The Road Back: Injury Recovery

July 29, 2007

I was a second-year corps member when I hurt my knee. One minute I was rehearsing William Forsythe’s
In the Middle, Somewhat Elevated
, and the next I was sitting in San Francisco Ballet’s third-floor P.T. office with my knee under a bag of ice, wondering what happened.

“You’re going to be out for at least a year,” the doctor would tell me the next day. I had shredded my anterior cruciate ligament—one of the knee joint’s primary stabilizers—and would be off for a full 16 months, as it turned out. It was the first time I’d spent more than a week away from ballet since fifth-grade summer camp, and the first time I’d ever dealt with a serious knee problem. The process of recovery was long and frustrating, but also turned out to be quite an education. As many dancers discover, what you learn on the way back can be as important to your health—mental as well as physical—as any amount of physical therapy.

I was lucky in that my accident—an off-center, hyperextended relevé that seemed to pop my knee out of joint—did clear, unambiguous damage to my ligament. There was no question as to what had happened, no real chance of misdiagnosis. At one meeting with my surgeon, a plastic knee joint mounted on a faux wood stand was placed in front of me so I could see exactly where the injury had occurred.

After four-hour reconstructive surgery and a week in the hospital, rehabilitation became my modus operandi. The physical routine, at least in the beginning, took my mind off my sidetracked career, and in that sense was comforting in an I’m-not-sitting-on-my-couch-while-everyone-else-is-rehearsing sort of way. It gave me something technical to focus on, except that instead of turning out my hips I was weight-loading my quads, trying to get the muscles around my knee strong enough to support the reconstructed ligament. I also came to discover, as do many dancers in this type of situation, that not all exercises are created equal. Pliés are not like parallel squats. Joan Boada, the San Francisco Ballet principal who underwent three knee operations similar to mine, told me jokingly that he had to work a little harder in physical therapy than he normally did in ballet class. “Because you know,” he said wryly, “there is no way to cheat.”

Indeed, the unfamiliar regimen of P.T. can often throw you for a loop. Dr. Phillip Bauman, an orthopedic surgeon who consults for both New York City Ballet and American Ballet Theatre, notes that dancers often tend to be either too casual or too ambitious with their exercises. “I’ve seen dancers who are otherwise very disciplined be very cavalier about their rehab,” he says. “And then there are those who feel that ‘If the doctor or physical therapist tells me to do an exercise 10 times, I’m going to do it 30 times.’ And very often, that will also get you into trouble.”

I was diligent with my exercises. But by the time the hip-to-ankle plastic stability brace that I’d worn since my operation (and hadn’t been allowed to remove, even to shower) was switched to a mid-thigh-to-mid-calf model, my knee felt like a foreign object. It had an odd swelling and restricted range of movement. These were apparently typical symptoms. I started floor barre and Pilates and was allowed to remove the brace for limited periods of time, but every minute became a constant, neurotic assessment of the sensations in my leg: Is it good pain or bad? How much is too much? Where is the line between making improvement and setting myself back? The process was trial by fire.

Simon Ball, a principal with Houston Ballet, says of his experience dealing with an ankle he’d broken sliding across a studio in a rehearsal, “I got a little overzealous sometimes. But really, the injury dictates how long you need to stay off—you can’t push it faster than it’s going to go.” Indeed. Once I was allowed to attempt a very simple ballet barre, this fact would rise up and smack me in the face with every plié.

On the recommendations of colleagues and fellow patients, I began experimenting with a range of supplemental treatments: the anti-inflammatory miracles of acupuncture, the three-dimensional expansiveness of Gyrotonics, the scar-tissue-busting power of massage therapy.

About a year through my rehabilitation, SFB’s Workers’ Compensation provider sent me to see a state disability doctor. He examined my knee for 10 minutes and declared, “You might never be able to dance again.” This particular physician had no previous experience with dancers and no understanding of ballet, and I wisely chose to ignore his prediction. Regaining strength and balance had been an issue at that point, but never returning to dance? I hadn’t allowed myself to consider it.

But the shadow of doubt had been cast, and I became troubled by the feeling that maybe a full recovery wasn’t actually possible. Even after I’d worked my way back into class—and jumping and turning—that feeling didn’t immediately go away. Was I really the same dancer I’d been before? Was I better somehow? Or was I worse?

Having a lot of time off gives you time to think. Some of the most educational aspects of being injured involve things you learn that have nothing to do with anatomy. My good friend Steve Coutereel, a first soloist with Les Grands Ballets Canadiens who spent two years nursing a torn patella tendon, began examining his chronic impulse to push himself beyond his limits when his body clearly needed to rest. “Am I that addicted to applause?” he asked himself. “Am I that unconcerned about the physical state I’ll be in when I stop performing?”

Joan Boada says that time spent recovering from his knee operations helped him recognize the price he was paying for a less-than-focused attitude toward his ballet technique. “Dancing was so easy for me,” he says now. “I had so many opportunities to get injured because I wasn’t paying attention.”

New York City Ballet corps member Kristin Sloan spent a staggering three-and-a-half years off dealing with labral tears in both hips. She says she had a realization that came out of her frustrations with the treatment she received. “You have to fight for yourself,” she says. “You’re your biggest supporter. If you keep going in and you’re not feeling any better, at some point you have to say to yourself, ‘What do I need to do to change this?’ ”

Initially, my big epiphany was that I never wanted to do Pilates again. Ever. But after a while, I also realized that the months I’d spent recovering had made me a lot smarter about dealing with my body in general, and perhaps a little more resilient as well. I’d made a physical and mental leap from “just-do-it” newbie to educated professional. I would never fully recover the range of motion in my knee, but I danced for another 10 years, more engaged and informed as a dancer than I’d ever been before. For although I’d lost, I’d found, to my deep gratitude, that I had also gained.

Kim Okamura, a Los Angeles writer, danced with San Francisco Ballet.