Pittsburgh Ballet Theatre corps member Gabrielle Thurlow never realized that simply going to the doctor could improve her technique. But after taking part in the new Dance/USA post-hire health screening hosted by PBT, “I found out I had weak lower abs and a tight IT band,” she says. “Since doing all the prescribed exercises, my turns and jumps have both improved.”
Dancers have a bad reputation for avoiding the doctor. A health screening done by a doctor or physical therapist associated with your company can be daunting. After all, it could reveal a weakness. But screenings are there to protect dancers’ health, leading to more time onstage and a more pain-free career.
Some dance companies have carried out their own screenings for years. But with different tests and terminology, there was no way to collect data that could be used for dance medicine research.
A call for help came from dance companies themselves. “Dancers were still smoking, rarely seeing their doctors and often never leaving the building,” says Richard Gibbs, MD, supervising physician at San Francisco Ballet. The Dance/USA Taskforce on Dancer Health came together in 2005 to write a standardized post-hire screening protocol. It is now used by 33 companies.
The screening is completed by whoever is responsible for company medical care (usually a physical therapist). It’s similar to a physical, but more focused on a dancer’s needs, including tests for biomechanical imbalances that could lead to injury. The range-of-motion test may be the most crucial. “We measure the internal and external rotation of the hips, the stability of the pelvis, the flexion and extension of the ankle joint, flexibility of the hamstring and quadriceps muscles and the tightness of the iliotibial band,” says Dr. Gibbs, who is chair of the taskforce. The screening is followed by personally tailored exercise recommendations. Dancers are in and out in 30 minutes.
“There is tremendous potential to prevent injury,” says Dr. Gibbs. He once caught high blood pressure in a young dancer during the screening. “He was heading for heart disease and a possible stroke,” says Dr. Gibbs. It is now managed with medication, and he will likely be able to continue dancing for much longer.
A benefit for Thurlow is that the company physical therapists are familiar with her. “Screening helps them know my body so they are already aware of what they are dealing with,” she says.
AGMA (the professional dancers union) makes sure the screening is voluntary, dancers get paid for their time and the results stay confidential. Privacy is key. The information can never be used to deny a job; neither management nor artistic staff have access to it. “HIPAA [the Health Insurance Portability and Accountability Act of 1996] calmed everyone’s privacy concerns. The screen is slam dunk protected,” insists Dr. Gibbs. HIPAA violations can result in serious fines and loss of medical licenses.
Yet some dancers prefer not to get screened. At Houston Ballet, for example, 17 percent of dancers opt out, including principal Ian Casady. “I wasn’t one of those dancers who never went to a doctor,” says Casady, 29. “I had my own doctor who was very knowledgeable on dance; we’d developed a strong rapport.” Casady is considering doing the screening next year to contribute to the research but will continue with his own doctor.
Today the taskforce has finally gathered a body of data available for research. Studies on the aerobic capacity and range of motion differences between ballet and modern dancers are currently underway.
“There’s a general sense of ethical caring,” says Dr. Gibbs. “Everyone benefits; this is a win/win situation. There are more dancers on stage, companies have lower insurance costs and dancers are doing what they are trained to do. And finally, we are moving dance science forward.”