News

Patricia Barker Responds to All Those Royal New Zealand Ballet Rumors

Still via YouTube

The past few months have brought on a media storm surrounding accusations about the culture and employment practices at the Royal New Zealand Ballet. But it turns out, much of the reported information doesn't tell the whole story.

Caught up in the rumors has been newly hired artistic director Patricia Barker. The former Pacific Northwest Ballet star and concurrent director of Grand Rapids Ballet took over RNZB last June, and although the most troubling aspects of what has been reported, such as accusations of abusive behavior and other workplace grievances, pre-date her appointment, some complaints have been directed at her.


Class at RNZB. Photo by Evan Li, via rnzb.org.nz

The board of RNZB said in a press release last month: "Recent speculation about the culture and employment practices of the RNZB are troubling and unfair." To further address such allegations, the board has arranged for an independent review of RNZB's employment processes.

One of the issues widely reported in the New Zealand media is that half of RNZB's thirty-six dancers have left the company or didn't have their contracts renewed. Barker says in her tenure as director that number is actually ten; three retired, four were not reengaged and three, Tonia Looker, Kohei Iwamoto and Isabella Swietlicki took positions at Australia's Queensland Ballet. Barker also points out Looker (who is Australian) and Iwamoto had auditioned for Queensland Ballet a year ago and were awaiting positions before she even worked with them, and that Swietlicki left to follow boyfriend Iwamoto.

Barker in class with Royal New Zealand Ballet. Photo by Stephen A'Court, Courtesy RNZB

While dancer hirings and departures are a normal part of any professional ballet company, it is perhaps the lack of long-term stability in RNZB's artistic leadership—three directors in the past six years—that has made the number of recent dancer departures into an issue. "As far as dancers coming and going, it's the evolution of any company," says Barker. "All of the attention towards that gives me a sense the community really cares about the organization and I hope that we continue to get this much media coverage as we move into the next season and the wonderful ballets are done."

Another debate directed at Barker centers around a sense that the country's only ballet company should contain a certain percentage of New Zealand-born and trained dancers and be staffed by New Zealanders. But according to RNZB board member Isaac Hikaka, 42% of the company's dancers are New Zealanders or New Zealand-trained (in line with their historical average) and the company is working to improve those numbers.

For Barker's part, she has reached out to New Zealanders dancing abroad to gauge their interest in returning home to dance with RNZB. And contrary to early reports that the company for the first time did not look to RNZB's affiliated New Zealand School of Dance to hire new dancers, Barker did offer two graduate students contracts with the company but they chose to dance elsewhere.

A big stumbling block Barker says she is addressing is the non-industry standard December-to-January contracts which makes it difficult to hire dancers when many become available halfway through that term. Barker says to work around that she is having ongoing auditions throughout the year and keeping a few contracts in reserve to use on new talent.

Another challenge is that unlike many large ballet companies, RNZB has no studio company, second company or apprentice program in place, which limits RNZB's ability to hire qualified young dancers."We're missing that important step for young dancers, and this might also be why some of the talented dancers from New Zealand have gone elsewhere," says Barker. Barker is working on an apprentice program with the support of New Zealand's Ministry of Culture, and has worked with Youth America Grand Prix to create an internship program. "Being as we don't have a summer program this is a great added benefit for young students to get to know the company and for us to attract young talent," says Barker.

Barker has also taken some heat for her artistic staff hires not all being from New Zealand. She says one change she knew she wanted to make was hiring permanent ballet masters instead of short-term ones, as the company had done previously. The first of those she hired was New Zealander Clytie Campbell, who had worked with the company in that position on a yearly contract, and most recently former Grand Rapids Ballet stars, husband and wife Nicholas and Laura McQueen Schultz.

Despite the rumors about the company's troubles, there's plenty to celebrate about Barker's new role. Though the 2018 season had been already programmed by former artistic director Francesco Ventriglia, Barker was able to add a Strength & Grace program of internationally acclaimed women dancemakers in honor of the 125th anniversary of women's suffrage in New Zealand and RNZB's 65th birthday.

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Cover Story
Alice Sheppard photographed by Jayme Thornton for Dance Magazine

It can be hard to focus when Alice Sheppard dances.

Her recent sold-out run of DESCENT at New York Live Arts, for instance, offered a constellation of stimulation. Onstage was a large architectural ramp with an assortment of peaks and planes. There was an intricate lighting and projection design. There was a musical score that unfolded like an epic poem. There was a live score too: the sounds of Sheppard and fellow dancer Laurel Lawson's bodies interacting with the surfaces beneath them.

And there were wheelchairs. But if you think the wheelchairs are the center of this work, you're missing something vital about what Sheppard creates.

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Health & Body
Photo by Jim Lafferty

Do you have a sprained ankle that won't heal? It's not that rare. Studies have shown that 10 to 30 percent of sprains will have symptoms later. So what is a sprained ankle anyway? It's the most common injury in all of sports and dancing.


Dancing pushes your body to its limit. If you roll over on your ankle when landing from a jump, you can sprain or injure the ligaments on the outer (lateral) side that hold the joint together. This is different from a "strain," which affects your tendons and muscles. An easy way to remember this distinction is this: You sprain your ankle, but you strain your Achilles tendon. The degree of injury varies, depending on the damage to the ligaments. We determine this by a physical exam and X-rays that help us classify the ankle sprain as Grade I (mild), II (moderate), or III (severe). The most serious sprain involves a complete tear of the ligaments with marked instability that often requires surgery. Fortunately, most sprains are Grade I or II and heal in three to six weeks. The exceptions are those that continue to cause trouble. This is the "sprained ankle that won't heal."

In medical circles, residual problems from sprained ankles cause considerable angst, because they can be hard to diagnose and difficult to treat-especially when telltale signs are ignored by stoic dancers. Problems with old sprains tend to fall into three categories: swelling, pain, and instability ("giving way").


Swelling

It's normal for a sprained ankle to swell, sometimes for four to six weeks, or longer. But swelling that persists for more than three months may be a sign of trouble. The lining of the capsule surrounding a joint is called the synovium, and anything inside the joint that irritates the synovium will cause it to secrete fluid. Swelling inside of a joint is often a sign that something is causing irritation. (The swelling that is seen from the outside is a combination of soft tissue swelling around the joint and fluid within the joint itself.) In the ankle there are several reasons for this condition. While these may seem alarming, treatment is possible. But first, let's take a look at the culprits.


Chronic synovitis Sometimes there is damage to the surface of the joint that does not show up on any tests, such as an X-ray or MRI, even though it continues to cause irritation and excess fluid.


A bone chip At the time of injury, a bone chip may have been knocked loose, leaving a "loose body" floating around inside to cause trouble.


An OCD lesion "OCD" in sports medicine stands for osteochondritis dissecans (not obsessive compulsive disorder). The easiest way to think of this is like a cavity in a tooth. It is something that leaves a small hole in the surface on the ankle bone (the talus) with a dead piece of bone in it. An MRI study will usually pick this up.


A bone bruise This is not black and blue. Instead, it feels like an achy pain that is difficult to explain and lasts for months. There is edema, or fluid, within the bones themselves that we can only see on an MRI study. Fortunately, it is rarely serious and gradually fades away.


What can you do? Treatment for chronic swelling, no matter what the cause, usually requires sleeping with the leg elevated on a pillow at night and putting on an elastic ankle support in the morning when you get out of bed. If the swelling is minimal and is slowly going away with no other symptoms, it is OK to dance, but go easy on the jumps and grand plies till all the swelling is gone. However, if it doesn't feel so good then don't do it! An ankle support (no need for metal hinges, etc.) usually feels good at this stage.


It also helps to avoid the saltshaker, which leads to water retention. With diligence, the swelling should go away. However, if the leg is swollen up the shin, something else may be happening, and it needs to be checked out by your doctor. Swelling that does not go away is a sign that something more is wrong. Normal joints do not swell.


Pain

There are several common causes of ankle pain that does not go away:


The sinus tarsi syndrome Lingering inflammation, scar tissue, or a partly torn ligament can occur in the hollow place in the side of the anklebone called the sinus tarsi (sinus in Latin means hollow or sunken and the tarsus is the ankle). This is the most common cause of the sprained ankle that won't heal. While it can be difficult to discern this problem on an X-ray or MRI, a physical exam by a dance medicine specialist can pinpoint the diagnosis by locating the exact area that hurts.


A tarsal coalition Residual pain in the sinus tarsi after the original sprain heals can also be due to an unrecognized tarsal coalition. The ankle has two components: the regular ankle joint that moves up and down, and the subtalar (ST) joint beneath it that moves in and out. Together, they make up the ankle joint complex. Some people are born with limited motion in their ST joint because the bones in this area are joined together where they ought to be separate—a coalition. It can usually be seen on an X-ray or MRI. This condition is present in about five percent of ankles. It usually occurs in one ankle only, rather than both. As with a sprain, it can be mild, moderate, or severe. In dancers, it is usually mild or it would have caused trouble before the sprain. Dancers with mild symptoms can often work around it.


The high ankle sprain This is marked by tenderness in the front of the ankle on the outside. Unlike routine ankle sprains where the main damaged ligaments lie right in the sinus tarsi, this one affects a ligament that is higher up, at the level of the ankle joint itself. This is the so-called "high" ankle sprain, which can be a real bugaboo because it takes two to three times longer to heal than a routine sprain. It may not show up on medical tests, so the diagnosis is usually made on the basis of the physical exam.


Secondary problems Lastly, there are several conditions, such as FHL tendonitis ("dancer's tendonitis") and the os trigonum syndrome that seem to pop up out of nowhere. Dancers often think that the residual pain is part of the healing process when it is actually a separate problem. Later the sprain may heal, but these conditions can continue to be painful and may even require surgery if left unaddressed.


Instability

"My ankle gives way" is probably the second most common leftover problem with ankle sprains after the sinus tarsi syndrome. We doctors see it all the time. Many things can cause this problem. Fortunately most respond to appropriate treatment.


Peroneal weakness There are two peroneal tendons that run parallel down the outside of the ankle; one is short and the other is long. Their major function is to keep the ankle from rolling over and prevent sprains. After an injury they can remain weak, so the ankle is poorly protected from further roll-overs. It's easy at this point to fall into the vicious cycle of "Because it's weak it rolls over and because it rolls over it's weak," which can go on for months. If this is the problem, it is easy to fix. Simply restore the normal peroneal strength with physical therapy. A few months of daily use of a theraband, under the guidance of a physical therapist, will usually strengthen the peroneals. (They gain strength faster if the exercises are done in the full "tendu" position.)

Laxity of the ankle ligaments Grade I sprains do not usually damage the ankle ligaments to any extent, but repeated Grade II or Grade Ill injuries can lead to permanent looseness of the ligaments that hold the anklebones together. This is a difficult situation, because they can be tightened only by surgery. The surgery is quite effective, but the recovery is usually three months or more. So it is nice to avoid it if you can.


Many loose ankles often give way because of a combination of looseness and weakness. These can often be brought up to full strength with physical therapy and then they don't give way anymore. The number one indication for ankle ligament surgery is the failure of rehab to correct the problem.


Pain, swelling and instability

The problems associated with a recurring sprained ankle can co-exist and produce all three symptoms. In this ease the diagnosis is particularly difficult. There is one last problem that might be going on:


Peroneal tendon damage With repeated sprains, the peroneal tendons can develop small longitudinal rents or tears. When this happens, the tendons swell up in the sheathes that surround them and cause achy pains, chronic swelling and weakness that cannot be corrected by exercise. This problem is easy to miss and hard to correct because it usually gets worse in spite of all treatment. Fortunately, this condition also responds well to surgery.

The best way to diagnose these various problems is to see a sports or dance medicine specialist for a history, physical exam, and appropriate studies. Your doctor may request X-rays followed by an MRI, CT and/or bone scan. Physical therapy is usually the first step in the recovery. Do not try to treat yourself! There is an old expression in medicine that says, "Someone who treats themselves has a fool for a physician." Merde!


William G. Hamilton, M.D. is the orthopedic consultant for New York City Ballet, American Ballet Theatre, The School of American Ballet and the Jacqueline Kennedy Onassis Ballet School.

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