The intent of this article is to illustrate communication patterns between dancers and medical practitioners. The main findings include:
- Medical practitioners rarely communicated amongst each other concerning a dance patient
- There was limited communication between medical practitioners and a dancers’ teachers, choreographers, and directors
- Injured dancers were not bothered by this lack of communication
- Dancers lacked education regarding their dance-related injury when seeking treatment
- Dancers did not request additional information although they did not understand their injury
- Both dancers and practitioners believed that dancers would benefit from learning more about human anatomy
Note that this study was performed in a single Canadian city and the findings may not extrapolate to the world at large. This study was also conducted in 2009 and some of these barriers may have been addressed.
Pain is also the precipitating event that causes a dancer to seek medical treatment. However, the experience of pain is highly individualized and the severity of the injury has little to no correlation with the intensity of pain experienced. Fear of loss of time from training or performing often prevents dancers from seeking medical treatment. They may seek alternative treatment due to the perception that medical practitioners do not understand their vocabulary and demands of dance and may lack dance-specific psychological training. The cost of medical care may also present as a barrier to treatment.
What did medical practitioners report?
The majority of respondents from the questionnaire regarding communication were female (30 out of 48 responders), physical therapists (36%) or chiropractors (34%), between the ages of 30-39 (44%), mostly participated in some form of dance (70%), and often attend seminars related to dance medicine (54% had attended at least one sports medicine conference). While the majority (>50%) considered dancers understanding of anatomy “essential” and 24% thought it “moderately important”, one considered it “detrimental”. Practitioners that inquired about a dancers technique had a higher perception of improvement rates. While previous dance experience seemed to catalyze communication amongst health care practitioners, it was not the same with communication with dance teachers or directors. The better the communication between medical care and directors, the better the chance of a dancer modifying harmful activities.
What did the dancers report?
The majority of the dancers that responded to this questionnaire were between the ages of 18-20 years (53%), and 21-24 years (39%); averaged more than 10 years of dance; were undergraduate students (65%), professional students (32%), and dance teachers (15%), and mostly female (92%); most had training in ballet (50%) and one other type of dance including modern, jazz and musical theatre; a great majority believed that basic human anatomy was essential to dance training (68%); 13% had experienced one injury, 45% 2-3 injuries and 3% more than 10 times due to dance; 67% reported at least one injury sustained outside of dance; less than 1/3 of dancers sought medical care within 3 days of their injury.
When asked about the quality of advice given from health care practitioners, dancers reported the following, where a “1” represents “significant deterioration” and “10” represented “significant improvement”. Family physicians scored a 4.43, sports medicine physicians scored a 7.03 and physical therapists scored a 7.62.
Dancers stated that they are willing to learn basic human anatomy and were willing to adjust dance techniques in the short term in order to follow prescribed treatment protocols. However, they would not do so in the long term. Dancers were more willing to reduce dance participation intensity more so than dance participation frequency.
The single greatest variable of importance to dancers was the frequency with which practitioners observed dance.
Conclusion: The lack of compliance with dancers and treatment programs is multifactorial. Financial, psychological, social or aesthetic concerns may create barriers to effective resolution of dance related injuries. A dancers body is part of their identity, and as such, the culture of dance often demands a type of stoicism towards the pain experience. Thus, avoidance of treatment seems to ameliorate their concerns with missing training (attending medical appointments), development of poor aesthetics (due to exercise) and ostracized from the community (not being able to “handle the pain” associated with dance). The fear of losing an aesthetically-pleasing body is another barrier due to a health care practitioners instructions to modify dance activity or rest until recovered. However, collegiate dancers that pursued physical therapy treatment reported greater levels of energy and a more positive outlook.
It seems that education in basic human anatomy, communication between health care practitioners as well as directors or choreographers, and a plan of care that the athlete and therapist can mutually agree on may significantly improve reinjury rates, given that some 45% of dancers report at least 2-3 dance related injuries.
My name is Dr. Cory Abbate, I am a physical therapist in Miami, FL currently helping performers from all over the world while they rehearse at Royal Caribbean Studios in North Miami. These talented athletes are chosen from a select few performers that audition in England, Canada, Australia, Italy, Romania and the United States.
Dancers from all different backgrounds, professional handstanders, aerialist and acrobats as well as vocalists and contortionists come to Miami to learn the shows they perform on the cruise ships. If they are injured I facilitate their successful return to dance to continue on with their contracts and professional careers.
I wrote these blogs to help you, the performer, develop and evolve your technique so you can show the world your talent.