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PROTIP # 19

What does your walk say about you?

Gait and Gait Deviation in Dancers

Gait is defined as a manner of walking or moving on foot. It involves a series of rhythmical, alternating movements of the limbs and trunk causing a forward progression of the center of gravity (CoG). Gait also involves a repetitive loss and recovery of balance through displacing and controlling the motion of the CoG in the most efficient manner. (Merriam-Webster, Loudon, 2008)

Each individual has their own unique gait pattern. Furthermore, gait development is not an exact science. (Johnston, 2014)

Three gait deviations common with dancers will be covered in this pro-tip:

1. Out-Toeing

2. Hyper Lumbar Lordosis

3. High Heeled Shoes

Gait Deviation: Out-Toeing

Dancers, particularly ballet dancers, are known to exhibit the gait deviation termed “out-toeing”. Out-Toeing is defined as a lateral rotation of the foot relative to the direction of walking. This gait deviation is common in infants and usually resolves within the first year of life.

Out-Toeing alters the gait and increases the risk of damage to the foot, ankle, knee, and hip joints.

Out-Toeing in the Population

Out-Toeing is commonly found in the dance population, particularly ballet. It is caused by an imbalance of muscle development between the inward and outward rotators. This imbalance can lead to periformis syndrome as well as other soft ligamental injuries. (Lunes et. al, 2016)

Gait Deviation – Excessive Lumbar Lordosis or Lumbar Hyper-Lordosis

This posture is often found in combination with hyperextended knees, kyphosis and forward head tilt. Combined, this is termed fatigue posture.

Excessive lumbar lordosis may increase the risk of low back injury due to the increased shear forces of the lumbar spine. This can further lead to fractures of the vertebrae known as spondylolysis. (Wolf, et. al, 1979)

Fixed hyperlordosis interferes with the cyclic loading and unloading of the facet joints necessary for proper cartilage nutrition, which may precipitate early breakdown of this cartilage. (Stanish, 1979)

Lumbar lordosis in the population:

Ambegaonkar, et al., 2014 found moderate or marked lumbar lordosis in dancers and gymnasts. Further research is needed to determine if the increased lumbar lordosis affects gait patterns and/or influences injury incidence in these populations.

Gait Deviations with High Heeled Shoes

Any shoe with an elevation above 10cm is considered a high heeled shoe. Despite the risks, high heels remain extremely popular with 37%-69% of women wearing them daily.

Many dance jobs require hours of rehearsal and performance time in high heels:

The effects of high heeled shoes are not localized to the foot, but rather travel up the leg and spine.

When walking in heels, the loading characteristics of the foot are altered. There is a lack of heel strike which causes more flat foot or toe walking. The forces on the foot also shift anteriorly and medially which increases the shear stress and loading force on the first metatarsal head (the big toe joint).

Many common injuries are associated with high heels including ankle sprains, foot pain, tendonitis, metatarsalgia, broken ankles, hammer toes, bunions, corns, calluses, Achilles tendon tightness, plantar fasciitis, etc., etc.

In summary, dancers are encouraged to avoid high heels whenever possible. Hang the high heeled shoes out to dry.

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