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Working together for healthy dancers
at The Australian Ballet School

by Janet Karin and Lucinda Sharp,

July, 2003

 

Marilyn Rowe, Director of The Australian Ballet School since 1999, has focused on providing holistic care and education for dance students. Part of her vision is to balance the rigorous demands of professional training with a creative, caring and challenging environment where excellence can flourish. Marilyn aims to create thinking artists who are healthy in mind, body and spirit - students who emerge prepared to fulfill their potential, whether that lies in dance or elsewhere.

At the School we recognize the many pressures full-time students face – striving to gain technical excellence, overcoming physical limitations, the threat of injury, long hours, educational commitments, the usual coughs and colds and, for many, the pressures of living away from home. In this complex situation, the School aims to provide health care beyond the ‘band-aid’.

Marilyn Rowe has gradually built a health team consisting of a sports medicine physician, a general practitioner, a full-time psychologist and a consultant psychologist specialising in adolescent mental health, a nutritionist, a physiotherapist, a myotherapist (like a sports massage therapist), a Pilates instructor, a strength and conditioning coach and a full-time injury prevention specialist. The psychologist, the injury prevention specialist and the Pilates instructor are all former members of The Australian Ballet. The team works closely together with our teaching staff to define a holistic understanding of each student’s welfare with a particular emphasis on the causes, prevention and care of injuries. Of prime importance is that this work is seen as part and parcel of improving technique and maximizing the body’s potential so that each dancer’s artistry can flourish.

Cooperation between health professionals and teachers occurs on many levels including formal and informal discussions, daily health bulletins and student note books. On a formal level, dance teachers meet weekly with the psychologist, physiotherapist and injury prevention specialist to discuss students’ progress and injuries. These discussions provide a broader understanding of individual student problems and often lead to new, more effective approaches. On a more informal level, the psychologist and injury prevention specialist frequently observe students in class, and teachers may also watch individual sessions with the injury prevention specialist in order to increase their understanding of a student’s difficulties and the approach he/she is taking. In some cases the psychologist and injury prevention specialist combine forces in practical sessions to assist students to overcome mental blocks which are causing technical difficulties. While confidentiality must be maintained in sensitive areas, students have learned to welcome the fact that so many people are working together for their success.

These changing perceptions are all part of Marilyn Rowe’s desired cultural change. Traditionally, students felt that early warning signals such as pain or movement limitation implied weakness and inadequacy, so they would not seek help until injuries were too severe to be hidden any longer. In these circumstances a visit to the health professional usually resulted in ‘time off’, so deepening the fear of medical diagnosis. With the support of The Australian Ballet’s Artistic Director, we are teaching students that first-hand experience in injury management and rehabilitation can have its benefits in terms of preparation for a professional dance career. In other words, hard-working professional companies require dancers who can deal with injuries effectively, and this skill can be practiced during their training. While our emphasis is on injury prevention, we encourage those students who do get injured to see the time out as a valuable opportunity for developing other skills.

When students have to take time off dance classes they are assisted by the psychologist, in consultation with the director, to design individual programmes which may include extra physiotherapy, myotherapy, Pilates, strength and conditioning work, technical reprogramming and counseling. Technical rehabilitation focuses on correcting the factors that predisposed the body to the injury and on improving the way the body works in ballet technique. Extra work on core control, alignment and correct movement patterns can enable the student to return to work with a more secure technique; an important factor in maintaining self-esteem during recovery and in building confidence for the return to class. Psychological counseling helps students to view the rehabilitation period in a positive light.

In addition to the individualised approach outlined above, students’ attitudes to injury are also examined in general psychology classes. Students learn about psychological factors that can put dancers at risk of injury and impact upon the rehabilitation process (be it in a negative or positive way). For example, students examine the roles of stress and anxiety (and their relationship to positive and negative perfectionism), problem-focused and emotion-focused coping strategies, personal thinking style, identity as a dancer, social support and secondary gain. The aim of such education is to de-stigmatise injuries and encourage students to take a proactive approach to injury prevention, management and/or rehabilitation. We hope to give them a feeling of personal control and self-responsibility thus preparing them more fully for life as a professional dancer.

A major component of a proactive approach is learning to seek support from the various health team members. For example, injury prevention sessions are usually at the request of the student (although sometimes with the recommendation of the teacher, physician or physiotherapist). The injury prevention specialist and the student spend half an hour working on the student’s individual problems and concerns, usually starting with spine alignment, abdominal stability and leg and foot alignment, while many students ask for help with turnout and with shoulder stability. If a student is already suffering any sort of injury, the focus is firstly on ensuring the problem will not recur when the student returns to class and then on building extra skills to raise the general technical level. Injury prevention sessions can cover all the principles of classical technique, such as alignment and correct muscle action during basic exercises, so that the student can solve problems in exercises and steps as they arise.

At times we have observed that an injury that first presents appears as simple as a muscle ‘strain’ can benefit from the whole health team. An injured student may be found to be working with poor alignment, sleeping badly (and consequently easily fatigued), coping with the physical changes of puberty, suffering a short-term loss of self-esteem, and struggling to meet ever-increasing technical demands at the same time. Add boyfriend troubles and a bout of ‘flu and treating the injury is clearly not going to be enough.

We have had considerable success with the psychologist and the injury prevention specialist sharing students’ rehabilitation sessions. By combining relaxation and imagery with technical instruction, students learn more easily and retain information in a readily applicable form. A major problem for students who are returning to class after injury is in applying the newly acquired knowledge, so it is essential to give attractive, flexible imagery that can be applied easily in a variety of situations. After all, we can’t dance expressively with our minds on transverse abdominus, but an image of radiating light can be incorporated into almost any choreography.

Our comprehensive injury records help us to define the reasons for any short-term increase in any type of injury, as well as allowing us to track the long-term risk factors of students’ physical limitations. We will soon be able to track the health of our dancers from as young as ten until they retire from a professional career, so we can recognise early-warning signs and instate preventative measures for injuries that may not have occurred until a dancer reached principal status. The Australian Ballet School shares its knowledge in workshops, seminars and information-sharing sessions for the wider Australian dance-teaching profession, creating a lively forum for debate and learning.

We find that both teachers and students are increasingly enthusiastic about the resources out health team provides and are eager to contribute their own discoveries and experiences to the ever-increasing body of knowledge. We are realizing our goal – to have our students and dancers regard health practitioners as essential and welcome partners in their dancing careers.

Authors:
Janet Karin O.A.M, Artistic Educator and Injury Prevention Specialist.
Lucinda Sharp BSc (Hons) MPsych, Psychologist/Counsellor
The Australian Ballet School

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This article is reproduced with the kind permission of The Australian Ballet School. It first appeared in issue 49 of Dance UK News.’

To find out more about Dance UK and its Healthier Dancer Programme visit www.danceuk.org

 

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