Dance Physical Therapy: Getting Dancers Back on Their Feet

As athletes, dancers are unique. Most start young, while their bodies are still growing. They endure long hours of training that requires repetitive movements and extreme flexibility. And for many, dance is an all-consuming passion — less an activity than a way of life. For some, it defines who they are.

Physical therapist Kristin Goldstein, PT, DPT, holds a device used to measure functional turnout range of motion with ballet dancers in clinic. So, when a dancer is sidelined by an injury, it can be earth-shattering.

“When you tell a dancer they have to stop for six weeks, they can view that as a failure,” says physical therapist Heather F. Stewart, DPT, PT, SCS, a former dancer who works with performance athletes at the Sports Medicine and Performance Center at Children’s Hospital of Philadelphia. “That psychosocial piece always has to be at the back of your mind.”

Physical therapists who are trained in dance medicine are familiar with the psychological toll of being shut out of dance and aim to safely get their patients back to the studio as soon as possible. Sometimes that means modifying routines to avoid harmful moves.

For dancers recovering from surgery or a serious injury, the Dance Medicine specialists at CHOP’s Sports Medicine and Performance Center work together to develop a “return to dance progression” approach, which eases dancers back into action.

“We try to have minimal time lost for these dancers so they’re not deconditioned when they fully go back into dance,” says Naomi Brown, MD, FAAP, CAQSM, an attending physician with CHOP’s Sports Medicine and Performance Center. “We recognize that if we tell a dancer that he or she cannot dance at all it can be very detrimental to their psyche. Much  of their social life and happiness comes from the studio. So being able to give specific direction as to what they can and cannot do rather than restricting them altogether can be helpful to their recovery.”

No ordinary body

Dancers are considered performance athletes, a group that includes gymnasts and figure skaters. They move their bodies in extraordinary ways, which can lead to injuries rarely seen on the field or court. These injuries are often misdiagnosed, which can mean longer healing times and other complications.

“A dancer’s body is unique and the demands on the joints are different,” says Kathleen J. Maguire, MD, an attending physician with CHOP’s Sports Medicine and Performance Center. Dr. Maguire is herself a former ballet dancer. 

Specialists trained in dance medicine know what to look for when diagnosing dance injuries. They also know that a full recovery will look different for a dancer than a non-performance athlete.   

“Dancers, gymnasts and figure skaters need to put their hips in positions that most humans are not required to do,” Maguire says, adding that a hip x-ray that’s perfectly fine for a 14-year-old runner could be problematic for his or her ballet-performing classmate. “Therapists who understand dancers know what the demands are.”

What does physical therapy do for a dancer?

While the focus of dance physical therapy is on regaining full function after injury, it’s equally important to teach dancers how to avoid future injuries. Sometimes that means breaking down myths, like the “pain is gain,” mantra, or the misconception that strength training builds unwanted bulk.

Young dancers in particular rely on flexibility, but without strength and control they can get hurt. Stewart shows dancers how to use resistance bands and other techniques to build strength without mass. When she assesses a dancer, she looks for signs that they might reinjure themselves. Flaws in technique and muscle weaknesses are common culprits in stress fractures, tears, tendonitis, sprains and other injuries.  

“Our goal is to see the compensations that are occurring and help the dancers correct them,” Stewart says, adding that she always tells her patients exactly how her suggestions will help. “It’s one thing to tell somebody what to do, it’s another thing to tell them why they need to do it and how it’s going to lower their risk of injury and decrease their pain.”

Treating the whole dancer

Proper nutrition is critical for performance athletes. Unfortunately, it’s often low on the list for dancers who are intent on staying slim. Stewart talks with the children and adolescents she works with about eating, body image, their typical daily schedule and the amount of sleep they get each night.

It’s an opportunity to reinforce the importance of staying healthy. If there are issues, nutritionists and other specialists at CHOP will help dancers get back on track — and on stage for years to come.

“Dance consumes their lives in a positive way most of them time, but we want to make sure they’re taking care of their body as much as possible,” Stewart says.

If you’re looking for a dance physical therapist in the Philadelphia area, call the Dance Medicine team at CHOP’s Sports Medicine and Performance Center at 215-590-1527 or contact us online for more information. Our dance medicine specialists practice at locations throughout the CHOP care network in Pennsylvania and New Jersey.

• Buerger Center for Advanced Pediatric Care in Philadelphia (dance PT and dance medicine)
• Specialty Care & Surgery Center, King of Prussia (dance PT and dance medicine)
• Specialty Care & Surgery Center, Bucks County (dance medicine)
• Specialty Care Center, Virtua (dance medicine)

Contributed by: Naomi Brown, MD, FAAP, CAQSM, Kathleen J. Maguire, MD, and Heather F. Stewart, PT, DPT, SCS