Is It Possible to Enhance the Turnout in Classical Dance by Myofascial Manipulation?

Turnout in classical dance refers to the external rotation of the lower extremities so that the longitudinal axes of the feet form an angle of up to 180°.  It is generated mainly by external hip rotation, as well as small amounts of tibio-femoral rotation, tibia torsion, and external rotation of the foot-ankle complex.

A study published in Journal of Dance Medicine & Science by researchers from University of Hamburg in Germany evaluated if myofascial manipulation (or myofascial release, MFR) could enhance this external rotation.

In this pilot study, 16 students of dance and 3 dance instructors were randomly assigned to an intervention group (MFR, N = 10) and a group of control (N = 9). The MFR group received four 20-minute MFR treatments of the lower limb at weekly intervals between pre- and post-measurement. The MFR treatment consists of long and deep myofascial rourines on: the lower extremities, pelvic and throracolumbar region, and also Anterior and Posterior Fascia of the Trunk.

Isolated external hip rotation (EHR) and functional turnout (TO) were evaluated three times (pre-, post-, and follow-up measurement) using a plurimeter and Functional Footprints® rotation discs. In addition, subjectively perceived physical flexibility (PPF) was determined by means of a written survey. The interval between pre- and post-measurement and between post- and follow-up measurement was 4 weeks.

The outcomes show that in both the post-measurement (pre versus post) and the follow-up measurement (pre- versus follow-up) the MFR group showed a significantly improved isolated external hip rotation of the right hip and a significantly increased perceived physical flexibility. However, the left  external hip rotation as well as the right and left functional turnout were not affected by the intervention.

The study demonstrated that four sessions of MFR of the lower limb can induce an improvement in the isolated external hip rotation (right hip). The authors hypothesized that the improvement in the hip’s ROM due to reduced myofascial stiffness after the MFR treatments,
which in turn was followed by an elongation of tendons, aponeurosis and other connective tissues. It is also interesting to note improvement is only observed on the right side of the body. The authors further speculated that this maybe due to “Common Compensatory Pattern“.

The beneficial effects of the treatment regarding an improvement of functional turnout could not be entirely verified in this pilot study. However, the significant increase in the participants’ subjective flexibility supports the promising trend in the objective parameters and emphasizes the need to undertake further research.