Freelance dancer Rebecca Greenbaum was looking forward to a fun and lucrative Nutcracker gig when she became plagued by ankle pain. An orthopedist diagnosed her with tendonitis and sent her to physical therapy. Though it was informative, her ankle troubles persisted. "I would maybe feel better for a day, but the pain would come back," she recalls, so her therapists suggested acupuncture. Greenbaum was skeptical, but she was willing to try anything. Finally, she found relief that lasted: Acupuncture combined with physical therapy got Greenbaum onstage, pain-free. Two years later, both treatments remain part of what Greenbaum calls her arsenal for maintaining wellness.

Getting injured is overwhelming for any dancer, and figuring out a recovery strategy can add to the stress. Oftentimes, it takes a team of medical professionals to help you return to the stage safely. Since knowing who to see can be confusing, we've outlined some of the most common practitioners ballet dancers might visit and why.



Rebecca GreenbaumPhoto by Rachel Neville, Courtesy Greenbaum

While it's a good idea to have any concerns seen by a physician, there are certain injury symptoms that warrant prompt medical attention. These include acute trauma (especially involving the head), severe swelling, fever, significant or lingering pain, inability to bear weight, unexplainable weight loss or gain, or debilitating fatigue.

Primary-care physicians: Even with symptoms more mild than these, your primary-care physician is a great place to start your care. These doctors are trained to help with a variety of challenges that can impede your dancing. They'll identify symptoms that require a specialist's attention and make appropriate referrals.

Orthopedists and orthopedic surgeons: Ballet injuries usually require a doctor with vast knowledge of muscles, bones and connective tissue, so this often leads dancers to an orthopedist. If there's any concern that your injury might require surgery—for instance, if you need to have painful bone spurs removed or damaged connective tissue repaired—you can expect to see an orthopedic surgeon.

Certain situations, like a complex bone break, may require surgery, but most injuries don't, or they can tolerate a wait-and-see approach, says Dr. David S. Weiss, MD, associate director of the Harkness Center for Dance Injuries at New York University Langone Medical Center. To determine the right treatment plan, Weiss suggests you ask "What's the risk of the surgery?" and "What's the risk in waiting?" All surgeries have a degree of risk, so seek a second opinion if you're not confident with the answer to either question.

Osteopaths: This type of physician traditionally favors preventive care and relies minimally on medication. Today, you can find osteopaths (identified by the credentials "DO") in every medical specialty, even surgery. New York City–based dancer-turned-osteopath Dr. Stasia Blyskal, DO, explains that practitioners "receive extensive training in the interrelationship of the body's structure and function." For example, they might look at how the shape of your pelvis affects your turnout. Osteopathic physicians like Blyskal, who specializes in osteopathic manual manipulation, use their hands to help rebalance the body's systems. Treatments can include the high-velocity adjustments you might associate with a chiropractor, or a more subtle technique called "osteopathy in the cranial field," which feels like gentle pressure, lifting or lengthening. "Dancers work so hard, they sometimes think that if they're having pain, they need to work their body harder," she explains, "but gentle techniques can be very helpful."

Physiatrists: A physical medicine and rehabilitation physician, or physiatrist, specializes in injuries involving muscles, bones and connective tissue, as well as the brain and spinal cord. At your first visit, a physiatrist will test your joints for flexibility, strength and balance, and watch how you walk. Physiatrist Dr. Elizabeth Manejías, MD, who sees dancers at New York City's Hospital for Special Surgery, says that about 60 to 70 percent of her treatments involve a type of acupuncture for the muscles, called dry needling, while other physiatrists might give injections of steroids, lidocaine or other medications.


Acupuncture can be used to treat physical symptoms, like swelling and muscle strains, as well as mental challenges, like anxiety and exhaustion.Photo: Thinkstock

Other Wellness Professionals

Most dance injuries are neither spontaneous nor completely debilitating. Instead, they develop gradually due to poor alignment, overuse or stress. If you're proactive, you can catch some of these problems before they become a full-blown injury. It's wise to see a health professional, though not necessarily a physician, for irritating issues—hips that click during certain movements, or ankles that are cranky every morning. Though only an MD or DO (along with physicians assistants and nurse practitioners) can legally make diagnoses and write prescriptions, there are many other practitioners who can help with these pre-injury puzzles.

Physical therapists, certified athletic trainers and massage therapists: In addition to getting you back into shape post-injury, these specialists can help prevent injuries, especially if they have dance-specific training. Along with manual treatments like assisted stretches and joint mobilization (where you typically relax and breathe while someone moves your bones), PTs and ATCs may suggest exercises and stretches for homework to help improve your alignment, range of motion, muscular balance and ballet technique. Massage can be a useful tool for preventing muscular imbalances that can lead to injury, and is also a popular post-performance ritual for dancers. Specializations vary, so look for professionals with certifications in sports medicine, orthopedics, rehabilitation or manual therapy.

Chiropractors: Because of the immediate effect of their treatments, many dancers like to see chiropractors. They employ a range of techniques aimed at helping the bones become better aligned. Expect a chiropractor to explain their plan for your visit. For instant changes, they might ask you to inhale and then bend you sideways, eliciting a loud pop, or, for more gradual transformations, simply have you lie with small wedges under your pelvis. Occasionally, chiropractors support their treatments with other modalities, like acupuncture or massage.

Acupuncturists: NYU Langone's Harkness Center for Dance Injuries' Megan Richardson, MS, Dipl Ac, LAc, ATC, an acupuncturist and certified athletic trainer who treated Greenbaum's tendonitis, calls acupuncture a "reset button." This form of ancient medicine inserts very thin needles under the skin to alter the body's energy. It can be used to treat physical symptoms, like swelling and muscle strains, as well as mental challenges, like anxiety and exhaustion.


Healing Takes a Team

Don't be frustrated if the professional you choose refers you to a different expert—in fact, be glad! As Greenbaum found, it often takes several kinds of treatment to fully recover. A reliable practitioner should recognize their limitations and have a good idea of who you should see next. You should also have a sense of when it's time to try something new. "Within three to four visits, you may not feel 100 percent better, but there should be a change," says Richardson. This is true of most treatment plans, so if your progress has plateaued, ask yourself and your provider if it's time to try another approach.

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Extra Tips

Don't Ignore These Aspects of Healing

  • What you eat can impact injury. Without the proper balance of micro- and macronutrients, the body isn't able to effectively repair itself, says nutritionist Heidi Skolnik, MS, CDN, FACSM, who works with students at the School of American Ballet and The Juilliard School. A nutritionist can assess your particular diet and suggest foods that will help you stay strong and heal.
  • The stress-injury connection is real. Boston-area clinical psychologist Dr. Elisabeth Morray, PhD, explains that stress can lead to a feeling of bodily disconnect, which can prevent dancers from detecting the warning signs of injury. Stress can also disrupt sleep, which compromises the immune system and reduces healing. Consider working with a mental-health professional to keep your mind and body performing at their best. —EK

How Important Is Dance Expertise?

Seeing a practitioner who's familiar with ballet is ideal. If you live near a professional ballet company, find out who their dancers see. However, depending on your insurance or location, this may not be possible. Dr. Selina Shah, MD, FACP, a physician who treats dancers from San Francisco Ballet School, suggests that you be prepared to "be a partner in the process." You may need to do a bit of teaching by demonstrating steps and explaining class format. When dance-specific knowledge is not an option, a practitioner who is curious and open to learning about ballet can be a great health collaborator.

Ellie Kusner, MSc Dance Science, researches, writes and lectures on dancer health and wellness in New York City.

Many of us take our ballet training for granted. But for dancers living in Puerto Rico, which is still reeling from the devastating affects of last month's Hurricane Maria, pursuing a ballet career or simply taking class must now feel insurmountable. What do you do when Mother Nature not only destroys your dance studio, but your home and the majority of the city you live in? Priorities must shift to those of basic survival.

Now, the Sarasota Herald-Tribune reports that the Sarasota Cuban Ballet School is trying to help six Puerto Rican dancers resume their training. The students, whose studio in San Juan was badly damaged, had recently attended SCBS's summer intensive. School directors Ariel Serrano and Wilmian Hernandez have started a fundraising effort called "Sarasota And Puerto Rico Dance Together" to temporarily relocate the dancers. While they can easily offer them scholarships, Serrano and Hernandez must raise an additional $36,000 to provide housing, food and living expenses for one year. (SCBS has a dormitory for female students, but not for male students.)

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Alexei Ratmansky with members of the corps de ballet. Photo by Gene Schiavone, Courtesy American Ballet Theatre.

When the choreographer Alexei Ratmansky joined American Ballet Theatre as artist in residence eight years ago, the company hadn't had a house choreographer since the days of Antony Tudor. The gamble seems to have paid off handsomely. In that time Ratmansky has either made or restaged 12 ballets for the company. In 2011, the company extended his contract to 2023. Such commitments are practically unheard of at a time when top dancers and choreographers hop from company to company, continent to continent. The scale and ambition of the works Ratmansky is making for ABT is a rarity too, in a world of tight budgets, scant rehearsal time and pared-down esthetics.


Set design for new "Harlequinade." Courtesy ABT.

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Houston Ballet's Jared Matthews and Sara Webb in"The Sleeping Beauty." Photo by Amitava Sarkar, Courtesy Houston Ballet.

Despite the devastation and pain that Hurricanes Harvey and Irma have left in their wake this fall, it's been encouraging to see dancers step up in aid of their communities: When the future of Houston Ballet's Nutcracker seemed uncertain, venues around the city pulled together to allow the company to produce the show on a "hometown tour." And when Florida ballet companies had to evacuate, Atlanta Ballet and Charlotte Ballet welcomed them with open arms. In addition, New York City-based studio Broadway Dance Center offered community classes in September with proceeds donated to the American Red Cross.

The next in this series of good deeds is Hearts for Houston, a benefit performance bringing dancers from seven major companies together at New York City's Alvin Ailey Citigroup Theater to raise money for the United Way of Greater Houston's Harvey Relief Fund. Scheduled for Sunday, October 22, the evening will feature members of the Houston Ballet, American Ballet Theatre, New York City Ballet, Pennsylvania Ballet, Texas Ballet Theater, The Washington Ballet and Alvin Ailey American Dance Theater. Hearts for Houston is imagined and produced by Houston Ballet principal dancers Yuriko Kajiya and Jared Matthews (both formerly of ABT) and funded by patrons Phoebe and Bobby Tudor and sponsor Neiman Marcus.


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Catherine Conley. Photo by Alex Garcia.

When I was 4 or 5, I told my mom, "I want to go to a real dance school with barres and a mirror." My preschool recommended Chicago's Ruth Page Center for the Arts. That's where I trained until I left for Cuba a year ago. I went to regular school during the day, and then had ballet class for four or more hours per day during the evenings and weekends. Nobody in my family has a dance background, but they've been supportive through all of it.

My school in Chicago teaches a technique that draws on Vaganova, Cecchetti and Bournonville. I went to very different summer intensives, as well: American Ballet Theatre, the Royal Ballet School in London and Boston Ballet. Then, two summers ago, Ruth Page School of Dance director Victor Alexander, who is Cuban, arranged an exchange with the Cuban National Ballet School. A group of eight Cubans came to Ruth Page's summer intensive. I had to learn an entire pas de deux as well as a contemporary ballet piece in 10 days, and then perform them. I'd never had to do anything that quickly; it was hard work but exciting. I then realized that if I could dance professionally, I wanted to.


Conley in class at the Cuban National Ballet School. Photo by Alex Garcia.

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Pointe Stars
Photo by Paul Kolnik, via Instagram

Zachary Catazaro is ending his New York City Ballet Fall 2017 season on a high note. NYCB's ballet master in chief, Peter Martins, announced Catazaro's promotion from soloist to principal on Oct. 12th, just before the company's evening performance.

Catazaro had a stand out season, making his debut as Prince Siegfried alongside principal Sterling Hyltin's Odette/Odile in Martins' Swan Lake. He also debuted in featured roles in Martins' The Red Violin and Jerome Robbins' In Memory Of... as well as George Balanchine's La Valse.

Catazaro, originally from Canton, Ohio, joined the company as an apprentice in 2007, and has quickly moved through the ranks.

Principal dancer Rebecca Krohn retired from the stage earlier in the season, and Robbie Fairchild is set to give his farewell performance with NYCB this coming weekend, so we can't wait to see Catazaro tackle his new rank (and the feature debuts that come along with it) in the coming seasons.

Training
Eleanor Rodriguez. Photo Courtesy RAD.

"When I compete, I'm the type to get nervous and shaky," says 19-year-old Eleanor Rodriguez. Growing up, the Phoenix, Arizona native had competed in figure skating and archery, but last month she got her first taste competing in the ballet world when she traveled to Lisbon, Portugal for the Royal Academy of Dance's Genée International Ballet Competition. Rodriguez, who has been most recently studying at the Russian-based Master Ballet Academy in Scottsdale, trained mainly in the RAD style under Mary Mo Adams. "I've been working in the curriculum my whole life, and the Genée is the height of that experience."

Rodriguez was also the only American participant, adding to the pressure. "I definitely feel like I have to represent," she said a few days before leaving for the competition. "But I've been training really hard. I'm as ready as I can be." She prepared two solos ahead of time—the second Shades variation from La Bayadère and a "Dancer's Choice" neoclassical solo choreographed by her Master Ballet Academy teacher Albert Cattafi. Once in Lisbon, Rodriguez enjoyed four intense days leading up to the semi-finals that included classes, coaching sessions with RAD faculty and learning another solo created especially for the Genée by Portuguese choreographer César Augusto Moniz.


Photo by Ed Flores, Courtesy RAD.

While Rodriguez, who joins Ballet Arizona's Studio Company this fall, did not make it to the final round, she felt the experience was well worth it. "I loved receiving coaching and having an opportunity to perform." We asked her to share how she stayed calm and maintained perspective during the competition, below.

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Herman Cornejo in "La Bayadere." Photo by Gene Schiavone, Courtesy American Ballet Theatre.

A double tour, says American Ballet Theatre principal Herman Cornejo, "is the step that defines a male dancer." Here, he shares his thoughts on mastering this necessary trick.

Don't anticipate: "The takeoff is hard," Herman Cornejo acknowledges. "You want to take all your force around, and that twists your back to the side and your fifth out of place." Instead, the impulse for the rotations comes from the bottom of the plié. "Be calm to start. Prepare to a relevé, plié, and the moment the heels touch down, then you take the force."

Use your glutes: A common error Cornejo sees is "sticking your butt out and your chest forward in plié so that you're not on top of your hips. You'll never make it to the other side!" Your glutes, he adds, are "so powerful that when you engage them, it really makes a difference."


Cornejo in a double tour en l'air. Photo Courtesy Cornejo.

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