Renowned dance physiotherapist cautions, advises parents



Lisa Howell is a physiotherapist, author, speaker and creator of The Ballet Blog which has revolutionized how dancers think about their bodies, injuries and performance enhancement.

She is well respected both nationally and internationally for her work with young dancers, professional dancers and dance teachers and works closely with some of Australia’s top Dance Medicine Specialists. She has lectured throughout Europe, the United Kingdom, the United States and Australia on dance anatomy, injury prevention, recovery and performance enhancement.


She visited La Crosse recently to share her knowledge with Misty’s Dance Unlimited and More Than Just Great Dancing™ studio owners, teachers and dance students, and we had a chance to talk to her from a parent’s perspective. We learned a lot that can help you keep your dancer healthy for dance and for life!



When Lisa Howell formed her dance physiotherapy practice in 2005, dance was a different industry. Back then she spent a lot of time treating foot and ankle injuries and the issues that come with preparing to and going en pointe. Then Instagram and Facebook came into being, along with shows like “So You Think You Can Dance,” showing—and in some cases showing off—incredible flexibility and tricks.


Consequently, today’s dancers, fed by those social videos and photos, are often putting their bodies at risk in a new and alarming way. Hip and spine injuries and growth plate issues are far more frequent with many of the injuries resulting from young students being pushed into stretches.


“What 14-year-olds consider as normal now wasn’t even something that professional dancers did in their 20s, 15 years ago,” said Howell. Referring to leg holds and overstretching practices, she adds “A young person’s hip joints don’t fully stabilize until they’re about 20. Imagine the damage that’s happening when the hips are excessively loaded while still growing.”


When looking at hip injuries in dancers, it goes far beyond the obvious biomechanics. In order to develop optimal rehab programs for fast recovery, Howell assesses:


  • Breathing—“If a dancer isn’t breathing well their core doesn’t fire naturally. With any kind of anxiety or unsteady breathing, the real core simply doesn’t work.”


  • Stomach—“When a dancer has any kind of intestinal discomfort or period pain, the core doesn’t work well. Pain inhibits all of the deep back stabilizers, contributing to injury.”


  • Spine—“A spine that is excessively mobile or a dancer whose hip or back joints crack frequently indicates a problem with instability that can lead to back and hip injuries.”


  • Hip—“The dancers who are naturally open in their hips can have more problems than the dancers with normal flexibility. Shallow hip sockets allow more range but are also more unstable, requiring very specific conditioning.”


Those are good indicators for parents to watch for at home, notes Howell. “Dancers need to teach their core how to fire without thinking about it. It’s about achieving a smooth, supple, dynamically-controlled spine.”


Howell says parents often think if their dancer isn’t in pain, certain movements can’t be hurting them. She busts that myth using a candy bar metaphor. If your child eats a candy bar once in a while, it’s not going to hurt them, but if you give them five per day over 20 years, you’ll see very different results. Effects of training are cumulative and often show up years later.


For parents, she offers excellent advice to keep their dancers healthy, not just during the time they’re dancing but for years after their dancing days end.


  • Screen time—It’s OK for kids to have screen time, but too often they’re hunched over on their phones, putting unneeded stress on the back and inhibiting their core. Howell advises that when kids want screen time, they should be encouraged to lie down on their backs to do it, knees bent with their arms in the air to hold their phones. When the arms or legs tire in this position, screen time is over.


  • Fluids—Dancers should drink small quantities of fluid throughout the day rather than one big glass with a meal. Large quantities of cold water with meals can affect digestive function.


  • Diet—Dancers need high-quality fuel. Parents can make a big difference by making certain their kids have a diet rich in fresh vegetables, some fruit, lean protein and minimal processed foods. Caffeine and a little sugar are OK on a limited basis in older teens but are often relied on for energy which is not optimal.


  • Sleep—All those working muscles need rest. Not only will adequate rest help dancers recover physically, it will also keep them clear, alert and focused (and more able to pick up new choreography quickly).


  • Spine—Check your dancer’s spine in a simple roll down once a month to look for that smooth, supple movement mentioned above. If the spine moves in chunks at a time, your dancer is at risk. This video explains what to look for.


  • Height—Remember when you were little and your parent marked your increasing height on the wall? It’s a great idea to do something akin to that with your dancers on the first of every month. That will help you spot any massive growth happening. During those times of rapid growth, dancers need to go back to the barre, minimize jumping and use knee pads. This is especially important between ages 11 and 16.


  • Physiotherapy—Most people wait until there’s a problem to see a physical therapist. But seeing a therapist on a regular basis—every four to eight weeks—can help you keep potential problems in check. Dancers need to understand their bodies and where to stabilize, where to mobilize and how to help their bodies cope with the demands of dance.


Howell, who is based in Australia, is working to educate and eventually certify teachers and therapists in the U.S. to work with dancers more effectively in their studios and clinics. To find a dance-trained therapist in the area, you can follow her blog for a list of those who have taken the course. In time, you’ll also be able to see those who are certified.


More tips and insights for parents are available in Howell’s “Perfect Pointe Parents Manual.” The manual covers far more than ballet and a great guide for dance parents. You can download an electronic copy of the manual for just $5 on




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