Paulo Arrais rehearsing Agon with Lia Cirio. Photo by Brooke Trisolini

Fear of Reinjury Could Make You More Prone to Hurting Yourself Again. Here's How to Avoid It

It was Boston Ballet's first full run-through of its upcoming show, Kylián/Wings of Wax. As he prepared with a plié for a big saut de basque, principal dancer Paulo Arrais, 32, heard a Velcro-like sound and suddenly fell to the floor. He went into a state of shock, hyperventilating and feeling intense pressure on his knee. It turned out to be a full patellar tendon rupture, requiring surgery and an entire year off before he could return to the company.

Though his physical condition continues to improve, Arrais' mental recovery has also been challenging. "Treating your mind is just as important as treating your body," he says.

Feeling safe when returning to the studio can be tricky for any dancer. Some researchers believe a fear of reinjury can actually make athletes more prone to hurting themselves again. We talked to several medical professionals to understand why that might happen and what dancers can do to overcome that anxiety.

Reasons for Reinjury

There are several theories about why worrying about another injury can make a recurrence more likely. "When we experience greater life stress, we carry greater tension in our body, which puts us at risk for strains and sprains," says Dr. Windee Weiss, professor of sports psychology at the University of Northern Iowa. She explains that as dancers realize that the injured part of their body doesn't feel the same as before, they often automatically assume that's a bad sign. This anxiety can distract them while they resume their training, leading to tense muscles and a lack of focus that could cause an acute injury with one misstep.

At the same time, being overly attentive to how your body feels can also make you susceptible to another incident. "It's easy to get too cerebral, but your body does better if the movements are preprogrammed," says Dr. Lauren Elson, the director of dance medicine at Spaulding Rehabilitation in Boston. "If people think too hard about a movement, their natural patterns are disrupted and their moves are less efficient, throwing them off balance."

A dancer could hurt themselves while adjusting to the new and unfamiliar patterns their body has adopted as the injured tissue heals. They might also refrain from dancing full-out, making it more difficult to properly learn choreography—which could lead to an injury later on when they attempt those movements in rehearsal.

Build a Team

A support system is key to overcoming these mental hurdles. "An injury causes a breakdown of confidence in your own body," says Miriam Rowan, psychologist at McLean Hospital/Harvard Medical School. "The honesty and supportiveness of a social network is key when we're asking, 'How much can I trust my friends to tell me that I'm back to where I was? Does the PT really know that I can push more?' Trust allows us to rebuild confidence."

Arrais admits that his medical team has sometimes protected him from himself. Six months after his injury, Boston Ballet was performing Giselle, and he wanted to be part of it. "My physical therapist said, 'Why don't you walk first?' I needed that reality check," he says.

Stay in Motion

Make rehab exercises dance-oriented as soon as possible. "Otherwise, you have a dancer who's physically cleared but overwhelmed because he hasn't thought about technique and feels behind," says Weiss. Engaging your turnout before your first barre back, for instance, will make a ballet class feel less awkward. For those recovering from acute lower-body injuries, Elson suggests focusing on core control, stability and non–weight-bearing cross-training exercises to come back stronger.

Use Imagery

Practicing compassion-focused imagery prior to entering the studio can help you relax and be less critical when doing self-corrections. "Thinking about a soothing breath that takes over your body, or a blanket in your favorite color wrapping around you, can bring you to a calmer place," says Rowan. "It will help you stay in the present and avoid muscle tension."

Weiss also recommends visualizing what it looks and feels like to do familiar movements. "Maybe you can do your entire warm-up in your head, or you can do the arm positions and remember what the movements feel like," she says.

Dancers are also likely to return strong if they practice self-modeling. "Every day, watch some of your greatest past performances," says Weiss. "It will increase your confidence and remind you what you're capable of."

Even watching other dancers, while sometimes emotionally hard, is an opportunity to keep learning. It will also help remind you of the movements and rep you already know. Weiss says, "Even if you're physically unable to dance, your brain needs to stay in that mindset."

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Courtesy Harlequin

What Does It Take to Make a Safe Outdoor Stage for Dance?

Warmer weather is just around the corner, and with it comes a light at the end of a hibernation tunnel for many dance organizations: a chance to perform again. While social distancing and mask-wearing remain essential to gathering safely, the great outdoors has become an often-preferred performance venue.

But, of course, nature likes to throw its curveballs. What does it take to successfully pull off an alfresco show?

Marisa Grywalski and Alejandro Diaz in Dwight Rhodens "Ave Maria," part of PBT's Open Air Series last fall.

Kelly Perkovich, Courtesy Pittsburgh Ballet Theatre

Keeping dancers safe outside requires the same intentional flooring as you have in the studio—but it also needs to be hearty enough to withstand the weather. With so many factors to consider, two ballet companies consulted with Harlequin Floors to find the perfect floor for their unique circumstances.

Last fall, Pittsburgh Ballet Theatre invested in a mobile stage that allowed the dancers to perform live for socially distanced audiences. "But we didn't have an outdoor resilient floor, so we quickly realized that if we had any rain, we were going to be in big trouble—it would have rotted," says artistic director Susan Jaffe.

The company purchased the lightweight, waterproof Harlequin's AeroDeck® sprung floor panels and the heavy-duty Harlequin Cascade™ vinyl, which is manufactured with BioCote® Antimicrobial Protection to help with the prevention of bacteria and mold. After an indoor test run while filming Nutcracker ("It felt exactly like our regular floor," says Jaffe), the company will debut the new setup this May in Pittsburgh's Schenley Park during a two-week series of performances shared with other local arts organizations.

Pittsburgh Ballet Theatre's Open Air Series last fall. The company plans to roll out their new Harlequin AeroDeck® sprung floor panels and Harlequin Cascade™ vinyl floor for more outdoor performances this spring.

Harris Ferris, Courtesy Pittsburgh Ballet Theatre

In addition to the possibility of rain, a range of temperatures also has to be taken into account. When the State Ballet of Rhode Island received a grant from the state to upgrade its 15-year-old stage, executive director Ana Fox chose the Harlequin Cascade vinyl floor in the lighter gray color "so that it would be cooler if it's reflecting sunlight during daytime performances," she says.

However, for the civic ballet company's first performance on its new 24-by-48–foot stage on November 22, heat was less of a concern than the Northeastern cold. Fortunately, Fox says the surface never got icy or too stiff. "It felt warm to the feel," she says. "You could see the dancers didn't hesitate to run or step into arabesque." (The Harlequin Cascade floor is known for providing a good grip.)

"To have a safe floor for dancers not to worry about shin splints or something of that nature, that's everything," she says. "The dancers have to feel secure."

State Ballet of Rhode Island first rolled out their new Harlequin Cascade™ flooring for an outdoor performance last November.

Courtesy of Harlequin

Of course, the elements need to be considered even when dancers aren't actively performing. Although Harlequin's AeroDeck is waterproof, both PBT and SBRI have tarps to cover their stages to keep any water out. SBRI also does damp mopping before performances to get pollen off the surface. Additionally, the company is building a shed to safely store the floor long-term when it's not in use. "Of course, it's heavy, but laying down the floor and putting it away was not an issue at all," says Fox, adding that both were easy to accomplish with a crew of four people.

Since the Harlequin Cascade surface is versatile enough to support a wide range of dance styles—and even opera and theater sets—both PBT and SBRI are partnering with other local arts organizations to put their outdoor stages to use as much as possible. Because audiences are hungry for art right now.

"In September, I made our outdoor performance shorter so we wouldn't have to worry about intermission or bathrooms, but when it was over, they just sat there," says Jaffe, with a laugh. "People were so grateful and so happy to see us perform. We just got an overwhelming response of love and gratitude."

Marisa Grywalski and Alejandro Diaz in Susan Jaffes "Carmina Terra," part of PBT's Open Air Series last fall.

Kelly Perkovich, courtesy Pittsburgh Ballet Theatre

February 2021