Meredith Butulis

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  • Hip Trigger Point Release: The Big 4

    Hip Trigger Point Release: The Big 4

    Ever hear “just roll it out?” Maybe you’ve used a release ball on your feet, hips, or other places to decrease muscle tension.

    Ever have questions about where to roll, or how long to hold each spot?

    Dancers, athletes, and fitness enthusiasts tend to have very predictable spots of hip tension.

    Here are “the big 4” key areas:

    1. TFL— This muscle is found as you place your hand half way into the front pocket on a pair of jeans. It is a hip flexor, but it is not designed to flex the hip beyond 90 degrees. Many dancers and athletes overuse this muscle, particularly when fatigued. This overuse creates trigger points that can be decreased with use of a release ball. This muscle is also often the first to go into spasm to protect an underlying injury, so be sure to see a medical provider if you think you might be injured. There is a bone on the side of your hip (greater trochanter), as well as a bursa (fluid sac that can become inflamed); avoid these areas.
    2. Glute max–This is a major power source for the hip. It also stabilizes your low back. Place your hands on the bony part of your pelvis (iliac crests). Slide your hand down about 1-2 inches into the muscle. You will likely find an entire rainbow of trigger points thru this rainbow shaped area. Try releasing one point at a time and pick 2-3 key spots from this region.
    3. Piriformis–This is a major turnout muscle for the hip. It is easiest to find on a release ball when lying on your back with your leg in a bit of a turned out position. It is about 2 inches away from the tail bone, close to the bones you sit on every day (ischial tuberosities). Be mindful of the sciatic nerve. If pain is radiating below knee level or into your foot, move away.
    4. Pectineus/Adductor–This is an inner thigh/groin muscle that can serve as a major hip stabilizer. It can best be found lying slightly face down on a ball with your toes turned out. Be careful of the artery in this area. If something is pulsing or zinging down your leg, move away.

    How long should we hold each spot?

    Generally, try to hold the spot for about 30-180 seconds or until the tension under the spot decreases by 50-80%. Try holding instead of continuously rolling, as we are trying to get the nervous system to decrease the signal to the overactive spots

    How should we select the density of the ball?

    There are many balls that can be used, ranging from those designed for self trigger point release to tennis balls and lacrosse balls. You need to be able to relax into the pressure for the trigger point release to be effective. If the ball is too hard, you will not be able to relax. If the ball is too soft, you won’t feel the effect.

    How should self trigger point release feel? 

    Trigger points are a bit painful, but pain decreases when you hold and relax into the spot. Pain goes away when you move off of the spot. It is common for discomfort to radiate into nearby areas. However, if you feel pain radiating below knee level while performing a hip trigger point release, move away from that spot.

    If you feel anything zinging or pulsing, you may have found a nerve or artery; move away from those spots. Trigger point release should not leave bruises; if it does, the ball you are using is too hard.

    Summary:

    I hope that this blog post has helped you identify key points where dancers and athletes often benefit from self trigger point release. What thoughts and questions do you have?

    Disclaimer:

    This blog post was written by Dr. Meredith Butulis for general education and is not intended to diagnose, treat, or prevent any condition.

  • High Kick Technique: The Big 4 For Instant Improvements

    High Kick Technique: The Big 4 For Instant Improvements

    Dance team sections is definitely the buzz today! Congratulations to every team and tribe of supporters, as you have worked very hard to peak this season!

    Coaches, if you find your team working toward state, you might wonder “what can I do right now to help my team improve kick in just a couple of weeks?”

    First, let’s take a moment to consider 3 common practices to leave OUT of your plan:

    1. Increase full out kicks with extra run throughs, two a days, etc. There’s a good chance your dancers already have sore hips, and many are dancing injured. Adding more reps will increase inflammation and pain, which will lead to more compensation like bent knees or lower kicks.

    2. Extra partner stretching or over stretching. Over stretching can create soreness. Soreness will also limit your kick height.

    3. Strengthening the hip flexors with bands, weights, or extra high knee running. It takes 4-6 weeks to gain sport performance strength. You don’t have 4-6 weeks right now. If you happen to pick an exercise that targets the TFL muscle, injuries may really increase at this point in the season.

    Now, let’s look at the big 4 that you can use right now to help create instant kick improvements:

    1. The standing leg– When you stand on 2 legs, the tail bone should be evenly between them. When you stand on your right leg, your tail bone should align more toward your right heel instead of being centered.

    Take a moment and have your dancers practice being aware of how the tail bone needs to shift over the standing side when you move from standing on 2 feet to a parallel passe. Next, try this awareness during a kick set of 8 counts slow. Next, repeat more quickly.

    When dancers can experience the subtle right to left shift, and then apply it to kick, they will pull less on their fellow dancers when hooked up in formation. That will help the upper body posture, which is also critical to kick technique.

    2.The upper body– Have your dancers wear a bun or high pony tail for this drill. When you stand on 2 feet, the bun lines up over the tail bone. When you lift one leg in front of you (i.e. kick), the bun needs to travel both upward to lengthen the spine AND slightly back to be slightly behind the line of the tail bone. This allows ease of motion for the leg to lift in front of the body.

    Have your dancers practice the slight backward upward movement of the bun on their heads as they alternate high knee marching, and then kick sets of 8. See how their ease of motion in getting the legs up changes.

    3. The pelvis– Let’s talk about sits bones. When you are sitting, you feel two bones (ischial tuberosities) that you sit on. One is under your right buttock area, and the other is on the left. Let’s call these “sits bones.” If I’d like to perform a right front kick, the left sits bone needs to lengthen toward the floor/standing side heel. This is not a level change, but rather a sense of lengthening that will create a sturdy standing leg and opposition for ease of movement in the kicking leg. If we have a stable standing leg, we can do just about anything with the moving side.

    Now, let’s think about the right leg (kicking leg). The pelvis has a hip socket toward the front side. If the dancer can orient that socket upward to face more toward the ceiling, it will free up the right kicking leg to go higher without pinching the front of the hip. Think of it like a steering wheel, or a tuck only on the kicking side. The pelvis steering wheel rotates so the front of the hip can go up toward the front. We will share some video drills later this week to help dancers feel immediate success with this complex movement.

    4. The kick initiation– From a choreography standpoint, we often focus on the accent up to “whip” the top of the kick, or the accent down by pounding the feet toward the floor. If you want to see straight knees and pointy toes, then don’t delay the straight knee pointy toe motion.

    Have the dancers try traditional ballet degage front, alternating sides. Have them really focus on brushing the floor so they can feel their straight knee and pointy toes before the leg elevates to 45 degrees. While high kick technique does not typically have the brush component, the dancers can still learn how to properly weight shift right to left and achieve the correct straight knee – pointy toe line before 45 degrees. This improves both technique and ease of motion in elevating the kick height.

    Summary:

    The secret to improvement at this point in the season is to work with alignment and sensory motor processing. These are the two areas that can lead to immediate improvement.Remember that not all cues or drills work equally for all dancers; building your toolbox over time is critical to helping more dancers achieve success. While the above tips can help immediate improvement, they can also be practiced for years on end with continued skill development.

    Give these tips a try and feel free to share your experiences and thoughts here or on social media; this community is stronger together, and I hope that these tips help add to your toolbox.

    This article was written by Dr. Meredith Butulis for educational purposes. It is not intended to diagnose, treat, or prevent any condition.

  • 3 Daily Habits That Can Make You a Better Dancer

    3 Daily Habits That Can Make You a Better Dancer

    Dancers,

    What if there were 3 daily habits you are already performing where slight modification could make you a better dancer?

    Give these 3 modifications a try:

    1.Where are your ears? Keep your ears over your shoulders. Do this at school, while walking, while driving, while texting, and most of the time while you are upright.

    Why: If you hunch forward to perform daily activities, you will develop muscle imbalances that alters arm movement. The increased effort to elevate the arms overhead changes the alignment of the ribs and pelvis. This then makes proper muscle use for skills like pirouettes, various kicks, leaps, and port de bras difficult.

    As a faculty member from the Pro Arte Centre  in North Vancouver, Canada shared at IADMS in 2017:  “You just can’t become a professional dancer with those forward posture habits.”

    2. How are you sitting? Work on sitting (and sleeping) more symmetrically. This means equal weight on both sits bones, knees that are even with each other, and shoulders that face the same direction as your hips. If you like to curl up with one leg or cross a leg, then give both sides equal turns.

    Why: Consistently sitting and sleeping asymmetrically while favoring one side leads to pelvis imbalances. When the pelvis is not balanced, it is very difficult to access the supporting hip rotator muscles, inner thighs, and psoas. This often leads to hip and back compensations that cause injury over time.

    When dancers come to Dance Medicine based Physical Therapy, I often see this as a major area to address for “I can’t find my rotators,” “My leg just won’t go up,” and “I have snapping hip.”

    3.How are you walking? Try to keep your toes mostly forward. Many dancers think that walking turned out will improve turnout, but walking in turnout actually creates injuries over time.

    Why: Walking excessively turned out decreases the stability from your glutes, which are major protectors and stabilizers for the hips. It also shortens the IT Bands, which can create knee pain like patellofemoral tracking issues and IT Band syndrome. Rolling the IT Bands alone isn’t enough; the movement patterns creating the recurrent tightness and muscle imbalances need to be addressed.

    Summary:

    Try consistently keeping your ears over your shoulders, sitting symmetrical, and toes mostly forward when you walk. See what you notice about your technique after a week of consistent daily attention? What did you find? Share with us here to keep the discussion going.

    This article was written by Dr. Meredith Butulis for educational purposes only. It was not intended to diagnose, treat, or prevent any condition.

  • 3 Tips and a Host of Resources for a Healthy Heart Lifestyle

    3 Tips and a Host of Resources for a Healthy Heart Lifestyle

    It’s Heart Health Month!

    How many people do you know affected by stroke, heart attack, or other heart/blood vessel conditions? What about the precursor of high cholesterol or high blood pressure?

    I know many.

    • My friend in her 20s had a heart attack while teaching fitness classes. She was very active, often teaching 3-5 high intensity classes per day. She had no warning signs.
    • My colleague in her 40s experienced a life changing cardiovascular event while taking a dance class. She had danced her whole life, at least an hour a day. She had no warning signs.
    • My uncle died from a stroke. He was in his 60s. He had no warning signs other than high blood pressure and high cholesterol. Overall, he felt fine in life, but was generally quite sedentary.
    • The list continues. There are many, many more.

    So many people have the option to choose quality of life for the next decades to come!

    Heart/cardiovascular disease continues to rank as the number one cause of death, but it is often preventable with lifestyle modification.

    With over 25% of people being affected, it’s time to take back your health today!

    Here are 3 daily lifestyle habits to promote your heart health:

    1. Sleep – Most adults need 7-9 hours of sleep/night. This is when your body recovers. Have you ever pulled an all-nighter and discovered that your heart rate was elevated the next day? Perhaps workouts felt really difficult as well. Your heart is trying to tell you that recovery is key for health. Make sleep a top priority instead of last priority. Take this sleep quality quiz, and discover more pearls on how sleep affects your health in this Experience L!fe article.
    2. Nutrition – Diets higher in fiber promote heart health. Vegetables, fruits, legumes, and whole grains contain fiber. Also replace your saturated fats with more unsaturated fats. Examples of unsaturated fats include tree nuts, olive oil, and avocado. Canada takes the lead in their new 2019 food guide with practical every day strategies on what to eat.
    3. Get moving – Many blogs call sitting the “new smoking,” meaning that being sedentary subtracts from your health. Add to your health by setting a goal like 10K steps/day. Need to adjust for more or less? Looking for ideas beyond walking? Here is a great interactive resource to Move Your Way.

    Now that we’ve explored the foundations of lifestyle, and many practical choose-your-own-adventure resources, what questions do you have on your healthy heart lifestyle? Leave a post or use the contact form, as I’m here to help and live a healthy lifestyle along side you every step of the way!

    Seeking more detailed practical tips? Join the monthly e-mail newsletter via the sign-up on the home page.