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Breakdancer moves in on injury prevention Theoharis Constantinou is currently studying for the UCL MSc in Performing Arts Medicine, which is run in collaboration with the ISEH. We spoke to him about the background to his MSc and Project Breakalign, a research project looking at ways of reducing injury among breakdancers.

ISEH: Can you tell us a little bit about your background, why you chose this course, and some background to your project?

Theo: I grew up in Cyprus and when I was thirteen I was playing a game called Tekken 3, one of the characters, Eddy Gordo, inspired me so much that I was determined to learn his moves. So I started breaking which is a mixture of movements such as capoeira, gymnastics and lindy hop.  That then stimulated my interest in how the body moves, what are its limits, and how it regenerates; I was fascinated how the body heals itself. I was always really passionate about movement specially the more extreme side of it like acrobatics and flips so I thought, "If I'm going to get involved in something, I want to surround myself by people with a similar passion." Meeting such people in the UK is really motivating and inspirational, it keeps the fire burning. So I came to the UK and studied sports therapy.

ISEH: So you’ve been performing for a while?

Theo: I was a member of Liquid Fire Crew and at the time we were winning every major competition in Cyprus which lead us to competing across Europe. These competitions were great, but obviously you do get injured. So I thought: "Why am I injured? How did I get injured and what is going on in my body right now?” I really wanted to know more about this and help other people in a similar position.

There was also social pressure. People were asking "Do you really want to pursue a career as a performer? You'll get injured. How long will your career last?" So I said, "Right, well I'm going to be the best therapist and remove this stigma."

ISEH: What else do you do beside breakdancing?

Theo: When I came to the UK, I was based in Luton and there wasn't much of a breaking scene there. So I started tricking (a mixture of gymnastics, martial arts and breaking) ­– I love all the acrobatic elements it makes me feel like I can fly. At the same time, anything I found exciting I would do. Juggling, fire spinning, fire breathing, slacklining (a bit like tightrope walking between two trees). I love the circus as well and I'm also thinking about joining the stunt register.

ISEH: What brought you to the UCL MSc here at the ISEH?

Theo: When I finished the sports therapy course I thought: "Okay, where do I go from here?" I took some sports and exercise rehabilitation modules at the University of Hatfield. Then I found out about the Performing Arts Medicine course and it sounded perfect.

ISEH: Do you work with other sports as well?

Theo: I work in rugby. With a team called Stockwood Park which is now like a big family for me in the UK. I have learnt a lot from working there, it’s a contact sport and there are always many injuries. Breakdance has also been described as a contact sport because we're colliding with the ground all the time – you're jumping, spinning, falling on the floor. That's a contact sport in a way. I also coach gymnastics to 3-12 year olds, and lecture at a College on Sports Injuries and Advanced Soft Tissue Techniques.

ISEH: How did Project Breakalign get started?

Theo: I wanted to do something for the break dance community and I had met up with a friend of mine called Nefeli Tsiouti, she's a dancer as well. I told her I had some ideas for a breakdance project and she mentioned that she had started a project called Project Breakalign and we decided to collaborate, Dance UK was involved as well and we thought it is the perfect team; they helped out by recruiting the breakers, organise the time slots and brining in members from the team to help on with data collection, which was great because we had a lot of dancers going through. It was quite an intense day – we spent 15 hours or so in the labs and we have another 2 days of testing.

ISEH: Where did the idea for the project come from?

Theo: It started with wrist pain ­– every breaker has had wrist pain at some point. The main idea behind the project is that the bones in our ankles are designed to for us to walk on; biomechanically, they are able to withstand that pressure. The carpals in our wrists, on the other hand, are not. Our hands are meant for more delicate things. Breakers jump and spin on them, large torqueing forces pass through when performing some of the bigger moves. In gymnastics they do that as well but they've got a sprung floor, and also have regimented training. They say: "You have to start here. Then do this, then that.”  This all aims to ensure that the joints and muscles are ready for the moves.

When learning breaking you rarely have a coach or teacher, I was lucky to have a good mentor but learnt a lot from YouTube and even from a VHS cassette. So a lot of the time you are training unsupervised and as kid, you're in a rush to learn the bigger moves, so it’s easy to skip the fundamentals.  This is a big reason why injuries manifest as you might be rushing your body. Lets take Ballet for example, you have to be assessed and the teacher decides if you are ready to go on point, whereas with breaking it doesn’t work like that… yet.

But of course it goes beyond the wrist forces travel up the elbow, shoulder, the back and neck. Injury risk is related to your overall endurance. So I thought: "Okay, let's fatigue a dancer and find out what coping mechanisms they have. “It would be interesting to look at the difference between professional and amateur dancers. The full working title is ‘The Relationship Between Fatigue, Weight Distribution, and Pressure in Breaking’.

ISEH: Can you tell us more about how the project aims to improve breakdancers’ conditioning and reduce injury?

Theo: I wanted to replicate, as closely as I could, a ‘battle’ situation. At an event like this the dancers are in cyphers – a circle where one dancer goes in one at a time, small side battles, so there’s little rest time, especially if you are successful and move on to the next stage. It could be a long day especially if there are other dance styles in the same event. That is where the fatigue kicks in and we know that it is linked with injury.

Not to mention in battles adrenaline is sky high and you are pushing yourself often not noticing when you’re going to far. That happens with dance all the time. You know, you've got to win the battle. You've got to prove yourself. So you say, "It's all right. I've got a few days to recover."

What the project is looking at is if someone who has better endurance may be better at reducing the pressure in the wrist. Then we're hoping to create a methodology, much like you have in gymnastics. If you want to go for this move, make sure you have this strength. We want to hold workshops and encourage dance teachers and dancers to come and see the science behind it. Project Breakalign aims to help reduce injury within the breakdance community by creating a methodology of corrective practice.

ISEH: One of the things that the ISEH does is to try and promote physical activity and support the public health agenda. We've got rising obesity among young people, less physical activity. Presumably something like this could help – if you can reduce the risk of injury during breakdancing, that could encourage young people to take it up?

Theo: Exactly. I've heard so many times: "Oh breakdancing. It's too risky." But learning breaking is very rewarding and can actually reduce injuries in other physical activites because it teaches you how to fall safely gives you great body awareness and toughens you up. As a youngster, I was addicted to video games. There was this game called World of Warcraft, and I had 360 days of play time recorded – that's a year of me sitting in front of the computer. The buzz I was getting from breaking and the friendships I made was what made me stop, physical activity is so important in life and we all have to find a way to channel our energy with the right activity, we spend enough time in front of a screen as it is why have hobbies that make you spend even more time.

Watch the video about the project