Your Best Body: Moving Beyond "No Pain, No Gain"

January 18, 2011

Moving Beyond “No  Pain, No Gain”

When you get injured, not dancing can be the smartest career move.

On opening night of Coppélia last June, the light, sprightly Pacific Northwest Ballet powerhouse Kaori Nakamura tore a calf muscle midway through Act I. “I couldn’t point my foot,” she says. “It was so painful and numb.” During a moment offstage, the company director asked Nakamura the fateful question: Do you want to stop?

Every dancer gets injured at some point in her career, and the decision to pull out of a performance can be wrenching. But while dancers may be tempted, pushing through the pain can lead to a more serious injury that requires weeks of time off, months of physical therapy, possible surgery and even cause permanent damage. It’s a roll of the dice—and the risks are huge.

Even though they are aware of the consequences, many dancers choose to power through anyway. Eight weeks pregnant, Nakamura knew her next performance was a year away. “Of course I wanted to finish! I had worked so hard for this,” she says. She made it through the next two acts, but when the curtain went down, so did Nakamura. “I couldn’t walk,” she says. “I couldn’t even touch my calf, it was so painful.”

Pain, as Dr. William Hamilton, orthopedic consultant for New York City Ballet and American Ballet Theatre, points out, “is Mother Nature sending you the message that something is wrong, and that what you’re doing is keeping it from healing.”

But like any athlete, dancers deal with aches and pains almost daily. How do you recognize pain that is telling you to stop now? Traumatic pain like a snapped Achilles or ACL is obvious and impossible to ignore. “If you hear a pull, pop or the pain persists when you return to the activity, it needs to be evaluated,” says Dr. Patrick McCulloch, MD, an orthopedic surgeon with the Center for Performing Arts Medicine at The Methodist Hospital in Houston, TX. “Swelling and bruising are also signs that something is structurally wrong.” Slow-onset injuries are less startling, but can be just as dangerous to dance on. If it’s chronic pain that gradually worsens, “look for a certain sharpness and intensity of the symptoms that maybe you haven’t felt before,” says Boyd Bender, a physical therapist at PNB. “Another telltale sign is that this pain causes you to consciously compensate with another part of your body.”

Any pain that persists after 24 to 48 hours of rest, ice, compression, elevation and anti-inflammatories needs the help of a doctor. Dancers too often avoid seeking medical attention, afraid the doctor will put them on bed rest. But not getting a diagnosis is a dangerous choice. “Lower leg pain could just be shin splints—or it could be a stress fracture,” says McCulloch. Bender once worked with a dancer who refused to seek help for shin pains and eventually fractured his tibia, which required far more time off for surgery and healing. In a scary coda to the story, his tibia fractured again—onstage.

While talking to other dancers about symptoms and remedies can seem like a shortcut to a solution, your colleagues don’t necessarily have better information than you do. Plus, what works for someone else’s body might not work for yours. And dancers’ standard practices sometimes backfire. After consulting with a physical therapist on his back pain, for example, PNB principal Lucien Postlewaite discovered that the gently-stretch-it-when-it-hurts strategy “was actually the exact opposite of what I should have been doing; it was contributing to my injury!”

The paradox is that the very qualities it takes to be a dancer can turn against you here. The idea of persevering through pain is deeply ingrained in ballet culture—the show must go on, and self sacrifice is often romanticized, even considered heroic. Let’s face it: In order to gain the strength and flexibility needed to succeed in ballet, dancers endure tremendous discomfort, which they’re trained to ignore. But that same willingness to push yourself to the limit can end up affecting the longevity of your career.

To get back on your feet quickly, seek treatment as early as possible. “When you injure yourself, your body sort of turns on the healing switch,” says Hamilton. A change in your hormones results in “a great capacity for healing in the first month or so—if proper attention is given to the injury.” So, the sooner you rest up, the sooner you’ll be back onstage—and the longer you’re likely to be there.

Balancing Act
If you want to improve your balance, hop on a Bosu ball—the funny-looking exercise prop that looks like a Pilates ball cut in half. The unsteady surface challenges your control and forces your core to work overtime to find stability. Test your balance by standing on one foot (in parallel) on the Bosu’s bull’s-eye. Try a few simple ballet exercises, such as modified low battements and développés en avant, à la seconde and derrière. Then step off the ball and perform the same movements—they will suddenly feel like a piece of cake on the floor’s solid surface!

Timing Is Everything
Smart dancers already know that eating lean protein is a strategic way to fill up on a relatively small number of calories. But Purdue University researchers recently discovered that when you eat it can make a difference. Including lean protein in your breakfast will keep you satisfied longer than if you only add it to meals later in the day. Eat some eggs or low-fat yogurt in the morning to keep your stomach from grumbling later on in rehearsal.

Unkink Your Calves

The next time your lower legs are full of knots at the end of the day, try going to sleep on your stomach with your toes hanging off the edge of the bed. Gravity will lightly pull down on your feet, gently stretching your calves all night long.

Full Steam Ahead
Running out of energy halfway through grand allégro? Make sure you’re getting your daily dose of antioxidants. Researchers recently found that cyclists who amped up their antioxidant intake were able to pedal at the same pace with less effort than those who didn’t. That’s because antioxidants protect muscle proteins from the free radical damage that can lead to fatigue. Get your fill by eating at least five servings of fruits and veggies a day.

Sweetly Satisfied
Sometimes it seems like Valentine’s Day should be renamed National Chocolate Day. Instead of denying yourself, indulge in a few bites of quality dark chocolate (at least 70% cocoa). Your body may thank you! Here’s why:

1. Chocolate increases blood flow to the brain, boosting memory, reaction time and attention span, according to research at Wheeling Jesuit University.

2. Eating small amounts daily decreases stress hormones, according to a study in the American Chemical Society’s Journal of Proteome Research.

3. Small, regular doses of dark chocolate can help reduce inflammation, according to researchers from the National Cancer Institute in Milan, Italy.

Tip: What Vitamins Should Dancers Take?
In addition to a healthy, balanced diet, all you need is a women’s once-a-day multivitamin with at least 18 mg of iron for energy, plus a calcium supplement with 1,300 mg of calcium and 400–800 IUs of vitamin D for strong bones. Take them at different times of the day for maximum absorption. —Emily Harrison, registered dietitian with The Centre for Dance Nutrition and Healthy Lifestyles at Atlanta Ballet