Dancer Health

How to Spot—and Train—Dancers With Scoliosis

At age 12, doctors advised Paige Fraser to stop dancing and have surgery. Instead, she chose physical therapy and team of chiropractors and massage specialists to help work through her condition. She has just begun her 5th season with Visceral Dance, based in Chicago.

Scoliosis is a condition in which the spine, when viewed from the back, has one or more curves. The vertebrae are abnormally rotated, which creates twisting and more prominent visibility of the rib cage on one side, and it is most commonly seen in adolescents ages 10 and older. Most cases cannot be reversed, but they can be controlled, for example dancer Paige Fraser who despite suffering from severe scoliosis, has thrived as a dancer. Dance teachers can play an essential role in spotting the condition at an early stage.

“Teachers can help to notice that scoliosis is there in the first place," says Sophia Fatouros, a New York City–based dance teacher and and former professional ballet dancer who has struggled with scoliosis since she was 12. “Parents do not always see their children in tight clothes, like leotards."


So what should you keep an eye out for during class? In addition to a curved spine, other warning signs are: head not centered directly above the pelvis; uneven shoulders; one raised hip; rib cage sides at different heights; uneven waist; changes in color or texture of skin overlying the spine (like dimples or hairy patches); entire body leans to one side; fatigue; difficulty breathing.

Sophia Fatouros shows the extra effort it takes to keep her curved spine aligned.

Once you notice that a dancer may have scoliosis, the next step is to alert the student and her parents. But, “encourage the student to continue with her dance career," recommends Fatouros, who is the former director of dance at The Harlem School of the Arts. “Let her know it's not over." Wendy Whelan, Deanna McBrearty, Alexandra Ansanelli and Katie Bergstrom, for instance, all had successful careers with New York City Ballet after being diagnosed with scoliosis in varying degrees.

Every case is unique, says Rebecca Dietzel, an anatomist who works with The Ailey School. “Dancers need to find a physical therapist to pinpoint where the curves are happening and to get personalized exercises." And while scoliosis is not usually painful, if a dancer does develop pain, it is important to see a doctor. “She should be encouraged to see her health care provider and bring back recommendations for movement modifications to the teacher," says Karen Clippinger, a dance professor at California State University at Long Beach and author of Dance Anatomy and Kinesiology, who was diagnosed with mild scoliosis as a teen.



Video created by Short Stack Creative


If a dancer has a curve of 10 to 15 degrees, her doctor may suggest exercises that will strengthen the muscles around her spine (see below for a spine-strengthening exercise). Fatouros recommends trying Hanna Somatics, a system of neuromuscular mind-body training that helps improve spinal strength and symmetry. While there is still debate about the effectiveness of back braces, some doctors suggest that patients with a curve between 20 and 40 degrees wear one, and they can be removed during class. If a curve is greater than 40 degrees, the dancer may need surgical treatment.

When a dancer undergoes surgery for scoliosis, parts of the spine are fused together or may be held in place by a rod, which immobilizes those joints. “She can no longer move that part of the spine," Dietzel says. “Movement will come from above or below those joints, and the movement will look different. Teachers should not compare the student to how she moved before surgery or to other dancers in class." After surgery, Clippinger advises, teachers should promote the use of abs to support the spine. “Because the fused segment moves as a unit, the vertebrae adjacent tend to bear extra stress," she says. “Students should use the abdominals to support and distribute the arch of the spine throughout the area that is moveable."

But don't fret: There's no need to overhaul or create special combinations for students with scoliosis. Most can do all movements, unless advised otherwise by their doctor. Simply using certain imagery in class instruction can help these students work on maintaining a straight posture. “Use images that are strong and balanced," Fatouros advises, “like a fountain that comes straight through the body and goes out in all directions."

Another helpful technique is to think about pulling up with the front of the body and down with the back of the body. “You can use a physical or verbal cue to help a student bring the shoulder forward or hip bone back so that it is even with the other side," Clippinger says. “Encouraging the student to feel the weight evenly placed on the feet and to keep the hips and shoulders square with the rib cage directly above the pelvis can help the dancer develop a sense of how much symmetry their body will allow." Clippinger adds that students with scoliosis should alternate the use of their right and left sides during class exercises and barre work for better balance.

But the most important thing a teacher can do for a student with this condition is to encourage them in every way. “Be sensitive to students with scoliosis," Fatouros says. “Understand that they may not always look like the other students. Check in on a regular basis to make sure she is doing her exercises, and keep her moving and motivated." Fatouros recalls one particular success story: “I once had a student who would do an exercise, and then she would slump on the barre. It wasn't helping her scoliosis." Once she fully dedicated herself, it affected her posture positively. “By junior year, her doctor said the degrees of curvature had lessened," she says. “I saw evidence of a dancer holding herself well, and it helped."

Straighten Up Scoliosis!

Dance professor Karen Clippinger breaks down a simple spine-strengthening exercise from her book Dance Anatomy and Kinesiology for dancers with a 15-degree or less spinal curve. (Dancers with curvatures going in the opposite direction will need to adjust accordingly, and those with greater degree curves should seek medical recommendation first.)

Curl-Up with a Twist:

1. Begin by lying on your back with knees bent and feet flat on the floor. Curl the torso up vertebra by vertebra until the shoulder blades are off the floor. Then, use hands to curl the torso slightly higher off the ground, emphasizing rounding the spine and pulling the abdominal wall inward toward the spine.

In this position check for symmetry, and if needed, shift your upper rib cage (generally to the left) so that its center is aligned as close as possible with the center of your pelvis. Let go with the hands and hold this position for four counts before lowering to starting position.

2. As strength develops, when letting go with the hands bring the left arm overhead and think of reaching out with the fingertips and lengthening the spine as if curving around a large exercise ball. Hold for four counts before bringing the left arm forward and lowering to the starting position. Perform six repetitions with the left arm going overhead and then four repetitions with the right arm going overhead.

3. As skill improves, rotate the upper torso to the left when the left arm is overhead. Be sure to isolate the rotation to the upper torso and think of keeping the right hip bone back so that the pelvis and lower back are not allowed to rotate. Reverse the pattern when the right arm is overhead.

The Conversation
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Here, Clough shares her best advice for new studio owners, and the answers to some common questions that come up when you're getting started.

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Facebook. Twitter. Instagram. Snapchat. The list goes on—and you have to decide not only what type of presence you'll have on each platform, but also whether you and your faculty will network with students and family members. How can you set boundaries for yourself and your faculty on social media?

The easiest option may be to prohibit these interactions entirely. At the Harid Conservatory in Boca Raton, Florida, staff and faculty may not "friend" or otherwise connect with current students or those under the age of 18 on social media, explains Gordon Wright, Harid's executive vice president and director.

At the Dance Zone in Henderson, Nevada, the handbook states that social media should be handled "in a professional manner." Owner Jami Artiga encourages students and faculty to share photos and tag the studio, but prefers not to "friend" kids from her personal account. "Of course, my son dances at the studio, and we have teachers with kids who go here, so sometimes the line gets blurry," she says.

Robin Dawn Ryan of the Robin Dawn Academy in Cape Coral, FL, also has a few students on her Facebook friend list, "but I don't put a lot about my personal life on the site," she says. She uses the platform more to keep track of what dancers and their parents are posting about the studio. "If they put up something they shouldn't," she says, whether that's a bullying post or an unflattering image, "I'll ask them to take it down."

Ryan tends to keep her social-media shout-outs generic: "So proud of this year's graduates!" and "Our dancers looked beautiful at prom!" That way, she can show support without spending hours online or worrying about missing any one student's achievement.

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When ballet star David Hallberg sought out the medical team at The Australian Ballet to help him recover from his ankle surgeries, one of the things rehabilitation specialist Megan Connelly had him learn was to jump from his hips. By doing so, he learned to put less stress on his lower legs and feet and access the powerhouse group of muscles surrounding the hips, most commonly referred to as the glutes. While many parts of his rehab were particular to him, understanding how to properly engage the glutes is something many professional and pre-professional dancers can stand to gain from.

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Many a studio owner might agree that the idea of maternity leave is laughable. "So many people say, 'I was back after two weeks—we had a competition,'" says Meagan Ziebarth, a former owner who sold her studio two years ago. "If that works for you, and you feel great, wonderful. But I feel passionately that having a baby is one of the most transformational life events, and you don't need to put that kind of pressure on yourself and accept that that's the norm."

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Be OK With Crazy

Suzana Stankovic and Natalia.

Suzana Stankovic
Wild Heart Performing Arts Studio
Astoria, New York
Enrollment: 500 (drop-in)
2 years in business

Suzana Stankovic signed the lease on her New York studio a mere 10 days before she gave birth to her first child. The space she'd been renting hourly for private and group lessons unexpectedly became available for a lease takeover, and, despite the timing, it felt like the right decision. "I said, 'This is happening for a reason,'" she says.

For the first two months after her baby was born, Stankovic recovered (she'd had a C-section). She held a soft opening in mid-November (2 1/2 months postdelivery) for existing students and officially opened her studio—with a drop-in class format—to the public the following January (4 months postdelivery).

  • Figure out your childcare. "It's the most important thing. You've got to figure that out, whether that means visiting daycare centers and finding one you're comfortable with or involving your entire family," she says. Stankovic's parents are retired and live near her, luckily, so they became her nannies. "That's the major reason I was able to do this," she says.
  • Expect to feel different after giving birth. "When I had my baby, and it came time to leave her and go to work, it was very, very difficult," says Stankovic. "I wasn't prepared for that. I was texting my mother constantly: 'Is she OK? Did she have her milk? Is she colicky?' It was hard to be fully present, initially. Be prepared for the effects of sleep deprivation and not eating well and the postpartum blues."
  • Have a support system in place. That's how Stankovic got through the roughest times, postbirth. "Have a friend or your husband or partner," she says. "And know that the very difficult times are temporary. They do abate. And if they don't, there are resources. There's help out there."
  • Be OK with crazy. "I would plan my lesson and do my combos in the shower," she says. "On my way to the studio, I'd finish up my grand allégro in my head. I'd send e-mails in the middle of changing her diaper—I'd write two sentences, change the diaper, write two more, then hit send." The result of so much multitasking? "I realized, 'Wow, I can do so much more than I thought I could,'" says Stankovic. "I'm ready for anything."
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