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Featuring DanceWell Podcast hosted by Marissa Schaeffer Listen to the episode at the link below
by Brianne Dwyer, PT, DPT
Dance, specifically pre-professional programs, cultivates an environment of poised disciplined young people. Dancers are raised in this homogenous community all working towards a common goal of getting certain roles, parts and jobs. Our art form requires an effortless grace even for the most challenging choreography. What happens though when we get injured? Do we have our voice? Have we developed the capacity to know what we need and how to express to others around us what those needs are? While working with a touring Broadway show, I had the pleasure of working with actors, musicians, dancers and other performing artists. A cast member, whose background was in musical theater, made an enlightening point to me. He said all the cast members, besides dancers, know when and how to ask for self care (physical therapy, doctors visits, massage, etc.) to maintain their “instrument”, whether that be their body, voice, or mind. In a world where we are primarily quiet and spend the majority of our time listening. We have not developed this skill to speak up for ourselves and our needs. In the podcast, DanceWell Podcast, co-host Marissa Schaeffer, PT, DPT speaks with two former ballerinas turned mental health practitioners: Dr. Miriam Rowan, PsyD and Katherine (Kate) Wilson, LICSW about this. During the interview Schaeffer asks “Do you think, in the dance world, is it hard for dancers to articulate what they need or feel like they have the right to ask for what they need?”. I have found, as a broad generalization, the answer is yes. For example, I discuss with dancers modifications they should implement during class. Then on the next visit they say things such as “I tried” or “I was scared of one teacher so I still jumped” and the list goes on. As dancers, we need to find our voice, respectfully of course. In order to approach our dance educators and say “I’m in physical therapy right now. I am currently working on x, y, and z. My dance medicine provider at Magna PT has provided me these modifications for now. Can you help me look out for these?” The “tough it out” mentally can only take dancers so far. We need to get better at finding out what our needs are, how to go about those needs and how to voice them in a respectful articulate fashion. So then our support system, whoever that consists of healthcare providers, patients, and teachers, are all on the same page. Not addressing problems, such as pain and injuries, will not allow you to move forward. Interested in the full conversation? Listen to DanceWell Podcast, Episode 49: Differentiating and Developing a voice within a Rigorous Dance Training Program. Clinician's Corner
Chronically Unstable
Richelle Stevenson, LAT, ATC
Instability
Have you heard of chronic ankle instability (CAI)? This is a condition which often develops with recurring ankle sprains or if an ankle sprain is not rehabilitated correctly. After injury, structures (muscles) around the joint must be strengthened to protect the ankle and help it function properly. If a dancer neglects a strengthening program alongside treatment for swelling, or if this dancer returns to activity before the ankle has fully recovered, the ankle can become chronically unstable. *To be clear, flexibility and instability are drastically different. We talked about this briefly in our journal on hyperextension.* Not only will CAI predispose a dancer to additional injury, it can also affect the dancer’s functional performance. (In other words, the ankle may not be able to jump as fast or balance at the level before injury.) A study from the Journal of Dance Medicine and Science examined the prevalence of CAI in university dancers (see the link below). It found 53.2% of the modern and ballet dancers evaluated had CAI! Can’t I dance with instability? Well if half of dancers have this instability, what’s the big deal? As the authors of this study state, “Chronic Ankle Instability can create long-term problems for anyone but especially female dancers, who place extreme stress on their feet and ankles from being en pointe or demi-pointe.” Imagine riding a bicycle with a loose wheel. Not only is the tire likely to pop due to the imbalanced pressure within the wheel, but more importantly, the bike frame may be damaged, and YOU would probably fall off the bike! Ankle instability increases the likelihood of further ankle injury AND increases the likelihood of more significant injury, perhaps even a knee or back injury which might shorten a dancer’s career! What’s the big picture? Just because the pain goes away doesn't mean the problem has resolved. Many dancers, including my younger self, operate under the philosophy: if it’s no longer swollen then it’s no longer injured. But as you can see, this lingering instability can still be a significant problem, even if it doesn’t “feel” unstable or painful. It is important to identify instabilities so you can strengthen accordingly and have a longer dance career. Don’t forget to look at the big picture, especially when it comes to injury. When recovering from an injury, it may seem that dancing in every competition or every part within a performance is as necessary as breathing. Yet, you might think otherwise in 20 years when your chronic ankle instability causes a major injury and may even end your dancing career. Be sure to seek medical advice and communicate with your instructors when you have pain in class. Not all pain is an injury; but remember the reverse is also true: not all ‘injuries’ have pain. Additional ResourcesChronic Ankle InstabilityJournal of Dance Medicine and Science Study
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