I'd been a professional dancer for five years when I realized the pain I'd been feeling in my hip and down my sciatic nerve was not going away. I had been treating it for two years as we dancers do—with regular visits to my masseuse, physical therapy, baths, ice and lots of Aleve—but I never stopped dancing. It finally dawned on me that if I kept going at the speed I was going (which was, well, speedy), the pain would only get more severe and unrelenting, and I might never dance again.
I told myself I'd take two months off, and all would be better.
That first morning when I woke up at 10 am, I had no idea what to do with myself. My life until that moment had been dictated by class and rehearsal, every hour accounted for. How should I fill the huge swath of time ahead of me?
In my last years dancing, the tears came constantly. And I felt a deep shame and embarrassment every time it happened in the studio, which only exacerbated the situation. I felt my tears were giving me away—a manifestation of my weakness on display for all to see.
The truth is that science has proven that there are benefits to a good cry and that your tears serve a purpose in your overall wellbeing.
It's become second nature in dance studios: The instant anyone gets hurt, our immediate reaction is to run to the freezer to grab some ice (or, more realistically, a package of frozen peas).
But as routine as icing our injuries might be, the benefits are not actually backed up by scientific studies. And some experts now believe icing could even disrupt the healing process.
I feel like a failure because I canceled a big competition after getting injured. I'd hoped that ending up in the finals might get me a position in a company. Now what?
—Devon, Washington, DC
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Since its founding in 1999, more than 80,000 ballet dancers have participated in Youth America Grand Prix events. While more than 450 alumni are currently dancing in companies across the world, the vast majority—tens of thousands—never turn that professional corner. And these are just the statistics from one competition.
"You may have the best teacher in the world and the best work ethic and be so committed, and still not make it," says YAGP founder Larissa Saveliev. "I have seen so many extremely talented dancers end up not having enough motivation and mental strength, not having the right body type, not getting into the right company at the right time or getting injured at the wrong moment. You need so many factors, and some of these are out of your hands."
Dance Theatre of Harlem dancers Christopher McDaniel and Crystal Serrano were working on Nacho Duato's Coming Together in rehearsal when McDaniel's foot hit a slippery spot on the marley. As they attempted a swinging lift, both dancers went tumbling, injuring Serrano as they fell. She ended up being out for a week with a badly bruised knee.
"I immediately felt, This is my fault," says McDaniel. "I broke my friend."
How could I get a bone bruise from wearing a boot for a stress fracture in my fifth metatarsal? It's taking forever to go away, and I can't dance full-out. Help!
—Anonymous, New York, NY
I always knew my ballet career would eventually end. It was implied from the very start that at some point I would be too old and decrepit to take morning ballet class, followed by six hours of intense rehearsals.
What I never imagined was that I would experience a time when I couldn't walk at all.
In rehearsal for Nutcracker in 2013, I slipped while pushing off for a fouetté sauté, instantly rupturing the ACL in my right knee. In that moment my dance life flashed before my eyes.
When dancers get injured, they often think they should eat less. The thought process goes something like, Since I'm not able to move as much as I usually do, I'm not burning enough calories to justify the portions I'm used to.
But the truth is, scaling back your meals could actually be detrimental to your healing process.
Injuries occur in dance frequently. Numerous studies show that at any given time, 40 to 95 percent of the dancers in a given studio or company are injured. This is not news to anyone. But how many times have you been told your injury is because of "overuse"? Doctors use this term often when dancers have pain that comes without any specific injury.
I think It's time to re-evaluate this word, especially in the dance world. Calling injuries "overuse" may actually be harmful.
To help you avoid this disappointment, we tapped Daniel Cuttica, D.O., an orthopedic foot and ankle surgeon with The Centers for Advanced Orthopaedics and consultant to The Washington Ballet, for expert advice on how to keep your body healthy, safe and injury-free this summer.
The first time I got injured, it felt like my life was put on hold. I'd fractured my fifth metatarsal, and was only out for six weeks, but it felt like six years. While everyone else was dancing, improving and performing, I was hobbling around in an ugly boot, with nothing to do but attempt to salvage my core strength via a terrible Pilates DVD. I felt completely lost.
But I shouldn't have: There are plenty of ways injured dancers can get back on their feet—and return even stronger than when they left. Take charge of your healing process with these 10 steps to speed up recovery and actually use the time off to your advantage.
#brokebutnotbroken Wendy Whelan and Marcelo Gomes
1. First things first: If a doctor tells you that you'll have to quit dancing for good, get a second opinion. Take it from a dancer/med student whose diagnosis only got worse after hip surgery.
2. Learn the ins-and-outs of worker's comp so you can still receive part of your paycheck.
Photo by Nathan Sayers
3. Few experiences are more stressful than injury. But finding a way to calm your mind and body could actually help you heal faster.
4. Pay attention to what you're eating. Getting the right nutrients is essential for recovery.
5. Check out The Dancer's Resource, an injury support group launched by Bebe Neuwirth for dancers who can't dance. You'll find group and individual counseling, referrals to dance medicine specialists, information on disability insurance and even emergency financial assistance.
6. Knowledge is power: Educate yourself about the most common dance injuries, and how you can avoid and overcome them.
Photo by Nathan Sayers
7. Once you get a green light from your doctor, physical therapy will not only strengthen your muscles to prevent relapse and prepare your body to dance again, but also give you a physical outlet. Find an expert familiar with dancers. Also, search for a cross-training regimen that you enjoy to protect yourself from overuse injuries and correct imbalances.
8. Know that you're not alone. Whatever you're feeling, it's normal. Paul Taylor dancer Parisa Khobdeh admits that being sidelined for months left her so defeated she almost didn't want to dance anymore. Wendy Whelan says the loneliness was one of the hardest parts of injury, but sharing her healing process on social media helped her feel less disconnected from her dance life.
9. When you first return to the studio, self-doubt can be paralyzing. Are you pushing too hard? Playing it too safe? It can take awhile to overcome the fear of re-injury, but taking it slow and focusing on your progression can help you overcome the mental hurdles.
10. Reframe injury as an opportunity. Stephen Petronio argues that it's a chance to get to know your body better, and become a smarter, more nuanced artist. Through the process of researching what's wrong and repairing what needs to be fixed, dancers often break through what they previously considered their bodies' limits. Embrace the time to hit the refresh button.
If you're sitting out of rehearsal today, chances are you're not alone: Dancers are among the most frequently injured of all athletes. The long hours of training, along with repetitive and wide-ranging movements, put dancers at an exceptional risk. But knowing you're not the only one on the sidelines doesn't make it any easier. “Dancers identify so strongly with their bodies. If something is inhibiting their ability to execute a tendu pain-free, that can create a lot of stress," says Suzanne Semanson, DPT, a physical therapist at Harkness Center for Dance Injuries at New York University's Langone Medical Center.
Yet many dancers don't realize that stress and injuries can sometimes raise a question of chicken-or-the-egg. Stress has both psychological and physical components, and the two are not easily separated. While stress usually results from injury, it can sometimes be part of the cause—and the reason why it takes so long to heal. Nadine Kaslow, PhD, past president of the American Psychological Association and psychologist for the Atlanta Ballet, advises: “If you find that your body is just not serving you well—it's shin splints this month, you hurt your shoulder next month—you need to stop and look at what might be going on for you emotionally."
The Body on Stress
How can an emotional state affect your body? When we feel stressed, our nervous system goes on high alert, and our brain signals the release of a hormone called cortisol. This ancient physical response can be helpful when we need to, say, quickly outrun a saber-toothed animal. But cortisol can cause problems if ongoing stress means our bodies are exposed to too much of it. “Cortisol needs to come in waves," says Brad R. Moser, MD, founder and director of the Minnesota Dance Medicine Foundation. “When it is released for too long at a very high rate, it can cause injury to cells and tissues."
Cortisol decreases bone formation, an essential part of the healing process when bone is injured, bruised or broken. And it triggers an anti-inflammatory response, which affects the immune system, making it harder to fight illness. “It can also lead to depression and fatigue, which eventually lead to more frequent injury," says Moser.
Physical symptoms of excessive stress can include dizziness and loss of balance, putting dancers in danger. Additionally, we tend not to sleep or eat well when distressed, compromising our strength.
In a catch-22, injury itself is one of the leading causes of stress among dancers. For a study published in the Journal of Dance Medicine and Science in 2013, researchers in the Netherlands surveyed more than 150 injured dancers. The subjects answered questions about a variety of psychological symptoms, including trouble concentrating, paranoia, anxiety and feelings of inferiority, as well as physical symptoms like dizziness or loss of balance. About 60 percent of the respondents had psychological symptoms far enough out of the norm that they warranted referral to a psychologist or psychiatrist for treatment.
Dance culture isn't helping. “Dancers often don't pay attention to the signals that their body is hurting," says Kaslow. “They've learned that they have to keep going." The injured dancer, she says, is afraid to be viewed as weak. “When a dancer has to take time off because of a bad injury or they need surgery, they feel like they have lost everything," she says. Often, injured dancers are forced to give up roles or take a hiatus from the company, compromising their personal identity, and compounding the stress further.
So what can a dancer do? The key is to lower your stress baseline before you get injured. Stress builds on itself: With each new stressor, “that baseline just goes up and up," says Kaslow. If you can lower your stress level a bit each day, new problems that arise—like a sprained ankle—won't take as big of a toll.
Start by taking your breaks. During heavy rehearsal periods, dancers will often chat with each other or keep dancing during their lunch or 15-minute rest periods. “Your body actually needs a break," says Kaslow. “Learn how to do some relaxation training. Go into a quiet space in the studio, and focus inward." Use the time to squeeze in a few minutes of meditation or mindfulness while letting your muscles recharge.
Also learn to wind down at the end of the day. “It's usually hard to go to sleep after a show," says Semanson. “The nervous system needs a chance to transition from that heightened state of performance to calming down. The muscles need to relax so that when you go to bed, your nervous system levels out." Semanson teaches her patients cool-down exercises that combine deep breathing with gentle body movements (see sidebar below). This combination cues tense muscles to relax and dials down the nervous system.
Kaslow also recommends researching meditation books and tapes. “Find something that fits the way you think about the world: You are more likely to use it."
But if the stress feels like too much to handle on your own, don't be afraid to seek out a psychologist. Make sure you're getting the best medical attention possible from an expert who understands the demands of dance. Just the way you take care of injured limbs, take care of your emotions, too.
Write It Out
In 2013, researchers in New Zealand found that expressive writing for 20 minutes three days in a row sped healing in healthy adults who underwent biopsies. Study authors believe writing about our thoughts and feelings can help reduce stress.
Exercises to De-Stress
Each of these sequences, recommended by physical therapist Suzanne Semanson, starts by lying on your back with your knees bent and feet flat on the floor.
Full Complete Breath
Place one hand on your lower abdomen, the other on your chest, and close your eyes. Take a full breath. With the inhale, expand your abdomen and chest. Notice how your body responds. What moves first? What is not moving? As you exhale, notice how your chest and abdomen soften back toward the floor. Repeat for 10 slow breaths.
Rest your hands in a triangle on your abdomen, the heel of your hands on your hip bones, and your fingertips pointing toward your pubic bone. Inhale and gently move into an anterior pelvic rock where the triangle is pointing down. Exhale and tuck your pelvis under so that the triangle points up as your back flattens against the floor. Repeat 10 times.
Place your arms at your sides, palms down. On an exhale, press through your heels to lift your hips up. Hinge through your hips so you're not tucking or rolling your spine. Pause at the top for an inhalation. Exhale and lower your hips back to the ground. Repeat 10 times.