Your Best Body: A Deeper Hurt

The emotional trauma of injury can be the most painful part.
Published in the October/November 2012 issue.

Photo by Nathan Sayers

The day after she tore her calf muscle, Lindsi Dec woke up in a state of denial: She thought her body was still healthy, and planned to go to rehearsal. Then her husband had to carry her to the bathroom. “Once I realized how bad it was, there was a lot of crying,” remembers Dec, a soloist at Pacific Northwest Ballet. “Never mind missing dancing—I missed walking.” The hardest part came once she finally acknowledged what had happened, and that she would be out for nine weeks.

For dancers, injuries are more than broken bones or torn tissue. They come with a deeper kind of loss, one of precious stage time, the momentum of a burgeoning career, even personal identity. In the early stages of a serious injury, the physical pain is often overshadowed by the emotional trauma. Dancers’ fusion of self and body is so complete that when they can’t move, their world unravels.

“Injured dancers may experience a form of grief,” says Elizabeth Manejías, MD, who works with dancers at the Hospital for Special Surgery in New York City. She says mild depressive symptoms and anxiety are common. Lynda Mainwaring, PhD, associate professor of psychology at the University of Toronto, led a study on the topic. “We found that dancers, both here in Canada and in the United Kingdom, reported that often the psychological aspect of injury was the most difficult component to cope with,” says Mainwaring.

Dancers are trained to be stoic. And because their whole world is connected to their physical presence, when they’re forced to be stationary, there’s a void. “Especially when the injury is serious and involves long-term recovery, it threatens a dancer’s identity,” says Mainwaring. When dancers can’t dance, they temporarily lose not only their career but also their lifestyle, their means of expression, their sense of purpose.
“I’ve been dancing since I was 8; without it, I felt incomplete,” says the Joffrey Ballet’s Miguel Angel Blanco, who spent a year off the stage after two consecutive surgeries on his Achilles tendon. “I had days where I asked myself, ‘Why did this happen to me?’ I missed a lot of great shows, including a world premiere by Edwaard Liang and Wayne McGregor’s Infra.”

The danger of depression is twofold: In addition to the emotional drain, it can put the brakes on recovery. “Depression can hurt concentration, sleep and appetite, all of which are necessary to support the healing process,” says Manejías. A 2001 study in the journal Psychosomatic Medicine found that patients with leg wounds who had depression were four times as likely to experience delayed recovery. “Also,” says Manejías, “there are studies to suggest that depression can heighten the experience of pain because similar areas in our nervous system process both feelings.”

Dangerous Territory: The Studio

Every dancer has a different coping strategy. Some feel so betrayed by their bodies that they want to avoid dance at all costs. Others find comfort in maintaining a connection to ballet. For Houston Ballet’s Madison Morris, who was out with ankle injuries at the end of last season, deciding to watch her peers proved a turning point. “I feel ashamed to admit that I had to drag myself to see our mixed rep program ‘Made in America,’ ” she says. “I knew it would be difficult to watch them while I was still unable to dance.” Ultimately, she found viewing the performance helped her feel closer to the work she loved.

“Some dancers may benefit from attending rehearsals and taking notes, or assisting in some way that helps them feel involved,” says Mainwaring. “Some may not feel comfortable watching others perform when they can’t.” The ability to return to the studio also evolves over the course of a recovery. Many dancers can only handle being back once they can start marking again. “Every step of the process is important,” says Dec. “I got my hope back once I was reaching certain milestones, getting closer to dancing again.”

Expand Your Artistry
Exploring a new passion while sidelined can be enormously beneficial. “I encourage dancers to focus on nurturing activities and exercise to give themselves the space to process any emotional turmoil,” says Manejías. Having another outlet helps keep dancers from getting obsessively wrapped up in their injury, and what they were—or weren’t—able to do in physical therapy that day.

It isn’t just about distracting your mind. Many dancers discover new dimensions of themselves. Whether it’s photography or Pilates, developing other talents will help you return to the studio as a more complete artist. Morris, for example, taught private ballet lessons, choreographed for a youth group and even joined a 24-hour film project. “I thought acting would be a fun and a less physical outlet while I recovered,” she explains.

Morris also found support from an unexpected source: an audience member. One day, while Morris was in the theater, a woman approached her wanting to know when she would be performing again. “Her concern during that simple conversation made me feel like I was still part of what was happening onstage,” she recalls. “I was still part of our talented team even if I was riding this one out on the bench.”

Nancy Wozny took her first stab at writing while she was out with a pair of torn hamstrings.

Pumpkin Perks
Don’t feel guilty about digging into a slice of pumpkin pie this Thanksgiving. Fall’s favorite squash is loaded with nutritional benefits.
-One cup of pumpkin offers 11 percent of your daily fiber and only 49 calories.
-Pumpkin is rich in potassium, which helps keep your muscles strong and cramp-free.
-The orange color comes from beta-carotene, which has a mild anti-inflammatory effect.

The Science of Epsom Salts
Many dancers swear by Epsom salt baths. Old wives’ tales suggest that the salt’s magnesium and sulfate will help sore, fatigued muscles and improve nerve function. Is there any truth to the claims? “Those sorts of uses haven’t been verified by research, but we wouldn’t discount the placebo effect,” says Lauren Kreha, ATC, a certified athletic trainer and clinical specialist at the New York University Langone Medical Center, Hospital for Joint Diseases, Harkness Center for Dance Injuries. “Whether you’ve got salt or not, hot baths have been shown to ease stress and tension—and that itself can speed healing.”

What Epsom salts can definitely help with is toughening your skin to avoid blisters. Highly concentrated salt water will draw moisture out of the skin, drying it so that calluses form to protect your toes. All it takes is soaking once a day for about 15 minutes, or until you feel your skin getting rougher.

The one time to avoid an Epsom salt bath? Directly after injuring something. “When you have an acute injury like an ankle sprain, hot water will just increase inflammation,” explains Kreha. In that instance, you’re better off with ice.

Unconventional Wisdom
A salad can make a healthy lunch—but don’t skip the dressing. Although dry leaves might seem virtuous, they actually offer little benefit. A recent study at Purdue University showed that your system needs to digest some fat in order to absorb carotenoids, the nutrients from vegetables. You don’t have to drench your lettuce in ranch dressing; a drizzle of olive oil will do the trick.

Om My Goodness

Every few months, it seems like a new study comes out saying that meditation can make us superhuman. MRI scans of the brain have shown that it increases gray matter in the hippocampus, for learning and memory, and decreases gray matter in the amygdala, which is connected to anxiety and stress. One study linked meditation to longer attention spans. Other research suggests it can improve focus, decrease depression, fight fatigue, reduce chronic pain.

But is it worth it for dancers to spend time just sitting there? “I can’t think of anything dancers could use more,” says Kate Solmssen Stephan, a former dancer who now teaches yoga at New York’s Downtown Meditation Community. “Dancers have to take in a lot of information quickly. If your mind is focused, that’s a lot easier to do. A dancer’s life is also fraught with anxiety,  and physical and emotional pain; meditation can help you center yourself.”

Don’t be intimidated. All meditation takes is concentrating your attention. The best gateway for dancers is usually yoga. “It’s got that physical component that dancers’ bodies crave,” Stephan explains.

Or you can try this exercise at home: Find a comfortable position, and focus on your breath for 10 minutes. When distracting thoughts inevitably come up, just acknowledge them and let them go. It’s simple, but not easy.

Put the Supplements Down

Ever since the craze over antioxidants began, dancers have been devouring supplements. But a recent study in Sports Medicine found that, when taken in excess, antioxidant supplements could come between you and the benefits of exercise. High doses of antioxidants interfere with bloodflow to muscles that you’re working out. That means your calves and hamstrings won’t get the nutrients they need to grow stronger. The solution? Put down the supplements and go for the real deal. Adding vitamin- and mineral-rich foods, such as fruits, vegetables and nuts, to your diet will give you ideal levels of antioxidants.