Orthopedic Test for Young Students
Here is a simple orthopedic test for new and growing students. This kind of test is administered in the major academies throughout Europe and anticipates and helps the teacher correct physical problems before they begin. Teacher and parent should see the results so that they may adjust to the evaluation.
Here are test areas for the family doctor or an orthopedist. We should urge regular examinations during the dance education period from 7 to 18 years of age. Students should wear leotard and socks for pointe shoes for the examination.
1. Check the alignment from the side; an imaginary plumb line should descend from the mastoid process in front of the ear; though the center of the shoulder joint, just in front of the greater trochanter (the ball of the ball and socket portion) of the hip; slightly behind the center of the knee joint; and slightly anterior to the lateral malleolus (part of the ankle bone).
2. Shoulders seen from the front: Check for equal clavicles, a tight trapezius limits head movements; a "winged" scapula (wing-like shoulder bone) indicates weakness in the upper torso.
3. Shoulders from the back: Check for unequal shoulders which may indicate scoliosis (sideways curvature of the spine) although unequal shoulders are not unusual. With the student leaning forward almost to a right angle, hands touching in front of the body, feet parallel, note if one side of the back reveals a slight curvature, more pronounced on the side of the shoulder that is higher.
4. Hips. With the student facing the evaluator, feet parallel, check to see if the anterior superior iliac crests are level. Have the student raise the working leg à la seconde (raised to 90 degrees or higher). If there are snapping or popping sounds in the pelvis or a grinding sensation, the student is using the quadricep muscles to raise the leg higher than 90 degrees inhibiting the height instead of using the psoas muscles, that flex the thigh, at the inside of the pelvis.
Legs: still facing front: equal length of legs can be determined with a small steel tape measure, extending from iliac spines to medial malleus. Student may also lie on the back, knees bent to see if they are level. If not, a measurement of the femurs is required and perhaps an device should be recommended for wear outside the classroom or at night. Evaluate the ankles from the back with the feet parallel...arches should not supinate or pronate. The Achilles tendon should ascend in a straight line, neither curving to the lateral or medial sides.
Knees: Facing sideways, check for hyperextended or swayback knees, from the front, look for tibial bows, knock-knees and patella rotation.
Ankles: In First Position, (heels together, feet turned out) second toe should be in line with kneecap. Have the dancer assume Second Position (feet 12 inches apart, feet turned out) check once again for supination (upward turn or pronation, a downward turn). Have the dancer rise to demi-pointe (heels up, support on the metatarsals) to observe correct alignment.
Thumb to wrist: To test natural flexibility, have the dancer bend a thumb to the wrist as far as it will go. Nearness to wrist indicated joint and turn-out flexibility. Arms should be measured for equality. Hyper-extended and hyper-mobile wrists are a potent cause of injury from falls. Male partnering in lifts requires maintaining muscle strength in the wrist area.
Hamstrings: Have the student lie down, one leg up, the other straight or bent if more comfortable. Gently stretch the uplifted leg to the shoulder to test tightness.
Feet: Observe the alignment of the toes to determine stability in demi-pointe on a rise of the heels to the metatarsals with the toes on the floor. Ankles should be held firmly.
Pointe: With the girls in pointe shoes, have each rise into First Position on full point heels should meet) and also in Second Position (heels should not rotate inward).