Health Care Volunteers Work to Keep You Dancing

By Kendall Alway

December 1, 2013, PUBLISHED BY IN DANCE

Are you aware that there is a Healthy Dancers’ Clinic (HDC) at ODC Dance Commons for the Dance community? The clinic is open to all ages, disciplines of dance and all levels of experience. The clinic is free, advice-based and staffed by volunteer licensed physicians and physical therapists, many of whom are (or were) dancers.

Dancer being treated at The Healthy Dancers' Clinic
Photo by Steve Maller

The HDC was founded in 2005 by Richard Coughlin, MD, an orthopedic surgeon with a passion for community-based medicine in underserved communities. He was awarded the American Academy of Orthopaedic Surgeons Humanitarian of the Year Award, which is given to one surgeon worldwide annually, for care of disadvantaged populations both at home and abroad. As the Dance Commons was in the design process, Dr. Coughlin, a longtime ODC/Dance board member, began brainstorming with Brenda Way, Artistic Director of ODC, about ways to keep the dancers dancing. Together they found a shared vision of wellbeing for dancers and what became the HDC. Grant money was secured and a fully equipped treatment room set aside in the heart of the Dance Commons (the Town Hall), and in 2005 the HDC opened within the Dance Commons.

Nancy Kadel, MD joined the HDC 2006-2009 as the Medical Director and remains a great friend and consultant for the HDC. She is a foot and ankle orthopedic surgeon and internationally recognized as one of the leading dance medicine specialists in the world. She is currently the chair of the Performing Arts Medicine Association, co-chair of the Dance/USA Task Force on Dancer Health and on the board of the International Association for Dance Medicine and Science. She remains an avid supporter of the HDC and since her return to Seattle, WA founded the Seattle Dance Medicine Free Clinic based on the Healthy Dancers’ Clinic model and organizes a monthly Dance Medicine journal club meeting in Seattle. Dr. Coughlin resumed the role of Medical Director in 2009, and I, Kendall Alway, DPT, started with the clinic in 2006 remain as Associate Director.

The main objectives of the clinic are to provide guidance and advice to dancers/performance artists on injury management, recovery and longevity. Licensed clinic volunteer physicians and physical therapists advise dancers on injury management, make referrals to other practitioners and train dancers on strengthening programs. If your treatment plan requires an immobilization boot, crutches, braces or even an ace bandage, these items have been donated by former patients and physicians involved with the clinic and are available to you at no cost.

Since 2005, the clinic has tallied well over 2,000 visits. At this time, the clinic sees about 350 patient visits per year and is staffed 100% by clinical volunteer physicians and physical therapists with the help of two very part time work exchange administrative helpers. The HDC currently operates 4-5 times a week, and provides additional care in the form of backstage coverage for the ODC/Dance performances.

Online appointment scheduling is available through the ODC website.

Our mission

The Healthy Dancers’ Clinic at ODC, through the volunteer collaboration of academic health care professionals, strives to improve the well-being and healthcare of the dance community through education, musculoskeletal screening, integration of health services, enlightened treatment protocols and injury data analysis, hoping to culminate in prevention.

Why is a Dancers’ Clinic needed?
The most dynamic factor is health insurance (or the lack thereof), and while this should be changing with the Affordable Care Act, how much, we do not yet know. Traditionally, dancers have worked multiple part-time jobs, none of which provide health insurance. If dancers are insured, they frequently have high deductible plans that are too expensive for them to use if they are unable to save enough money to pay out of pocket for treatment, or if they do not have a health savings plan of some sort. This problem may persist with healthcare reform. The other insurance related problem frequently encountered by HDC patients (collected from our own data in 2012) is a lack of access to a healthcare provider covered by their insurance that the dancer believes is skilled in treating dancers.

Dancers have also been shown to have a great deal of anxiety about healthcare providers and seeking help for injuries. The problem is so widespread that the latest Journal of Dance Medicine and Science featured an article entitled “Psychological Distress Among Dancers Seeking Outpatient Treatment for Musculoskeletal Injury,” by Mary Elizabeth Air, MD. The article underscores the need for healthcare professionals who understand the needs of the dancer and can anticipate the stress an injured dancer is facing. For dancers, not only are they at an economic disadvantage in pursuing medical care, they are also psychologically fragile due to the fear of losing their ability to dance (and therefore their identity). Dr. Air found increased rates of depression in injured dancers when compared to similarly injured control groups. These findings come as no surprise to most dancers. Although dancers sustain an exceptionally high rate of injury, fewer than 50% of dance-related injuries are thought to receive treatment by a physician.

Data from the Healthy Dancers’ Clinic collected in 2012 has demonstrated that although 59% of our patients are insured, only 54% of our patients have a primary care doctor. At this point the cause of this is unknown, but may in part be explained by a fear of engagement with healthcare providers as outlined above. The goal of the HDC is ultimately prevention. Being embedded within the dance community and providing help from dancers to dancers, the HDC has made some progress, as the data demonstrate dancers who may not otherwise have had help for their injuries have been seen at the clinic. How well injuries have been prevented is a harder thing to measure.

The clinic will continue as it has under the Affordable Care Act, as dancers will continue to need specialized advice. It will still operate on a volunteer model and will not charge for services.

How can I help? (Ways to support the Clinic)
If you are a licensed PT, MD, DO, NP, nutritionist, or mental health professional specializing in orthopedics and dance medicine, and would like to volunteer to assist the dance community, the HDC would love to speak with you about volunteering your time. A great way to start your clinical involvement is to come to the Monday night meeting at the ODC Dance Commons where we enjoy sharing clinical academic information through guest lecturers and a journal club. We have often had the assistance of medical and physical therapy students, acupuncturists and Pilates instructors and have guest presenters visit our group.

Of course, donations are always helpful.

Healthy Dancers’ Clinic FAQ

I am dancing but not professionally. What are the criteria to be seen at the HDC?

Anyone who says they are a dancer is welcome to be seen at our clinic. We welcome all ages and all dancers.

I have had a cough for weeks; can I come to the HDC?
At this time the physician with the HDC is an orthopedic surgeon and the other volunteers are physical therapists. We are looking for more physicians and nurses to volunteer so we will be able to handle things like respiratory problems,
but are not staffed for them at this time.

I don’t know the difference between having an injury and having my “normal” pain. Could you help me out?   
We hear this all the time. Please come in to have it looked at. A “normal” pain really should not be normal and you should have it checked out. Aches and pains that become chronic can quickly become more serious and can take you out of dance.

I don’t dance at ODC, am I still eligible to be seen at the HDC?
Absolutely, we would love to help you. We have seen dancers from out of state, out of the country, and from studios and dance companies all over the Bay Area.  The HDC is a resource for all dancers.

I have a lot wrong. Can you help me?
Appointments are 15 minutes. That said, we will do the best we can to prioritize, triage and advise you on your most pressing concerns; basically, one concern per visit, but as always, will take into account the rest of your body. In some cases, we find dancers don’t actually have as much wrong as they think they do, in other cases, we will work with you in trying to help you find the care you need.

I can’t wear my dance shoes any more. What’s wrong?
We may be able to help you figure out footwear issues with pointe shoes, ballroom, tap, jazz, etc.

How about my shoulder? I have this strange bump.
See your doctor. We can check out your shoulder, but if we think you have the possibility of having a medical problem, we will refer you to a physician.

What about my pointe shoe readiness?
We frequently see dancers for pre-pointe assessment. If you are looking for a quick pre-pointe assessment, please indicate that in your appointment request so one of our helpful work-study staff can get you scheduled in the right time slot.

Director Volunteers:
Richard Coughlin, MD – Medical Director
Kendall Alway, DPT  – Associate Director

Current Active Clinical Volunteers:
Kendall Alway, DPT
Margaret Anderson, PT
Kristen Belcastro, DPT
Richard Coughlin, MD
Julie Cox, PT
Michelle Dierberger, PT
Kim Holt, PT
Shirley Kollman, PT

Other Volunteers/Contributors:
Helena Bireki, Pilates instructor
Nancy Kadel, MD
Deena Leevy, PT
Suzanne Martin, PT
Augusta Moore, Director of Ballet, ODC
Selina Shah, MD
Vita Yee, Lac.

This article appeared in the December 2013 issue of In Dance.

Kendall Alway, DPT is the Associate Director of the Healthy Dancers’ Clinic at ODC, and has her own practice, SF Performing Arts Physical Therapy. There, she practices a combination of manual therapy, Pilates based exercise and movement retraining for injury recovery in a dance studio setting. She has a BFA in dance and is a former professional dancer focused on meeting the rehab needs of dancers for the last 12 years. She has presented as an invited speaker at IADMS, the International Association for Dance Medicine and Science, and is a member of the American Physical Therapy Association.