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Sidelined?

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By Samantha Hope Galler

Louise in Kenneth MacMillan’s “Carousel” with Miami City Ballet. Daniel Azoulay.

Understanding Injuries

Since I began my career nearly 10 years ago, I have discovered that professional ballet dancers are among the strongest human beings. When I was 5 years in to my professional career, I met with a sports medicine doctor. During our conversation he said to me, “Well, it’s not like you are playing tackle football.” I could not believe it. His comment opened my eyes to how little people understood the dance world and the risks that come with it. Dancers put their careers on the line every day. We must deal with disappointments, but, most of all, we must deal with injuries. Discovering mental stamina while sidelined is the biggest challenge.

The Worst News

The worst news a dancer can receive is that she or he must hold off on what they live and breathe. Dance injuries come when you least expect them. Performing and rehearsing is going along so well and then all of a sudden things come to a screeching halt. It is a complete shock. Many injuries will take weeks, months, or even years to come back from. Emotional attitudes are compromised and difficulties arise from being sidelined. Fortunately, dancers today have access to advanced dance and sports medicine doctors who will answer any questions they have regarding their path to recovery. Depending on the severity of an injury, movement may be limited. This can force a dancer to be away from the studio for quite some time. Other injuries may allow a dancer to continue some normal activity like watching rehearsals or marking in the back of the studio. It is common to find a young dancer joining a company and sidelined early on from an overuse injury. A professional dancer’s schedule can be drastically different from that of a student and they may not be used to it. I have learned that a dancer’s first injury is a crucial learning experience. It was for me. It is the first time a dancer is forced to sit out, cross train, and build back mental and physical strength. There is a significant amount of time to reflect on yourself and any recent experiences. Reflection can be a positive experience, especially when the person is in their most vulnerable state. Reflecting can build a dancer’s confidence while they discover new ways to approach goals. This is when a dancer finds their deepest strength to pull through.

Learning to Cope

Mental stamina and mental clarity are two crucial elements dancers require to tackle their careers. Interestingly enough, our training prepares us for injuries in more ways than one. It is a matter of finding the patience we need to keep our head in the game. Most professional dancers are accustomed to spending 7-8 hours a day rehearsing. It can be quite a shock when all of a sudden you do not have that schedule anymore. Time seems to go by more slowly because the schedule is quieter. It is important to fill that schedule with activities that keep the mind and body alert.  A portion of time can be spent working with a sports psychologist to learn how to compartmentalize, gain focus, and grasp the situation. Feeding the mind with positive thoughts and meditating has helped me find trust and confidence. I really have to believe there is a master plan behind it all.

Back to Work

Photo by Samantha Hope Galler.

Visualization plays a key role in my return. As I approach the weeks before returning to the studio, I begin to visualize my pirouettes and jumps. Sometimes I watch rehearsals just to become accustomed to the sounds of the pointe shoe hitting the floor. In addition, I find time to research and study ballet videos.  Even though injuries stop us from being able to physically practice, we can still keep our minds going. Watching these videos reminds the mind what the movements feel like without actually doing them. All of these practices guide us in the right direction. When the chance comes to finally step back into the studio, it is important to feel ready. I find comfort in knowing what muscles I can and cannot move. This helps me narrow down a productive workout routine to stay into shape.  Although it is not easy to work out equivalently to a daily rehearsal schedule, two or three hours in the gym can make a huge difference. The more I do while recovering the more I can focus on the main issue once I am given the ok to move on. My workouts typically include reformer sessions, gyrotonics, biking, and swimming as permitted. My advice for those coming back from an injury is to try all different forms of cross training. If you do Pilates all the time, make sure to throw in a few sessions of swimming to build stamina in a different way. This career is first and foremost visual so it is important to understand how to make an appropriate comeback so that you can feel confident with your progress once you are in the studio or on stage. Be ready to face anything that comes your way.

Dance Wellness: Causes of Dance Injuries (Risk Factors) Part I

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KEEPING DANCERS DANCING

by Jan Dunn, MS

Jan Dunn, MS

This month’s topic in our ongoing Dance Wellness series is “Causes of Dance Injuries” (also called “risk factors” in the dance medicine world).  We all know that dance is a risky business – injuries do happen.  But learning what causes them can go a long way in helping to reduce that risk, and keep you “Dancing Longer / Dancing Stronger” (actually the title of an excellent dance medicine books for dancers!).  All of the information in this article is supported by dance medicine research over the last thirty years.

The risk factors discussed below are NOT listed in any order of importance!  In many dance injury situations, more often it is a combination of “causes” that may result in injury (I will explain what I mean by at the end !). We’ll cover five today, and five tomorrow:

1)  Poor alignment and faulty technique:

While it is true that many injuries result from a combination of factors, this one is usually agreed to be one of the most important.  Dr. Justin Howse, longtime physician to The Royal Ballet in England (now retired) and one of the early pioneers in Dance Medicine, went so far as to say that all injuries were the result of faulty technique. Most current experts would agree that while faulty technique is a major component of injuries, they would not necessarily concur that it is the only factor.

By “Alignment problems” we mean such postural patterns as:

-forward head (the head not in good alignment with the spine and torso)

-forward shoulders (rounded shoulders)

-lumbar lordosis (“swayback”)

-thoracic hyperextension (protruding ribcage)

-hyperextended knees (knees straightened beyond 180)

– foot pronation or supination (rolling in or out)

A dancer who has good alignment is more likely to have “efficient movement” (using only the muscles and amount of energy necessary to accomplish the movement), and is less likely to be putting strain and tension on soft tissue (ligaments / tendons / muscles) around the joint, thus resulting in less possibility of injury.

An example:

A young dancer complains of knee pain. The dance medicine physical therapist or physician gives a diagnosis of patellofemoral syndrome, which frequently involves the patella (kneecap) not tracking properly in the patellar femoral groove (the groove in the femur through which the patella glides, on knee flexion and extension).  Looking at the dancer’s plie in first, the medical specialist and the dance trainer note that the dancer’s feet are turned out to 65 degrees, and the knees are not aligning over the toes, but falling instead in front of the great toe.  Foot pronation (rolling in) and lumbar lordosis (“swayback”) is also noted. The dancer’s external rotation (turn-out) in the hip joint is then tested lying prone (on the stomach), and is found to be 48 degrees – so she is “forcing her turn-out”, which can cause knee pain (and possibly other problems).  Recommendations are given for medical treatment for the knee pain, and she is also given cueing for proper plie technique, using her natural turn-out of 48 degrees, and not forcing at the knee and ankle.

The crucial point here is that ALL injuries in dance need to be evaluated for technique concerns, to see if this may have played a causative part.  If the dancer rehabs the injury without knowing if faulty technique is involved, the injury is more likely to re-occur when returning to full dance activity.

2). Anatomical limitations: [Read more…]

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