When Nicholas Leschke, a Houston Ballet first soloist, experienced pain in his left knee while rehearsing at the end of the season, he thought the summer break would take care of it. “If I just made it through the season, I could use the summer to rest and all would be fine,” Leschke remembers thinking.
When he returned after the break, the pain came back with a vengeance. “I get aches and pains on a daily basis,” says Leschke. “But this felt very different.” He finally bit the bullet and saw a doctor. After an MRI showed some cartilage damage, he had surgery to remove bone fragments, and was out for eight months. These days he pays close attention to his body’s sometimes blaring messages.
Many dancers react with denial to pain, often dismissing it as part of the professional territory. How can you tell the difference between a garden-variety ache, and a serious injury? Kevin Varner, MD, an orthopedic surgeon at Methodist Hospital’s Center for Performing Arts Medicine in Houston identifies five tell-tale signs.
The Pain Doesn’t Go Away
“Aches come and go; injuries linger,” says Varner. Treated with ice, anti-inflammatories, and some rest, most aches will resolve in 24 hours. “A continued ache in the same location,” he says, “can indicate tissue damage,” such as a tear or fracture.
It’s not just the duration of discomfort but the kind of pain that can determine the seriousness of an injury. A sensation of creaking, squeaking, scraping, and grinding in the joint can add up to trouble. A sudden pain can feel different from a creaking sensation, but both are out of the normal range of discomfort. “If, for instance, the pain feels sharp and stabbing, you need to be attentive to that,” says Varner.
Is It Sensitive to Touch?
An injury may also be extremely tender upon palpation, while aches just feel sore. If the area is uncomfortable to touch, you should have a doctor take a look.
Are You Walking Funny?
Often compensation patterns develop as a result of an injury. Changes in technique, even walking, can indicate it’s time to ponder what you are trying to avoid.
What Color Is It?
Swelling, sometimes accompanied by redness, bruising, and a sensation of heat, is another obvious sign. “Keep in mind that with some injuries, like stress fractures in the foot and hip, swelling may not be present,” Varner adds. “Still, the pain will linger. Hip injuries are particularly tricky.”
Pacific Northwest Ballet corps member Josh Spell knows firsthand the difficulties in dealing with a hip injury and the trials of compensation patterns. When he first experienced a pain in his right hip during Swan Lake rehearsals, he knew it was outside what was normal for him. He had trouble standing comfortably in fifth position, sitting cross-legged, and sleeping. Yet he ignored it.
“If something is causing a dancer to walk differently, it’s probably causing a larger problem in their dancing,” says Boyd Bender, PNB’s resident physical therapist. “Obviously, they have to make the decision to go to a doctor. It’s clear to me that if you are compensating, you are putting yourself at risk for further injury.”
Some two years later, Spell finally got an MRI, which revealed a torn labrum (hip tendon). Eventually, he had surgery and, like Leschke, spent eight months recovering. “I was so focused on dancing and doing well,” remembers Spell. “I thought it was mind over matter and I just kept going.”
But keeping going may prolong and complicate the situation. According to Varner, the longer pain persists, the more your body is signaling a problem. “If an ache is not resolved in three days, it’s time to call the doctor,” he says. Once you have a diagnosis and treatment plan, it’s the quickest path back to the stage. Keep an open line of communication with your doctor and physical therapist. Ask questions, request further information, and look at all your options. “You have to know when to push for an MRI and to take advantage of the PT at your company,” urges Spell.
While Varner says watching for warning signs may be useful, nothing compares to a dancer’s own internal monitor. Both Spell and Leschke feel they have come out of the ache vs. injury experience stronger and wiser. Today, both have ramped up their maintenance routines and take action sooner when something seems amiss. “It was a relief to know what was going on in my knee,” remembers Leschke. “I can sulk about it or deal with it, fix it, and move forward.”
The bottom line is that waiting and wishing the problem away can only make it worse. “If things don’t seem right, they probably aren’t,” says Varner. “Dancers have excellent insights into what their bodies are doing.”
Nancy Wozny writes about the arts and health from Houston, TX.