Tips to avoid a compression injury.

The human body is wondrously made. Still, repeated stress and sustained pressure will take a toll. Dancers are often susceptible to compression injuries, which typically occur in feet, legs, hips, and lower backs. They tend to come from the microtrauma of overuse. Pointework can exacerbate a stress fracture in the making. Sloppy landings jeopardize hips. And poor posture can strain the lower back.

How you work can help you protect yourself. Young female dancers are particularly vulnerable, especially when they're undergoing adolescent hormonal changes, or have low body weight, which can result in low bone density. Pay close attention to jumps and turns, since dancers are particularly prone to compression injuries in their feet and legs. Develop your core muscles to build the maximum amount of lift and ballon, which will help lift your torso up and out of your legs. Perfect your landings with an eye to your demi-plie, so the most intense impact is dissipated out into the floor and through your entire body as you land. The foot must yield in these landings or else the stress will injure the knee cartilage and ligaments or break a bone. (Injuries to the fifth metatarsal in the foot from jumping are so common that it's often called "dancer's fracture.) You need to work your feet to keep them pliable. Try rolling on a tennis ball 20 times with each foot before class and performances.

Marika Molnar, a New York physical therapist at Westside Dance Physical Therapy, notes that dancers who wear pointe shoes all day are taking a risk, because the sweat that accumulates softens the shoe, causing the foot to sink and the posterior ankle to jam. "My advice is take your shoes off when you're not dancing," says Molnar. "Lie on your back and put your feet up for a few minutes, occasionally flexing your ankle to stretch the Achilles."

Hip related compression problems can occur when a dancer's abdominals are weak and the pelvis tends to tip forward. Also, notes Molnar, injuries may occur when a dancer lands on a single leg in a jump, because the hip joint gets compressed, which can cause a pinching sensation. She warns against "sitting into your hip," when landing or even standing on one leg. "Engage your abdominals so they keep your pelvis level."

Protecting your lower back and spine also poses a challenge. Spinal compression often is due to poor posture combined with an excessive arabesque. "If a dancer's pelvis is continually tipped, and her ribs thrust forward, the spine is already in an extended position," Molnar notes. As the dancer increases her arabesque, it can compress the spine to the point of stress fracture over time. "Lengthen the spine, level the pelvis, and keep the ribs from protruding by using your abdominals," Molnar advises. Initiate leg movement from the hip joint and then allow the back to follow through. Work for control in your arabesque, not flexibility or leg height.

Compression injuries can manifest in the nerves as well. The sciatic nerve, which is about the length of your thumb, can become compressed when the pear-shaped turn-out muscle, the piriformis, squeezes on it too hard or long. Try walking with a normal stride, not a turned out position. This lets your hip joints move into a more neutral position and relieves the stress on the nerve. Another way to remove stress is to lie on your back with your legs elevated, and gently rotate your legs internally and externally from the hips. Keep them in parallel position for a few minutes as well.

Being a dancer is a mixed bag. Injuries are a constant threat. You can never ignore the benefits of good form. You also must be willing to do strengthening work, while delivering a good performance night after night--no easy task. Mindful dancing, being present as you dance, and mindful maintenance, will keep you onstage under the lights.

Suzanne Martin is principal physical therapist for Smuin Ballet in San Francisco. She also has her own practice in physical therapy and Pilates.