by Janine Bryant for The Dance Journal
Demi-plie´ Maximal knee flexion reached
by knees before heels rise
The proper mechanics of a demi-plie´
Closely associated with the body’s dynamic alignment, the first position demi-plié in ballet is a coordinated turned-out movement of flexion and extension of the hip, knee, and ankle, with the foot remaining flat on the floor. Demi-plié constitutes the basis of numerous dance movements, like jumping, and is taught to dance students from the earliest classes. It is frequently the first movement performed at the beginning of ballet class, and is subsequently repeated in almost every dance sequence during the training session. Despite its artistic importance and apparent simplicity, anecdotal evidence suggests that 95% of dancers do not plie correctly, while many dancers, teachers, and health professionals remain surprisingly unaware of the biomechanics and anatomy of this primary and fundamental movement. Like any other dance movement, when incorrectly performed, demiplié can eventually lead to overuse injuries. Unwanted movements frequently observed during the demi-plié include:
*A “rolling over” of the feet, especially prevalent in young dancers, characterized by having only two points of contact with the floor, the first metatarsal and the heel bone;
*A “sway back,” with excessive external rotation, unsupported core stability, and excessive activity in the quadriceps (especially the rectus femoris, which has a tendency, due to its attachment on the anterior inferior iliac spine, to rotate the pelvis forward into an anterior tilt, which in turn destabilizes the entire spine)
*An “over-recruitment of the biceps femoris,”(the hamstring muscle located toward the lateral or outer side of the thigh ) especially in elite ballet dancers, which can disrupt dynamic alignment and diminish technical brilliance. 
Why does my hip make that ‘snapping’ sound?!
The ‘‘snapping hip’’ refers to a click with a snapping sensation that occurs during movement of the thigh. Lateral (toward the outside of your hip) snapping on the hip corresponds to motion of the iliotibial band (ITB) over the greater trochanter.
Medial (internal) snapping that occurs medial (more toward the inside) or anterior (front) to the hip is caused by the iliopsoas tendon moving across the femoral head. Lateral snapping more commonly affects the supporting leg while attempting turnout or when landing from jumps, as the hip extends from a flexed position. Medial snapping mainly affects the gesturing leg (non-weight-bearing limb), causing a painful arc when performing semicircular motion around the torso to bring the hip into extension from a flexed, adducted, and externally rotated position (ronde de jambe). The snapping sensation is usually audible and palpable to the examiner on movements that reproduce the symptom.
The snapping sensation may be painless; however, over time, it can turn painful and limit dance activities. Physical examination of the lateral snapping hip may demonstrate local tenderness behind the greater trochanter and ITB tightness with a positive Ober’s test result (a special test that identifies tight ITB). Physical examination findings of medial snapping include pain on resisted motion of the iliopsoas and symptoms while moving through the painful arc. Treatment can be initiated with nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy modalities, and ambulation devices for unloading (taking stress off of) the joint.
Therapeutic exercises should promote stretching of the involved muscles, iliopsoas, and ITB. Treatment goals should include correction of posture and technique as well as strengthening of the hip musculature. For refractory cases of medial snapping, one may consider the use of an MRI study to rule out intra-articular pathologic findings and referral for surgical release or lengthening. 
Surprising news on stretching and warm up protocols for dancers
Until next time, dance healthy and long, friends!
Co-Director of Dance
Faculty of Biokinetics, Education
and the Campolo College for Graduate and Professional Studies
Eastern University, St. Davids Pa.
Next article will include: Local resources, dance medicine and science practitioners and sports medicine physicians who specialize in treating dancers.
1. Coulliandre A., et al, Exploring the effects of kinesiological awareness and mental imagery on movement intention in the performance of a demi plie, J of Dance Medicine and Science, 2008; 12(3): 91-98
2. Morrin N., Redding E., Acute effects of warm-up stretch protocols on balance, vertical jump height and range of motion in dancers. J of Dance Medicine and Science, 2013;17(1):34-40.
3. Motta-Valencia K., Dance related injury, J of Phys Med and Reh Clinics of N Am, 2006;17: 697-723.
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