What You Need to Know About Concussions

Thinkstock

With a competition weekend looming, studio owner Kim McDonough was rehearsing students for an up-tempo jazz piece at Dansations in Jacksonville, Florida. As one dancer crouched low to the floor, a nearby teammate kicked her leg up, connecting her foot with the side of the crouching dancer's forehead. McDonough stopped the music to assess the situation.


“It wasn't a horrible thing where she fell over or anything like that," McDonough says. “We looked for bumps or any kind of raises to put ice on, and she said, 'No, I'm fine. It's OK.'" McDonough asked the student—a senior in high school—if she felt dizzy or confused, and she said no, but McDonough asked her to sit out the rest of class, just in case. That turned out to be the right call. The next day, she had a headache and her doctor diagnosed a concussion. She missed three weeks of dance.

Whether a dancer gets a concussion in or outside the studio, she will need to take time off and re-enter class gradually. If a dancer comes back before her concussion heals, she risks life-threatening complications or endangering other dancers. If someone hits her head in your class, you'll need to know what to watch for to make sure the student gets the treatment she needs and resumes training safely.

How Concussions Happen

A concussion is a type of traumatic brain injury. It's often caused by getting hit in the head, but it can also result from whiplash or violent shaking. The force of rapid acceleration or deceleration from the blow or shake causes the brain to move suddenly inside the skull, which can cause the brain to swell and temporarily alter its chemical levels. The injury is not rampant in dance like it is in football, but it's still an issue. A 2014 study published in the Journal of Dance Medicine & Science details the cases of 11 dancers who suffered concussions during class, rehearsal or performance. They happened in all styles of dance, caused by everything from falls and drops (sometimes where another body part hit the floor first, like an elbow or the buttocks) to whipping the head and neck during choreography or getting hit with a stage prop. There is no typical dance concussion.

Reacting in the Moment

If a dancer hits her head in your studio, it may require more attention than other injuries. The British Journal of Sports Medicine created the Pocket Concussion Recognition Tool (available for free online) to help non–health professionals quickly check for concussions in children, teen and adult athletes.

There are physical signs you can look for, like being slow to get up after the hit or fall, being unsteady or uncoordinated, clutching the head, acting confused or unaware of recent events or losing consciousness. You should also ask the dancer about symptoms you can't see: nausea, drowsiness, sensitivity to noise or feeling “in a fog." Asking memory questions can be helpful, too. The Recognition Tool lists examples like “What venue are we at today?" and “Who scored last in this game?" which can easily be adapted from sports to dance, with questions like, “What exercise did you do last?" or “What piece are we rehearsing?"

If you suspect a dancer could have a concussion, she should be removed from participating in class and be evaluated by a physician.

There are also some red flags that require a trip to the ER: if the student complains of any neck pain, shows increased confusion or irritability or other behavior change, vomits repeatedly, seizes or convulses, experiences weakness or tingling/burning in arms or legs, or has a severe or increasing headache or double vision.

Dancing Through It

Even if the dancer seems fine after her hit or fall, make sure her guardian knows she's been hit in the head—even if another body part hit the ground first and appears to be more injured. Symptoms of a concussion can take a while to show. In the 2014 study, concussions were identified anywhere from a few hours to three months after the incident, which means students can dance through a concussion for weeks or months without knowing they have one.

Tell your students that they should not ignore headaches or any other symptoms of concussions after a fall or hit. They should see a doctor who can perform neurological tests and, if necessary, brain-imaging tests to assess the damage.

Risks and Recovery

Doctors prescribe mostly rest—physical and mental, with no texting, TV and limited reading—for healing a concussion. Headaches, dizziness and difficulty thinking can last a few days, weeks or sometimes even months. In the study, dancers had symptoms everywhere from several days to more than three months. One dancer, who hit her head on the floor while flipping over the back of a partner in modern class, experienced headaches and fatigue for more than two years.

Insist that your dancer listen to her doctor about how much time off she needs. Consider requiring a doctor's note before allowing her to resume classes. Returning too early can be extremely dangerous. In the worst-case scenario, if a student experiences a second concussion while the first is still healing, it can cause the brain to swell—often fatally. More typically, she'll find herself feeling head pain, and if she's still having balance or coordination troubles, she could bump into other students and cause more injuries.

A Smooth Return to Class

The study outlines stages of returning to activity from a concussion, adapted from other sports to dance. The length of each stage depends on the severity of the concussion and should be discussed with a doctor, but the trajectory generally follows a course from pure rest and recovery to light aerobic activity like gentle walking, swimming or stationary cycling; then going back to class for just a barre or warm-up; slowly resuming center work, turns and jumps; getting back into tumbling and partnering; and finally returning fully to all classes, rehearsals and performances.

Unfortunately, once a dancer has had one concussion, she's at greater risk for another one. When another of McDonough's students, who'd gotten a concussion from a car accident, insisted she was feeling better and ready to compete, McDonough let her try taking class. She could quickly tell the dancer needed more time to recover. “After one class I said, 'You're not dancing. You're done.' She was tired quickly, and her head was hurting her. It was visible to me that it was not a good idea."


Teachers Trending
Alwin Courcy, courtesy Ballet des Amériques

Carole Alexis has been enduring the life-altering after-effects of COVID-19 since April 2020. For months on end, the Ballet des Amériques director struggled with fevers, tingling, dizziness and fatigue. Strange bruising showed up on her skin, along with the return of her (long dormant) asthma, plus word loss and stuttering.

"For three days I would experience relief from the fever—then, boom—it would come back worse than before," Alexis says. "I would go into a room and not know why I was there." Despite the remission of some symptoms, the fatigue and other debilitating side effects have endured to this day. Alexis is part of a tens-of-thousands-member club nobody wants to be part of—she is a COVID-19 long-hauler.

Keep reading... Show less
Teachers Trending

Annika Abel Photography, courtesy Griffith

When the murder of George Floyd in Minneapolis last May catalyzed nationwide protests against systemic racism, the tap community resumed longstanding conversations about teaching a Black art form in the era of Black Lives Matter. As these dialogues unfolded on social media, veteran Dorrance Dance member Karida Griffith commented infrequently, finding it difficult to participate in a meaningful way.

"I had a hard time watching people have these conversations without historical context and knowledge," says Griffith, who now resides in her hometown of Portland, Oregon, after many years in New York City. "It was clear that there was so much information missing."

For example, she observed people discussing tap while demonstrating ignorance about Black culture. Or, posts that tried to impose upon tap the history or aesthetics of European dance forms.

Keep reading... Show less
Studio Owners
Courtesy Tonawanda Dance Arts

If you're considering starting a summer program this year, you're likely not alone. Summer camp and class options are a tried-and-true method for paying your overhead costs past June—and, done well, could be a vehicle for making up for lost 2020 profits.

Plus, they might take on extra appeal for your studio families this year. Those struggling financially due to the pandemic will be in search of an affordable local programming option rather than an expensive, out-of-town intensive. And with summer travel still likely in question this spring as July and August plans are being made, your studio's local summer training option remains a safe bet.

The keys to profitable summer programming? Figuring out what type of structure will appeal most to your studio clientele, keeping start-up costs low—and, ideally, converting new summer students into new year-round students.


Find a formula that works for your studio

For Melanie Boniszewski, owner of Tonawanda Dance Arts in upstate New York, the answer to profitable summer programming lies in drop-in classes.

"We're in a cold-weather climate, so summer is actually really hard to attract people—everyone wants to be outside, and no one wants to commit to a full season," she says.

Tonawanda Dance Arts offers a children's program in which every class is à la carte: 30-minute, $15 drop-in classes are offered approximately two times a week in the evenings, over six weeks, for different age groups. And two years ago, she created her Stay Strong All Summer Long program for older students, which offers 12 classes throughout the summer and a four-day summer camp. Students don't know what type of class they're attending until they show up. "If you say you're going to do a hip-hop class, you could get 30 kids, but if you do ballet, it could be only 10," she says. "We tell them to bring all of their shoes and be ready for anything."

Start-up costs are minimal—just payroll and advertising (which she starts in April). For older age groups, Boniszewski focuses on bringing in her studio clientele, rather than marketing externally. In the 1- to 6-year-old age group, though, around 50 percent of summer students tend to be new ones—98 percent of whom she's been able to convert to year-round classes.

A group of elementary school aged- girls stands in around a dance studio. A teacher, a young black man, stands in front of the studio, talking to them

An East County Performing Arts Center summer class from several years ago. Photo courtesy ECPAC

East County Performing Arts Center owner Nina Koch knows that themed, weeklong camps are the way to go for younger dancers, as her Brentwood, California students are on a modified year-round academic school calendar, and parents are usually looking for short-term daycare solutions to fill their abbreviated summer break.

Koch keeps her weekly camps light on dance: "When we do our advertising for Frozen Friends camp, for example, it's: 'Come dance, tumble, play games, craft and have fun!'"

Though Koch treats her campers as studio-year enrollment leads, she acknowledges that these weeklong camps naturally function as a way for families who aren't ready for a long-term commitment to still participate in dance. "Those who aren't enrolled for the full season will be put into a sales nurture campaign," she says. "We do see a lot of campers come to subsequent camps, including our one-day camps that we hold once a month throughout our regular season."

Serve your serious dancers

One dilemma studio owners may face: what to do about your most serious dancers, who may be juggling outside intensives with any summer programming that you offer.

Consider making their participation flexible. For Boniszweski's summer program, competitive dancers must take six of the 12 classes offered over a six-week period, as well as the four-day summer camp, which takes place in mid-August. "This past summer, because of COVID, they paid for six but were able to take all 12 if they wanted," she says. "Lots of people took advantage of that."

For Koch, it didn't make sense to require her intensive dancers to participate in summer programming, partly because she earned more revenue catering to younger students and partly because her older students often made outside summer-training plans. "That's how you build a well-rounded dancer—you want them to go off and get experience from teachers you might not be able to bring in," she says.

Another option: Offering private lessons. Your more serious dancers can take advantage of flexible one-on-one training, and you can charge higher fees for individualized instruction. Consider including a financial incentive to get this kind of programming up and running. "Five years ago, we saw that some kids were asking for private lessons, so we created packages: If you bought five lessons, you'd get one for free—to get people in the door," says Boniszewksi. "After two years, once that program took off, we got rid of the discount. People will sign up for as many as 12 private lessons."

A large group of students stretch in a convention-style space with large windows. They follow a teacher at the front of the room in leaning over their right leg for a hamstring stretch

Koch's summer convention experience several years ago. Photo courtesy East County Performing Arts Center

Bring the (big) opportunities to your students

If you do decide to target older, more serious dancers for your summer programming, you may need to inject some dance glamour to compete with fancier outside intensives.

Bring dancers opportunities they wouldn't have as often during the school year. For Boniszewski, that means offering virtual master classes with big-name teachers, like Misha Gabriel and Briar Nolet. For Koch, it's bringing the full convention experience to her students—and opening it up to the community at large. In past years, she's rented her local community center for a weekend-long in-house convention and brought in professional ballet, jazz, musical theater and contemporary guest teachers.

In 2019, the convention was "nicely profitable" while still an affordable $180 per student, and attracted 120 dancers, a mix of her dancers and dancers from other studios. "It was less expensive than going to a big national convention, because parents didn't have to worry about lodging or travel," Koch says. "We wanted it to be financially attainable for families to experience something like this in our sleepy little town."

Get Dance Business Weekly in your inbox

Sign Up Used in accordance with our Privacy Policy.