What Ballet Dancers Need to Know About Surgery

Thanks to a successful operation, a strategic physical therapy plan, and lots of patience, I made a full recovery and landed my first contract three years later. But in retrospect, there’s a lot I wish I’d known—not just about the procedure, but about the long and challenging recovery process that followed.

From preparation to rehabilitation, emotions, and more, here’s what ballet dancers need to know about undergoing surgery.

Prep and “Prehab”

Before surgery, most patients do prehabilitative physical therapy to strengthen the area and offset muscle atrophy. Dr. Angelina Vera, an orthopedic surgeon based in Las Vegas, Nevada, works with ballet dancers and says most of her clients’ injuries do not require immediate surgical attention. In fact, ample prehab time is optimal. “The stronger you are before surgery, the less difficult the rehab,” she says. Depending on the case, prehab can last from weeks to a year.

Joffrey Ballet dancer Max Dawe was finishing a long rehearsal day when he landed a saut de basque strangely. An MRI showed he’d torn his right ACL and both menisci; he was scheduled for surgery for a month later, facing a nine-month recovery at minimum. He began prehab immediately. “You can’t bend your knee right after an ACL tear,” he says. “If you go into surgery without that mobility, it’s almost impossible to fully recover.” For a month, he worked on exercises like sitting while straightening his leg with an ankle weight.

Understanding the Risks

Vera states that with any operation, there is some risk of reinjury, or losing mobility. “I could do a perfect surgery and the patient could do poorly if they don’t have the proper rehab,” she says. “But most people, over the course of a year, get back to where they are comfortable with their range of motion.”

When João Pedro Silva, a new member of BalletX, tore a ligament in his right ankle, one doctor suggested repairing it, noting that it could affect his foot’s point. Another recommended a less-invasive “ankle scoop” to remove frayed tissue (he could still dance with a torn ligament). Silva opted for the latter. But just a month after surgery, they realized the inflammation had reached the back of his ankle, and he needed a second operation—with six stitches. “It’s what I’d tried to avoid the first time,” he says.

When operating, Vera aims to avoid the need for repeat surgery, preserving the native tissue as much as possible. Still, factors like genetics, lifestyle, and the injury’s severity play a role.

Building Back

After surgery, both Dawe and Silva felt emotional, exhausted, and fuzzy from medication. “I didn’t feel like myself at all,” says Dawe. “All I did was sleep.” Because of his torn menisci, he couldn’t put weight on his leg for weeks. He eventually progressed to walking with crutches, got back to the barre after four months, and felt fully recovered after a year. Both he and Silva prioritized nutrition, sleep, and PT while healing.

When discussing timelines with dancers, physical therapist Dr. Traci Stevens, DPT, provides a range to account for variability, and errs on the side of overshooting. “If you get there sooner, it’s always better,” she says. “Then it’s a win, versus them feeling like they failed.” Once they’re cleared, she often sees dancers as soon as a day post-op and works with them for up to a year, depending on the procedure and the surgeon’s rehab schedule. “Anything with a repair has a longer timeline,” she says, versus procedures that remove tissue, like Silva’s ankle scoop.

Recovery progress is variable and highly dependent on the surgery. But in general, Stevens says, dancers recovering from a larger repair spend the first six months building back to everyday tasks and slowly integrating ballet-specific movements, like turnout or relevés, into exercises. After five or six months post-op, they’ll get into more agility-based training and start at the barre. “By a year, they’ve forgotten they’ve had the surgery,” says Stevens. (For less-invasive or smaller-scale surgeries, this timeline can be expedited.)

For surgical repairs, dancers should pay extra attention during the eight-to-10-week post-op zone not to push too far, Stevens says, though they should be mindful all through recovery because of their tendency to go all or nothing. “I have to help them understand you don’t have to be perfect with every movement,” she says, and purposefully gives instructions: “I want you to do a coupé balance, not a passé,” or “You’re going to use 50 percent of your turnout.” With dancers returning to pointe, she uses tests akin to typical pointe-readiness exams, like assessing ankle strength and mobility, hip and knee strength, relevés, hops, and balance.

Pain Point

In addition to feeling frustration (“I’d already done all those exercises in prehab!”), Dawe experienced significant pain during early PT sessions. “I don’t think I’ve felt anything more painful than bending my knee for the first time after surgery,” he says. But if he hadn’t gone through that early mobility training, it would have been much harder getting back to dance—something he says would have been more painful, physically and emotionally, in the long run.

Given dancers’ tendency to minimize pain, Vera pays special attention when they express discomfort. “They know their bodies so well that they can really judge when something is wrong,” she says. She encourages dancers to note sensations they feel during PT, and especially when returning to dance. And while patients receive pain-management medication after surgery, Stevens says that in the months following, dancers should get used to “nudging” against discomfort to regain strength and retrain mental pathways. “It’s that biopsychosocial model,” she says. “The brain, your body, your life—it’s all connected.”

The Mental Side

Silva felt that connection keenly. “It took a long time to feel comfortable in my body again,” he says. “I was so worried I was going to get hurt.” On top of adjusting to being away from the studio and the resulting loneliness, Silva feared he’d lost precious time. “Our careers are short,” he says. “I thought, What if I don’t get back to where I was?” He reviewed choreography with extra care, visualizing himself doing movements correctly to rebuild trust in his body and combat the feeling of falling behind.

Dawe felt similarly, especially after a tweak during Nutcracker last year required a second meniscus surgery in the same knee. “I lost a lot of confidence—not just in my dancing,” he says. “It’s like your body has betrayed you. It affects you in more ways than you ever expect.”

Stevens explains that nudging against pain, which helps progress past fear avoidance (the instinct to avoid using the healing area), helps rebuild confidence. She also recommends seeing a sports psychologist or therapist. “As dancers, our self-worth is so wrapped into our physical ability,” she says. “When you remove that, there’s a whole mental spin. It helps to have someone to unravel that.” Both Dawe and Silva benefited from counseling and recommend it to other dancers, especially right after surgery, and when returning to ballet—when frustration and self-consciousness flare. Silva also looked at photos of himself in his surgical boot as a progress reminder. Now, he feels his experience has made him a stronger artist by honing his sense of movement and attention to detail.

“That’s one of my biggest blessings now—being forced to take the time and think,” he says. “I wanted to return stronger. And I feel the results of that commitment every day.”