Haskins in Michael Smuin's "The Christmas Ballet." Photo by Keith Sutter, Courtesy Smuin Ballet.

Dancing With a Chronic Medical Condition: 4 Pros on How They Make it Work

Day in and day out, dancers expect their bodies to perform at the highest level of athletic and artistic achievement. However, some develop chronic medical conditions that prevent them from doing their best consistently. Still, many learn to manage their symptoms while dancing professionally. Pointe spoke with four dancers who haven't let medical problems stop them.

Holloway and Nicholas Rose in Glen Tetley's "Dialogues." Photo by Nan Melville, Courtesy DTH.

Alicia Holloway

At 13, Alicia Holloway almost quit dancing. Her asthma was so bad that she struggled for every breath during rehearsals. However, today the Dance Theatre of Harlem artist maintains a professional rehearsal and performance schedule.

To do so, Holloway takes good care of herself. To ward off illness, which aggravates her asthma, she sticks to a healthy diet: a lot of protein to build muscle, veggies for energy and sweets rarely. Also, when Holloway has physically demanding roles, she does extra cardio to build her stamina.

Despite these measures, Holloway's asthma occasionally erupts during class or rehearsals. In addition to fighting to breathe during her attacks, which last 2 to 15 minutes, Holloway worries she could pass out and hit her head. Therefore, she keeps her inhaler nearby and takes breaks when she needs them.

"When I feel an asthma attack coming on, I'll say, 'Give me a second and let me relax, and I'll be ready,' " she says.

Also, touring can be challenging for Holloway when the company performs in a high-altitude location. If her body can't acclimate, another dancer takes her place.

Holloway says she has always been supported by her artistic director and fellow company members when her asthma flares up. Even so, she says, she must put in the extra effort to ensure it doesn't interfere with her dancing or her career.

"I have to work 100 percent harder than others," Holloway says. "But if you have the will, you can do it."

Haskins in Michael Smuin's "Fly Me to the Moon." Photo by Keith Sutter, Courtesy Smuin Ballet.

Nicole Haskins

Two years ago Smuin Ballet dancer Nicole Haskins was diagnosed with psoriasis. The disease, which causes raised, itchy, painful red patches on the skin, can be aggravated by many elements dancers encounter daily, such as perspiration, tight-fitting clothing, and the harsh detergents and dyes used on costumes.

Haskins follows an extensive holistic regimen to keep her disease under control. "Taking care of psoriasis has become part of my routine, like brushing my teeth," she says. For instance, she uses all-natural soaps and lotions. Haskins also keeps her skin moisturized, which can be tricky when she's performing—if she mistimes it, she gets the stage oily. To keep sweat from irritating her skin, she frequently changes her dance clothes, which are made of high-quality fabrics and washed in all-natural detergents. She also uses an all-natural cleanser to remove stage makeup (the only makeup she wears).

Keeping inflammation and stress down is important, too. Therefore, Haskins eats a healthy diet, sees an acupuncturist and takes herbal supplements. She also practices yoga, journals and meditates.

Despite her efforts, Haskins says, she often has patches of psoriasis."But that doesn't mean I don't have things to offer," she says. "It's all in how we embrace what we have and use it to its greatest potential."

Walborn eats a high-calorie diet to keep her Crohn's disease in check. Photo by Ed Flores, Courtesy Walborn.

Sarah Walborn

In 2016, after a decade of remission, freelance dancer Sarah Walborn's Crohn's disease flared up, and it almost ended her career. Walborn suffered the severe gastrointestinal distress typical of Crohn's and lost weight and muscle. The company she was with said she didn't look well enough to perform and took away her roles, Walborn recalls. She left at the end of the season.

"They didn't know how to deal with the situation and weren't supportive," Walborn says. After taking more than a year to heal and get back in shape, she resumed her career.

Today, Walborn maintains specific protocols to keep the disease in check. She sticks to a healthy, high-calorie diet that maintains her weight. Next, she surrounds herself with positive people, sees a chiropractor and gets massages to alleviate the stress that could bring on an episode. When Walborn does feel one coming on, she takes a steroid to prevent a full-blown attack. And, occasionally, she'll take sick days to recover from a flare-up.

Walborn hopes more dancers and companies will openly discuss medical issues. "It's important to acknowledge that as dancers we may have medical conditions, but we shouldn't have to label ourselves as a sick person," she says. "We live with it, but it doesn't define you as a dancer."

Long, here in "Rubbies," works regularly with a physical therapist for her scoliosis. Photo by Alexander Iziliaev, Courtesy MCB.

Jordan-Elizabeth Long

At 12, Miami City Ballet soloist Jordan-Elizabeth Long was diagnosed with scoliosis. In a year's time, the curve in her spine had grown so severe that Long was immediately fitted for a back brace. She wore the brace for a year, removing it only for ballet classes and showers. The next year, Long wore it at night.

By taking care of her back then and now, Long says her scoliosis hasn't limited her as a dancer.

Long's number-one spine-health strategy is to work regularly with a physical therapist and Pilates instructor. (Because she has a flexible back, Long has had minimal pain from scoliosis.)

Second, Long constantly adjusts her body to accommodate her spinal curvature: She keeps her right side back for pirouettes; pulls her right shoulder down and back for penchés; and checks the mirror to make sure her port de bras looks correct. "I must think of those things all the time, every day," Long says.

In addition, Long helps her partners understand her needs. For example, because her back is rounded, she tells her partners she must place her arm farther back than other dancers.

Though Long says her scoliosis forces her to "work smart," she doesn't consider it a shortcoming. "All dancers have gifts and weaknesses," she says. "Dance is about what you bring to the stage that is different from other people."

If It's You

According to the Americans with Disabilities Act, you don't have to tell your employer you have a medical condition. Further, unless you require reasonable accommodations (i.e., a diabetic needing breaks to get an insulin shot) or there is reason to believe you cannot perform the job successfully or safely because of your condition, an employer may not ask about it. Also, they can't withdraw a job offer or terminate you because of a medical condition unless you pose a direct threat to yourself or to others, or you can't perform the job even when reasonable accommodations are provided.

However, disclosing that you have a chronic condition could benefit you. Boston Ballet's artistic director Mikko Nissinen says it's best that he knows a dancer has a medical problem as soon as possible, upon hiring if not during the interview. "No one can help them if they don't let you know," he says. "The dancer must open the dialogue so everyone can be understanding and supportive."

Zippora Karz, a former New York City Ballet soloist who developed type 1 diabetes early in her career (and wrote about her experiences in her memoir The Sugarless Plum), recommends informing artistic staff in a way that reassures them that you can do the job: "Tell them, 'I have this condition, but it's well under control and I'm very responsible with it.' " Also, Karz adds, by opening up, you can enlist a company friend to be a safety net—someone who recognizes the signs when something is off and knows what to do to help.

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Last summer many intensives were canceled or online-only. And the past school year has been spotty and strange for many, as well. All the more reason to look forward to an in-person summer program this year with excitement—but also, perhaps, some nerves. Take heart, says Simon Ball, men's program coordinator at Central Pennsylvania Youth Ballet. "Once you get there the first day, all those fears will be relieved."

Here, Ball and two other experts share their advice for how to make the most of this precious opportunity to dive deep into dance—and how to handle complications that may get in the way, like injury and drama.

1. Show Off...Your Work Ethic

Summer intensives offer a preview of company life: You'll be dancing in a variety of styles over the course of the day, and all day, everyday. But that doesn't mean you have to be company-ready on day one! Though the first day may be filled with placement classes, try not to approach every class as an audition. "This year has taught us that the work is the important thing," says Ball. "Let go of trying to impress. The best impression I ever receive as a teacher is when I see someone receptive to doing things differently, even if that means taking one step backwards initially, to be able to take two steps forward by the end of the summer."

Angelica Generosa, a principal with Pacific Northwest Ballet, clearly made a splash during her first of three summers at the Chautauqua Institution's School of Dance. At 14, she was cast to dance the pas de deux from Balanchine's Stars and Stripes in the final performance. Generosa describes her younger self as "very eager." She'll be a guest teacher at Chautauqua this summer, and says that a similar eagerness catches her attention: "Dedication, and willingness to try. That twinkle in the eyes when a step is really challenging."

2. Make Friends

Even if friends from your year-round school will be with you this summer, branch out. During breaks at the studio, you may be tempted to spend time on your phone. "Take your headphones off," suggests Margaret Severin-Hansen, director of Carolina Ballet's summer intensive. "Share that ballet video with the person sitting next to you! Their eyes might see it differently; you could learn something. Or find that you have other things in common, too."

Do things outside the studio, too, even if your social circle is limited for safety reasons to a "pod" of classmates. "Sign up for activities," says Generosa. Go on that weekend shopping trip, or out for ice cream. "Be open," she says. "These are people you might see along the way in your future."

Simon Ballet, wearing dark clothing, is shown from behind demonstrating ecart\u00e9 arms while in front of him, a class of teenage ballet students perform d\u00e9velopp\u00e9 ecart\u00e9 devant on pointe in a medium-size studio. The dancers, all girls, wear leotards, pink tights and pointe shoes.

Simon Ball leads class at Central Pennsylvania Youth Ballet.

Courtesy CPYB

3. Stay Healthy

"The first week is tough—you're going to be sore," says Ball. "Prepare yourself." He means that literally. Before your program begins, ramp up cross-training, especially cardio to build your stamina. Severin-Hansen recommends you also keep dancing. It no longer matters that your regular school might be on break: We now know it's possible to take virtual classes from home or in a rented studio. If you're on pointe, make sure to put the shoes on every day, at the very least for some relevés. Keep the skin on your toes tough; the last thing you want is to be sidelined by blisters.

If you are recovering from an injury or managing something persistent like tendonitis, take action even further in advance. Find out if your intensive provides access to physical therapy, and if not, make a plan before you leave home. Learn exercises and massage techniques that you can do on your own, and ask about virtually checking in with your regular doctor or PT. Once you arrive, says Ball, communicate with your instructors. "Chances are it's a common ballet injury that teachers understand. They'll be able to help you."

During her summer intensives, Generosa often suffered flare-ups of inflammation. "I knew the tendonitis in my knees was from over turning out, and in my ankles from lifting my heels in plié." She was able to alleviate some of her pain by dancing more thoughtfully, addressing those habits. She also got creative about taking care of her tendons during off-hours. "I basically did ice baths in Chautauqua Lake."

4. Deal With Disappointment Constructively

Whether you're placed in a lower level than you'd like or were hoping for a soloist role that went to someone else, disappointment is understandable. Try, on your part, to understand too. The faculty may believe you'll thrive more in that particular group, or see a technical issue better solved by not pushing you too fast. If you're not sure exactly what you should be working on, ask. "Trust that you can make the most of your experience, whatever level you're in," says Ball. "Don't be afraid of the conversation."

5. Avoid Drama

Competition is inevitable, but unproductive competition is unnecessary, and bullying unacceptable. Severin-Hansen lays down a very clear guideline: "Nobody should ever feel uncomfortable." If you hear or see anything that bothers you—whether directed at you or someone else—don't hesitate to speak up. "If there's even one person creating drama, you feel it in the class. Summer is short. There's no room for that." Tell the resident advisor in the dorms, or bring the problem to the school administration.

Angelica Generosa performs an arabessque elong\u00e9 on pointe while her partner stands behind her holding her waist and with his left leg in tendu. She holds her left hand on her hip and extends her right arm out to the side with her palm up. Angelica wears a purple leotard, black tights and a white Romantic tutu while Kyle wears a yellow shirt, black tights and tan slippers.

Pacific Northwest Ballet principal Angelica Generosa (shown here in rehearsal with Kyle Davis) made notes of corrections she'd received and variations she'd worked on during her summer intensives to help retain what she had learned.

Lindsay Thomas, Courtesy PNB

6. Fuel the Long Day

Depending on your housing arrangement this summer, you may be on your own for buying or preparing your own meals. Generosa recalls her first time living in a dorm and eating cafeteria food: "I wanted to try everything: pizza, chicken tenders, the salad bar, the dessert section—that was also my introduction to coffee." She found, however, that caffeine and sugar rushes would give way to energy crashes, and soon enough her better knowledge prevailed. "I told myself, 'Angelica, get your protein, vegetables, complex carbs—the right kind of energy.'"

Masking requirements may make snacking at the studios slightly more difficult. Nonetheless, there will almost certainly be somewhere you can safely have a nibble in between classes, whether that's a dancers' lounge or socially distanced in the studio itself. Make sure you always have something with you that's easy to munch on during breaks. Ball recommends protein bars or fruits and veggies. "Hydrating is huge," he adds, and suggests bringing packets of powdered electrolyte supplements to add to your water.

7. Retain Corrections

Take a moment each evening, Severin-Hansen advises, to write a few things down. "Say the whole class got a general correction, like 'Use your head.' The person who takes notes will think about it: 'When could I have used my head?' It's all about how you come back the next day and improve."

Generosa set a goal for herself to get better every day. To accomplish this, she would stay late to practice, she says, "so my body could adjust to what I was trying to achieve in that class." If you're inclined to follow her example, ask a friend to practice with you. You can film each other to get a glimpse of your own progress.

At the end of her Chautauqua summers, Generosa made notes of some things she had worked on and which variations she'd learned. "Then it wasn't like I left and that was that. I brought the summer experience with me, for my whole year."

Michael Cousmano, AKA Madame Olga. Courtesy When I'm Her

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