Investigating the effectiveness of a turnout-focused exercise program in reducing turnout compensations in classical ballet dancers

Abstract

Turnout is a fundamental aspect in ballet, involving bilateral external rotation of the lower limbs. The hip contributes to 60% of total turnout, while 40% originates from the knee, ankle and foot (Champion et al, 2008; Jenkins et al, 2013; Sherman et al, 2014; Quanbeck et al, 2017; Gorwa et al, 2020). Ballerinas have always been indoctrinated to achieve 180o of bilateral turnout, for aesthetic appeal (Coplan, 2002; Cimelli and Curran, 2012). However, this angle is rarely achieved without compensatory strategies (Bhakay et al, 2017). Turnout compensations are aesthetically unflattering and biomechanically unfavourable, subjecting ballet dancers to an increased risk of injuries (Negus et al, 2005; Kauffmann et al, 2021). Therefore, the aim of this study was to investigate whether a turnout-focused exercise program can reduce turnout compensations in healthy, amateur ballet dancers. Twenty-six female ballet dancers were included in this study. All participants had their passive hip external rotation range of motion and functional turnout angle measured for both limbs. The positive difference between the dancer’s total functional turnout angle and total passive hip external rotation was considered to be their degree of compensated turnout. Participants were randomly assigned to experimental and control groups. The experimental group followed an 8-week exercise program 3 times a week, targeting motor control, core support, pelvic alignment, muscle engagement, and flexibility. This was followed via an exercise video. While within-group analysis showed a statistically significant reduction in turnout compensations post-intervention, between-group analysis did not yield statistically significant results. This suggests that the exercise program’s effectiveness in reducing compensations is inconclusive, possibly due to factors such as favourable musculoskeletal anatomy (Theintz et al, 1992; Hafiz et al, 2016), training level (Hamilton et al, 1992; Hamilton et al, 2006) and participation in other dance styles (White et al, 2004) which influenced the study’s outcome. Given these findings, future research should include larger sample sizes to validate the efficacy of the exercise program, establish a gold standard for TO measurement and account for individual anatomical differences and training backgrounds to better understand the factors influencing turnout improvements.