Why do back injuries seem to be so common these days among dancers?
"It used to be that if you were in a company, you did all the work of that choreographer," says Rocky Bornstein, a New York City–based physical therapist who specializes in professional dancers. "Now companies feel like they have to bring in choreographers to work with the company, so the work is much more eclectic." More and more dancers are also building freelance careers, which forces them to hop between various styles. This is an unprecedented challenge for the body.
Dr. William Hamilton, who was an orthopedic consultant for New York City Ballet and American Ballet Theatre for four decades, adds that even big companies are getting smaller, which puts more pressure on each individual dancer. A minor injury in one member can cause a domino effect within the company: Other dancers need to do double duty, which puts their bodies at risk for injury as well.
Clad in her signature loose black T-shirt and baggy gym shorts, Emma Portner is standing in a cavernous industrial space in downtown Los Angeles. A glass box—big enough to fit five dancers with only a little room to maneuver inside—sits in the middle. The five performers, Portner included, are standing inside it, side by side, palms on the glass.
"Question," Portner asks. "Are we looking at our hands?"
She steps out to watch the others try the phrase, and adds a few more steps. Quick, staccato movement, legs kicking out, torsos swiveling around, fists hitting glass. "This is a puzzle," she says, almost to herself. "I'm not sure I'll like it." The statement, like so many, is punctured with a sweet, nervous laugh.
When I moved to New York City in 2000, my life looked like that of most 22-year-old aspiring modern dancers: I lived with two roommates in a rundown two-bedroom apartment deep in Brooklyn. I was paid $100 a week to dance for Tamar Rogoff, but I also worked the front desk at a yoga studio and as a "counter girl" at a coffee shop. I made a few hundred dollars a week.
But I had a safety net. My parents insisted I have health insurance, so they paid it. If I couldn't make rent, they paid it. And when a rent-stabilized apartment became available—an alarmingly cheap one-bedroom that would allow me to survive as an artist in the city for the next decade—I used an inheritance from my grandfather to pay the sizable broker's fee, which I admitted to nobody. Without help, none of this would have been possible.
How does a choreographer pressed for time raise a whole lot of money quickly—really quickly?
In an unassuming industrial neighborhood east of downtown Los Angeles, five tap dancers are huddled in a bunker-turned-tap-studio. With concrete floors and a windowless, tunnel-like interior reminiscent of old London Tube stations, it feels like a place far below the earth.
Ciara's "Like a Boy" blasts through the speakers, and the dancers, dressed in camo and golden tap shoes, saunter into their positions facing the lights and camera, eyes focused forward, bodies vibrating with energy. "Wish we could switch up the roles," Ciara sings, and the Syncopated Ladies, led by choreographer Chloe Arnold, hit it—hard, again and again, as the cinematographer glides the camera along a track across the room, capturing their every move.
In the spring of 2001, I sat in a room at the VA Hospital in New York City, surrounded by five war veterans with post-traumatic stress disorder.
I was a member of Tamar Rogoff Performance Projects, and we were working on a dance-theater piece about the psychological effects of war. These men told us stories about dropping bombs over Vietnam and being held in POW camps during World War II.
I was terrified. What did I—a 23-year-old dancer—have in common with them, and how could I gain their trust?
The process wasn’t easy, and the veterans were occasionally resistant. But over nine months of get-togethers and interviews, I became very close with John McCarthy, the WWII veteran I was “paired” with. He told me about being blown out of a plane and being held over a cliff by an enemy soldier, stories he had told almost no one. And while the piece wasn’t meant to be therapeutic, it was healing for both the veterans and the dancers. John died a year later, and his nephew asked me to dance at his funeral. Never had I felt the transformational power of dance so strongly.
For decades, choreographers have been making work with—or about—victims of disease or war; and teachers and dance therapists have been using dance to help people heal from trauma, torture, and abuse. I spoke with three choreographers who have worked, respectively, with children living in post-war Bosnia and Rwanda; survivors of domestic abuse; and ex–child soldiers in Sierra Leone. While the three have very different approaches, they all agree on a few points: Know why you want to work with a specific population, what you have to offer, and why you think dance would be of service. Educate yourself before entering a community: What have these people been through and what are they facing now? It helps to be guided by social workers and/or an elder in the community. And lastly: Be flexible. That said, all three concur that this kind of work is tremendously challenging and rewarding.
Rebecca Davis became interested in teaching children in war-torn areas after choreographing a work about Darfur for her company, the Philadelphia-based Rebecca Davis Dance Company. “When I made Darfur, it was very fulfilling to see an issue that I cared about transform the dancers and audience,” she says. “But I wanted to understand on a deeper level how genocide can come about.”
In 2008, she traveled to Rwanda with Global Youth Connect, a human rights organization that held seminars for the volunteers before they worked with them.
Davis taught jazz dance to boys who lived in a child-headed household. (All of the childrens’ parents had been killed in the 1994 genocide.) Twenty boys, ages 10 to 17, were living under one roof. Despite the tragedy of the situation, Davis says, “What’s so shocking and powerful and optimistic is that you walk in and see these kids—some are Tutsi and some are Hutu—being forced to live together, because it’s their only chance. No one will take care of them.”
Davis admits that they were surprised to see a white woman put on jazz shoes and lead them in a warm-up (women do traditional dances in Rwanda but not contemporary styles) but says the boys loved it. “You put on music and everyone starts moving,” Davis explains. “It’s how they’re able to handle their aggression and channel their emotions. Dance is a part of their culture.”
A master’s student in international relations with a concentration in peacekeeping at the online American Public University System, Davis says she “gained an understanding of how important dance is in post-conflict countries. Working with these boys, I learned that dance is what they do: They go to school and then they dance.”
The trip inspired her to go to Brcko, Bosnia, last summer, where she developed a program for students 4 to 18. Fourteen years after the war, ethnic tensions are still high, and Serbs, Croats and Muslims rarely interact beyond what is required. But Davis found that the two best dancers in her teens class were a Serb and a Muslim. The girls had to dance together so much that they became friends. At the end of the workshop, the Serbian girl asked the Muslim girl to celebrate Christmas with her family.
Gina Gibney and her company, Gibney Dance, have been providing movement workshops to survivors of domestic violence in shelters for over 10 years. But Gibney was very clear from the get-go that they were not doing movement therapy. “My interest has been to take what dancers are naturally good at,” she explains, “and apply it in a broader more inclusive context.”
Gibney developed a program in conjunction with Sanctuary for Families, which assists survivors of domestic abuse and their children. “We identify the women’s needs and issues,” Gibney says, “and figure out how those dovetail with the skills that are intuitive to dancers.” The company members go through a rigorous training program, learning everything from what these women have faced to what life is like in a shelter.
Once trained, each company member travels alone to undisclosed locations around New York City. Most of the time the dancer works with a support group that has a trained mental health professional on-hand to address anything serious that comes up.
“The class gives the women tools to open and inhabit their bodies and to overcome resistance they have from being physically traumatized,” Gibney says. It starts with a gentle warm-up, which helps the women uncover where they are tense. “It gives them a chance to think about their own lives—where they’ve been and where they want their feet to take them.” It also gives the women a sense of self-worth: “These women have been told the worst possible things about themselves,” Gibney reports, “so to hear a room full of women shout what is great about them is an unbelievable experience.”
For most of the 15 years that David Alan Harris was dancing and choreographing in New York City, he also worked as a writer for Human Rights Watch, a national group dedicated to protecting human rights. “I remember sitting at my desk one day, and having the idea to become a dance movement therapist to work with torture survivors,” Harris says. He imagined that dance could be healing to survivors because they often undergo a mind/body “split.” When a torturer inflicts bodily pain in order to gain access to the victim’s mind—and thus gain control over him—the pain is often so unbearable that the victim will divorce himself from his body (what clinicians call “dissociating”). “The task of healing for torture survivors is reintegration,” he explains. “I intuited from years of focusing on my own body and working improvisationally, that reintegration would mean working at the body level as well as the psychic level.”
While pursuing his degree in creative arts therapy at Philadelphia’s Drexel University, he worked with a group of resettled “lost boys” from Sudan. He asked them to teach him their traditional dances. “I put them in the role of expert and me in the role of recipient,” he explains. “It helps to undo the stigma.”
Four years later, he traveled to Sierra Leone and worked with ex–child soldiers. “These teenage boys had lived in a unit under a commando where if they did the wrong thing, they’d be shot,” Harris says.
Harris began the session in a circle, with Sierra Leonean hip hop playing on a little battery-operated stereo. He asked the boys to follow his movements. As the warm-up progressed, leadership would change hands organically, encouraging the boys to stay attuned to the group and trust each other, which is particularly difficult for ex–child soldiers.
“In the first session, we found ourselves on our stomachs looking around,” Harris recalls. “I said, ‘What are we doing?’ Somebody replied, ‘We’re hiding from our enemies.’ This is five years after the war! These kids are orphans—they’ve been shunned and they live on streets. But they found a way to symbolically reenact the central conflicts of their existence. I believe that in doing so, they find a way to tolerate their memories.”
Harris worked with the boys for several months. Although the emphasis was on process (and healing), the boys decided they wanted to perform for the community. Most of the village watched the boys reenact the roles they had played in the war; they even depicted a scene in which a boy is ordered to shoot a gun into the corpse of his father and sister. “One boy who had been forced to kill his parents went to the village elder and asked to be welcomed back into the community,” Harris says. “At the end of the performance, the elders stood one after the other and welcomed the boys back. People who had feared these guys said they weren’t afraid anymore. It was the most amazing thing that’s ever happened in my life.”
Harris feels that this work required everything of him—in the same way that dancing once did. “It involves the integration of mind and body, passion, spirituality. It’s holistic. It gives me a sense of hope, of creatively building a new future.”
Abigail Rasminsky is an MFA student in writing at Columbia University.
Illustration by Tifenn Python.
Like most college seniors, Carolyn Steeves has one foot firmly planted in the business of graduating (counting credits, honing her technique) and the other somewhat gingerly feeling its way out into the real world (exploring job possibilities and cities to move to). But due to the economic crisis, the 21-year-old Cornish College of the Arts dance major is not sure exactly how she’ll be able to pay for her final year.
“I have an internal turmoil every time I take class,” she says. “You have to dance every day if you want to be the best you can. But it’s hard to know if I’m going to be back here next year. Am I not going to be able to finish my degree because of this economy? Is it all going to be for nothing?”
Carolyn’s family has struggled to stay afloat during the recession—her father’s hours at an auto-body shop have been cut, and her parents have lost a big chunk of their retirement fund, all of which has cast a burden on Carolyn. She works almost 30 hours a week at a Seattle coffee shop in order to pay the rent, and 6 to 10 hours as an administrative assistant for the Cornish Preparatory Dance Program. Though she has secured a dance department scholarship for 2009–2010, it will cover only 10 percent of her tuition, leaving her and her family close to $60,000 in debt by the time she graduates. “I’m extremely scared that I won’t be able to take out as many loans as I need to graduate. Loans loom over my head every day when I wake up.”
Carolyn is not the only dancer laboring long hours to pay for her education during this economic downturn. DM spoke with college and high school scholarship students from University of the Arts in Philadelphia, Cornish College of the Arts in Seattle, and the Boston Ballet School who are staying in school by taking out loans and working multiple jobs in administrative offices, dance studios, clothing stores, and restaurants—and often by making sacrifices as a family.
Last April The New York Times reported that while most schools are not decreasing their financial aid budgets, more students—even those who didn’t request assistance when applying—are vying for aid, meaning there is less to go around. Some schools, like the Ailey/Fordham BFA program, anticipated that fewer students would be able to attend, and as a result accepted more dancers for the incoming class in order to meet class sizes.
That said, many universities are committed to retaining their students in need. “Because dancers spend so much time rehearsing and performing, they have less time available for traditional work placement, which puts a lot of pressure on their ability to save for an education, both during high school and college,” explains Chris Pesotski, director of financial aid at University of the Arts. Knowing that the economy was getting worse, UArts set aside an appeal fund specifically geared towards retaining students. (The school has already gone through $360,000 and has budgeted in the same amount for 2009–2010. Ailey has a similar fund.)
Additionally, dancers are working harder than ever outside the studio, clocking in between 10 and 30 hours a week in dance department and financial aid offices, in cafés and clothing stores. At UArts, Pesotski has seen a 10 percent increase in student hours worked per week—and he’s seeing more students seeking summer employment.
Recent grad Makeda McGill, 21, got through UArts by working four jobs her senior year as a work-study student. With six younger siblings, the modern dance major had to be self-sufficient. So on top of receiving several grants and scholarships (which paid for most of her tuition) and a small subsidized loan, Makeda worked four part-time jobs. She was an administrative assistant in the dance department and student financial services offices; a dance tutor for underclassmen; a mentor to incoming freshmen; and a sales girl at an Ann Taylor clothing shop on the weekends.
“With the economy going down, I’m a little more nervous about paying back my loans, because there are less job openings,” Makeda admits. Nonetheless, her plan is to continue dancing with choreographer Zane Booker and working at Ann Taylor. And she’ll take dance class at UArts for free. “It’s a great alumni benefit,” she says. “I don’t have to worry about paying for class.”
Many students are making it through the crisis by making sacrifices as a family. “My mom jokes that she hasn’t bought new mascara for herself in forever because of me,” says Brittany Rogers, 17, a student at Boston Ballet School. While 20 percent of Brittany’s room and board is covered by scholarship, she takes care of her subway passes, groceries, and pointe shoes by working as a teaching assistant at Citydance, Boston Ballet’s educational outreach program. “When I got the job,” she says, “I called my mom and cried hysterically because it was going to help so much.”
Brittany has also learned to forgo a latte at Starbucks in favor of the bigger picture—with her mom’s help: “My mom logs on to my bank account to see how I’m doing and what I can cut back on,” she says.
Willie Smith III, 22, a recent UArts work-study ballet graduate who dreams of dancing with Complexions or Cedar Lake Contemporary Ballet, has also learned to budget and save. “Whenever I need groceries, I always make a list and look at coupons,” he says. Willie received the National High School Dance Scholarship, which covered 10 percent of his tuition for four years (after UArts matched the scholarship). He also worked in the dance department office and as a host at an Italian restaurant, before getting hired by Eleone Dance Theatre (where he gets paid for performances). But with his sister in a pre-med program, and his father in and out of the hospital after suffering a stroke, Willie has taken on more responsibility since the economic crisis hit. Now he pays for his leotards, tights, shoes, and travel to auditions.
But more than learning to budget and stand on his own two feet, Willie has learned to never take no for an answer. When he realized that he needed more money his freshman year, he approached his department head, who told him that scholarships were only for upperclassmen. Instead of giving up—or dropping out—he walked over to the financial aid office and applied for the NHSDS, which he got. “The more you put yourself out there,” he says, “the more people will see how eager you are to get the money.”
Despite ongoing fears about how she’ll pay down her debt, Carolyn—a self-declared “workaholic”—is determined to figure out a way to finish her degree. “At the end of the day, I still have arms, legs, and a head, and I can still dance,” she says. “I’m going to school and it’s grueling, but I have to remind myself: This is what I’ve loved since I was 3 years old. It hasn’t changed for the last 18 years, and it’s probably not going to.”
Abigail Rasminsky, a former editor at Dance Spirit, has written for Dance Magazine, The New York Times, Nextbook.org, and Fit Yoga.
Illustration by Diane Bigda
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It’s no secret that a career as a professional dancer can be unpredictable and stressful. But with the economy in a deep recession, this year has been an especially difficult one for the dance world. Many companies have been forced to cut dancers or tours, and have lost rehearsal space. A dancer who once lay awake in bed replaying a botched pas de deux may now be staying up into the wee hours worrying about whether she’ll have a job come fall.
But before your heart rate begins to accelerate just thinking about it, remember that stress isn’t always a bad thing. “Our responses to stress are supposed to be helpful,” explains Dr. Richard Gibbs, MD, supervising physician at San Francisco Ballet and the chair of the Dance/USA Task Force on dancer health. In intensely stressful moments, the endocrine system and the sympathetic nervous system work together to release higher levels of cortisol and adrenaline. In an audition, for instance, this can actually benefit a dancer. “You’re going to be more alert, pick up choreography faster, and move more assuredly,” says Dr. Gibbs.
But when stress becomes chronic—say while searching for work in a depressed economic climate—its positive effects quickly turn harmful, which can have a big impact on your dancing. Too much adrenaline, for instance, keeps you in “fight or flight” mode, which leads to anxiety and fatigue. This slows down your reflexes and thinking processes, so learning choreography becomes a challenge. Extra adrenaline also makes your heart beat faster, speeds up your breathing, and makes you sweat more. (This is why staying hydrated is key.)
Because stress also causes an increase in cortisol levels, dancers are susceptible to all kinds of viral infections, since cortisol lowers immune system resistance. Cortisol also activates your gastrointestinal tract, which leads to more acid in the stomach, causing peptic ulcers. But perhaps most significantly, stress creates the perfect breeding ground for injury—and makes healing more difficult. “When stressful situations are on the line, injury rates go sky-high,” Dr. Gibbs explains. “This is because cortisol actually weakens tissue and bone.”
On a psychological level, stress also does damage. “Irritability is more likely,” says Dr. Harlene Goldschmidt, PhD, director of education and wellness at the New Jersey Dance Theatre Ensemble. “It’s easier to lose control of your emotions.” She also adds that stressed-out dancers often have trouble taking criticism, causing them to miss out on valuable feedback (and jeopardize a relationship with a teacher or director).
So how do you reduce the effects of stress? In addition to the obvious (like get eight hours of sleep), Dr. Gibbs suggests low-impact aerobic activity like riding a stationary bike, walking, or going for an easy jog one to three times a week. “If I have a stressed-out dancer, I recommend exercise,” he says. “It releases endorphins, and reduces injury and cholesterol. It’s the number one treatment for depression and anxiety.”
Yoga—which stretches and strengthens the body while calming the mind—along with a regular meditation practice have been lifesavers for Shila Tirabassi of the Stephen Petronio Company. Like others, the company has had dates cut this season, and the dancers have struggled with reduced income and more anxiety—all of which has an effect on Tirabassi’s body. Her hips get tense and her back goes into spasm. “Yoga has saved me,” she says.
And above all, don’t panic. If you’re in financial straits, ask yourself whether you need a second job, or could turn to a trusted friend in a worst-case scenario. Dr. Goldschmidt notes, “There are a lot of steps between having performances cut and being on the street.” And even if you’ve just been laid off, take advantage of downtime. “Give yourself permission to feel good on days when you’re relaxing,” she says.
Whatever happens, enjoy dancing while you are dancing. “Even in the midst of a struggle, remember that we’re striving to do something that we absolutely love—and that’s a gift that most of the world doesn’t get,” Tirabassi says. “Let those be the wheels that turn, not the ‘I need money and stability’ wheels. Getting to do the thing you love all day is what you should hold dear in your heart.”
Abigail Rasminsky, a former editor at Dance Spirit, has written for The New York Times, The Forward, and The Nextbook Reader.
Photo: Erin Baiano; Photo illustration: Hanna Varady
I am 4, and it's a muggy July evening in the Berkshires. I am holding my mother's hand; my father and 12-year-old sister are just ahead of us in the sea of over-sized people streaming into the theater. It is 1982, and I am at Jacob's Pillow on my way in to see the first dance performance of my life—the Paul Taylor Dance Company.
Blame it on that elusive thing, memory: In my imperfect one, we sit front and center on wooden chairs. My feet don't touch the floor. The ceilings are high, the wood beams rustic, and there is no air conditioning. Adults are fanning themselves while we wait. I am nervous and excited and feel tiny inside such a big space. The lights dim and I squeeze my mother's hand.
The dancers are so close they look immense, superhuman. I can hear the sounds of their bare feet taking off and landing, and the screeching of their skin against the marley. I can see sweat staining the armpits of their bright costumes. I can see them smiling—beaming, it seems, with real and relentless joy—as they throw themselves fearlessly into each others' arms or leap heartily over each other to the ground, and I am riveted. I want so badly to join them that my little bum is practically levitating off the bench.
Later, I find out this piece is called Esplanade.
At intermission, I refuse to leave my seat. I'd rather pee in my pants than risk missing a single instant of this new magic. The following week, my mother enrolls me in a dance class.
I am 29, and it's a cold March afternoon in New York. It's been 25 years since I've seen Paul Taylor live, and I am, needless to say, nervous and excited. In the quarter century since Esplanade inspired me to dive and fall and jump and run—to reach for that kind of bliss and feral abandon in movement—that story has become family legend, as good as gold, the uncontested story of my movement beginnings. I am worried that the real thing just won't—couldn't possibly—hold up.
In the last 10 years I have had, and lost, a dance career—not one of the Paul Taylor variety, with a steady income, busy touring schedule, and historical significance—but a career nonetheless. Mine was made up of overlapping rehearsals and odd jobs and unpaid performances on dirty, unsafe stages. It was of the fragmented downtown variety where I danced in silence, or with gigantic puppets, or to words. One that Paul Taylor might not recognize as a dance career, but one that allowed me to reach those mysterious places I saw in his dancers' eyes and bodies that night; a place where you really can be that free, that bold, that brave, and that human.
Once I am settled into my seat at City Center, feet touching the ground this time, I gaze around the audience, curious, hopeful. And there he is, sitting perfectly still in a suit and tie at the back of the theater. My heart flutters. I cannot believe that I am sitting mere yards from the man who changed my life. It takes all my powers of restraint to stop staring. I dig into my program and pretend to read.
Esplanade is, of course, on the program this afternoon. I have planned it this way. When I rented Dancemaker, the PBS documentary about Taylor, I had a potent, visceral reaction to Esplanade—it was like switching on a light in a dark, abandoned room and seeing that everything was just as I had left it. I knew immediately that was what I had seen—and, by extension, wanted to be.
Since then I have watched Dancemaker dozens of times and know the fragments of the piece as if I had danced it myself. Still, I am nervous. What if I think Esplanade (not to mention the rest of the dances) is stupid, boring, or obvious? What if my taste has changed so much that I can barely recognize what about Taylor's work made me want to dance so desperately? What if this family legend suddenly makes no sense?
Esplanade sneaks up on you—the simple walking patterns turn into skipping and running and sliding and jumping. The happy lifts and turns transform into sadder images of failed connections, of families that can't, or just don't, touch. But the mood lifts again, Bach's violin concerto speeds up and the movement becomes death-defying—the dancers soar backwards and seem to be plummeting to the ground—before being swept up by another body at the very last moment. The women jump into the men's arms from great distances, dismount, and start all over again. It is exhilarating and terrifying to watch, all of this humanness onstage, and I start, slowly, surprisingly, to cry.
It is not that the dancers are so terrifically skilled—which they are. It is humbling to witness such physical perfection at work. It is not that I am feeling nostalgic or regretful or angry or jealous, or even happy. It is something deeper, this feeling, something that slices right through to my guts. I feel that rare burst of light that only great art delivers: I feel lucky to be alive in such a wonderful, painful world.
If the words "hip replacement surgery" inspire a twinge of panic, read on: The topic is cloaked in misconceptions. Dancers endure more injuries on the job than, say, bankers, but are we all-after decades of plies, leaps, and extensions-fated to the operating table by age 50? No, say our experts. Proper mechanics and dietary choices are key; listening to pain and slowing down in the face of injury can go a long way. Interestingly, however, genetics-not career choice-is still the strongest determinant of hip arthritis.
Dance Magazine spoke with Dr. Mark Sinnreich, orthopedic surgeon and lead medical consultant for Miami City Ballet; Dr. William Jaffe, Clinical Professor and Vice Chairman of Orthopedics at NYU Hospital for Joint Diseases and an expert in total hip replacement who has helped in their design; and Ruth Solomon, Dance Medicine Research Coordinator, Division of Sports Medicine, Harvard Medical Center. Additional information was adapted from the website of the Harkness Center for Dance Injuries (www.med.nyu.edu/hjd/harkness). The International Associatoin for Dance Medicine & Science also has a helpful website (www.iadms.org).
-Signs of arthritis are decreased range of motion; deep and aching pain in the groin (which refers to the socket) or thigh pain (which refers to the ball) and the surrounding muscles; joint stiffness; increased pain when you are dancing, and continuous pain when at rest. An X-ray can confirm a diagnosis of arthritis.
-Decrease inflammation naturally with a diet high in glucose, fish oils, and Omega-3 fatty acids, says Dr. Sinnreich. Keep bones strong with calcium.
-Maintain flexibility in the hip joints, as well as strengthen muscular balance on both legs. Avoid repetitive trauma when you sense an injury coming on.
-Ruth Solomon adds that pelvis tilts (which open up the anterior hip) and core strengtheners, which stabilize and balance the area, may also help. (Pilates is great for this.)
-If you are too young for a hip replacement, you have a variety of options. With the help of a doctor, you can manage the pain with topical analgesic products and NSAID's (non-steroids), which reduce both pain and inflammation. But remember: NSAID's will mask the pain and can eventually lead to further tissue injury if the area goes untreated.
Years of turn-out may cause hip arthritis: "There have been no studies to my knowledge to confirm that hypothesis," says Dr. Sinnreich. "There are also none to refute it, but I think all dancers would get arthritic hips if this was a risk factor." Dr. Jaffe agrees: "I doubt if external rotation in a finely trained dancer would cause a problem."
I can't get a hip replaced before a certain age: "There is no age limit for hip replacement surgery," says Dr. Jaffe. "But we are reluctant to do hip replacements in young active patients unless they are severely disabled. In those cases we do the procedure with the understanding that they will require additional revision surgery at a later date."
If I dance, I am doomed to need my hips replaced by age 50: Even with all the wear and tear that dancers endure, genetics still play the biggest role in determining whether you are at high risk for arthritis. "If you're going to get it," says Dr. Sinnreich, "you're going to get it."
Hip Resurfacing is a good option for younger dancers: Not true, says Dr. Jaffe. There is a false assumption that hip resurfacing (see below) has a longer lifespan than a total hip replacement (which lasts a minimum of 15 years). Other downsides? Resurfacing does not allow for increased physical activity; the procedure is almost as invasive as hip replacement surgery; and you still run the risk of dislocating the hip post-op.
Labral Tear: a tear in the fibrocartilage that interfaces between the head of the femur and the acetabulum, or socket. "It can get torn with various injuries such as in the extremes of motion that a dancer may encounter," says Dr. Jaffe. A tear can be repaired with arthroscopic surgery. It may lead to arthritis.
Acetabular dysplasia: a congenital condition which results in a shallow hip socket that does not effectively enclose the head of the femur. "In the milder forms," says Dr. Jaffe, "it increases the risk of developing secondary osteoarthritis in adulthood. This condition is much more common in women." Dancers who are naturally very turned out may have this.
Hip Resurfacing: An alternative to total hip replacement. The head of the femur is not removed, but "is ground down to a smaller ball," says Dr. Jaffe. "A metal ball is cemented over the remaining head fragment to articulate with the previously placed, artificial (metal) socket."