Ballet Fundamentals: Discipline and Barre Work

Ballet technique is first introduced in the beginner levels with discipline and structure; an appropriate level of respect for authority and discipline is engrained from day one. At the base of ballet technique, there is a necessity for humility; ballet is a technique that is passed down by instructor to student, without an ability to digest critique and criticism, one will not be successful at a study of ballet. This criticism and critique will be offered by a set of instructors, so a level of respect must be learned for students to succeed.  In the younger levels, this structure and mental toughness is taught through a military like approach to ballet class and ballet technique. In my case, a staff of Russian teachers were my first instructors. The decorum set by these teachers was rooted in the highest levels of respect for timeliness, physical presentation, hygiene, politeness, and ability to follow direction. If one was late for a class, the student was responsible for asking permission to join late and participate on set day. Often, the answer was no and an example of one’s tardiness was made; there was an emphasis on timeliness being a personal responsibility and it was made clear that the result of failure to arrive on time results in one falling behind the rest of their classmates. From an early age, it was made clear that the peers in your classroom were your competition, all of you are competing for continued placement at the School of American Ballet and ultimately for the scarce employment that one will find in the professional ballet world. Everything in these beginner classes is regimented, from the way one turns from one side of the barre to the other, how one is to stand and finishes a combination, how one is to thanks the instructor at the end of the class, etc. At the end of combinations, we were instructed to hold a final position until the instructor signaled we could be at ease. There was total control, often we were asked to hold our leg in the air, I can recall shaking and struggling to keep my leg airborne while wishing and praying that the Russian instructor at the front of the room would relieve us. Tears would be ignored, recognized only if to point out that we would get over our struggle and prevail stronger. Often the teacher would return students to their parents in tears, only to say that one day the student and parent would understand. Physical displays of exhaustion were not tolerated; yawns would result in one being sent to the water fountain to splash their face with water and requests to use the bathroom would be turned down with an emphasis on failure on the student’s part to plan ahead.  “Class is one hour and a half, you must plan ahead”, was a common response to requests to use the facilities. While this basis for ballet technique may seem cruel and/or over militaristic, it is deeply rooted in the art of ballet instruction and technique. It is the discipline and personal sense of responsibility that is learned through this approach that matures young ballet students, those unable to conform are weeded out; such mental toughening is essential to finding success in the study of ballet, which is a study that requires laser focus, perpetual self-drive, and physical/mental perseverance.

Ballet technique is heavily rooted in the practice of barre work; the barre work is what develops the elementary skills on which the rest of classical ballet is based. The exercises performed at the barre allow for reinforcement and repetition of the basic movements in ballet; beyond building strength and virtuosity of the legs and feet, repetition makes technical feats automatic. Since the barre lends balance support to the dancer, it allows for repetition of steps in as close to perfect form as one’s body

allows, building strength in hyper correct positions. This way, when the barre is removed, steps are as close to perfect as possible. It is essential that when steps are practiced at the barre that they are executed as a dancer, not as a pedestrian. Great detail is given to the posture one has at the barre, for it will carry over to the rest of their technique; one must stand erect with their chest held high, butt tucked beneath their torso, and the back of their neck long. This posture is rooted in having square shoulders, a square torso, and square hips; one’s body must be in equilibrium, not allowing one shoulder to be in front of the other or one hip to be in front of the other. This equal alignment is reinforced by stabilizing of the stomach muscles, a lifting motion is achieved by the tightening of the stomach muscles, one must be careful not to grip stomach muscles (like a crunch) but lift them. To enforce square execution of basic steps, bar work is taught behind the barre in the beginning levels. Steps are taught and performed with two hands on the barre, one’s body is in the space between the barre and the wall in which the barre is mounted. This method is used to ensure that one’s body is square and lifted; if the student drifts from this equilibrium position, their butt, shoulder, hip, chest, etc. will hit either the barre or the wall behind them, thus allowing for early stage self-correction.

Beginner ballet classes consist mostly of barre work if not entirely of barre work. In the case of the School of American Ballet, it is customary that beginner students don’t leave the barre for the first two years of their training. As dancers progress through levels, it is common that an hour and a half class can consist of an hour to an hour and fifteen minutes of barre work before moving on. Ultimately, by advanced training levels, the barre will be highly refined and be completed in a half hour to forty-five minutes’ time. It is at the barre in beginner classes that the basic steps of ballet are taught.  After posture has been established, the Plié is introduced; plié in French means bent, so the motion of a plié is to bend the knees. Plié is the most important step in all of ballet because it is what begins, ends, and connects all steps. Through the plié, the five basic positions of ballet are taught and pliés are performed in four of the five positions at the beginning of every ballet class, beginner through professional. First position is when the heels of one’s two feet are touching with their hip rotation at 180 degrees, 90 degrees coming from each leg. Essentially one’s toes are facing away from each other, while their heals are kissing. Second position is similar to first position, but instead of the heals touching, there is space between the feet; the correct amount of space between the two feet is different for each dancer but can be approximated by the size of one’s foot. The correct distance between one’s two feet is found by an instructor splitting the difference between the amount of space between one’s two feet that is the size of their foot and the space that would be created if one were to draw a line directly to the floor from the side of both dancer’s hips. The correct space between one’s two feet, for a perfect second position, is individual and can be achieved with these

two metrics and the eye of a well-trained ballet instructor. Next is third position, one’s feet are again in full turnout rotation, with the heel of one foot in front of the other. The heel of the front foot sits directly in front of the arch of the back foot, touching, as to leave no space between the two feet. Forth position is when one’s front foot is about six to nine inches in front of the back foot, both feet are in full turnout rotation and one foot is directly if front to the other.  If this position is to be viewed from directly in front of the dancer or directly behind the dancer, the appearance of one foot should be achieved; no heel or toe should be peeking out to the left or right of the dancer’s silhouette. Fifth position is similar to fourth position but there is no space between the front and back leg; both legs are in ninety-degree rotation with the toes of each foot ‘kissing’ the heel of the other foot. There is no space between the two feet and the appearance of one foot should be achieved. Fifth position is referred to by some ballet teachers as home base, this is the strongest and sturdiest position in ballet technique and because of this, numerous steps are performed from and to fifth position, it often is said that one should perform a step with the rest of their body, as though they have never left fifth position. When performing a plié in each of these positions, (1) one’s back should remain straight, not bending forward or arching back, as one’s legs bends and straightens, (2) one should keep their heels on the ground while performing a small plié and only lifting their heals when necessary in a big plié (grand plié), (3) one should resist the floor and lift up as their knees bend and push the floor away assembling their inner thighs as their knees straighten, and (4) one’s plié movement should be continuous, never stopping, while maintaining a consistent pace; no part should be faster and/or slower than the rest.

The next step introduced is the battement tendu and it is one of the most essential steps in the ballet technique.  Battement tendu is executed in first and fifth positions, but the methodology to a tendu is the same in both positions; both a tendu performed in first and fifth are crossed. The motion of a tendu is to extend the leg out with a pointed foot and return it to the position from which it came. However, there is much to think about in this seemly basic motion. One must maintain the largest degree of turnout at all times during the outward and inward motions, one’s heal should lead the motion outward while one’s toes should aim to reach first or fifth before their heals do on the return motion. While the leg is moving out and in, one’s weight in the standing foot should be over the ball of their foot; it is as if one can lift their heal off of the floor at any time during the tendu. At no point during the tendu motion should the metatarsals of the food become relaxed, it is often taught that battement tendu goes through a demi-pointe, dropping one’s metatarsals to the floor, but this is wrong. It is as if the foot is always on its way to a full point from the moment it leaves first or fifth position. Battement tendu is always crossed; to the front, one’s toes should be directly in front of their belly button, to the side, one’s toes should be directly to the side of their body (neither in front or behind their hips), and to the back, one’s toes should be directly behind their belly button. Once again, while this motion is performed, one’s body must remain erect with their shoulders and hips as square as possible, with their butt tucked under, and their stomach muscles pulling up.

Jeté is the next step taught, since it shares a lot of similarities to the battement tendu. Essentially jeté is the same step as a tendu, in a tendu the toes remain on the floor but in a jeté the toes come off the floor; about three inches for quick jetés and about four to five inches for slow tempos.  The jeté is essential for building the speed, foot dexterity, and strength for more advanced ballet steps; the speed at which one moves in and out of fifth position in a jeté prepares one to execute jumps such as assemblés and glissades later on.  The same principles of a battement tendu must be observed when executing a jeté, such as maximum turnout, exact placement (directly in front, side, and behind), heels leading out, toes leading in, full point of foots instep, lifted torso, etc.  What is emphasized in ballet technique, concerning the jeté, is that the leg shoots out quickly and arrives back quickly in fifth; teachers often shout “BAM”, “AND IN”, “FIFTH”, etc. to verbally exemplify the quality of movement one should achieve with their jeté.  In ballet technique, it is taught that no matter how fast or slow the tempo/jeté is, one must be concentrated on having a light touch to the floor and one must take care to make no noise when closing in fifth from their jeté.  Exercising the strength and control needed to avoid noise when closing from a quick jeté allows for a catlike quality later on, when closing from a large jump; no noise should be made when closing from a large jump in performance.

After jeté, the piqué is taught; often piqués are performed in combination with jetés.  The piqué is performed out of fifth position and similarly to the jeté is performed directly front, side, and to the back of the body.  The beginning of the movement is exactly like the jeté, the foot explodes out of fifth, but as the leg reaches the highest point of the leg extension, one stops their foot midair.  The foot is held off the floor, three or four inches, for a moment and then instead of returning to fifth, the leg and toes are lowered to the floor in a sharp movement, lightly tapping the floor and then immediately the foot is lifted back up to three or four inches off of the ground.  After this movement is performed the requested number of times by the instructor, the foot returns to fifth in identical form as the jeté.  When performing a piqué, one must be sure to have both a strong standing leg and working leg, a correct piqué is achieved through a joint muscular effort between the two legs.  It is important to remember that the accent of the foot striking the ground is up in a piqué, the movement is sharp always accentuating the return to the position with one’s foot three or four inches off the floor; special importance must be given to separating each piqué, never allowing the movements to blend into one another, each piqué is its own step.  The mastery of the jeté is essential to every beginner ballet dancer, allowing them to develop the strength, clarity, and control to stop and start the leg at high speeds when in the air.  This skill is essential to excelling at jumps such as cabrioles and glissades, as well as developing the inner thigh strength for jumps with beats.

Following piqué, the step that is taught at the barre is fondu, meaning to melt; execution of fondu incorporates many elements taught up to this point in the barre work.  By using one’s demi-plié, relevé, coupé, and développé, a dancer begins connecting different technical ballet elements to produce movement that begins to look a lot like the movements they will do at center, onstage, and in choreography.  In other words, an understanding and aptitude must be achieved with these given steps to move on to learning a fondu.  It is often useful to teach fondu starting in fifth position; the step begins by moving one’s working leg into coupé, while simultaneously executing a demi-plié with their standing leg.  There is an emphasis on the knee of the standing leg gliding over the foot; during the demi-plié, one’s weight must concentrated over the ball of their foot.  It is emphasized, when learning this step that one should not let their standing leg roll in at the expense of achieving maximum turnout and that one’s plié should be continuous, not stopping and starting back up at any time. The depth of one’s demi-plié is determined by the tempo of the music with which they are executing the step, if the tempo is quick, the plié will be short, whereas if the tempo is slow, the plié can be low enough to release the supporting heal from the floor.  Practicing fondu in differing tempos will develop the control and strength necessary to dance as quick and/or slow as choreography will one day require.  From this demi-plié, both the standing and working legs should straighten, reaching fully extended knees at the same time.  Regarding the working leg, the foot should be drawn up the working leg, towards the knee, before being extended to either the front, side, or back, turning out a little more as the leg is presented.  Low fondus are executed in a range from presenting the foot to the floor all the way up to forty-five degrees; when executing a low fondu, the path of the working leg follows a similar action to that of a pas de cheval. This is to say that the leg moves in a similar circular motion except that it doesn’t go through a sur le cou-de pied.  The action of a fondu should be a continuous plie that arrives in an extended line with both the working and standing leg, pausing in the extended position as though to indicate the completion of the step.  Fondus that are executed to a high line are characterized by the working foot being presented to ninety degrees or higher and instead of using the pas de cheval trajectory, they are executed like a développé (see page 20).  Like a développé, the standing leg will reach full extension before the working leg; the supporting leg reaches full extension while the working leg passes through passé, continuing to be lifted to higher levels of extension.  When executing a fondu, one should focus on presenting their working leg exactly front, side, and back; extra turnout should be displayed as the working leg reaches each of these positions.  While keeping these details in mind, care should be given to the timing with which one starts and finishes their fondu, arriving at extended legs at the right time with a standing leg that has no abrupt stop in plie and a working leg that goes through an exact coupé position (coupé should never be over crossed) is essential.  It is also stressed in the execution of fondus, which are above ninety degrees, that when returning to coupé for consecutive fondus, one should keep their knee straight on their working leg, as the leg lowers; the knee of the working leg should not bend until it reaches a level below forty-five degrees, at which time the knee bends and the working foot returns to coupé.

After fondu, frappé is introduced to develop the control and speed needed to excel at jumps such as a jeté, which requires one to throw their leg out in a manner that is sharp and fast, arriving at a precise place in space.  Also, the quick return to sur le cou-de-pied, within the execution of frappé, builds strength and coordination in the muscles of the inner thigh, which are necessary for execution of beats within jumps.  The basic execution of a frappé is that the working leg is shot out from its originating position of sur le cou-de-pied, striking the floor on its way to continuing up and out, away from the body.  The working leg reaches a height of a few inches off the floor, with a straight knee.  The returning motion of the frappé is a recoiling of the working leg, the foot returns to sur le cou-de-pied in the most direct line while the working knee maintains maximum turnout, with the knee directly to the side of the standing leg.  The striking of the floor in a frappé is characterized by being as strong of a contact with the floor as possible without producing a large noise.  One method used to teach students how to strike the floor is to instruct students to imagine that there is a bug on the floor that they want to squish; this imagery requires of the dancer that they strike the floor hard enough to squish the bug but also with distinct accuracy, aa to indeed hit the bug and not the floor around it.  The specifics of how one strikes the floor depends on the direction in which a frappé is executed, there are specific parts of the foot that are supposed to strike the floor.  In frappé to the front, contact with the floor should be achieved initially somewhere between the side and bottom of the big toe, in between the tip and the first joint of the big toe.  To the side, the initial frappé strike should be achieved within the same space between the tip and the first joint of the big toe, but more to the bottom of the toe.  To the back, the initial striking point of the frappé is completely on the side of the big toe joint between the tip and the first joint of the big toe.  At no point should the motion of a frappe allow the metatarsals to drop down, essentially going through a demi-point.  The outward motion should have the appearance of an upward motion; teachers often make the analogy of frappé’s outward motion being similar to the peeling of a carrot.  When peeling a carrot, one moves their tool away from their body in a quick motion, pushing their hand and tool upward and pulling their too and hand up when contact with the carrot is lost.  This is the type of motion that a dancer should aim to mimic with their feet when executing a frappé, a sharp movement outward that finishes with a slight lift.  When executing frappé, it is important to keep in mind that (1) the foot reaches either exactly front, back, and side, (2) that the knee reaches a fully stretched position with a fully pointed foot, (3) the foot lifts slightly when reaching the extended position, staying fully stretched as long at the tempo permits,  that (4) the knee achieves full turnout when returning to sur le cou-de-pied, and that (5) the toes of the working leg are always engaged, never leaving a pointed position with the toes, going through a demi-point.

Ballonné battu is logically the next step taught at barre because it begins and ends similarly to frappé, originating and ending in sur le cou-de-pied, but has almost the exact opposite energy as the frappé; frappé employs an accent which emphasizes the outward motion with respect to the music while ballonné battu shows the accent that emphasizes the inward motion with respect to the music.  The inward motion of ballonné battu is particularly helpful in cultivating the necessary inner thigh strength to execute beats within jumps, by requiring both the standing leg and working leg to work in tandem to recoil the leg quickly, the same muscle contractions used in jumps with beats is achieved.  While one can in theory do a ballonné in all directions, the step is primarily executed to the side; from sur le cou-de-pied, the working leg is thrown with great energy to the side, achieving a height that is just above forty-five degrees.  The motion with which the leg is thrown is direct, the foot creates a direct line from sur le cou-de-pied to the extended position; at no time does the working foot slide up or down the standing leg in sur le cou-de-pied and at no point does the working foot encountered the floor.  Once the leg achieves an extended knee and pointed foot, directly to the side, just above forty-five degrees, the leg is instantly snapped back down to sur le cou-de-pied, using the hamstring to initiate the recoiling force.  During the execution of a ballonné battu, it is crucial to keep the hips still, core strong, only allowing the working leg to move; it is this isolation of the working leg from the rest of one’s body that allows for beats to be achieved during jumps later on.

Petit battement follows ballonné battu and is a wonderful exercise for challenging the dancer to find stability on one leg.  The quick movements of the working foot challenge the dancer’s balance and requires of the dancer continuous recalculation of their balance in space.  It is this development of proprioception, when petit battement is practiced with the arms off of the barre, that helps a dancer to sustain multiple turns later on in the class; if a dancer is off of their leg going into a turn, they will be able to use the proprioceptive skills developed through petit battement to get on their leg!  Petit battement starts in sur le cou-de-pied, holding one’s entire body still, the dancer moves only the portion of their working leg, below the knee, and moves the foot from sur le cou-de-pied front to coupé back.  It is important to show a distinct beat when executing petit battement, the step should not look muddled or as though the working leg is scratching the standing leg; showing the transition from front to back is achieved by the leg moving out to the side and back in, the movement of a petit battement should be more of an out and in motion than a front to back motion.  It is important to keep in mind (1) that the working knee is fully turned out to the side and kept still during petit battement, (2) that the beats go over the music (executing the beats as fast as possible, while still being clear), and (3) that the sur le cou-de-pied is at the ankle.  Often the sur le cou-de-pied will creep up the standing leg while executing multiple beats and it is essential that the dancer resist this tendency.

Following petit battement, the next barre step that is taught is called rond de jambe par terre, referred to as “rond de jambe”; in French, rond de jambe par terre means circle of the leg on the ground.  It is important for the correct execution of a rond de jambe par terre to keep the imagery of one’s leg making a circular motion that originates from one’s hip in mind, while set circle is being traced on the floor by one’s foot.  Rond de jambe can be executed from a tendu side and from fifth position but is often taught from tendu second.  By teaching rond de jambe par terre from a tendu second, the correct shape of half a pizza pie can be traced with the working foot/leg.  From tendu second, the dancer initiates movement from high up on the working leg, starting with their inner thigh pushing their working heel forward.  Ultimately the toe of the dancer’s leg moves straight forward; great care is taken to avoid one’s toes from being “over crossed”, the initial movement of a rond de jambe par terre should not point along the dancer’s center line as it does in a tendu.  When executing a rond de jambe par terre, one should imagine that they are tracing a shape that is just shy of half a pizza pie. The working leg and foot continue to reach away from the body, drawing the curve of half of a circle until the foot reaches roughly three quarters of the way around the imaginary half circle.  At this point, the foot moves through first position and repeats the movement for multiple rond de jambe par terre.  When a rond de jambe par terre is executed en dehors, from the front to the back, one begins the movement by pointing their foot in an uncrossed tendu front and when executed en dedans, back to front, one begins the movement by pointing their foot to an uncrossed tendu back.  One is taught to be conscientious of both the working leg and standing leg maintaining maximum turnout at all points; maximum turnout is achieved not only while passing through first position, but when the leg is tracing the pizza pie as well.  It is stressed that one must be careful not to roll in on their standing foot and/or their working foot when passing through first.  Allowing one’s foot to roll in, in attempt to achieve maximum turnout, will only prove to be a disservice because one’s stability while executing such a circular movement away from the barre will reveal itself to be unstable when rolling in. When executing a rond de jambe par terre, it is stressed that the working leg doesn’t swing without control; a rond de jambe par terre’s movement is achieved through the continuous fight to maintain full turnout with both the working and standing leg at all times during the tracing of a circle on the floor.  It is this continuous muscle contraction that creates the forces that moves the working leg.  To assist in this development of stability, it is stressed by instructors of beginner classes that one be vigilant about their body positioning and form, when executing rand de jambes.  One must continue to hold their body with square hips, square shoulders, and a straight body, with the weight primarily over the ball of the supporting foot, no matter what point of the rand de jambe is being executed.  This approach is essential for building torso control and core strength that allows dancers to change direction on the spot and turn on one leg multiple times! This control will be achieved if these key details are kept in mind when executing a rond de jambe par terre: (1) never cross your foot to the center line of one’s body at any time, (2) avoid rolling in one’s feet when passing through first position, (3) the accent step should be that the foot passes through first on the count in the music, (4) maximum turnout should be achieved at all stages of the circular movement, and (5) the body should remain straight up and down, with square hips and the weight of the standing leg over the ball of one’s foot.

Rond de jambe par terre is also practiced with a plie, to develop strength in the thigh of the supporting leg.  When practiced with a plié, students are instructed to plié deep enough that the heal of their supporting leg comes off the floor; when a plié this deep is utilized, it is imperative to keep the knee of the standing leg tracking over the standing foot.  If correct alignment is not achieved, the dancer will leave their knee susceptible to strain and tendonitis.  Challenging one’s leg and core strength while executing rond de jambe par terre in plié is useful for developing the ability to execute full, big, and sweeping movements that require the working leg to reach far away from the center of the body.  For instance, performing a temps lie or pas de basque will require this strength of the upper thigh, as will controlling the landing of a big jump and/or single leg relevés.

As rond de jambe can be done par terre, on the ground, it can be performed en l’air, in the air; when the leg is thrown in the air, tracing a large circle to the side of one’s body, the step is called rond de jambe jeté.  The benefit of grand rond de jambe jeté is an increase one’s hip flexibility to all directions, which develops the dancer’s ability to reach maximum turnout in all positions to which the leg could possibly be lifted.  Rond de jambe jeté also develops the dancer’s ability to be both explosive with part of their body and completely still with the rest of it.  Grand rond de jambe jeté is often taught from tendu back, later it is incorporated into rond de jambe exercises.  As the working foot passes from tendu back through first position, the leg gathers kinetic force by pushing down into the floor; as the leg/foot pass through first position, the leg explodes with energy, pushing the foot forward with the toes pointing as they do in a rond de jamb par terre.  The gathered force throws the working leg in a circular arc that passes through à la second (the leg directly to the side of the body), through écarté back (the dancer’s body and shoulders are square, while the leg is lifted behind their body, turned out like it is in à la second), finally returning to tendu back.  While the leg is thrown in a grand rond de jambe jeté, (1) one’s weight is primarily in the ball of their standing leg, (2) the leg is thrown, never overcrossing, with a calm held body, (3) the leg continues to turn out throughout the whole jeté, passing through écarté back, (4) the barre should be used minimally, it should never be held on to or pulled off of for support.

The next step taught is often executed in tandem with rond de jambe par terre and it is called the rond de jambe en l’air; this is a step that is especially important for developing stability in a dancer’s core and teaching the dancer how to get on their leg for turns.  Rond de jambes en l’air can be done in jumps and mimics the movement of fouettés and a pull in from turns à la seconde.  The rond de jambe en l’air is executed with one’s leg directly to the side at ninety degrees; one’s leg from the knee up should remain as still as possible while the foot carves out an elliptical shape in the air.  When this step is taught to beginners, the tempo is kept rather slow and at its fastest, is given at a moderate speed; teachers emphasize the importance of the correct shape and resistance created by one’s body against the air when performing the motion of rond de jambe en l’air.  Forcing one to do multiple rond de jambe en l’air at slow tempos builds extreme strength and control of one’s lower extremities and core.  As the dancer progresses in their technique, rond de jambe en l’air is executed at faster speeds, which challenges one’s ability to fully execute the step with full technical accolade. The increase in speed challenges the dancer to keep the shape, control, and quality they achieved at slower speeds.  Rond de jambe en l’air begins with the working leg in à la seconde, at ninety degrees, with the thigh parallel to the floor, and the knee straightened.  When performing a rond de jambe en l’air en dehors, the working knee bends, keeping the thigh still, while the working foot traces an elliptical shape; the elliptical shape starts back and towards the standing leg’s knee.  The working foot’s big toe scratches the working leg just below the vastus medialis oblique, the bump on the side of the knee.  The elliptical shape continues, with a larger circle taking place in the front of knee, continuing to arrive back in à la seconde with a fully turned out working leg and with an accent that shows total control in placing the foot to the side.  A slight pause before the next rond de jambe en l’air indicates that the dancer has finished a complete elliptical and is in command of their limbs. To perform a rond de jambe en l’air en dedans one reverses the movement; beginning with the leg at ninety degrees to the side, one bends their working knee, while tracing an elliptical shape with their foot from in front of the knee, brushing their standing leg’s knee, and completing the elliptical shape by returning the leg to ninety degrees directly side.  When completing a rond de jambe en l’air, special emphasis is given to the care and phrasing with which one arrives with their leg to the side.  Dancers are instructed to resist the movement at the end of a rond de jambe, as though to give a labored appearance when arriving back in the extended side position.  By doing this phrasing, the appearance of control is given and one develops the strength to avoid jamming into this final position, independent of tempo given.  This is a skill that comes in great use when one progresses to the professional level; having the ability to arrive in a position with complete control allows professionals to develop their own signature way of executing steps and give the illusion of ease.  At the beginner level, many things are stressed when one learns rond de jambe en l’air, such as that maximum turnout/rotation being achieved, special emphases is given to maintaining full turnout in the standing leg, while the working leg executes the prescribed elliptical shape.  By focusing on maximum turnout in both legs, rond de jambe en l’air will be sturdy in execution away from the barre.  Also, there is great emphasis on showing the elliptical shape made with the working leg; one should be able to decipher the difference between a rond de jambe en l’air en dedans and en dehors from the fifth ring of a theater!

They next thing one learns is a series of adagio exercises, which are particularly helpful in creating strength and control to move around on one supporting leg.  It is the strength developed through this set of exercises that allow for dancers to spin and turn on one leg; executing pirouettes and turns in various positions begins with adagio exercises.  The steps that make up adagio exercises are the développé, arabesque penché, and attitude.  Throughout the exercises of adagio, it is stressed that dancers test their balance by lifting their hand off the barre during the adagio combination.  It is very common in beginner levels for adagio exercises to be repeated twice; the first time the adagio is executed, the hand is on the barre and the second time, the whole combination is completed with both hands off the barre!

Développé translated from French means to develop and more accurately it means a developing moment; développé is the step that is the process of developing an adagio position.  Starting in fifth position, a développé begins by the foot of the working leg traveling up the standing leg; the working foot wraps around the ankle of the standing leg, starting with the toes and traveling through sur le cou-de-pied.  It should seem as though the working foot peels itself off the floor and caresses the ankle.  The working foot travels though sur le cou-de-pied and travels through passé, extending to an open position either directly in front, to the side, or behind the body.  When the leg is extended out from passé to the front or back, the leg should move to the center line of the body as soon as the foot leaves passé.  When the leg is développéd to the front, the position is en face, when it is to the side, it is à la seconde, and when it is to the back it is in arabesque.  The body should remain quiet and square throughout the execution of développé, with special care given to keeping the hip down as the leg is extended front, side, and back.  When the leg put into arabesque, it is appropriate to allow the hip to open slightly; keeping one’s hip completely square in arabesque is physically impossible!

When the leg is développéd to the back, in the arabesque position, penché is taught to advanced beginners; penché means to lean in French.  Penché is an advanced balance exercise that increases the flexibility of dancer’s hips and hamstrings.  Back strength is also developed through penché, which is critical to the execution of grand jeté and saut de chat jumps.  Beginning in arabesque, the dancer is instructed to lift their leg as high as they can behind them, without allowing their upper body to shift further forward.  When the back can no longer allow the leg to move higher, the dancer leans forward with their body.  The movement of leading forward is initiated by the leg lifting to the back; the relationship/angle of the leg to back should not increase or decrease at any point during the penché.  The dancer leans forward until their back is at a ninety-degree angle to their standing leg and one’s torso is parallel to the floor.  When taught penché, teachers stress that the back not be allowed to collapse beyond the parallel relationship to the floor.  It is often called diving into a penché when dancers don’t hold the relationship of their leg to their back constant; teachers can be heard screaming “DON’T DIVE” throughout beginner ballet classes.  Ideally, the leg height achieved in a penché is one hundred and eighty degrees, although this level of strength and flexibility takes years to develop and cultivate.

Following a penché during adagio at the barre, often attitude is taught and practiced while balancing on relevé with the standing leg.  Attitude is executed almost identically to développé, the main difference being that the leg doesn’t stop in a straightened position with the knee fully taught.  Instead, the leg stops with the working leg bent and completes the développé motion to close back into fifth.  Like a développé, attitude is executed to the front, side, and back; when the leg is in attitude front and side, the degree of the bend made by the knee should be about one hundred and forty-five degrees.  To the back, the degree of bentness should be smaller, depending on each individual dancer’s shape and ability to turn out, the leg should be bent between ninety-five and one hundred degrees.  When executing attitude to all directions, it is stressed that maximum turnout should be achieved in the finishing position; the ankle and foot should give a slight degree of extra rotation, which is initiated from the bend in the knee.  When one does attitude, it is critical to achieve the correct angles within each direction or else an attitude can be mistaken for a poorly executed développé.

Following adagio exercises is the completion of barre with grand battements, an exercise which challenges the body’s ability to keep still while the legs move quickly to extremes.  Grand battement is executed exclusively in and out of fifth position.  The step is initiated by the leg pushing down into the floor and the knee straightening, this builds the kinetic energy needed for the leg to explode out of fifth position.  When the force is built, the dancer throws their leg to the front, side, or back; special attention should be given to making sure the leg is in the dancer’s center line to the front and back.  The leg should reach the highest degree possible by the dancer; the height of the leg is determined by how high the leg can go without bending and/or disturbing the equilibrium of the upper body.  When the foot leaves fifth position, the heal should lead the leg out of fifth position and when returning to fifth position, the toes should lead back into fifth.  Grand battement is essential for execution of large jumps in grand allegro at center; the explosive energy that is achieved through grand battement is what is used to propel one’s body into the air for big jumps.  When the leg is thrown out, as it is in grand battement, the body follows the leg into the air.

As students progress from beginner to advanced levels, the steps that are described in detail above are merged in series of combinations designed to build strength, challenging the dancers both physically and mentally.  Steps will be combined and tempos will be adjusted to create dancers that can respond to all different types of music and tempos; Balanchine dancers are trained in the specific techniques above and are known for being able to dance faster and slower than dancers who are trained in alternate methods.  These exercises and positions prepare the dancer for center work, which is the beginning of dancing and choreography.  While barre work may become quicker and more complex, the set of steps described above are the same steps that dancers of all levels practice daily.  A barre is a dancer’s version of brushing their teeth; as brushing one’s teeth daily helps to maintain oral health and clean teeth, a ballet barre practiced daily helps to maintain clean technique and a healthy body for dancers.

Take these technique pointers to your next ballet class and don't forget to share them around the rosin box!

Getting Back to the Stage: A Dancer's Recovery

In December of 2013, while talking morning class at the New York City Ballet, I rolled my left ankle and sustained a minor sprain. It was a grade one sprain, the type of sprain that only sidelines a dancer for a week or so; in my case I only missed five days of work. This sort of occurrence is not out of line with the norm at a company such as New York City Ballet, but what made this occurrence significant is the history of ankle sprains my left ankle had endured over the years. Three times during my life as a dancer, I have sustained a third-degree sprain of my left ankle joint. Third-degree sprains are characterized by the total rupture of ligaments in one’s ankle joint; following a third-degree ankle sprain, there is severe pain and swelling of the ankle joint and it is not possible to walk on the foot/ankle. In most cases, surgery is required to repair the joint following a third-degree sprain, but I always chose to rehab in a more conservative manner. By choosing a prolonged immobilization period, ultimately taking more time, I was always able to avoid surgery. Each third-degree sprain occurrence resulted in a casting/non-weight bearing immobilization period of six to eight weeks, allowing the ligaments to scar over and tighten up as much as possible. Following the casting period, two to three months of physical therapy was required to strengthen the ankle joint, to return to dance.

Following this minor sprain in December, I returned to work with little to no concerns, since I had dealt with much worse sprains over the course of my career. At first everything seemed fine, but as the months passed I realized that my ankle was swollen and red all the time. As the level of chronic swelling increased, so did the discoloration and level of pain in my ankle.

 By the end of March, I was in constant pain and spent my evenings icing and elevating, in too much pain to do much else. By April, the range of motion in my ankle joint became increasingly limited. The limitation in movement of my ankle joint was effecting my ability to turn, jump, and to create appropriate ballet lines. At this point, I stopped jumping in classes and rehearsals, the only time I would jump was in performance. Problems didn’t stop with the loss of motion; by mid-April, my ankle joint would get caught in certain ranges of motion. For instance, I would be walking home from a show and my ankle would freeze up.  Moving the joint in any direction was excruciatingly painful, requiring me to sit down on the side walk until the ankle gave way to moving again. I was living in constant fear of my ankle joint locking during a performance.  During the first week of May, I had reached my breaking point, the pain was too much to push through and I spoke to work about cutting back on my performance schedule. New York City Ballet was agreeable to lessening my work load, while I sought answers to what was happening with my ankle joint.

In a consultation with the company’s Orthopedic Surgeon, Dr. Hamilton, it was decided that an MRI of the joint was necessary to get to the bottom of what was going on in my left ankle. Magnetic resonance imaging (MRI) is a medical imaging tool that is used by radiologists to form pictures of the inside of the body. The images produced by this machine show all sorts of anatomy, such as the bones, ligaments, muscles, fluid, etc. Using radio waves in tandem with magnetic fields, the machine can construct 3-D images of a joint, such as my ankle. Dr. Hamilton was the physician that had treated all three of my prior third degree sprains, so he was familiar the history of this specific ankle and knew that something severely wrong was taking place in my joint.

Part of being a dancer is having an extremely intimate relationship with the signals one’s body sends to their brain.  Part of this heightened awareness is knowing the anatomy of one’s body and what receptors are telling one based on their knowledge of the joint shapes, ligament structures, and muscular syntax. Part of having my ankle evaluated and understanding what was plaguing my ankle requires is an in-depth knowledge of the anatomy of the ankle joint.  Over the course of my career, I have had to study the ankle joint with every sprain, but with the deterioration of my ankle, I was tasked with further study of the joint. To understand the findings of my MRI, I needed to understand the following details about the ankle.

The ankle joint is a synovial joint, meaning that it is engulfed by a membrane that forms a sac around the joint itself. This flexible membrane houses a secreted viscous fluid (a sticky/thick liquid) that lubricates the movement of the joint. The ankle joint connects the leg bones to the foot bones; the tibia and fibula of the leg meet the talus of the foot creating the point at which the ankle joint rotates around. The tibia and fibula of the leg are bound together by a group of thick ligaments called the tibiofibular ligaments. The securing of these two bones creates a bracket like socket that floats above the talus, which is coated in a glassy like cartilage called hyaline cartilage. This bracket like socket that makes up the upper portion of the ankle joint is called the mortise. The talus of the foot fits into the space provided by the mortise, creating the hinge for the ankle joint. The talus is wider at the front of the ankle (anterior) and thinner at the back of the ankle (posterior). Movement of the socket, the mortise rotating around the talus, is described by dorsiflexion and plantarflexion. When the ankle joint is in dorsiflexion, the anterior part of the talus (the wide part) is in the mortise; dorsiflexion is when one bends their knees and pliés and/or when one brings their toes and foot up towards their shin bone. Contrastingly, the ankle joint is in plantarflexion when the posterior (thin part) of the talus is in the mortise; plantarflexion is when the foot is pointed or when a dancer is on relevé.

The stability of the ankle movement is supported by a series of ligaments that create a suspension of the ankle joint. One set of such ligaments is attached to the medial malleolus of the ankle joint; the malleolus is the bony prominence on both sides of the ankle. The medial malleolus, referenced above, is formed by the lower end of the tibia; looking down at the human ankle, it is the bony prominence on the inner part of the ankle. The lateral malleolus is formed by the fibula and is the bony prominence on the outside of the ankle. The set of ligaments that attach to the medial malleolus is referred to as the deltoid ligament. The deltoid ligament is comprised of four separate ligaments, all four begin at the malleolus but attach to different bones: the talus, calcaneus, and navicular bones. The function of the deltoid ligament is to prevent the ankle from extreme eversion, where one’s foot rolls in too far. The lateral ligament, which attaches to the lateral malleolus, is really three individual ligaments: the anterior talofibular ligament, posterior talofibular ligament, the calcaneofibular ligament. The calcaneofibular ligament connects the lateral malleolus to the calcaneus, the posterior talofibular ligament attaches the lateral malleolus to the posterior aspect of the talus, and the anterior talofibular ligament spans between the lateral malleolus and the posterior part of the talus. The posterior talofibular ligaments prevent the ankle from inverting too much, such a motion could be explained by severe sickling of the foot. This is all quite complicated, this video should help!

The MRI results of my left ankle were compared to a prior study done in 2008, completed following one of my past ankle sprains. The MRI showed progressive signs of synovitis, compared to prior studies, meaning that the synovial membrane that encapsulates my ankle joint was inflamed and swollen. Progressive cartilage loss was reported, in relation to the past study. The images showed prominent anteromedial capsular traction spurs, which were enlarged since the study in 2008; anteromedial traction spurs are bone growths on both the talus and tibia surfaces, created by the collision of the two bones during traction.

Basically, the two bones meet at the bottom of a deep plié and had created bone growths over time. The MRI showed a shearing injury of the cartilage over the tibia plafond, which correlates to the bone spurs on the talus surface. Over time, the bone spur had encountered the cartilage surface on the head of the tibia and had scored away at the cartilage’s robustness. Because of this sheering, trauma and bone spur contact, the MRI showed presence of a bone marrow edema pattern. Bone marrow edema is the body’s protective reaction to bone injuries, in which excessive fluid accumulates in related structures of bone marrow. The edema substance is thick/murky and in my case filled the cavity in the front/medial side of my left ankle. The MRI also showed cartilaginous debris in the posterior lateral recess of the ankle joint; essentially the cartilage that had been sheered away accumulated in the back of my ankle. In addition to the cartilaginous debris, the MRI identified six separate loose bodies in the joint; these loose bodies were thought to be pieces of bone that broke off with ligaments during past ankle sprains. Since the sprains, the loose bodies bounced around in the joint, enlarging in size and wearing down some of the cartilage on the talar dome surface. Moving to the back of the left ankle joint, the MRI showed subchondral sclerosis on the calcaneal side of the posterior facet. Subchondral sclerosis is bone formation which occurs as the result of cartilage loss; in the case of the subchondral sclerosis, there was a growth of bone in the lateral recess of the joint, on the fibula. The bone growth is a result of repetitive contact between the calcaneus and the fibula during extreme plantarflexion. The MRI showed that the repeated trauma of this contact between the calcaneus and the fibula was contributing to moderate synovitis, inflammation of the synovial membrane, in the posterior talar process. More bone marrow edema was seen in the medial (inside) sidewall of the talus, where there were signs of a prior high-grade deltoid injury. Since there is no new trauma in this area, the edema was thought to be passing through from the front part of the ankle. The MRI also showed signs of residual hyper intensity and thickening and plastic deformation in both the calcaneofibular and anterior talofibular ligaments. Hyper intensity and thickening refers to unhealthy and damaged ligaments and the plastic deformation refers to ligament that is so overstretched/damaged that they won’t support the load they are intended to carry. Ligaments that are in the plastic phase take about two to three years to remodel and heal on their own; in many cases, ligaments in the plastic phase will not heal adequately on their own. Within the poor remodeling of the anterior and posterior tibiofibular ligaments, there was an ununited fibular avulsion fragment; this is a bone fragment that resulted from ligament tearing away from the bone and taking bone with it, the bone fragment had healed into the ligament structure. Within the MRI’s findings, it was noted that none of the ligament damage was acute, meaning that there is no evidence that the damage in the joint was new, all damage was resulting from years of deterioration. Lastly, the MRI showed a stress fracture in the midshaft of the of the third metatarsal and bony proliferation around the flexor halluces longus. Stress fractures are small cracks in a bone caused by overuse and repeated stress on the bone; often stress fractures are the result of bone not being able to rebuild itself as quickly as it is being broken down. The bony proliferation around the flexor hallucis was attributed to signs of tendinosis extending down to the knot of Henry, the area in which the flexor hallucis longus tendon and flexor digitorum longus tendon cross over, around the navicular bone.

Having received what Dr. Hamilton referred to as “one of the longest” MRI reports he had ever read, he referred me to an old student of his Dr. Martin O’Malley. Dr. O’Malley is the Associate Attending Orthopedic Surgeon and Fellowship Director of the Foot and Ankle Service at the Hospital for Special Surgery. Dr. Hamilton referred to him as, “the best guy with an ankle scope around!” Dr. O’Malley is the go to guy for ankle surgery for the NFL, NHL, Major League Basketball, and the NBA; his office was kind enough to open space for me the same day for an appointment.  My consultation with O’Malley was unlike most doctors’ appointments. Dr. O had read the MRI report before coming into examine me and after taking a glance at my ankle exclaimed that “dancers are the most intense of athletes he has ever seen.” He claimed that none of his other sports patients would ever let an injury get this bad before seeking treatment. Essentially, my appointment went something like this. Dr. O asked me what I was doing one week from the day of my appointment and naively I responded by rattling off the ballets I was supposed to perform that given night. The doctor grabbed a set of crutches before responding and told me that he was opening room on his surgical schedule, one week from that day, to operate on my ankle. As he handed me the crutches, he instructed me to put no further weight through the joint until after surgery. At this time, Dr. O gave a brief description of surgical procedure but established with me that I would have to sign off on an open-ended procedure because it was impossible to know exactly what needed to be done in the joint until I was under anesthesia and he had a chance to evaluate the joint from within.

For my surgery, Dr. O’Malley had an epidural for pain management and I was put under general anesthesia. Three portholes were made in my ankle, two in the front (anteromedial and anterolateral) and one in the back of the ankle, the posterior outflow. One of the portholes in the front of the ankle has a camera inserted for visual, the other has a tool entry and the back porthole is used both for tools and for suction of items out of the joint. The first step of the surgery was to evaluate the ligament laxity in the joint and this was done with a scope and ankle manipulation. Next, Dr. O used a 3.5-millimeter shaver to shave down the synovium, which is the thickened and inflamed growth of the synovial membrane. Next, they identified the large loose body in the back of the back of the ankle joint; the size of this circular loose body required the use of a fragment grasper and a bone shaver to break the piece in two. Removal of this piece took fifteen minutes. Following the removal, another smaller bone fragment was identified in the posterior recess of the joint and was removed.

With the joint space cleared out of the debris, Dr. O could evaluate the dome of the talus for cartilage damage. After inspection, chondral wear of the articular cartilage in the midpoint of the talar dome was identified. To address this issue, a hole was drilled into my iliac crest and sixty milliliters or bone marrow was harvested; the sixty milliliters was spun down to 4ml of my own stem cells. The surface of the talus was drilled into for blood supply, a process which is called micro fracturing, and some of the spun down marrow was adhered to the newly fractured talus surface. The next step in the operation was performing an ostectomy of the distal tibia for the removal of the anterior spurs; by taking great care to not damage the talar surface, a miniature saw was used to shave down the bone spurs in a medial to lateral movement. Following the reduction of the bone spurs, a full synovectomy of the posterior lateral part of the ankle joint was performed; a synovectomy is the surgical removal of the synovium, the membrane that lines the ankle joint. Having removed all the inflammatory tissue and edema patterns from the posterior lateral part of the joint, a full inspection of the flexor hallucis longus was performed. All damaged tissue was removed from the sheath of the tendon, the tube-like casing that directs and tracks the tendon.  An aggressive exploration of the sheath showed no loose bodies in the FHL’s path. Having fully cleared out the joint of debris, inflammatory tissue, and bony proliferations, some bone marrow aspirate was placed on the worn-down cartilage surface of the tibia and the three portholes were closed.

Now, Dr. O moved to address the ligament laxity of the joint; a lateral incision was made over the fibula and was carried down through the skin and subcutaneous tissues to expose the peroneal muscle and anterior talofibular ligament. The anterior talofibular ligament and calcaneofibular ligament were identified and appeared to be thickened; thickened means that they both suffered from severe tendinopathy. K-wires, which are anchoring fixations used in orthopedic repairs, were secured to holes drilled in my fibula. Fiber wires, a product that has an elasticity that was created to mimic ligaments, were attached to the K-wires and secured to part of the anterior talofibular ligament and part of the calcaneofibular ligament. Essentially, these fiber wires are synthetic reinforcements of my

natural ligaments. The left ankle was placed in slight eversion and the wires were tightened and secured. Following the tightening of the wires, both the anterior talofibular ligament and calcaneofibular ligament were cut and shortened to lengths that corresponded to the wires. Having successfully repaired the laxity of the ankle joint, the remaining bone marrow aspirate was placed in the joint and the incision was closed using stitches. This video of a full brostrom procedure is a great visual of the ligament tightening procedure I had done!

Immediately following the surgical procedure, I was sent home in a posterior ankle splint and bandages.  I was instructed to be non-weight bearing and to keep the ankle elevated for as much of the day as I possibly could.  Immobilization and no weight bearing was essential following my procedure to let the ligament repairs heal but also to avoid disruption of the stem cells that they placed onto the joint, for the repair of the articular cartilage.  Sleep was especially important during this phase and not surprisingly, I slept for most the week following my operation, only walking up to eat and take pain killers.  After two weeks, I was reevaluated, stitches were removed and my ankle was casted at a ninety-degree angle.  I remained in the cast, non-weight bearing with elevation requirements for four more weeks.  Upon removal of the cast, I was given a boot, which provides similar immobilization and support to a cast but is removable for physical therapy purposes.

The day I had the cast removed was the first day of my physical therapy program. On day one of physical therapy, the ankle was evaluated to make sure there were no signs of infections and that the wounds were healing well. Until the scars are fully formed, there is not much manual therapy that can be performed on the ankle because there is a risk of pulling the wound apart and enlarging the scar/increasing the time until the wound is fully healed. The first days of P.T. were spent doing lymphatic draining exercises, designed to wake up the lymphatic system, which was dormant in my ankle following immobilization. The lymphatic system is part of the circulatory system and it helps to clear fluid from the extremities, bringing it back towards the heart. It is this system that ultimately reduces the fluid that comprises the inflammatory fluid in the ankle joint, following the surgery. My lymphatic exercises were to lift the ankle joint above heart level for thirty seconds and then return it to the ground for a minute. I would repeat this process for a half hour, four to five times a day. The repetition of this change in elevation is designed to exchange fluids in the way that the lymphatic system would if it was operating properly. By exchanging fluids within the body, through the force of gravity, the lymphatic system gets the message that fluids are being exchanged and it itself is jumpstarted. Within two weeks of doing these exercises, my lymphatic system kicked in and the inflammation and colorization of the joint started to normalize. While the joint was still swollen, it was not as warm to the touch and as red in appearance; a healthy joint is cooler to the touch and has a pigmentation that resembles the skin on the rest of the leg.

When the scars had healed enough to begin moving the joint, I added ankle flexing and isometrics to my exercise lists. I was instructed to flex my ankle joint without the use of my toes, initiating the movement from my shin muscles. Ankle flexes are done in a pain free range of motion and were used to get the ankle joint moving again. At first, the ankle joint was extremely stiff and it was as if the joint was glued together. The scar tissue in the joint and post-surgical inflammation makes the joint feel fused together. These ankle flexes led to multiple painful, sometimes nauseating cracks, which ultimately gave way to increased movement. Isometrics exercises of the ankle are characterized by strength training movements, in which muscle length does not change during the muscular contraction; specifically, my ankle isometrics were done in static positions, pushing against a wall. The purpose of these exercises was to engage the muscles that move my ankle, to wake them up and help to reconnect the brain and muscle synapses. Making the movements static allows the body to rebuild strength and muscular awareness without straining and/or damaging any surgical repairs that are not yet ready to be loaded. It is unbelievable how hard it is to rebuild the body’s ability to engage

Atrophied Calf

certain muscles after long periods of immobilization; when the body has completely atrophied, it is as if one never had muscles, yet alone knew how to use them. Isometric training allowed me to feel confident to put my best efforts behind getting muscles to fire because ultimately, I was not afraid of the strain on my ligaments that would be caused by the muscle contractions.

As I built strength with isometrics and ankle flexes, I progressed to doming of the feet and toe lifts. These exercises had dual purposes: (1) they rebuild strength in the intrinsic muscles of the foot (the small muscles in the foot that are essential for balance) and (2) they helped to pump blood through the joint and foot, helping to push inflammatory fluid out of the joint. Doming is a movement that challenges the core muscles of the foot, one starts with their foot flat on the floor. This movement is performed seated, with your feet about hip-width apart. Keeping one’s tips of their toes on the floor, one lifts the balls of their feet to make a dome shape underneath their foot. The toes should stay long and straight, for if the toes curl under the feet, one is not getting an intrinsic muscle contraction. Each dome is held for six or so seconds and then the foot is relaxed; at first performing one or two doming exercises was near impossible, but I worked up to doing sets of ten domes, eight times a day. Toe lifts are done seated as well and are essentially the anti-dome. Keeping one’s whole foot on the floor, one lifts their toes towards the ceiling, shifting their weight back into the heal and ball of the foot. Eventually, I progressed to doing as many of these exercises as I could in a day; doing toe raises whenever my ankle was elevated proved to be very helpful in pumping swelling out of my joint.  This video of intrinsic foot exercises gives you a good idea of the exercises I did to rehabilitate!

At this time in P.T., the use of modalities became essential to my healing process.  Electric muscle stimulation, less commonly known as neuromuscular electrical stimulation (NMES) was used to rehabilitate and strengthen muscles that were dormant during the immobilization period.  Electrical muscle stimulation uses electric currents to elicit muscle contractions in patients.  My calf muscle

would be connected to electrodes and varying programs of electrical pulses were used to rebuild my calf muscle, before I was even able to contract the muscles myself postoperatively.  The calf muscle works as a pump for the whole ankle joint and the muscle contractions that were induced by the electric muscle stimulation proved valuable for pumping swelling out of the joint.  The other modality used in my rehabilitation was the use of low-level lasers.  Diodes with laser lights were put directly on the ankle joint and supplied my joint with non-thermal photons of light; by transmitting light waves in the near infrared ranges, light can penetrate deep into the body.  Light that is transmitted into the body has an anti-inflammatory effect and immunosuppressive response.  The use of lasers coaxed my body into increasing blood flow to the region, which aids in the supplying oxygen to all the cells that were rebuilding the tissues, collagen, and bone in the joint.

At the three-month post operation point in time, I was cleared by Dr. O’Malley to put weight through my left foot once again. That day, I went straight from my appointment to physical therapy, where I began the process of learning to stand and walk again. The first time one puts their foot on the ground and puts weight through the foot, following a prolonged period of immobilization, it feels like one

has thousands of needles poking at the surface of the skin. In addition to this nervous system overload, one’s fat pads on the bottom of their feet, which cushion the metatarsals and heel bone, are depleted. At first, it is painful to stand on one’s two feet! For the first week, I was tasked with just standing stationary for minute periods at a time. My proprioceptive (balance awareness) capabilities were extremely rudimentary and by standing, I not only improved these proprioceptive sensors but I encouraged my body to restore robustness to my fat pads. Since my ligaments were essentially cut and shortened in surgery, the sensations that are translated in my brain to messages about where my weight and balance lies had to be completely rebuilt. Standing still allowed me to take stock in this new feeling and build an understanding of where my tibia and fibula now rested in relation to my talus. After necessary fat pad rebuilding took place and I felt comfortable putting weight through one leg, I started practicing standing on one leg. At first I needed the help of my physical therapist to hold on to me, but eventually I worked up to standing on one leg for periods of time on my own. At first I worked up to standing for thirty seconds, then I was tasked with standing for a minute, then a minute with my eyes closed. Proper form for single leg balancing is to avoid any contact between the foot that is off the floor and one’s standing leg; this form, coupled with a slightly bent knee forces one to use only the proprioceptive receptors in their ankle to stay in balance. Adding the challenge of closing one’s eyes removes the proprioceptive capabilities of eyesight, leaving one with purely their ankle’s receptors keeping them straight up and down.

Around the time that I started balance exercises, I was instructed to walk without the aid of crutches for the first time.  My foot was still safe in the walking boot, provided by Dr. O’Malley, but it was freeing to be able to walk around the city once again. The act of walking helped me to strengthen my core muscles, hip stabilizers, and hamstrings. Following a few weeks of walking, now in the four-month post operation period, my physical therapy team began the process of teaching me to walk again. All the core strengthening, hamstring rebuilding, stabilizer bolstering, etc. training was done to prepare me for this task and moment. My physical therapy team approached teaching me to walk again by discussing the mechanics of walking with me. Having an in-depth knowledge of how the foot strikes the ground, transfers weight, and pushes off allowed me to approach the task in an

analytical way. Walking is a complex movement, not only does a foot/ankle move through space, but one’s head, shoulders, spine, hips, and arms must move in tandem to keep the human body balanced, while propelling oneself through space. It is the feet and legs that initiate the movement of a walk; the stride of a walk begins with the leading foot in an extended position and it is in this position that the feet are their furthest apart. As the heel of the leading foot strikes the ground, the heel touches the ground first followed by the outside of the foot. While being retaught to walk, I was taught to think of my heel hitting the floor, followed by my fifth metatarsal, then the pinky toe; each subsequent toe, ending with the big toe, hit the ground individually. As all toes are firmly on the floor, the weight of the body is transferred into the leading foot. The weight of the body should be evenly distributed between the toes as the knee bends over the foot, lining up with the second and third metatarsals.  The shock of the body’s weight transfer is caught by this knee bending motion. The position in which the knee is bent and the back foot is coming off the floor is called the recoil position it is in this position that the body is at its lowest proximity to the ground, during the walking motion. As the back-foot travels forward, the knee of the leading foot straightens out and the body is lifted once again. This position where the foot travels from the back to the frond is called the passing position; the free foot passes directly under the body, passing the supporting leg. As the passing foot passes the supporting leg, the weight of the weight-bearing leg shifts into the ball of the foot and the heel lifts off the ground. I was taught to focus on the weight transferring to the first and second metatarsals (the big toe and the second toe) as the foot pushed off. This placement was coordinating with a pendulum like motion to the free foot, which moved forward to strike the floor with the heel. This is the motion of half of a walk, two or more steps make up the act of walking.

The most difficult aspect of walking for me was allowing my shoulders, hips, and spine to move normally; I was so concerned with the motion of my ankle and foot, guarding against any possible misstep, that I would forget about the movement of the rest of my body.  Breaking down how the shoulders, hips, and spine function in the walking motion helped me to recreate a normal walking gait. My P.T. team taught me about how the hips are the center of the body’s gravity; understanding that the body’s ability to balance begins with the placement of the hips was essential in my efforts to walk again. During the walking motion, the P.T.s taught me to focus on the hips as two separate motions and parts: the left hip and the right hip. For instance, if the right leg is extended forward, the hip rotates along the axis of the spine and puts the right hip forward. As the left leg swings through from the back to the front, the left hip meets the right hip in neutral and then travels forward, essentially the left hip rotates along the spine. As the hips rotate around the spine, the shoulders do as well. The shoulders have a mirroring motion to the hips; if the left hip is forward, the right shoulder is front as well. As the hips meet in neutral, so do the shoulders. Essentially, it is the counter balance and opposition created by the hips and shoulders, around the spine, that keeps the body in balance as the legs and feet propel the body forward through space. It took me many weeks before walking felt normal; for the first two weeks, I had to think critically about this motion and all the mechanics that went into walking, to maintain balance and successfully walk. Like many things, with practice, walking became easier and eventually an intuitive motion that needs no extra thought.

After five months of rehabilitation and the return to walking and pedestrian life, I was at the point where I could begin the process of becoming a dancer again. With my P.T. team, I worked through the basics of a barre, retraining my muscles and joints as if for the first time. The primary difference of retraining at this point, following the ankle reconstruction, was training is less extreme positions (smaller degrees of turnout, lower leg extensions, etc.), to work on alignment and strength. Practicing ballet alone will not recondition the body to be an elite athlete; thus, cross training was a huge part of my rehabilitative process.  A strict cardio regimen of biking and swimming were implemented by my P.T. team.  I preferred my two swimming sessions a week to my daily thirty-minute bike rides. 

Biking was essential not only for my stamina but was instrumental in rebuilding my calf strength to absorb the shock of landing jumps.  Swimming was beneficial for the full body workout it provided; swimming was the closest feeling to the challenges of dancing with the full body.  In addition to swimming and biking, my cross-training regimen included pilates, gyrotonics, and weight training.  Returning to the stage required not only that I be able to use my foot again to dance but I needed to recondition my body to lift women and partner again.

One of the last major challenges of returning to the stage was learning to jump again. The male dancer repertoire is heavily based in the act of jumping and one must be able to control the eccentric and concentric phases of jumping when enormously fatigued. Jumping was reintroduced on the pilates reformer, with the utilization of a jumping board. This equipment allowed for my body to go through the jumping motion, while lying horizontal to the floor, with “gravity” created by a set of springs. At first, jumping was done with two feet, landing back on two feet with one spring.  Basically, the spring provided enough “gravity” to pull me back down towards the spring board but with no added weight; using one spring allowed for a prolonged period of push off and landing, in which form could be assessed by my P.T. and my body has time to make corrective adjustments. Over the course of a week, springs were added to my regiment to increase the speed of the jumping motion and the force with which I was working against. Two legged jumps were progressed to jumps that took from two legs but landed back on one foot. This allowed for me to build the confidence to land on one foot and to rebuild the strength necessary to land back on one foot. Single leg jumps followed, taking off and landing on one foot. Once I had the strength and coordination back to the jumping motion, my repetitions were increased and I worked up to jumping for five minutes at a time.  Jumping for five minutes was essential to rebuilding my endurance, which was necessary for me to complete a male variation once again.

Jumps progressed to the floor, using the real forces of my own body weight and gravity. The next step my P.T. team took with me was rebuilding my ability to rebound from jumps. With an extreme focus on alignment, meaning that my foot landed in a neutral position with sixty percent of my weight in the heel of my foot and forty percent of my weight in the ball of my foot, I would jump and rebound into a second jump. To increase the challenge of rebounding, my P.T. team had me take off from elevated surfaces; jumping from elevated surfaces mimicked the landing of a large jump, requiring me to rebound from increased forces of a landing like I would experience with a higher jump. Once I mastered the double leg rebound, I repeated the process of rebound training with single leg jumps. Landing with my weight in an acceptable sixty/forty distribution proved difficult with single leg jumps. My P.T. team concluded that I still lacked glute strength on my surgery side, the left side of my body, so I was given single leg bridging exercises to supplement my program. Within a week, I could control single leg rebounding jumps, landing in an acceptable sixty/forty weight distribution.

The last set of exercises I was given to help me retrain jumping was single leg jumps in a square. My P.T. team made a box on the floor with painter’s tape and instructed me to jump consecutively on a single leg, hitting all four corners of the box on the floor. This helped me to retrain changing directions with landings and takeoffs. Much of ballet choreography requires dancers to be able to change direction on the drop of a dime; landing in one trajectory and taking off in another is very common. To increase the difficulty of the exercise, my P.T. would call out which corner I was supposed to land on next, while landing form the preceding jump. Imagine a complex game of Simon, in which one must jump to the next highlighted corner. This exercise challenged the mechanics of my jumping as well as my mental ability to adapt on the spot. This skill is essential when dancing in the corps of a ballet; often one’s directions and spacing are continually recalculated to stay in each formation and/or line. If the formation changes due to other dancer’s spacing, one must recalculate mid-jump and correct the spacing with their next step; often corrections such as these require steps to be performed in minutely different directions and in varying size, due to the human errors within a group trying to move as one.

The most challenging part of returning to performance, following an injury period such as this one, is reestablishing one’s place in their professional ballet company. I remember feeling so excited to return to work after the uphill battle of my nine-month recovery and I was excited to explode back on the scene. Having established a day to return to work, I was disheartened to see that I was not cast in my roles, roles that I had been dancing for years. The roles that I was scheduled to perform were roles that I had previously done in my first couple years with the company. Essentially, I had to rebuild my reputation from scratch, as if I was new to the company. Even though my P.T. team, doctors, and myself has assured the company that I was back in tip top shape, nothing was taken at face value. The artistic staff outspokenly needed to see proof that I was worthy of the casting that I had come to expect. The process of reestablishing myself at work took almost two years and prolonged my feelings of being injured and “less than.” Overcoming the challenges of my injury were ultimately about proving to myself that I could dance again and that I could enjoy being a dancer again with the challenges it had thrown my way. Waiting for validation from the artistic staff at New York City Ballet was not a healthy way to gauge my progress of ultimately overcoming what could have been a career ending injury.

Back to Performance

The lessons I learned while rehabilitating from my ankle reconstruction have been lessons that I carry through to my everyday practice of ballet. I have taken it upon myself to learn more about the human anatomy and the function of each of the joints, muscular systems, nervous systems, etc. within my body. The way that I listen to pain in my body and care for my body has totally changed. Before my ankle surgery I felt invisible and now I have gained a respect for my body, for I only have one! The cross-training that I used to get back in dancer shape has become a part of my body maintenance regiment; having multiple techniques and approaches to condition my body, outside of ballet itself, has proved to be important for my levels of pain and longevity. Most importantly though, I have learned the value of perseverance and inner strength to overcome the curveballs that life throws one. The human experience is one that is fraught with many challenges but the human body and mind is infinite in its ability to cope and persevere. Above all, I have learned that validation and measuring of one’s success must be done on a personal level, for if one waits for the validation of others, one may wait forever to feel fulfilled and happy.

The most important thing to know as a member of the rosin box community is that perseverance is everything!