Emily Giacalone, modeled by Elizabeth Steele of The School at Steps.

Do I Have a Labral Tear? What You Need to Know About Treating This Common Ballet Injury

In fall 2012, New York City Ballet associate artistic director Wendy Whelan, then a company principal, was taking morning class when her foot slid out from under her, causing her to pull the very top of what felt like her right hamstring muscle. "It shocked me from the inside out," she notes.

Whelan spent three months nursing her hamstring. But once she got back to performing, her right hip flexor began flaring up. "By the end of Nutcracker season, I could no longer bear standing in fifth position. I could not lift my right leg without severe pain," she says. "I couldn't imagine why or how this was suddenly becoming so debilitating." A sonogram revealed a complex labral tear in Whelan's hip.

The labrum is a horseshoe-shaped band of cartilage that lines the acetabulum, or hip socket. The labrum's soft tissue acts as a shock absorber; it also helps keep the ball of the femur securely positioned in the socket, provides stability and protects the joint surface. Whelan's complex tear was more debilitating than most, but it's important to understand the warning signs and varying treatment options available for this common and painful dance injury.

Illustration of a pelvis and hip pone showing the location of a labral tear.

Emily Giacalone

What Does It Feel Like?

Symptoms include a deep aching or burning sensation in the hip and groin area (sometimes the pain radiates to the back of the hip). Side extensions, like développés or grands battements, frequently worsen the pain and cause a flare-up. Often a retiré or fifth position can be irritating. Even nondance activities like climbing stairs, bending over, getting out of a car or walking may become difficult.

"Many dancers describe the pain like sandpaper in the joint," notes Emily Becker, PT, DPT, a dance medicine physical therapist in Denver. You may also experience clicking or locking sensations when lifting or lowering the leg and feel limited range of motion and stiffness throughout the area. Sharp, stabbing sensations in the hip during quick movements can indicate a more significant tear.

Sometimes dancers can identify a slip or fall when the labrum tears abruptly. But often the pain comes on slowly due to progressive wear and tear of the joint. "There wasn't a specific moment in which I knew something was wrong," says Orlando Ballet dancer Isabella Mendez, who was a young trainee with the company when she was diagnosed with a labral tear. Instead, she gradually started feeling pain in her right hip during retirés and side extensions. "It eventually turned into constant pain," says Mendez, who then saw an orthopedist.

Isabell Mendez in a pink skirt, crop top and pointe shoes stands in an elaborate, fancy hall above a wrought iron staircase, with a large chandelier.

Isabella Mendez. Jerry Kestel, Courtesy Mendez.

Why Are Dancers So Prone to Them?

Dancers are prone to these tears because of the strain placed on their hip joints, and because labrums tend to dislike direct or rotational force. Many also discover that they have a rough edge or irregular shape along one or both of the hip bones called femoral acetabular impingement (FAI), which contributes to labral wear and tear.

"Hyperextension, in addition to doing oversplits, will weaken the hip ligaments," says Becker, who adds that extreme stretching places stress on the labral tissue. "Forcing turnout on hips that are still developing will also strain the anterior capsule and create more instability of the joint," she adds.

How Do You Treat It?

Once an orthopedist has diagnosed you with a labral tear, it's important to know the treatment options available in order to decide which choice is best for you.

Conservative management, including massage, acupuncture, anti-inflammatory medication and physical therapy, is recommended first. Physical therapists work to strengthen the muscles surrounding the labrum, which frequently helps decrease pain and improve function and range of motion. Most doctors agree that once labral tissue is torn it's not able to heal itself, but many dancers find relief from their symptoms with PT and can eventually return to dancing fully.

Unfortunately, depending on the location and severity of the tear, conservative treatment doesn't always work. Whelan attempted many therapeutic procedures in search of relief, but eventually required labral reconstruction surgery. "When nonsurgical options have been exhausted and the dancer cannot perform due to pain, that's when I would consider surgery," says Dr. Andrew Wolff, an orthopaedic surgeon and athletic hip injury specialist with Washington Orthopaedics and Sports Medicine and an official physician for The Washington Ballet.

Currently, there are three arthroscopic procedures that can be performed if labral surgery is deemed necessary. (Wolff notes that recovery time is similar for each of these procedures. Dancers are advised to use crutches for about a month—usually it is less—and then to incorporate barre work after 8 to 12 weeks. High-level performance resumes after about six months.)

Debridement: The surgeon shaves off the ragged and torn areas of the labrum in order to limit further tearing and decrease pain.

Labral repair: The surgeon reattaches the torn portion of the labrum to the hip socket. This is most often done with small plastic pins/anchors and sutures.

Reconstruction: The surgeon removes the badly damaged, irreparable tissue, and the deficient labrum is replaced with an autograft (tissue from another area of the body) or allograft (tissue received from a tissue bank).

Many factors will determine which surgery is best. "These include the amount of damage to the labrum, the experience and skill level of the surgeon, and whether the athlete has failed a previous surgery," says Wolff. "In my experience, athletes with severe labral damage or who have failed previous surgery almost always do better with a reconstruction." There are currently only a handful of hip specialists in the U.S. who regularly perform labral reconstructions.

Though Mendez was able to complete her trainee year at Orlando Ballet, she was in so much pain that she elected to have debridement surgery once the season ended. Post-surgery, she took most of the summer off and began barre work after several weeks of physical therapy. Although she recovered, eventually becoming a full-fledged company member, she still performs hip-strengthening exercises. "I don't have a lot of pain anymore, but sometimes my hip will remind me it won't go a certain way or height."

If you fear you have a labral tear, see your doctor—and keep in mind that many dancers are able to manage the injury and return to dancing fully. "Ballet is difficult and challenging, and one can't help but experience occasional aches and pains," says Whelan. "But learning how to listen to your body early on in your career can be extremely rewarding for it in the long run. We only have one body—we have to take the time to treat it well and check in with it thoroughly and thoughtfully each day."

Try This Exercise for Stronger Hips

A dancer in black leggings and a red leotard stands with one leg extended behind her with an elastic band wrapped around it that she's holding with her hands.

Emily Giacalone, modeled by Elizabeth Steele of The School at Steps.

Emily Becker, PT, DPT, recommends this exercise to strengthen the hip extensors, hamstrings, glutes and core muscles. Conditioning these muscles will help dancers maintain healthy hips.

1. Stand in a parallel fourth position with your front leg in a demi-plié. The back leg will be standing on a resistance band (positioned under your arch). Hold both ends of the band in your hands with your elbows against your ribs and your forearms parallel to the floor.

2. In one motion, extend your arms forward and transfer all the weight onto your front foot while staying in plié and gently extending the back leg into a low arabesque.

3. Return to parallel fourth. Practice 3 sets of 10 low arabesques.

Pay special attention to alignment so that your back does not arch in arabesque.

Think you have a labral tear? Don't self-diagnose.

Other injuries, like bursitis and snapping hip syndrome (iliopsoas tendonitis), can cause similar discomfort. And according to Emily Becker, PT, DPT, stress fractures, a sports hernia, abductor strain or even ovarian cysts can also mimic labral tear symptoms. "It's always best to see an orthopedic MD (or a physical therapist) to obtain a correct diagnosis and decide if any imaging is warranted," says Becker.

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Chisako Oga photographed for Pointe by Jayme Thornton

Chisako Oga Is Soaring to New Heights at Boston Ballet

Chisako Oga is a dancer on the move—in more ways than one. From childhood training in Texas, California and Japan to a San Francisco Ballet apprenticeship to her first professional post with Cincinnati Ballet, where she quickly rose to principal dancer, she has rarely stood still for long.

But now the 24-year-old ballerina is right where she wants to be, as one of the most promising soloists at Boston Ballet. In 2019, Oga left her principal contract to join the company as a second soloist, rising to soloist the following year. "I knew I would have to take a step down to join a company of a different caliber, and Boston Ballet is one of the best companies in the country," she says. "The repertoire—Kylián, Forysthe, all the full-length ballets—is so appealing to me."

And the company has offered her major opportunities from the start. She danced the title role in Giselle in her very first performances with Boston Ballet, transforming a playful innocent into a woman haunted by betrayal with dramatic conviction and technical aplomb. But she also is making her mark in contemporary work. The last ballet she performed onstage before the pandemic hit was William Forsythe's demanding In the middle, somewhat elevated, which she says was a dream to perform. "The style really clicked, felt really comfortable. Bill drew something new out of me every rehearsal. As hard as it was, it was so much fun."

"Chisako is a very natural mover, pliable and strong," says artistic director Mikko Nissinen. "Dancing seems to come very easy for her. Not many have that quality. She's like a diamond—I'm curious to see how much we can polish that talent."

Chisako Oga, an Asian-American ballerina, does a pench\u00e9 on pointe towards the camera with her arms held out to the side and her long hair flying. Smiling confidently, she wears a blue leotard and a black and white ombr\u00e9 tutu.

Jayme Thornton for Pointe

A Life-Changing Opportunity

Oga began dancing at the age of 3. Born in Dallas, she and her family moved around to follow her father's job in IT. Before settling in Carlsbad, California, they landed in Japan for several years, where Oga began to take ballet very seriously. "I like the simplicity of ballet, the structure and the clear vocabulary," she says. "Dances that portray a story or have a message really drew me in. One of my favorite parts of a story ballet is diving into the role and becoming the character, putting it in my perspective."

In California, Oga studied with Victor and Tatiana Kasatsky and Maxim Tchernychev. Her teachers encouraged her to enter competitions, which she says broadened her outlook and fed her love of performing in front of an audience. Though highly motivated, she says she came to realize that winning medals wasn't everything. "Honestly, I feel like the times I got close and didn't place gave me perspective, made me realize being a dancer doesn't define you and helped me become the person and the dancer I am today."

At 15, Oga was a semifinalist at the Prix de Lausanne, resulting in a "life-changing" scholarship to the San Francisco Ballet School. There she trained with two of her most influential teachers, Tina LeBlanc and Patrick Armand. "She came in straightaway with strong basics," Armand recalls, "and working with her for two years, I realized how clever she is. She's super-smart, thoughtful, driven, always working."

She became a company apprentice in 2016. Then came the disappointing news—she was let go a few months later. Pushing 5' 2", she was simply too short for the company's needs, she was told. "It was really, really hard," says Oga. "I felt like I was on a good track, so to be let go was very shocking, especially since my height was not something I could improve or change."

Jayme Thornton for Pointe

Moving On and Up

Ironically, Oga's height proved an advantage in auditioning for Cincinnati Ballet, which was looking for a talented partner for some of their shorter men. She joined the company in 2016, was quickly promoted to soloist, and became a principal dancer for the 2017–18 season, garnering major roles like Swanilda and Juliet during her three years with the company. "There were times I felt insignificant and insecure, like I don't deserve this," Oga says about these early opportunities. "But I was mostly thrilled to be put in those shoes."

She was also thriving in contemporary work, like choreographer-in-residence Jennifer Archibald's MYOHO. Archibald cites her warmth, playfulness and sensitivity, adding, "There's also a powerful presence about her, and I was amazed at how fast she was at picking up choreography, able to find the transitions quickly. She's definitely a special talent. Boston Ballet will give her more exposure on a national level."

Chisako Oga, an Asian-American ballerina, poses in attitude derriere crois\u00e9 on her right leg, with her right arm out to the side and her left hand grazing her left shoulder. She smiles happily towards the camera, her black hair blowing in the breeze, and wears a blue leotard, black-and-white ombre tutu, and skin-colored pointe shoes.

Jayme Thornton for Pointe

That was Oga's plan. She knew going in that Cincinnati was more stepping-stone than final destination. She had her sights on a bigger company with a broader repertoire, and Boston Ballet seemed ideal.

As she continues to spread her wings at the company, Oga has developed a seemingly effortless artistic partnership with one of Boston Ballet's most dynamic male principals, Derek Dunn, who Oga calls "a kind-hearted, open person, so supportive when I've been hard on myself. He's taught me to believe in myself and trust that I'm capable of doing whatever the choreography needs." The two have developed an easy bond in the studio she likens to "a good conversation, back and forth."

Dunn agrees. "I knew the first time we danced together we had a special connection," he says. "She really takes on the artistic side of a role, which makes the connection really strong when we're dancing onstage. It's like being in a different world."

He adds, "She came into the company and a lot was thrown at her, which could have been daunting. She handled it with such grace and confidence."

Derek Dunn, shirtless and in blue tights, lunges slightly on his right leg and holds Chisako Oga's hand as she balances on her left leg on pointe with her right leg flicking behind her. She wears a yellow halter-top leotard and they dance onstage in front of a bright orange backdrop.

Oga with Derek Dunn in Helen Pickett's Petal

Liza Voll, Courtesy Boston Ballet

Perspective in a Pandemic

The pair were heading into Boston Ballet's busy spring season when the pandemic hit. "It was really a bummer," Oga says. "I was really looking forward to Swan Lake, Bella Figura, some new world premieres. When we found out the whole season was canceled, it was hard news to take in."

But she quickly determined to make the most of her time out of the studio and physically rest her body. "All the performances take a toll. Of course, I did stretches and exercised, but we never give ourselves enough time to rest as dancers."

She also resumed college courses toward a second career. Oga is one of many Boston Ballet dancers taking advantage of a special partnership with Northeastern University to help them earn bachelor's degrees. Focusing on finance and accounting, Oga upped her classes in economics, algebra, business and marketing. She also joined Boston Ballet's Color Our Future Mentoring Program to raise awareness and support diversity, equity and inclusion. "I am trying to have my voice inspire the next generation," she says.

Jayme Thornton for Pointe

One pandemic silver lining has been spending more time with her husband, Grand Rapids Ballet dancer James Cunningham. The two met at Cincinnati Ballet, dancing together in Adam Hougland's Cut to the Chase just after Oga's arrival, and got married shortly before her move to Boston. Cunningham took a position in Grand Rapids, so they've been navigating a long-distance marriage ever since. They spend a lot of time texting and on FaceTime, connecting in person during layoffs. "It's really hard," Oga admits, but adds, "We are both very passionate about the art form, so it's easy to support each other's goals."

Oga's best advice for young dancers? "Don't take any moment for granted," she says without hesitation. "It doesn't matter what rank you are, just do everything to the fullest—people will see the hard work you put in. Don't settle for anything less. Knowing [yourself] is also very important, not holding yourself to another's standards. No two paths are going to be the same."

And for the foreseeable future, Oga's path is to live life to the fullest, inside and outside ballet. "The pandemic put things in perspective. Dancing is my passion. I want to do it as long as I can, but it's only one portion of my life. I truly believe a healthy balance between social and work life is good for your mental health and helps me be a better dancer."

Students of International City School of Ballet in Marietta, Georgia. Karl Hoffman Photography, Courtesy International City Ballet

A Ballet Student’s Guide to Researching Pre-Professional Training Programs

Many dancers have goals of taking their training to the next level by attending full-time pre-professional programs next fall. But it's hard to get to know the organizations without physically experiencing them first. Even when the world isn't practicing social distancing, visiting a school or attending its summer program isn't always possible. So, what can students and their families do to research programs and know what might work best for them? Who do you reach out to, and what are the questions you and your parents should be asking?

Here, pre-professional-program leaders share some practical advice for taking the next step in your dance training.

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American Ballet Theatre corps member Rachel Richardson. NYC Dance Project, Courtesy Rachel Richardson

ABT’s Rachel Richardson on Performing With Her Hometown Company, Eugene Ballet

When I signed my first professional contract with Eugene Ballet, one of the last things I anticipated was the opportunity to dance beside a member of American Ballet Theatre. Flash forward to the start of our spring season this year, and suddenly I'm chatting in the hallway and rehearsing the Cinderella fairy variations next to luminous ABT corps member Rachel Richardson. When ABT announced it was canceling live performances for the 2020–21 season, Richardson traveled back home to Eugene, Oregon, to be with her family—and this spring joined the company as a guest artist.

Growing up, Richardson trained locally in Eugene before moving to The Rock School for Dance Education's year-round program in Philadelphia. After securing a spot in the ABT Studio Company in 2013, she was promoted to corps de ballet in 2015. This unconventional year marks her sixth season with the main company.

After having the privilege of dancing with her this spring, I sat down with Richardson to discuss her recent guesting experience, how the pandemic has helped her grow and her advice for young dancers.

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