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Dancer Blog: Dance and the Menstrual Cycle




Welcome back to the dancer blog! Last week we wrapped up our discussion of common injuries of the lower chain with a discussion on how dance training and culture plays into the overall prevalence of common dance injuries. This week we’re going to be discussing a topic that, in all of my time in the dance industry, have never heard discussed or even considered when it comes to training. This week, we’re going to be discussing the menstrual cycle and how we can use the natural hormonal fluctuations that occur in bio-sex females to better structure our dance training.


Understand, that this will be a discussion on menstruation as it relates to dance training, not a comprehensive breakdown of all things hormones. We will be focusing on the important

hormones as they relate to physical activity and make connections with how they affect the body.


To do this we will be discussing the menstrual cycle throughout each of its four phases; menstrual phase, follicular phase, ovulation phase and luteal phase. We will discus the different hormonal changes involved in each phase and how these changes can affect a bio-sex female dancer’s risk of injuruy, energy levels and creativity.


Let’s start at the beginning with the menstrual phase. The menstrual phase begins on the first day of menstruation and lasts on average between 3 and 7 days. This is when the uterus begins to shed its innermost lining called the endometrium. This is signaled in bio-sex females by the appearance of thier period. During this phase Follicle Stimulating Hormone (FSH) is up and Luteinizing Hormone (LH), Progesterone and Estrogen are all down. For our purposes we will be ignoring FSH and LH as the role they play during menstruation is mostly related to egg development and release. They don't really play a role in dance training. Estrogen and Progesterone on the other hand play a very big role!


Simply put, Estrogen is related to a dancer’s risk of injury and Progesterone is related to a dancer’s energy levels. Starting with Estrogen. This is a hormone that, when abundant, increases the flexibility of tendons and ligaments throughout the body. Recall that increased flexibility of tendons and ligaments leads to destabilization of joints and as a result, increases the risk of injury. Therefore, when Estrogen levels are elevated, so too is our risk of injury. Adversely, when Estrogen is low, the tendons and ligaments are more durable. This leads to increased joint stability which reduces our risk of injury.


Switching to Progesterone, this hormone is linked to energy levels as it plays a role in fat

metabolism. That is to say, the more Progesteron you have, the more your body breaks down fat to use as energy. Without getting into the specifics too much, understand that fat metabolism yields several times the amount of energy that sugar metabolism does. Sugar, of course, being our standard source of energy. What this means for a dancer is that when your Progesterone levels are elevated, you’re likely to experience greater amounts of energy.


Getting back to the menstrual phase! During this phase, Estrogen and Progesterone are low. This means that we are more prone to feeling tired and fatigued. A good strategy here would be less intensive training with more breaks in between. Due to low levels of Progesterone, resulting in low energy levels, more ballistic styles of training are less ideal as they are more likely exaggerate your existing fatigue resulting in a greater chance of injury.


That said, because your energy pools are more limited during this phase, flexibility is much easier to train. Recall that flexibility is accomplished by lengthening muscles such that they consume large amounts of energy until the energy in the area is depleted and the muscle relaxes at a longer length. Low Progesterone means low energy stores, which in turn means flexibility will come easier during this phase. Cross training with activities such as yoga and incorporating more static stretching would be advantageous here.


However, if you are experiencing adequate amounts of energy during the menstrual phase, by all means challenge yourself! During this phase, estrogen is low. This means that your risk of injury is also lower. Your tendons and ligaments are more durable providing elevated joint stability. Proper diet and libral application of breaks throughout a workout or class can result in energy conservation which in turn may allow you to push yourself more than usual. The key is listening to your body and knowing when it's ok to push and when you need to account for a more limited amount of energy.


Moving onto the Follicular phase. During this phase, which lasts around 7-10 days on average, the egg cell begins to mature in the ovary. From the hormonal standpoint, FSH and Estrogen levels are beginning to rise. As Estrogen rises, so too does the flexibility of your tendons and ligaments. Progesterone, on the other hand, remains relatively low during this phase. What this means for the dancer is that they remain on the more fatigued side of the energy spectrum while also experiencing a slowly increasing risk of injury. In fact, research shows that bio-sex female dancers are more prone to hip, knee and ankle injuries during this phase.


Thinking back to our past several weeks of blog posts discussing the pathomechanics of common dance injuries and recall that most of those injuries occur due to repeated destabilization of joints over time. Improper dance training that focuses on forced turnout and hyperflexibility is now exacerbated by the hormonal changes that occur during the follicular phase of menstruation. The increased flexibility of the tendons and ligaments are allowing for even faster derangement of tissues such as the acetabular labrum and menisci.


So how should we train during the Follicular phase? With energy levels trending low, we should continue to take regular breaks and make sure to incorporate a proper diet to help generate as much energy as possible. Additionally, proper warm up here is CRITICAL! And when I say warming up, I mean dynamic stretching. Recall my blog post on Stretching vs. Warming Up for the difference between the two. The goal needs to be activating your flexibility, not further expanding it, as this will leave you even more fatigued than you already are as well as leave the joints even more destabilized.


One last note on the Follicular phase. Some research suggests that hormonal changes during this phase can cause increased brain activity in areas of the brain related to creativity. The research isn’t entirely rock solid and some studies argue how true this statement is but it may be worth investing some extra time working on improvisational skills or choreography during this phase.


Next up we have the Ovulation phase which on average lasts between 3 and 5 days. This is the phase in which the mature egg is released into the fallopian tube and travels towards the uterus. This is the time in the menstrual cycle where pregnancy is possible. With regards to hormones; FSH, LH and estrogen are all at their peak with Progesterone on the rise as well. What this means for the dancer is increasing energy AND a big increase to a dancer's risk of injury.


During this phase a dancer will experience more energy and will likely want to push themselves harder while training. The problem is, Estrogen is working at its maximum to increase tendon and ligament flexibility. Proper warmup is still critical during this phase, as is proper, healthy technique to combat the decreased joint stability. High intensity workouts are encouraged during this time but a special focus on listening to your body and avoiding overly repetitive exercises is also important.


Additionally, increased consumption of healthy fats will provide more fat for Progesterone to

break down and convert into energy. Fats such as; olives, almonds, peanut butter, flaxseed ,

salmon, tuna and tofu are all examples of monounsaturated and polyunsaturated fats that are good for you and will help maintain higher energy levels at this time.


Last up we have the Luteal phase. This phase on average lasts between 10 and 14 days. During the Luteal phase the uterine wall begins to thicken in preparation of the next menstruation. In regards to hormones; Progesterone peaks in the middle of this phase and then tapers off, returning to its low point in preparation for menstruation. FSH and LH each continue to decrease throughout this phase. Estrogen effectively follows Progesterone during the Luteal phase but to an overall lower degree never reaching the same peak as it did during Ovulation.


For the dancer this means that you should continue with your high intensity workouts during the beginning of the Luteal stage and then transition to middle intensity training while slowly

increasing the frequency of breaks as you approach menstruation again. In this way, the Luteal phase is sort of a combination of the Ovulation phase and the Menstrual phase.


From a nutritional standpoint, this is the phase where you may experience increased sugar

cravings. Bio-sex females will commonly increase their carbohydrate consumption during the

Luteal phase due to these cravings. This is because carbohydrates break down into sugar once digested in the body. This increased carb consumption can lead to weight gain. Instead of giving into the sugar cravings, increasing protein consumption will help with muscle repair which in turn will support your high intensity training regime during the beginning of this phase.


So how do I know when I’m in which phase? There are a lot of really good tracking apps out there that allow you to input each time you experience your period. These apps will allow you to more accurately predict when your body is transitioning from one phase to another. The best part is, the longer you use the app, the more accurate it becomes as you add more and more dates of

menstruation.


Ok, so that was a LOT of information and we’re just barely scratching the surface here. The big thing we should take away is that there are a lot of things we can do to take advantage of the fluctuating hormone levels that will benefit your training. Knowing when to take advantage of high energy levels to gain strength and endurance and when to take advantage of low energy levels to gain flexibility is a smart way to get more “bang for your buck” as they say when it comes to dance training.


On the other hand, failing to understand these fluctuations and instead deciding to fight your

body’s natural hormone cycle leaves you exposed to increased risk of injury due to increased fatigue and tendon/ligament laxity. An issue that can be massively compounded by improper training methodology such as we’ve discussed during our common injuries series. No matter which way you cut it, the smarter decision is to use your body’s natural cycle to your advantage if you want a healthy, long lasting career in dance.


Ok, time for our dancer shoutout. This week we have Samantha Watson. Originally from New Hampshire, Samantha studied at the Brattleboro School of Dance in Brattleboro, Vermont for 13 years, training under Kathleen Keller, Mucuy Bolles and Robert Royce among others. She graduated Magna Cum Laude from the University of Hartford’s Hartt School in May of 2019 where she received her BFA in Dance Pedagogy and a minor in English. Samantha has attended various dance programs including; The Rock School for Dance Education, Next Generation Ballet, José Mateo Ballet, and Burklyn Ballet. She has performed professionally in several productions such as; The Nutcracker, Cinderella, and Ballet Hartford’s Handel: Messiah. Samantha was a company apprentice with the New York State Ballet for the 2019-2020 season, and has returned as a full company member for the 2020-2021 season. She also is currently on staff at the Hochstein School of Music and Dance teaching ballet. Make sure to check her out during New York State Ballet’s upcoming production of the Nutcracker!


If you've been reading these blogs for a while, then you know that the New York State Ballet is a good friend of ours here at Pinnacle Hill Chiropractic. And as we all know, COVID-19 has left many sectors of the American economy struggling to survive. Among these are the arts. It’s never been more important to support local businesses and art communities. With that said, I’d like to draw some attention to the New York State Ballet’s upcoming production of The Nutcracker. Performances will be held on December 23rd, 26th and 27th. Due to social distancing and other safe health practices ticket availability is limited. The good news is, the show will be entirely streamable so there's no reason not to tune in! The Nutcracker is a Christmas staple if you’re a fan of dance and even if you’ve never seen a show it's a great tradition to start with the kids and grandkids. So help support local businesses and help to support the arts by visiting the New York State Ballet website and purchasing a ticket on December 12th when the box office opens.


And remember, if you have any questions or topics you would like me to address here on the

Dancer Blog comment below and let me know! Also if you want to help this community grow

faster, please like and share this blog on Facebook, Instagram, and Twitter. Until next time!


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