Getting Back from Serious Injuries

As both a dance teacher and a movement analyst, I have guided many dancers through injury and rehabilitation. Still, I was hardly prepared when my first significant injury changed my role from therapist to patient. What started as a sharp pain in my shoulder grew into a condition that eventually needed surgery. Although I knew immediately that something significant had happened, I hesitated to see a doctor—and that was only my first mistake! Dealing with a serious injury was an eye-opening experience, and I hope I can pass on the lessons I have learned to other dancers and teachers.

Always listen to your body. As dancers, we often minimize our bodies’ discomfort, perhaps because we think a certain amount of pain is inevitable, or because we know that another dancer who would love to go on for us is waiting in the wings. Whatever the reason, I decided that even though I knew something in my shoulder joint was injured, it wasn’t severe enough to visit a doctor. At first, my shoulder only bothered me if I moved my arm suddenly. Then it began to hurt when I raised my arm in high fifth, so I compensated by opening my injured shoulder to the side a bit. Finally, when my range of motion became more seriously impaired, I hunkered down and went to a professional. By this time, nearly a month had passed since I first felt pain.

I went to my favorite sports medicine physician, Vernon Patterson, a doctor of osteopathy. Part of the team that takes care of the Cleveland Indians, Dr. Patterson also cares for soccer players, ice skaters and dancers. He told me that I had irritated the bursa, the small fluid-filled sac that helps muscles and tendons glide over bones. When the bursa becomes inflamed, a condition known as bursitis, the swelling decreases motion in the joint.
 He added that I might have torn some cartilage, but that we couldn’t know for sure unless I got an MRI. He recommended looking at the shoulder with an X-ray, getting the inflammation down and seeing where we needed to go from there, keeping in mind that I might need to do some physical therapy. It turns out that by trying to work through my pain I had further irritated the joint.

Decreasing the inflammation using ice, anti-inflammatory drugs and cortisone shots helped, as did physical therapy, but the range of motion didn’t return. If anything, it felt worse, even though my pain wasn’t increasing. The MRI showed a slap tear, a possible bicep tendon tear, some fraying of tendons and inflammation, but nothing that fully explained why I still had problems. Three months later, with no real improvement, Dr. Patterson decided that it was time for me to see a surgeon who specializes in shoulders. He sent me to Dr. Mark Schickendantz, who also works with the Cleveland Indians. Dr. Schickendantz looked over the MRI report, compared the motion of my two arms and explained the pros and cons of arthroscopic surgery, a common method of assessing and treating joint injuries. Reassured, I scheduled the procedure for the end of the semester.  

During the weeks prior to surgery, I had to scale back classroom demonstrating. My upper back and neck muscles were screaming as I tried to work around the injury, and I decided that I would be better off just giving my arm a break. My ability to give verbal directions and use imagery improved as I demonstrated less, and my students began to show individual movement, rather than trying to copy me exactly. This is a lesson I will take with me as I continue teaching.

My surgery went well. The big surprise was finding out that I had adhesive capsulitis, a condition in which fascia or scar tissue binds the joint together, limiting its range and causing movement to be painful. Adhesive capsulitis is more likely in women than men, and in my case, it resulted from traumatic injury. My body responded to the initial injury by creating these adhesions that had to be surgically peeled away from the joint, a procedure we didn’t realize would be necessary until I was already in surgery.

I began physical therapy two weeks after surgery, and requested to work with someone skilled in biomechanics. I was referred to Jim Mehalik, a physical therapist for the Cleveland Indians. He took detailed measurements before beginning to manipulate my shoulder, and even though there was discomfort in the first few weeks of physical therapy, I really appreciated being in someone else’s able hands. Mehalik worked to increase my range of motion and break up adhesions that had returned, and he helped me to understand the reasoning behind each exercise. After several months, I was ready to strengthen the area, using Pilates and Theraband exercises. This point in rehabilitation was tricky: There’s a fine line between strengthening and overworking, and it’s normal to take five steps forward and two steps back.  

I found myself getting discouraged when I didn’t seem to be making progress or my shoulder started to ache. It was so easy to think that I was back to square one, that this was going to take forever and I was a failure at rehab! Mehalik was always quick to remind me that time is needed for the tissues to heal and respond, whether the injured person is a dancer, a professional baseball player or even an executive who is a couch potato. I decided to keep a notebook of observations, comments and questions as a way of doing my own reality checks.  

Mehalik cautioned me, “You’re doing great, but it may be six months to a year before your arm feels right.” I nodded that I understood and vowed to take one day at a time, to not let my fears get the upper hand. I reminded myself to appreciate how well my body can move and how it responds to my demands.  

If I could go back in time, I would have focused more on developing my upper body. Far too often, dancers are deficient in their ability to stabilize their shoulder joints against injury. Developing shoulder strength and flexibility can be overlooked in traditional dance classes. It’s important for dancers to supplement their regimen with free weight work or some form of Pilates or yoga to gain strength.

If your students get injured, tell them to breathe deeply, trust their bodies and be patient—and remember that the same advice applies to you. Seek out competent guidance and be prepared to stick it out during a long recovery. You can become a stronger and more beautifully balanced dancer or a more insightful, knowledgeable teacher because of the rehabilitation process, not in spite of it. DT

Deborah Vogel has a private practice in Oberlin, OH, and teaches at Oberlin College. You can sign up for a free weekly newsletter on injury prevention at www.thebodyseries.com.