A Deeper Hurt: The Emotional Trauma of Injury Can Be the Most Painful Part

September 23, 2012

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.”