A joint effort: Understanding what’s good for your joints

Discover the latest developments in research into protecting and treating your joints in a discussion by leading experts from La Trobe University and The Australian Ballet. Many factors impact the health of our joints during our lives, with some people developing joint pain and conditions like osteoarthritis. There are many schools of thought on how to effectively treat joint conditions, however one of the most promising preventative and management strategies is physical activity.

This broadcast brings together the leading experts of La Trobe University and The Australian Ballet to share the valuable insights they have uncovered into traditional and emerging options for treating and protecting joints. Joined by The Australian Ballet’s Principal Dancer, Amber Scott providing the athlete’s perspective on the impact the research is having.

You can view the discussion as a whole or broken off into 4 separate parts below.

A Joint Effort: Understanding what is good for your joints (full-version)

This panel discussion looked at traditional and emerging options for treating and protecting joints and showcased La Trobe’s leading research in human movement and sports science[1], sport and exercise physiotherapy and rehabilitation. Panellists included renowned sports medicine researcher Professor Jill Cook, Dr Sue Mayes AM, Director of Artistic Health at The Australian Ballet, and Professor Kay Crossley, Director of La Trobe’s Sport and Exercise Medicine Research Centre (LASEM)

[1] Rated ‘well above world-standard’, Australian Research Council, 2019, Excellence in Research for Australia (ERA) Outcomes 2018

Part One: How the research is supporting the elite dancers

Hear first-hand from Amber Scott, Principal Artist, The Australian Ballet about her dance journey and her insight into joint injury and management. Followed by Professor Jill Cook, La Trobe University, who sets the scene about normal joints, development of osteoarthritis and other joint conditions, diagnosis, and links to management.

Part Two: The Australian Ballet research

Distinguished Alumnus Dr Sue Mayes, Director of Artistic Health and Principal Physiotherapist, The Australian Ballet, shares a comprehensive summary of the hip joint research being conducted with the ballet company. Sue details dancer hip joint pathology and explains the ballet-related factors that may protect hips from damage.

Part Three: Elite to the community – uncovering best practice treatment

Professor Kay Crossley, Director La Trobe Sport and Exercise Medicine Research Centre presents knee osteoarthritis in the general and sporting populations. Kay describes risk factors, diagnosis, and best practice treatment options.

Part Four: Q&A

Listen to the expert panel, share their thoughts and knowledge as they respond to a range of thought-provoking audience questions about hip and knee joint health and management. The variety of questions reflect the wide appeal and audience, ranging from people experiencing joint pain, dancers, dancer teachers, researchers, and health practitioners.

FAQs from the live Q&A:

Is imaging important to help inform practitioners about what's going on in the joint and develop a plan to improve pain etc.?

Scans and X-rays are not able to indicate which, if any, of the imaging findings are linked to the person's clinical condition, e.g. pain, stiffness or swelling. Practitioners typically use the patient history and presentation and assessment of the joint to guide management . Imaging is important in ruling out serious pathology, e.g. fracture and can guide diagnosis.

Are the strengthening exercises tailored to each dancer or are they given a generic set?

All dancers are tested each year, and a general company program is modified to each dancer’s level of ability at a given time. Progressions of the core set of exercises are tailored to the individual dancer as they progress through their career. Specific strength training programs might be instigated if a group of dancers are soon to perform a repertoire that requires specific strength. Programs are tailored if a dancer is in rehabilitation from injury.

What about hips and other forms of dance? Are there similar findings?

Great question – but the research is not available to answer it yet. It is possible (and likely) that there might be differences based on levels of dance skill and between genres of dance.

Is there a paper that outlines the prevention/rehab programs the Australian Ballet uses?

Any must-do exercises for dancers and their hips? Do you still give clam or more functional exercises, e.g. monster walks?

I'm a physio and a dance coach. I find it difficult to balance the need for strength and flexibility in my young dancers plus the desire for the dancers themselves to increase their flexibility at a rapid rate. What advice would you give in relation to balancing the two while reducing risk of hip injuries and keeping their longevity in mind also.

Please see the article by Sue Mayes on The Australian Ballet website.

Running and knees – are you better to regularly run a little? Can you get away with short sharp periods of heavy load in prep for competition and build stability?

We don’t know the optimal dose of running for people with or at risk of osteoarthritis. Ideally you would start with a small amount (volume and intensity) of running, and gradually increase the amount of running over time. Getting and keeping strong muscles is also important. Use pain and swelling as a guide to when to increase your running.

Could osteoarthritis be related to stress in workplace or family or in the community with people?

This is a great question. Yes, stress and other triggers can exacerbate the symptoms of osteoarthritis. Looking after yourself, both mentally and physically, is important.

What is the best way to undertake resistance training? Should you do it with a physio or just in a gym? Or at home without professional supervision?

It will depend on the aims of your training and your own personal situation. You may not feel you have the knowledge and would like supervision, and then supervision at a gym or clinic would be useful. If you are experiencing pain or rehabilitating from injury then it is recommended at least to seek advice intermittently from a physiotherapist, but you may be able to exercise at home. If your aim is to develop large amounts of strength, you may need to visit a gym or physiotherapy clinic that has weights machines heavy enough to achieve your goals.

How does ballet differ from other high-performance sports in elite athletes in regard to the offset of arthritis in the joints?

In our research we found that the prevalence of imaging findings associated with hip osteoarthritis was similar in dancers and other elite athletes involved in non-contact sports and dancers do not appear to be at greater risk of developing arthritis of the hip. We are investigating the prevalence of arthritis in other lower joints through the partnership between La Trobe and The Australian Ballet.

Would you say that runners should be doing at least 25 calf rises on each leg too?

Yes, maybe not straight away – but this would be a great goal.

Learn more about our leading experts:

Professor Jill Cook - Sports Medicine Research at La Trobe University

Professor Jill Cook - Sports Medicine Research at La Trobe University

Jill is a professor in musculoskeletal health in the La Trobe Sport and Exercise Medicine Research Centre, researching sports medicine and tendon injury.

Since completing her PhD in 2000, Jill has investigated tendon pathology, treatment options and risk factors for tendon injury. She currently supplements her research by conducting a specialist tendon practice and by lecturing and presenting.

Dr Sue Mayes AM - Director of Artistic Health at The Australian Ballet

Dr Sue Mayes AM - Director of Artistic Health at The Australian Ballet

Sue joined The Australian Ballet company in 1997 after graduating from La Trobe in 1990 with a Bachelor of Applied Science (Physiotherapy), and a  Graduate Diploma in Sports Physiotherapy in 1996, and finished her PhD with La Trobe University in 2017. In 2018, Sue was awarded a La Trobe Distinguished Alumni Award and is now an Adjunct Research Fellow at La Trobe University.

Sue published findings from her research on ballet dancers as part of her PhD, and has been highly sought-after to advise and treat dancers and athletes both locally and internationally.

Professor Kay Crossley - Director of La Trobe’s Sport and Exercise Medicine Research Centre (LASEM)

Professor Kay Crossley - Director of La Trobe’s Sport and Exercise Medicine Research Centre (LASEM)

Kay’s main research focus is on the prevention and management of musculoskeletal injury and early-onset osteoarthritis after sports-related injuries.

Kay is a physiotherapist with many years of experience in clinical sports physiotherapy

Amber Scott - Principal Artist with The Australian Ballet

Amber Scott - Principal Artist with The Australian Ballet

Amber Scott joined The Australian Ballet School at age eleven. After graduating as dux, she joined The Australian Ballet in 2001. In 2003 she spent four months on a dancer exchange at the Royal Danish Ballet, giving her the opportunity to learn the Bournonville technique firsthand.

Amber was promoted to principal artist in 2011 after performing the Second Movement from Sir Kenneth MacMillan’s Concerto. Her career highlights include dancing Odette with Adam Bull in Graeme Murphy’s Swan Lake in Shanghai, Beijing, Paris, Manchester, New York, Los Angeles, Berkeley and London, and partnering with guest artists David Hallberg, Robert Tewsley and Damian Smith.

Dr Wade Kelly - Panel Moderator

Dr Wade Kelly - Senior Coordinator Research Impact at La Trobe University

Wade is the Senior Coordinator Research Impact at La Trobe University. He is passionate about knowledge-sharing with a focus on how academics exchange knowledge with the public and communities.

Wade has been working with adult learners in public and private institutions for almost two decades in a variety of roles. As part of his mission to make learning more accessible to the general public, he has hosted Nerd Nite in three cities.

He is frequently engaged by various media outlets, including having his story from the Moth Grand Final 2018 aired across Australia by the ABC.