Today’s post is the first of our Guest Writer contributions in Dance Wellness. Sarah Graham, PT, is a dance medicine provider working in Denver, CO, where she is Co-Director of Denver Dance Medicine Associates. Her article on working with a dance medicine PT is meant to give you information on what to expect when working with a physical therapist who specializes in dance medicine.
It could also be useful if you have a good PT who is interested in working with dancers, but does not have the background or dance knowledge base. You could give that person Sarah’s article, along with information on IADMS (International Association for Dance Medicine and Science), and that could help them get started. Many dance medicine PT’s are not former dancers themselves, but through a love of dance and dancers, became specialists by a dancer connecting them to the field in that way.
Jan Dunn, MS – 4dancers Dance Wellness Editor
by Sarah Graham, PT
Since dancers’ bodies endure more than their fair share of physical use, working with a physical therapist is a natural partnership. Many companies have a PT on staff to regularly treat the dancers and provide care prior to and after performances. For those without a PT, finding a dance familiar physical therapist can impact how quickly a dancer returns to dancing as well as provide valuable education to prevent future episodes of an injury.
Most outpatient orthopedic physical therapists with strong manual therapy skills will be able to help a dancer with an injury. Manual therapy is a clinical approach using skilled hands-on techniques, including but not limited to manipulation/ mobilization to diagnose and treat soft tissues and joint structures to increase range of motion in the joint, decrease pain, facilitate movement and improve function. However, two important elements that an outpatient PT who is familiar with dance will bring are:
-an understanding of the physical demands on a dancer
– the ability to assess dance technique for alignment/technique errors which may be contributing to the injury
Often when an injury is sustained, a patient will need to avoid aggravating activities or take time off from certain aspects of their exercise routine. That works well for mere mortals who have a desk job, but won’t get a professional dancer ready for an upcoming show! A PT needs to understand the psyche of a dancer in order to effectively work with them. Most of the dancers I work with dance because they have to. Dancing is ingrained in them as part of their soul, and the need to dance is as natural and necessary as breathing is.
Understanding the rigorous demands of daily classes and rehearsals is also key to keeping a dancer dancing. A PT doesn’t get to tell the Cavalier Prince he can’t lift the Sugar Plum Fairy because his back hurts during the Nutcracker season. If there is a serious injury requiring a break from dancing, adapting a class to keep movements pain free or setting up a rehab program is important to maintain conditioning.
Analyzing a dancer’s technique is also helpful to healing a dancer’s injury as well as preventing an injury from becoming chronic (an aspect of injury prevention which has been discussed previously in our Dance Wellness articles). Oftentimes, subtle changes using verbal cues and imagery can assist a dancer with using their body in the most efficient, functional manner. Part of the physical therapy subjective evaluation should include determining what dance movements aggravate the dancer’s injury, followed by assessing their technique. Once problem areas are identified, the PT can assign specific exercises to rehabilitate the injury as well as set up a program to prevent it from recurring.
Observing a dancer in class as well as rehearsal can be extremely enlightening in regards to dance injuries. It provides an opportunity for the PT to see what is actually demanded of the dancer. When a new choreographer is in town to set a piece on a company prior to a performance, it can also explain why there is a sudden epidemic of hip pain for a majority of the company. Certainly, challenging new choreography creates new areas of soreness and potential injury for the dancers. The PT is not going to be able to change the choreography (nor is she crazy enough to ask!), but can provide the dancers with stretches and exercises to focus on the tasks asked of them. Occasionally, something as simple as knee pads for the modern dancers to wear if movements end up going “down to the floor” can be helpful until the actual performance.
So where can you find a dance medicine PT? In addition to word of mouth in the dance community, IADMS (the International Association for Dance Medicine and Science) has a listing of all of its providers on its website. This listing is currently available only to members. However, IADMS is currently collaborating with the Rudolf Nureyev Foundation (Paris, France) to bring the “Dance Medicine Resource Guide” online. The DMRG is an IADMS resource (originally founded by 4dancers editor Jan Dunn) which lists medical providers worldwide who work with dancers. When this project is up and running, this column will alert readers that it is live.
Resources such as those mentioned above can also be an asset for companies unable to travel with medical assistance on a tour.
Wherever your feet end up taking you, keep dancing!
BIO: Sarah Graham, PT, has specialized in dance medicine for the past 14 years and is co-founder of Denver Dance Medicine Associates. She was the company physical therapist for the Cleo Parker Robinson Dance Ensemble for 5 years and currently provides physical therapy services to the school of Ballet Nouveau Colorado. She is a member of IADMS and also serves on the physical therapy staff of Presbyterian/ St. Luke’s Hospital in Denver. Sarah’s passion is treating dancers from all genres.