in external and internal rotationas well as a slightly longer right leg.Dancer 11 had a shorter right leg,slight scoliosis to the right, as well asinstability and hypermobility in theright hip. Tests on Dancer 16 showeda shorter left leg as well as a tighterleft hip in internal and external rotation and in flexion. None of the tests,including Thomas and Patrick tests,3,15forecast an inability to achieve a moreneutral pelvic alignment and no unusual bony or ligamentous restrictionswere detected for any of the dancers.Although none of the dancers wereexperiencing lower back or hip pain atthe time of the study, Dancer 15 hadsuffered a stress fracture in her lumbar spine (L3) several years prior andDancer 11 had experienced low back
114Volume 11, Number 4, 2007 Journal of Dance Medicine & Scienceand sacroiliac joint pain in the past.All three dancers hoped participationin this study would help reduce theirrisk of injury in the future and helpimprove their dance abilities.Setting and MeasurementAssessments of pelvic alignment wereperformed once or twice a week asdescribed in Experiment 1 for allthree subjects for the next nine weeks.Individual tutoring was conducted ondays convenient for the dancers, andfollowing the alignment assessments.Daily technique classes, the alignmentassessments, and tutoring all tookplace in the same studio.Training ProcedureAll dancers added tutoring sessionsto their highly structured danceroutine. When their time for individual training arrived, each dancerparticipated in one-hour tutoringsessions twice a week for threeweeks, for a total of six training sessions for each dancer. A major focusof the tutoring sessions was increasing awareness and motor controland developing good alignmenthabits to promote lasting improvements. The individual tutoringapproach allowed the experimenterto interact intensively with eachdancer and to tailor the intervention to each dancer’s specific needsand abilities.The tutoring sessions were eclectic, providing a wide range of information, skills and experiences forthe dancers. A central componentwas the introduction of a seriesof Pilates and pre-Pilates exercises designed to help the dancersfind and maintain a more neutralpelvic alignment. It has been suggested that such exercises increasestrength, flexibility, and controlin dance populations. 7,8,12 Theseexercises focused on the abdominal and lower back muscles, hipflexors, quadriceps, and deep hiprotators. The dancers were given apacket of exercises and were askedto work on them outside of the tutoring sessions as often as possiblewithout compromising their dailyroutines. It was suggested that theytry to incorporate two or three ofthe exercises into their warm-upbefore daily technique class. Table2 provides a list of the exercises. Abreakdown of the tutoring sessionsby day is as follows:1. Dancer received an explanationof why good alignment is useful to dancers, a visual analysisof their own still images takenfrom previous assessment sessions, and a short anatomylesson using a pelvic model asa visual aide to explain neutralalignment. The first few exercises where introduced.2. All exercises were taught andexplained. Standing and walking with a more neutral pelvicalignment was addressed, andthe dancers were encouragedto work toward a more neutralalignment outside the dancestudio.3. Session 2 concepts were repeated with the addition ofperforming a demi-plié and atendu in an externally rotatedfirst and fifth position. A focusTable 2was placed upon rotating thelegs from the hips using thedeep rotators and inner thighmuscles while engaging theabdominal muscles to bringthe pelvis toward neutral.4. Relaxation exercises were added to decrease excess muscletension, enhance awareness,and increase limbs’ connectioninto the center of the body.The exercises taught in theprior sessions were refined.5. Less time was spent on theexercises and more time wasspent performing simple ballet combinations with a moreneutral pelvic alignment andgood external rotation.6. Session 5 content was expanded by moving the combinations to the center of thestudio. Individual problem areas for the participating dancerwere addressed and all of thematerial covered throughoutthe sessions was reviewed.The dancers were encouraged to usethe information learned in the tutoring sessions in their daily techniqueExercises Taught During TutoringHook Lying Position (supine)1 Pelvic Clock: Tip pelvis through 12 positions of clock face2 Articulated Bridging: Roll up through the spine to support on shouldersand feet3 Marching in Bridge: Alternating, parallel retires with pelvis lifted tobridge positionSupine with Hips and Knees Flexed to 90 4 Supine Marching: Lower alternating heels to floor, torso and spineremain neutral5 Supine Spine Twist: Rotate lower spine and pelvis to shift knees side toside6 Single-Leg Stretch: Extend one leg long just above floor, other knee tochest; alternateProne (face down)7 Cat and Cow: On hands and knees, hyperextend and flex whole spine8 Swimming: Contra-lateral hip and shoulder extend and flex alternately9 Child’s Pose: Fold at hips, knees, and spine to release hips and lowerback musclesStretches10 I-T Band: Sitting with legs extended, grasp opposite foot and draw legacross centerline11 Hip Flexor: Keeling lunge with pelvis held as vertical as possible12 Hip Rotators, supine: One knee crossed-over other, pull knees to chestHip Rotators, seated: Sitting with folded, crossed legs, fold torsoforward
Journal of Dance Medicine & Science Volume 11, Number 4, 2007classes. They were also asked how technique class was feeling for them andwere free to ask questions at anytimeduring the sessions. Each session wasindividualized to the dancer and herparticular needs and concerns.Experimental DesignTo permit the intensive involvementwith each dancer that the tutoringintervention required, and to removeindividual differences as a source ofvariability, a multiple-baseline experimental design was used to assess theeffects of the tutoring on pelvic alignment.9,16,17 All three dancers’ pelvicalignment was measured repeatedlybefore, during, and following theirthree-week tutoring intervention. Tutoring was introduced in a staggeredfashion, one dancer at a time. Orderof intervention was based upon convenience for the dancer. This permittedthe direct observation of alignmentvariability and graphic analysis of theintervention effects. The experimentalconditions were as follows:1. Baseline: Three baseline measurements were taken for eachdancer from the weekly meansin Experiment 1. Due to thequick transition from Experiment 1 to Experiment 3, thesemeasurements provided a useful baseline.2. Training for Dancer 16: Starting in week one of the nineweek intervention period andcontinuing through weekthree, Dancer 16 receivedtutoring twice a week. Herpelvic alignment was measuredbefore each tutoring session.Dancers 11 and 15 continuedwith their daily routines andwere measured once a week.3. Training for Dancer 11: Starting in week four and continuing through week six, Dancer11 received individual tutoringwhile Dancer 16 returnedto her daily routine and wasencouraged to continue to perform the exercises on her owntime. Dancer 11 was measuredtwice a week before her tutoring sessions while Dancers 16and 15 were measured once aweek.4. Training for Dancer 15: During weeks seven through nine,Dancer 15 received tutoring,while being measured twicea week before each tutoringsession. Dancers 16 and 11continued to be measuredonce a week.The repeated measurements allowedeach dancer’s pelvic alignment duringand following tutoring to be compared to her own alignment prior tothe intervention, thereby eliminatinga major potential source of variability.This combination of conditions constitutes a true experimental design thatpermits isolation of causal variablesby visual inspection of graphicallydisplayed data, rather than relying oninferential statistical tests.17Social ValidityAt the end of the nine-week tutoringintervention, the dancers filled-out aquestionnaire to assess their experience in the study. The participantswere given no instructions other thanto answer honestly. The questions required the dancers to rate (on a scalefrom 1 to 5) the importance of neutralpelvic alignment for ballet dancers,whether the tutoring program was agood use of their time, and whetherthe tutoring program helped themimprove their pelvic alignment.Results and DiscussionFigure 3 displays the repeated measurements of pelvic tilt for each dancerduring all experimental conditions.The dashed vertical line shows thestaggered introduction of tutoringfor each dancer. Dancer 16 enteredthe tutoring sessions with a mean of18 of anterior tilt. When individualtutoring was initiated for Dancer 16,her degree of anterior tilt decreased toa mean of 15 with only one measurement modestly overlapping the lowestbaseline measurement. During thissame period, pelvic tilt for Dancer11 increased temporarily and thenreturned to baseline levels, and tiltfor Dancer 15 decreased initially andthen leveled off.115Three weeks later, when tutoringwas introduced for Dancer 11, herdegree of anterior tilt decreased from amean of 16 to a mean of 12 . All eightassessments of pelvic tilt following theintroduction of tutoring were lowerthan any of the seven assessmentsmade during baseline. The measurement of anterior tilt for Dancer 15,who had not yet received tutoring,stabilized between 13 and 15 .When Dancer 15 finally receivedthe tutoring intervention, she, likethe two dancers before her, decreasedher anterior pelvic tilt from a baselinemean of 14 to a mean of 11 during tutoring, with only one sessionoverlapping the lowest measurementsrecorded during baseline.For all three dancers, distinctreductions in anterior tilt occurredevery time the tutoring interventionwas applied, which suggests thattutoring, and not other uncontrolledvariables, was responsible for theFigure 3 Anterior pelvic tilt before, during, and following tutoring for all threedancers who received tutoring. Dashedvertical lines show the initiation of tutoring for each dancer. Data points connected with dashed lines were gatheredafter tutoring ended.
116Volume 11, Number 4, 2007 Journal of Dance Medicine & Sciencechanges in alignment. Even Dancer15, who reduced her anterior tilt earlyin baseline, made greater gains whenshe received tutoring six weeks later.In addition, once alignment improvedfor each dancer, the improvement wassustained, even after tutoring hadconcluded for Dancers 16 and 11.On average, the dancers reduced theirdegree of anterior pelvic tilt by 3.3 .The social validity questionnairesrevealed a top rating of 5 for the importance of good pelvic alignment, anda rating of 4.6 for the contribution oftutoring to alignment improvement.All three dancers mentioned the benefits of focusing on specific problemareas and asserted that tutoring was avery good use of their time that hadincreased their awareness and understanding of neutral pelvic alignment.Preliminary interviews indicatedthat pelvic misalignment was a problem the dancers were very aware of,but had been unable to correct withregular ballet classes. Their responsesto the questionnaire support the desirability of employing an individualizedapproach. The results from this studyshow that an individualized tutoringintervention can produce alignmentimprovements that are meaningfuland important to dancers in a relatively short period of time. In addition,the dancers were able to maintain thisimproved alignment after tutoringended.Changes in alignment occurredsoon after the onset of the i
Classical ballet technique emphasizes proper alignment of the pelvis to op - timize dancer performance. A series of three experiments was conducted in a major university ballet program to determine: 1. the average degree of pelvic tilt for freshman ballet majors, 2. the degree of pelvic tilt acceptable to university ballet teachers, and 3.
dysfunction. Strain on the pelvic connective tissues can lead to a myriad of pelvic floor disorders [9,10]. PFPT aims to restore normal pelvic muscle strength, endurance, power, resting tone or a combination of these to reverse damage to the muscles and connec-tive tissue [11]. aDivision o
: Stress distribution in the pelvic bone and the location of gages. (a) Medial view of the stress in pelvic bone; (b) lateral view of the stress in pelvic bone. modulus weakened to / of the normal bone means the fracture line was weakened to MPa [ , ]. e fragments were unable to keep the original position
If unable to determine pelvic fracture stabilization, stabilize with sheet or binder. Taping knees and ankles together can minimize additional rotational movement. Pelvic binders (all varieties) are correctly placed by centering over the greater trochanter of the femur. Treatment. 8. Pelvic fracture from blunt mechanism stabilized with sheet.
one fifth of all polytrauma cases [2]. Unstable pelvic fractures occur in up to 20 % of pelvic fractures and mortality can exceed 20 % in complex pelvic injury [3]. A study by Evans et al. showed that 23 % of deaths due to hemorrhage following trauma were due to bleeding from pelvic fractures [4]. Since bleeding often occurs
Alignment REPORTER website www.alignment-reporter.com. 3.2.1. Installing the Windows software If using the Alignment REPORTER CD, place it in the CD-ROM drive. The Alignment REPORTER welcome screen should appear automatically. If not in possession of the CD, visit www.alignment-reporter.com to create an account and download the software.
Chronic pelvic pain (CPP) is a common and often debilitating problem among women. In the literature, the definition is often variable but a useful clinical definition is pelvic pain that is noncyclical and of at least 6 months duration [1]. CPP occurs below the umbilicus and is severe en
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