Dr Sharmel­la Roopc­hand Mar­tin & Claude Mitchell

Imag­ine a young fast bowler with low­er back pain be­ing asked by a phys­io­ther­a­pist to per­form a wine as part of the as­sess­ment. Pic­ture an­oth­er ther­a­pist pre­scrib­ing win­ing, twerk­ing, or juk­ing as part of a re­ha­bil­i­ta­tion pro­gramme. Or a strength and con­di­tion­ing coach in­struct­ing foot­ballers to use these same dance move­ments dur­ing speed and pow­er train­ing. It may sound un­con­ven­tion­al, even hu­mor­ous, but it rais­es an im­por­tant ques­tion: can Caribbean dance move­ments be used to re­ha­bil­i­tate low back pain?

Win­ing is cen­tral to dance­hall, reg­gae and so­ca cul­ture. It ap­pears at fetes, Car­ni­val, street dances and di­as­po­ra events world­wide. Its sig­na­ture cir­cu­lar hip ro­ta­tion is deeply root­ed in African and Caribbean move­ment tra­di­tions, draw­ing from cer­e­mo­ni­al dances such as Ku­mi­na, Nyabinghi and Din­ki Mi­ni; tra­di­tions pre­served by en­slaved Africans and lat­er wo­ven in­to reg­gae and dance­hall cul­ture. Through sound sys­tem cul­ture, mu­sic videos and in­ter­na­tion­al Car­ni­vals, win­ing has be­come glob­al­ly recog­nis­able.

De­spite its cul­tur­al promi­nence, win­ing has nev­er been stud­ied as a func­tion­al move­ment. It does not ap­pear in re­ha­bil­i­ta­tion text­books, nor is it list­ed as a di­ag­nos­tic or ther­a­peu­tic tool. Yet, from a move­ment sci­ence per­spec­tive, whin­ing in­volves pos­te­ri­or, an­te­ri­or and lat­er­al pelvic tilts, along with ro­ta­tion achieved through iso­la­tion of the low back, ab­dom­i­nal and gluteal mus­cles. These are the same mus­cles tar­get­ed in phys­io­ther­a­py for man­ag­ing low back pain, where the goal is to sta­bilise the lum­bopelvic re­gion through core ac­ti­va­tion and con­trolled pelvic dis­so­ci­a­tion. Used prop­er­ly, win­ing could en­cour­age con­trolled mo­bil­i­ty and im­prove aware­ness of the core and pelvic mus­cles.

Twerk­ing, al­though pop­u­larised glob­al­ly through the Unit­ed States’ hip hop and pop cul­ture, shares rhyth­mic an­ces­try with win­ing. Twerk­ing in­volves re­peat­ed, pow­er­ful bursts of iso­lat­ed an­te­ri­or and pos­te­ri­or pelvic tilts while the trunk and knees are flexed. The move­ment be­gins with a back­ward pelvic tilt that flat­tens the low­er back, sim­i­lar to the load­ing phase of a coun­ter­move­ment jump, where elas­tic en­er­gy is stored. The pelvis then moves in­to an an­te­ri­or tilt, in­creas­ing lum­bar cur­va­ture. Re­lax­ation of the gluteal mus­cles cre­ates the char­ac­ter­is­tic “jig­gling” ef­fect as the but­tocks move rapid­ly. In Caribbean spaces, younger dancers of­ten blend twerk­ing with so­ca and dance­hall move­ments.

Like any ex­er­cise, twerk­ing and win­ing have vari­a­tions that can be mod­i­fied for ther­a­peu­tic use. In a phys­io­ther­a­py set­ting, ther­a­pists can adapt these move­ments to train joint aware­ness, co­or­di­na­tion, mus­cle iso­la­tion and core ac­ti­va­tion. They may al­so help pa­tients over­come stiff­ness or fear of move­ment by in­tro­duc­ing rhyth­mic, en­joy­able mo­tion.

Juk­ing or jook­ing is es­sen­tial­ly up­right twerk­ing. It is com­mon in dance­hall par­ties, street dances and youth-dri­ven chore­og­ra­phy, of­ten paired with win­ing. Of the three move­ments, juk­ing most close­ly re­sem­bles tra­di­tion­al re­ha­bil­i­ta­tion ex­er­cis­es such as gluteal bridges and pelvic tilts, which are typ­i­cal­ly per­formed ly­ing on the back. In juk­ing, the thrust­ing move­ment of the pelvis is cen­tral, while the knees, arms and hips con­tribute to pow­er and con­trol. This up­right vari­a­tion may of­fer a func­tion­al way to train pelvic mo­bil­i­ty and gluteal ac­ti­va­tion.

No pub­lished ev­i­dence shows that win­ing, twerk­ing or juk­ing can treat low back pain. How­ev­er, dance move­ment ther­a­py more broad­ly has been stud­ied for chron­ic pain and low back con­di­tions, and the mech­a­nisms over­lap with these Caribbean dance move­ments. Re­search shows that dance-based ex­er­cise can strength­en spinal mus­cles, im­prove flex­i­bil­i­ty, cor­rect pos­ture, re­lieve stress and en­hance cir­cu­la­tion; all rel­e­vant to low back pain. Dance ther­a­py has al­so been shown to de­crease pain in­ten­si­ty, re­duce fear of move­ment, im­prove body aware­ness and en­hance re­silience in peo­ple with chron­ic pain.

Many ex­er­cis­es used to treat low back pain re­quire care­ful in­struc­tion, su­per­vi­sion and prac­tice to en­sure cor­rect tech­nique. Mas­ter­ing Caribbean dance move­ments re­quires the same at­ten­tion to de­tail. The awk­ward­ness that some­times aris­es when teach­ing pelvic strength­en­ing ex­er­cis­es is no dif­fer­ent from the awk­ward­ness of learn­ing to wine, jook or twerk. Ther­a­pists of­ten strug­gle with pa­tient com­pli­ance; these cul­tur­al­ly fa­mil­iar, en­joy­able move­ments may in­crease en­gage­ment and should not be dis­missed as po­ten­tial di­ag­nos­tic or in­ter­ven­tion­al tools.

Of course, dance, like any phys­i­cal ac­tiv­i­ty, can lead to in­jury if per­formed re­peat­ed­ly with poor form. But win­ing, twerk­ing and juk­ing should not be equat­ed with im­prop­er bend­ing, lift­ing or pro­longed sit­ting, which are among the most com­mon caus­es of low back pain. Bio­me­chan­i­cal­ly, these dance move­ments may of­fer use­ful tools for man­ag­ing low back pain when ap­plied safe­ly and ap­pro­pri­ate­ly.

Caribbean cul­ture is rich with move­ment tra­di­tions that cel­e­brate rhythm, ex­pres­sion and com­mu­ni­ty. As re­ha­bil­i­ta­tion con­tin­ues to evolve, per­haps it is time to con­sid­er whether some of these move­ments, long prac­tised on dance floors and Car­ni­val roads, can find a place in the clin­ic. The idea may chal­lenge con­ven­tion, but in­no­va­tion of­ten be­gins with imag­i­na­tion.

Dr Roopc­hand Mar­tin is a se­nior lec­tur­er in the Fac­ul­ty of Sport at the UWI

Claude Mitchell is a grad­u­ate stu­dent in the Fac­ul­ty of Sport at UWI Mona Cam­pus