First Avenue, Downtown Minneapolis, MN
Aside from being a prolific musician, Prince was also a talented performer and dancer. His love for dance began while training in ballet as a child. Through the Urban Arts Program, he was able to take ballet classes at the Minnesota Dance Theater.1 He carried that love of dance with him throughout his career, dancing in live performances himself and utilizing other dancers in his shows. He was even known to have his band members from The Revolution and The Time take dance class with him.2,3 Dancers are often overlooked for being athletes because dance is considered a performing art and not a sport; however, dancers are unique athletes. There are multiple styles of dance that require different skills that may be perfected similarly to the way other athletes perfect the skills for their respective sports. But all athletes have this in common… they find JOY IN REPETITION of honing their craft.* Practice makes perfect, but repetition can also lead to injury.
Some injuries happen abruptly and are due to some blunt, traumatic force, fall or impact. Another type of injury is more surreptitious and unexpected. These are called repetitive use injuries. Repetitive use injuries are injuries that occur gradually over weeks, months or even years of repeating the same movement patterns. You may be carrying out your daily routine and suddenly, for no apparent reason, you find yourself in excruciating pain. Repetitive use injury of a muscle can happen in one of two ways: either 1. repetitive strain or elongation of a muscle over time or 2. repetitive shortening of a muscle causing a sustained contracture or spasm of a muscle. For dancers, both injury types are possible. It is likely that Prince’s chronic pain originated as a combination of improperly healed traumatic injuries such as broken bones or sprained ligaments and a series of untreated repetitive use injuries such as spasms and active trigger points due to excessive neuromuscular activity over time and improper recovery.
Like other athletes, dancers must develop motor control, agility, power, speed, coordination and psychological readiness. One important attribute more often found with dancers than other athletes is they often find it difficult to distinguish between pain associated with dance performance and pain associated with legitimate injury. This poor lack of distinction can be mistaken for and often praised as psychological toughness. In performance arts, there is a common mantra “the show must go on”. This mentality makes dancers prone to “dance through the pain” which in turn can lead to more severe injuries later in their careers.4 The longer an injury goes untreated, the more severe the injury may become which prolongs the road to recovery. It is important to treat injuries quickly after their initial onset to avoid muscle compensations, altered postures and other adverse effects on the body when compromised.
Being the showman he was, Prince likely danced through more injuries than we will ever know. Part of my job as a chiropractor and ergonomist is predicting injuries based on movement. I do not get to follow my patients around every day, to figure out what it is they do repetitively that causes their pain and injuries. The best I can do is ask questions, recognize patterns and help them become more aware of their own habits. But with Prince, luckily, his performance habits are all on video! You just have to watch closely and you will see it too. It also probably helps that I was a dancer and I am familiar with dance injuries because I have likely had most of them myself.
For this post, I have decided to use ballet terminology for describing Prince’s dance moves for a few reasons.
1. Ballet has the most specific and extensive vocabulary for dance movements and
many of these terms are often used across different dance styles.
2. Most dance research is specific to ballet dancers and while research for other styles
of dance is growing, I would like to stay as evidence-based as possible in my analysis.
3. In my last post, Prince: Part 2 - The Beautiful Ones, I discussed how Prince’s shoes
effected the muscle tone of the lower extremities. Prince wore high-heeled shoes.
So, it is accurate to say that Prince was in relevé (raised on the ball of the foot) or
raised in a demi-point position while he was dancing.5
4. He actually trained in ballet as a child! Can we just take a collective moment to
imagine this adorable Little Prince in ballet tights and slippers…my heart! Please,
God, let a picture of baby Prince in a leotard surface during my lifetime!
For all of my dancers out there, please understand that in the same way I am simplifying some medical terminology, I will also simplify some dance terminology for the sake of clarity for everyone reading this post.
In ballet, turns or spins are called pirouettes.5 Pirouettes were perhaps Prince’s most common dance move throughout his entire career. He did, however, have either a habit or preference of turning to the right. Occasionally there were some left turns, but most of his turns rotate to the right.6 As Derek Zoolander might say, “he’s not an ambiturner”.7 Unlike the fictional male-model, I am sure Prince did not actually have a problem turning to the left. Most dancers tend to have a dominant right turn and choreograph (whether consciously or subconsciously) to accommodate their stronger performance side. Another reason Prince may have formed this habit is because he played a right-handed guitar. In playing a right-handed guitar, it is safer for everyone on stage that the guitarist turn over his or her right shoulder so that no one is accidentally struck by the headstock of the guitar while spinning. So whether it was a conscious or subconscious decision, Prince heavily favored pirouettes to the right.
There are a couple of variations of this right-sided pirouette that Prince performed repetitively. For this analysis, consider the support leg (SL) the leg that is weight-bearing on the ground and the gesture leg (GL) the leg that is raised during the turn. Also, Prince most often performed a jazz pirouette instead of a ballet pirouette. The difference is that in a jazz pirouette the GL is turned in (raised to the front in the sagittal plane) and in a ballet pirouette the GL is turned out (raised to the side in the coronal/frontal plane).
So let’s break down the terminology first.
Pirouette = spin
Sur le de-cou-pied (coupé) = position where the GL is raised to the ankle
Retiré (passé) = position where the GL is raised to the knee
En dedans = turning inwards or toward the SL
En dehors = turning outward or toward the GL 5
Now let’s put them together as right-sided turn variations.
A. Coupé pirouette en dedans = SL is the right leg, GL is the left foot raised to the
ankle, spin is inward
B. Coupé pirouette en dehors = SL is the left leg, GL is the right foot raised to the
ankle, spin is outward
C. Passé pirouette en dedans = SL is the right leg, GL is the left foot raised to the
knee, spin is inward
D. Passé pirouette en dehors = SL is the left leg, GL is the right foot raised to the
knee, spin is outward
Based on my observation, Prince most often defaulted to D. - Passé pirouette en dehors (left SL and right GL). The major muscle groups that are activated to provide postural stability and control during this variation of a jazz pirouette are:
For the left SL: hip stabilizers (gluteus medius, gluteus minimus and tensor fascia latae), hip extensors (gluteus maximus and the hamstrings - biceps femoris, semitendinosus and semimembranosus), knee extensors (the quadriceps - vastus lateralis, vastus intermedius, vastus medialis and rectus femoris), plantarflexors of the ankle (gastrocnemius, soleus, flexor digitorum longus/brevis and tibialis posterior).
For the right GL: hip flexors (iliacus, psoas major/minor, rectus femoris), knee flexors (biceps femoris, semitendinosus and semimembranosus) and the deep lateral rotators of the hip (piriformis, superior gemellus, obturator internus, inferior gemellus, obturator externus and quadratus femoris). 8
Overuse of these muscles without proper recovery could easily lead to muscle spasms, trigger points and localized pain in the area of those muscles. I suspect if I would have been able to examine and treat Prince, I would have found active trigger points in his left hip stabilizers, specifically gluteus medius and in his right hip flexors, specifically psoas major. Another concern would be the hypertonicity and sustained spasms that would develop in these muscles. When the force of these muscles is strong enough, they can potentially pull the joints they cross out of alignment or hold them too tightly in place, decreasing the joints’ mobility and function. As we will see in a later discussion, these same muscles would have been put under additional stresses due to other dance habits that Prince developed over the course of his career.
There are a number of ways to treat active trigger points without drugs or injections including soft tissue techniques such as dry needling, active release and sustained trigger point techniques. Such therapies can help reduce muscle tone and subjective pain while improving physical function. 9,10,11 In the incident that the joints are pulled out of alignment, chiropractic adjustments (in my obviously biased opinion) are the best treatment to restore normal biomechanics and function. These are all treatments that must be performed by a trained practitioner. In a sense, this is still treating the symptom of pain. The goal of holistic care is finding the root cause of pain and correcting the behaviors that initially caused the pain and support with treatments as needed. A free self-treatment option I recommend to everyone is to begin a regular routine combining foam rolling or other self-myofascial release along with stretching. I am constantly astonished by how many people do not stretch even after some athletic activity! So many musculoskeletal injuries could be avoided just by stretching properly. Do yourself a favor and start making stretches part of your workout if you don’t already. Remember, healthy muscles are both strong and flexible. Yin and yang. There must be a balance in all things.
For everyone, whether their job is sitting at a computer or driving a delivery truck, there is a normal amount of “wear and tear” the body is subjected to over time. But for someone like Prince who utilized his body in an extreme manner over decades, an increased amount of “wear and tear” in the joints and muscles should have been expected. Regular, intentional recovery techniques and treatments should have been implemented as a part of his health routine beginning in his 20s. It is never too late to develop a health routine, but the earlier, the better.
In the next post I will discuss Prince’s signature dance move…the splits! It’s a big one y’all. Until then, if you learn nothing else from me, please take away this one piece of advice —STRETCH!
*Joy In Repetition — https://youtu.be/OlC4KxvU3Kc
Interview with The Revolution: https://youtu.be/-yCWato9aZ8
Joffrey Ballet support: https://youtu.be/BVpBgLc5gIo
Russell J. A. (2013). Preventing dance injuries: current perspectives. Open access journal of sports medicine, 4, 199–210. https://doi.org/10.2147/OAJSM.S36529
Ballet Terminology: https://www.abt.org/explore/learn/ballet-dictionary/
Dance Breaks: https://youtu.be/ufehm7pDr2g
Zoolander clip: https://youtu.be/8hJ1HDcMowk
Zaferiou AM, Flashner H, Wilcox RR, McNitt-Gray JL. Lower extremity control during turns initiated with and without hip external rotation. J Biomech. 2017 Feb 8;52:130-139. doi: 10.1016/j.jbiomech.2016.12.017. Epub 2016 Dec 29. PMID: 28057348.
Ceballos-Laita L, Jiménez-Del-Barrio S, Marín-Zurdo J, Moreno-Calvo A, Marín-Boné J, Albarova-Corral MI, Estébanez-de-Miguel E. Effectiveness of Dry Needling Therapy on Pain, Hip Muscle Strength, and Physical Function in Patients With Hip Osteoarthritis: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2021 May;102(5):959-966. doi: 10.1016/j.apmr.2021.01.077. Epub 2021 Feb 7. PMID: 33567336.
Moraska AF, Schmiege SJ, Mann JD, Butryn N, Krutsch JP. Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo Controlled Trial. Am J Phys Med Rehabil. 2017 Sep;96(9):639-645. doi: 10.1097/PHM.0000000000000728. PMID: 28248690; PMCID: PMC5561477.
Koo TK, Cohen JH, Zheng Y. Immediate effect of nimmo receptor tonus technique on muscle elasticity, pain perception, and disability in subjects with chronic low back pain. J Manipulative Physiol Ther. 2012 Jan;35(1):45-53. doi: 10.1016/j.jmpt.2011.09.013. Epub 2011 Oct 27. PMID: 22036530.