Sprained ankles, sore feet, pulled muscles. Dance injuries are, unfortunately, going to happen. While some minor bumps and bruises can be resolved at home with rest, ice, compression and elevation, other more serious aches or pains may warrant a trip to a doctor. But can your primary care doc help or do you need a sports medicine physician?
For an aspiring professional dancer, an unexpected injury can feel like a death sentence to a career that hasn't even started. The recovery process following an injury can be one of the most grueling and heartbreaking experiences a performer will ever face. In times like these, dance teachers have the power to boost or weaken a dancer's morale.
With that in mind, we've compiled a list of do's and don'ts for talking to a seriously injured dancer.
In the lead-up to competition season, "Again! From the top!!" can be overheard in studios across the nation. As students rehearse their routines ad nauseam in the final push to get ready, longer hours can sometimes mean that warm-ups get lost and increased repetition can create overuse injuries. Plus the extreme tricks and greater demands for flexibility can put stress on the joints and tendons of growing and adolescent bodies.
"In the dance industry, we are very used to releasing and stretching," says Dr. Alexis Sams, physical therapist and owner of AZ Dance Medicine Specialists. "But the key to injury prevention is matching mobility with stability. You are not going to get the results you want without doing the stabilizing work." While Dr. Sams does not recommend that students self-diagnose an injury and believes in the necessity of a professional assessment when a student reports pain, she has found that many overuse injuries can be prevented by strengthening the core and glute muscles, and sticking to a proper warm-up. Here are three common places where students report pain, what may be causing it, and the best exercises to address and prevent the injury.
Photo courtesy of AZ Dance Medicine Specialists<p> Side plank is a great way to work the core and stabilize the hips.</p>
It's news that Dr. David Weiss doesn't like to give. Sometimes dancers see him thinking they have shinsplints, when they actually have a stress fracture, a more serious injury that requires a longer recovery. “When dancers come in with stress fractures, I see a lot of denial," says the NYU Langone Medical Center orthopedist. “They say, 'This is just shinsplints, isn't it?'"
Like any dance teacher, Christopher Busbin witnesses his students' popping joints and often experiences his own. "My shoulders were always cracking, and I thought it was from torn rotator cuffs," he says. Busbin, who teaches at Fred Astaire Dance Studio in Birmingham, Alabama, saw a massage therapist, who discovered that the stress in his joints was caused by overworked trapezius muscles in his back. "Now that I know the real source of the problem, I can help prevent it by addressing it myself," he says.
When Richmond Ballet dancer Cecile Tuzii was a student, she repeatedly injured the same ankle and couldn’t find a solution. A friend suggested she see a chiropractor, who discovered that her lower back and sacrum were misaligned, putting stress on her ankle joints. After regular treatments, she finally found relief. Now, she regularly sees a chiropractor to maintain her body and identify causes of inflammation. “I probably owe my long career to chiropractic, because it’s taken care of me and prevented injury,” says Tuzii. “I prefer going to the chiropractor over taking pills.”
Dancers often favor holistic treatments to prevent and heal injuries. Chiropractic is a drug-free, hands-on option that could potentially help avoid more drastic measures, like surgery. While some medical professionals question its effectiveness (the practice was invented in the late 1800s by magnetic, metaphysical healer Daniel David Palmer), many dancers find it helps correct their alignment issues and identifies sources of pain.
Chiropractors are specialists in how the bones and muscles connect and relate to each other. The goal is to balance the body’s alignment, evening out the weight put on joints. Much of this is done to resolve small issues before they become a bigger problem. “When a dancer comes in, they may have pain on the outside of their left knee,” says chiropractor Joshua Cohen, who works with Pittsburgh Ballet Theatre dancers. But the discomfort, for instance, may be coming from a strained muscle in the hip. “Just because the knee is where they feel the pain, it doesn’t mean that’s where it’s coming from,” he adds.
Chiropractors will perform a series of manual adjustments to increase range of motion and release the affected muscles and joints. Most will use multiple methods of care within the same visit. Diversified Technique is one of the more common adjustment methods. During treatment, the chiropractor applies sudden pressure to the joints to help restore proper movement and alignment. (Sometimes, this manipulation releases gasses in the joint, creating the cracking often associated with the practice.) Other methods include Thompson Technique, which uses a special table that increases the force of the adjustments to a specific area, and Directional Non-Force Technique, in which the practitioner applies a softer touch that does not cause joints to crack.
Cohen practices Nimmo, or trigger point therapy, which can help treat injuries like tendinitis, arthritis and strained, sprained or pulled muscles. “Trigger points are localized areas of muscle spasm. When a muscle gets overused, it gets tighter and tighter until it tears on a microscopic level,” he says. By applying pressure to these points, blood flow is temporarily stopped, and when he releases pressure, Cohen says, “It allows fresh blood to rush in and wash away a lot of the inflammation.”
A Controversial Craft
Critics of chiropractic argue that the method is not a solution for injury. “Chiropractic is a temporary fix. Nothing is permanent,” says Cohen. Overuse injuries like arthritis can’t be cured, but a chiropractor may help manage them. Jennifer Green, a physical therapist at PhysioArts in New York City, is most concerned that dancers regularly seeing any kind of practitioner are trying to find a quick fix for their pain, instead of looking for the root of their problem, which is often tied to their technique. She concedes that chiropractic care may help some dancers. “Preventive care would likely include manual treatments, but also active treatments such as strengthening, stretching, technique modification, etc.,” she says. “Some respond better to massage, some to PT, some to chiropractic and some to acupuncture.” Ultimately, the dancer is the best judge. For Tuzii, working with a chiropractor helped her realize how her body parts worked together to achieve proper alignment. “I learned much more about my body,” she says. “It taught me that my work at the barre and in the center had to change.” DT
Kathleen McGuire is a former dancer. She also writes for Dance Magazine and Pointe.
Know Before You Go
|Finding a doctor: Chiropractor Joshua Cohen says, to find a trusted practitioner, ask peers or your regular doctor for a referral and look at patient reviews online. To find someone in your area, he suggests chirodirectory.com.|
|Cost: Most major insurance carriers cover at least a portion of the fee. If uninsured, treatment often costs $50–$150 per visit.|
|Scheduling: Chiropractic treatment usually takes 15–20 minutes. With active patients like dancers, Cohen suggests going once or twice every week. Tuzii visits hers about once a month on her day off from dance. Chiropractic care is often an ongoing process requiring regular appointments.|
|What to wear: Cohen suggests wearing loose-fitting, thin clothing, so your chiropractor can feel the muscles.|
Photos from top: ©iStockphoto.com; photo by Sarah Ferguson, courtesy of Richmond Ballet
A study shows dance-related injuries in kids and teens increased a whopping 37% between 1991 and 2007. Most injuries were caused by falls or sprains/strains.
Researchers theorize the spike is due to young dancers logging longer hours in the studio and advancing more quickly. We want our dancers to work hard and learn as much as possible, but only when safety is a top priority.
Stay tuned for the latest from DT on maintaining a safe studio environment. In the meantime, here are a few of our best articles on injury prevention. Let's bring those numbers down!
10 Common Dance Injuries (and how to prevent them!)
Safe Stretching: Five ways to help students properly increase their flexibility
When Bodies Change: Help your dancers stay injury-free during puberty.
Safety First: Maintaining a safe space for your staff members and students
First Aid Kit 101: Prepare for emergencies with a well-stocked studio.
Photo copyright iStockphoto.com/carlo dapino