KutcheriBuzz
Interviews
The Dancer's Doctor
- Category: Interviews
Dr. Krishna Raman graduated in Medicine in 1986 and has trained in the BKS Iyengar yoga system at RIM Yoga Institute, Pune, India. He practises western medicine and therapeutic yoga in Chennai.
.He has authored a book titled 'A Matter of Health', on the integration of yoga and Western medicine. The book published by East West books, Chennai, India, has sold 6000 copies within four years. His latest book is titled: 'Yoga and Medical Science: FAQ'.
Since 1987, he has worked extensively with classical dancers in India, and most top dancers follow his medical advice. In an interview with Aruna. S of KutcheriBuzz, Dr. Krishna Raman shares medical advice for dancers...
You're referred to as the dancer's doctor. How did it all happen?
I integrate medicine and yoga together. Most dancers with orthopaedic ailments like neck pain or back pain come to me for treatment, as conventional approaches haven't helped much. They do take medication, and get immediate relief, but further guidance is lacking. I prescribe medicines and then put them through yoga, for a long term solution. Many dancers have found the relief to be consistent.
What are the most common complaints that dancers have?
Back pain, neck pain, knee pain, foot pain, shin, ankle or pains in any part of the lower limbs are common.
What are the causes for such complaints?
It is partly because of the way in which dancers use their body. I have been told by senior dancers that you don't actually hit the floor, and there's a certain knack of doing it. But, most dancers hit hard and nothing is done to correct them. So, it is also because of the style of dancing. But most importantly it is the floor on which you dance.
Along with a structural engineer, I did an experiment at IIT. We made a dancer dance on wooden floor and on stone floor and we measured the impact. On the stone floor, the body was absorbing the impact which is harmful to the person, and on the wooden floor, the floor was absorbing the impact. So, it is safer to dance on wooden floors. When I presented a lec-dem at the Natya Kala conference at Krishna Gana Sabha, last year, I appealed to all the dance organisations and sabhas to change their flooring to wooden.
We are probably used to the concrete floor for ages in our country. Your comments...
It could be. But in those days, people used to walk barefoot a lot. Today, we're used to a soft life. Also, even if they danced on hard floors, we don't know how they danced. We don't know if they really banged on the floor! The teaching may have been different too. There are so many schools today, and we don't know what exactly the correct technique of dancing is. As far as aesthetics are concerned, styles may have been modified, so that a hand movement or a leg movement looks aesthetically nice. But nobody has questioned what is ergonomical. So we don't know if ergonomics was part of the yester-years' dancers.
What is ergonomics?
Ergonomics is the science of correct body movement. For example, if I do a yoga posture, there is a certain way of turning the neck to the different sides. Ergonomics tells you the correct technique of moving the body. Today it is a specialised science.
We don't know if ergonomics was part of the Bharatanatyam tradition. Even the exercises which Kathakali dancers practise, are not done scientifically. That's why many Kathakali dancers have problems. Their training methods for flexibility are not medically correct. In Bharatanatyam, the 'Araimandi' posture requires preparation of the groin muscles, by doing specific asanas.
One of the common reasons for ailments in dancers today, is not just the lack of understanding of technique, but also the frequency of dance performances which harm the dancer. In those days, it was more for the enjoyment of the soul, but today it is for competition, name and fame and the economics of it. These days, dancers accept ten performances in a row. I'm not finding fault with today's approaches, but if a dancer has a break and spaces out the performances, then they'll never suffer ailments.
How do you treat your dancer-patients?
If it is an acute injury then I give them medication. I check them after their performance, monitor and give them advice accordingly. I tell most senior dancers not to perform for a certain period in a year, say for a month or so. And they follow it. Some dancers have even started using specialised floor mats. It is good for the feet. And yoga is one of the best ways to treat dance related problems. It has to be done continuously. Yoga is a lifestyle...
Isn't it impossible for dancers not to dance?
It is unfortunate in India, that an understanding of the human body is not coupled with teaching dance. In the West for example, a Western dance teacher or practitioner has a better understanding of the human body and the bio-mechanics. But here, we don't find that understanding. So, when they get a pain, and we advise not to dance, they start worrying.
Dancers must have a basic understanding of the human body, like simple anatomy and physiology, so they will understand what they are doing to themselves. Then they will have a better understanding of dance itself and the movements. Then when a doctor advises, they can sail through the instructions easily. So, during treatment we ask them to stagger their performances, do yoga and understand how they move their body, so that while doing araimandi or other postures, they can understand where the stress comes from, how it comes, how much stress is on the knee, ankle, or the foot and how to counter it. Accordingly we suggest yoga poses, which they can practise before or after the dance or a daily yoga routine.
You spoke about understanding the body, how does one do that?
Dance teachers must first offer a class on anatomy, tell the students what muscles we use and how they work. And then proceed to physiology, understand what is movement and energy. It is my suggestion that dance classes have someone to teach the students basic anatomy and physiology, because you're constantly using the body. For example, if you consider western athletes, they understand a lot about muscle function, glycogen, glucose, right kind of diet and a whole lot of things. So, it is important for a dancer to learn basic human anatomy and physiology and then start dancing.
What is the right age to start learning dance?
At five. But children must be taught the right warm-up exercises before they learn dance. Most dance teachers today do practise warm-up exercises and there is an awareness. But it is still not comprehensive. Children can start at the age of five, but the real understanding comes only after puberty. Then the mind is more mature and they can understand the subtleties of the technique. Dance students must be prepared and made flexible with yoga, before starting dance lessons.
Can you elaborate on warm-up and warm-down exercises?
Pranayama calms the mind before you go on stage. If the performance is in the evening, you can do some standing asanas in the morning like Trikonasana. Just before going on stage, you can do stretching exercises, like lying on the back, bringing the legs up and to the side. Also doing Virasana and Padmasana, make the legs feel calm and fresh. These exercises can also be done everyday before your classes.
When you dance for a long time, the legs become hot, heavy and tired. So, there are certain yoga poses which soothen the legs and bring relief to the pain in the calf muscles, thigh muscles and at the knee joints. There are specific poses like Viparita Karani, Virasana, Supta Virasana and Baddha Konasana which give relief to the dancer after a performance.
Should dancers have a specific rehearsal pattern in a week?
Yes, they should. But rehearsals are not scientifically scheduled. Especially, just before a show, some dancers practise continuously for several hours in a day. What is optimum has really not been estimated. If a person is 65 kg, with thin legs and thick thighs, how much should that person practise? Or what is optimum for a person with a heel pain and a history of back ache, so how should that person calculate the practice - performance ratio? Height, weight, age, all matters. So practice varies from person to person, their lifestyle and capacity to practise. Someone whose bone structure is robust can practise more, whereas someone with delicate bones needs to practise less.
On an average is it ok to dance everyday?
You can dance everyday, or on alternate days. It depends on your focus and how skillful you want to be in your art. Medically, there is no harm in practising everyday. But, if you don't counter it with something like yoga everyday, then you may have problems.
During the December Season for example, some dancers have performances almost everyday. So how does one cope up with that stress?
Start yoga. The right kind of yoga. The BKS Iyengar school of yoga is the most precise. For example, if there is a cartilege damage in a particular area in the knee, we can tell you exactly what asana to do for that problem. While doing certain asanas, some pressures develop. We can tell you exactly how to counter that pressure.
Sometimes, after a rigorous practice, the muscles become stiff and there is an ache. What does one do then?
If you practice yoga, you can avoid these. But if you push too hard then it is unavoidable. That's why sometimes, it is good to do nothing, be it dance or yoga. Just take it easy. When you feel better, start your practice. I tell my dancer patients to plan their performances instead of pushing themselves too much. Once they get their name and the world knows their skills, it is better to call it a shot. You work hard in the beginning, and once you have your command, plan your performances. When you're an aspiring dancer you can work hard and push yourself. Once you enter the forties, you can plan it out. What is important is the concept of violence...towards yourself. Damaging your body is being violent towards yourself. If you're pushing yourself too much without caring for your body, then you're violent. You should respect your body.
Are there techniques to build stamina?
Stamina is something that dwindles with age. So, pranayama is one of the simplest and the quickest methods to build stamina. Asanas also help. There are two kinds of stamina. One that is active, when you need that burst. This comes with asana practice that has standing poses, inverted poses, back bends. The other kind is passive stamina which determines how quickly you recover. Stamina is not just what you expend but also what you pick up and come back to a resting level. It is the capacity to restore. Pranayama does that and helps you recover fast.
Any specific diet that dancers can follow?
You must first understand your genetic constitution. Whether you're short, thin, tall, hefty, thin and tall, there are so many combinations. Then you must understand how your body reacts to diet. Whether you lose weight very fast when you diet, or does it take time. Then find out your lifestyle, preferences of food and whether it is doing good to you. Definitely, today an awareness on diet is far better than what it use to be ten years ago. If you're slim, and able to maintain it and burn all the calories, then, you can eat whatever you want. But, if you tend to gain weight, and don't dance regularly, then eat less. The general rule is to take a low carbohydrate, high protein, low fat diet. But, diet is individualized.
The weight and the body mass index (BMI) has to be measured, the height=weight ratio has to be seen, how frequent one dances, what is the energy status, that is how long can you go on without getting tired...all this has to be calculated and then the diet is prescribed.
Medically it has been found that the south Indian food is one of the healthiest in the world. But today, globalization has caught us and we eat all the wrong kinds of food. Well, you can eat whatever you want (to a limit), but exercise to shed the calories.
Weight gain seems to be the most difficult to overcome! Your comments?
Most Indian dancers gain weight over a period of time and they are not able to shed it, because they don't do the right kind of exercises. With menopause and middle age, you tend to slow down and then you gain more weight. But those who are extremely dynamic and active throughout their career and highly motivated, don't gain weight. Some who are over 50, still active, tend to gain weight because of their genetic constitution. They must practice specific exercises, like walking on a treadmill, or weight training, to burn the excess fat.
Dance alone cannot burn the fat and yoga doesn't help in burning calories and making an obese person slim. Asian women, particularly Indian women have a tendency for lower body fat. I wouldn't say it is genetic, but it is mainly because of a sedentary lifestyle. In the West, the women are more dynamic. An 80-year old woman has to drive a car to buy these. Their lifestyle and society is very different. Here, the women depend so much on their husbands, mentally, physically and emotionally. Today's generation is of course very independent. Another point to remember is that once you're used to a particular kind of physical activity, like dance or walking, you will not accumulate fat in certain areas, but other areas may develop fat. This could be genetic. So, you have to identify these areas and exercise to burn the fat in those areas. But exercise is arduous and you have to work hard.
We hear of dancers who fast on the day of a performance. Is it alright?
No. They may become hypoglycaemic and feel giddy during the performance. If the performance is in the evening, it is better to have a lunch and later have energetic drinks, like lime juice, a beverage that gives energy, or a small snack like a sandwich.
Is glucose advisable in between a performance?
It is better not to have glucose as glucose, as it is rapidly absorbed into the blood stream, will be used up as energy and there will be a sudden drop in the blood sugar and you will feel giddy. If there is a break between performances, you can take a biscuit, or half a banana, few slices of orange, or half a cup of coffee or a protein milk shake. Medically it is not correct to take in glucose as such. It is best to take something where the glucose level goes up, where the absorption is slow and the degradation is slow as well. When you're dancing before the lights and sweat a lot, it is good to take a lime juice with salt that cools you down. When you're not sweating much, you can have something warm, that keeps you fresh and alert.
Your advice to those who wish to get back to dancing after pregnancy...
Immediately after delivery, it is good to exercise and bring back your weight to the pre-pregnant state. In the case of a normal delivery, you can start dancing in about five to six months afterwards. But intense practice can begin after about nine months. In the case of a caesarian section, you have to wait for the stitches to heal and there should be no practice for at least six months after delivery.
Is there a specific age-limit for dancing?
There are two issues in this and both sensitive. One is physical fitness. And the other is your aesthetic appearance. As long as you are physically fit, and you're aesthetic in your looks, you can go on. By aesthetic looks, I don't mean what is God-given. As long as you can keep yourself aesthetically approachable to people, you can certainly dance for as long as you want.
Very often we find dancers who don't take care to keep themselves aesthetically nice. Everybody can't afford to look beautiful. But everybody can afford to keep themselves trim. Dance is a performing art and when you come on stage, your appearance definitely matters. It is the responsibility of artistes to take care of themselves. You need to respect your self and the audience. What is lacking today is that self-imagery. And when a critic makes a comment, the artistes are hurt. Instead you can look for solutions. You don't have to be trim for the sake of others, but its just a nice feeling to be trim.
When you look at sculptures in temples, they are so beautifully carved. I would presume that centuries ago, people were more ethical and honest, in terms of self discipline, self ratings and presentation of their art. Today we sacrifice everything because we want a quick name and fame. Each dancer should ask oneself the question whether they are visually presentable. A trimness in form and figure does play a crucial role in the performance levels of an artiste, besides of course the abhinaya, and your ability to imagine and create.
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