If you have ever taken a dance class or had a rehearsal at ODC you may have noticed the door in the Dance Commons with the words “Healthy Dancers’ Clinic” written above it. Whether you have stepped through those doors or not, you have probably wondered at some point: what exactly goes on in there? A small room equipped with a treatment table and every type of athletic tape you could desire, The Healthy Dancers’ Clinic is a volunteer treatment center designed specifically for dancers. Through the volunteer collaboration of academic health care professionals, The HDC strives to improve the well-being and healthcare of the San Francisco Bay Area dance community through education, musculoskeletal screenings, and enlightened treatment protocols—the goal being injury prevention and longevity.
There are many approaches to dealing with injuries both preventatively and after the fact. A first step is to see a physician who may refer you to a physical therapist, or you can go directly to a physical therapist without a referral in the state of California. Massage therapists, acupuncturists, chiropractors, Pilates or yoga instructors; all can be beneficial to you. I spoke with three trusted healthcare professionals who have been providing highly specific care to dancers for years. Nancy Kadel, MD, Orthopedic Surgeon and Dance Doctor; Kendall Alway, Doctor of Physical Therapy; Stephen Coleman, Licensed Acupuncturist; and Lenny Stein, Doctor of Chiropractic have different methodologies in treating their patients and all three are passionate about the individuals they care for.
Initially, I asked them each to describe what they do. On Dance Medicine, Kadel said “For me the focus of dance medicine is to support dancers of any style or genre to perform at their best. This includes giving an accurate diagnosis, realistic rehabilitation options and goals, and assist in modification of activities in the case of injury to allow healing while not making the dancer lose conditioning. It sometimes includes technique evaluation or demonstration by the dancer of their specific choreographic demands.” Alway said “Physical Therapy is both preventative and for when you have an injury. Physical therapists use a combination of manual therapy and exercises as well as looking at your joint motion and alignment to determine what other things you need to work on. We also use treatments like taping and occasionally muscle stimulation with a machine to help you learn how to use your muscles more efficiently.” Coleman did not define acupuncture but took me through his history as a bodyworker for 44 years and an acupuncturist for 32 years. He said he, “…hadn’t intended to go into acupuncture. A lot of people come out of programs but they don’t really understand who they are. I also studied Rolfing at the same time. In ‘75 I started Acupuncture, Rolfing in ‘82, in ‘86 I got my license in acupuncture, studied somatic, and Feldenkrais kind of thing in ‘97. I felt like I could bring an awareness to people and developed my own style completely. It happens after a while, you just have a sense to things.” Stein mentioned, “Chiropractic care has a lot to do with function and balance in the body. It’s about trying to identify where people have imbalances and where people have overuse injuries or lack of high performance. We try to figure out where those imbalances are in terms of skeletal and muscular structure. We don’t use drugs or surgery, it’s an all natural approach to wellness. Whether it is in response to an injury or to perform at a higher level.”
Alway went on to explain that, “The first concern for everyone is their ergonomics, I want to make sure they are walking or sitting correctly before I check their plié. Sometimes I will ask them to show me a little bit of choreography. The most common injury in dancers happen in relation to the foot and ankle. Then it goes up the kinetic chain: knee, hip, lower back and lastly shoulders and neck. Of course, if a dancer is doing more weight bearing on their arms they will have more shoulder issues. I don’t fix people. I help people fix themselves.”
Coleman states, “It just depends on who the person is. Who they are, how serious the injury is. If someone has a very serious pain I will talk to them more about it. I don’t try to necessarily therapize them, I just try to help them understand why the pain is there. Usually they will tell me. I’ll bring up the idea of why pain is there in the body in general and they will come forward with why the pain is happening. The whole idea is that the body is speaking to them and that is why they are in a lot of pain. It is bringing awareness to them so they can figure out how to manage the situation.”
When asked how treatment differs between patients, for example: what’s the difference between treating a dancer or someone who works in the office all day? Kadel said, “Often the injury (for example an ankle sprain) may be the same, but the treatment and rehabilitation may be very different as what these individuals have to do with their ankles is different. Dancers can’t really dance with a brace that limits their motion. So understanding what dancers need to do helps in focusing the treatment and rehabilitation.”
Stein affirms, “Dancers are the most complex of all athletes. Unlike most people, they are required to use their body in a very specific way based on the choreography. You have to be much more precise and much more nuanced and more sophisticated in how you work on them than the average person. It’s way more detailed and way more sophisticated. You could be very skilled at working on the average person but that doesn’t mean you would be able to do all the things that dancers would need. They have very unique injuries and complicated relationships between parts relating to others. It is very unique even within sports medicine.”
All four of these healthcare providers are experts in what they do. Alway has played a huge role in The HDC since its inception, volunteering time to see dancers as well as maintaining the clinic today. She is also the person who has initiated the programming of a Day for Dancers’ Health in the Bay Area. The Day for Dancers’ Health will be held throughout ODC in the Theater Building and Dance Commons on January 26, 2019 from 10am to 6pm. The event will provide screenings where dancers will be able to be seen individually by physicians to test their strength, endurance, and learn more about form and function. Nancy Kadel will be presenting a keynote speech. Two panels, of which Kendall Alway, Stephen Coleman and Lenny Stein will be on, will take place where dancers can ask questions to various health professionals and choreographers to get feedback from a wide array of methods and approaches to healthcare and wellbeing. And that’s not all. During the day, there will be break-out sessions with physical therapists and mental health professionals including progressive ballet technique, stress management, finance, identity as a dancer, nutrition, core workout series and anatomy in clay. The day will include an open lab and a workshop hosted by ODC’s artist in residence: Kinetech Arts.
The event has been planned as an exciting and dynamic day designed for the dancer to explore and learn more about their body, their mind, and how to take care of themselves. There is limited space available for the health screenings and registration details can be found at odc.dance/hdc.
Dance Medicine and treating dancers is a tricky job to master, and these four have truly made a name for themselves in this field. Kadel, Alway, Coleman and Stein are trusted by the dance community to not only assist them in healing physical injuries, but in bringing dancers back to their craft and art form. A dancer’s career does not have to be cut short. A dancer can keep moving and dancing their whole life, with care that is specific and sensitive.
More to Consider
Most, if not all dance injuries are technique and overuse injuries, including injuries due to fatigue. There is sometimes a misunderstanding about overuse injuries. An overuse injury does not occur because you are doing too many battements or shoulder rolls. An overuse injury occurs because a dancer overuses specific muscles incorrectly in their battements or shoulder rolls, while underusing other muscle groups. As you train your body a certain way, you develop habits. The body is incredibly smart and may find shortcuts or compensate by activating other parts of the body to do work if you are weak in another area. A bad habit may not seem to affect your ability to dance until you begin feeling a consistent pain, get it looked at by a professional, and find out you have been doing battements incorrectly for years. It is not your fault. There is also a tendency for dancers to accept chronic pain as normal. Dancers will say “oh, I have always had back pain” or “that’s just my hip thing!” casually, brushing off their own pain. Ignoring aches and pains like this could result in a more serious injury later in your dancing career. Taking the time to see a professional you trust BEFORE you are injured is crucial. Learn more about your body, ask questions, feel good and pain free, and stay curious.
This article appeared in the January/February 2019 edition of In Dance.
