But for every giant step forward, ballet takes two steps back.
In December 2010, the New York Times dance critic, Alastair Macaulay, in his review of the New York City Ballet’s annual performance of The Nutcracker, took umbrage that the lead ballerina was fleshier than the ballerinas he had been used to seeing in his many decades as a seasoned dance observer. In print, he accused the ballerina dancing the role of Sugar Plum Fairy as having eaten one sugarplum too many, a cheap shot ostensibly meant to shame the dancer for having veered away from the skinny norm.5 Jenifer Ringer, the ballerina in question, a working mom, had, in fact, been battling an eating disorder for years; her curvier body was a result of her having shucked old and dangerous eating habits in favor of new, healthier ones. The critic’s jibes could have set her back. But it was a sign of the times that her public rushed to her defense, writing letters of protest to the paper and clogging the blogosphere with complaints about ballet’s tyranny of thin. It was evidence that the public was all for a curvier, healthier aesthetic. Ringer showed herself to be equally in step with the times, appearing unfazed by the negative scrutiny of her body; she knew it to be an antiquated mindset, a relic of ballet past without relevance or currency. Ringer told Ann Curry on the Today Show that ballet no longer felt a need to demand and reward thinness: “If you are too thin really you can’t do the job,” she said with poise and aplomb. “You’re weak. You can’t do the job. You can’t perform it well.”6
Helping the ballerina perform well—and stay healthy—is science. It might seem a strange dance partner for her to have, but, as Jeffrey Russell, an assistant professor of dance medicine at the University of California, Irvine, points out, without science, ballet couldn’t exist: “Without the physics of muscular force there would be no movement, without biochemistry there would be no muscular activity; you need food to create the energy needed for your body to perform as a dancer. If you take science away, you’ve taken away life itself.”7
At the dance research lab he has been operating out of the university’s engineering wing since 2010, Russell applies these rudimentary scientific principles to enhancing the life of ballet dancers as experienced on the stage. The aim, he says, is “to develop dancers to be better at what they do.” Although his clinic cares for dancers hurt as a result of their jobs, the primary focus is on injury prevention. “It’s a lot easier to maintain something than it is to fix it,” he says, using the analogy of a car, which runs better if it gets regular lube jobs instead of being driven into the ground. “When it breaks down, it’s harder to get it moving again. So it’s better to anticipate the problems than let them happen in the first place.”
Russell views injuries as the biggest problem plaguing ballet as a career choice. “That must mean something is wrong,” he says. As is often the case, it takes an outsider to question what, to the initiated, has become accepted practice. “So let’s study what’s going wrong so we can reduce the number of injuries that come as a result of a dancing career.”
Russell works with a research group of eighteen students, and he isn’t the first health practitioner to devote his energies to helping ballet dancers. Many professional dance companies today are staffed with physiotherapists and other health-care workers who help ballet dancers stay in optimum condition. Russell cites the New York City Ballet, the San Francisco Ballet, the Mariinsky (or Kirov) Ballet, the Alvin Ailey American Dance Theater, and the Birmingham Royal Ballet in England as companies where dance medicine is practiced. But Russell is the only dance scientist he knows of working within a university setting, alongside community-based dance programming. At UCI, there are over two hundred fledgling ballet dancers, and they constitute Russell’s main area of study. But his reach also extends into the community; he uses Twitter to advertise his particular area of expertise. He’s a New World doctor working to help an Old World profession keep in step with the times. Why hadn’t anyone thought of it before? “By and large, people don’t consider dancers as athletes,” Russell says. “There is a complete lack of understanding among the general population about what ballet dancers do. People look at them up on the stage and don’t see the effort. They seem beautiful and not really working hard. Dance isn’t in people’s consciousness the same way that professional sport is. The rigors of what they do and the injuries they sustain just aren’t that well publicized.”
Russell owes his unique perspective on ballet to not having a dance background. He is, by profession, a certified athletic trainer, one of those guys seen running to help an injured football player on prime-time TV. He was working in a sports medicine clinic at Mississippi’s Belhaven College, tending to injured basketball and football players, when a slip of a dancer came in among the jocks desperately seeking his help for a damaged Achilles tendon. He had never treated a ballerina before, but he brought her back to full functioning after a series of therapeutic treatments, including body-strengthening exercises. She told her friends, and soon one ballerina turned into a trickle that became a flood of dancers, all seeking his help. They were mostly young people, community as opposed to professionally trained, left to fend for themselves. Their bodies were a mess, and many weren’t even out of their teens. Their plight inspired him to switch professions. He moved to England to pursue a PhD in dance medicine, which he received in 2008.
Russell did his thesis on the wearing of pointe shoes by ballerinas, specifically the cruel damage they inflict, including tendon damage and sprained ankles. At the forefront of dance science, Russell developed an MRI method for evaluating the ankles of female ballet dancers standing on their toes. The scans shed light on the weight-bearing anatomy of female dancers, affording doctors and scientists a rare glimpse at how pointe shoes impact bones, joints, and soft tissue.8 Together with scientists in England, Russell analyzed the images, comparing them to dancers’ own descriptions of their pain. “I wanted to know the demands of ballet on the ankle and the foot. What are the stresses imposed by the pointe shoe?” It was a breakthrough study, which not only showed “how the musculoskeletal system responds to dance” but also furthered “progress toward the ultimate goal of reducing injuries.”9
“After examining the MRIs of ballerinas, I can tell you that dancing on pointe is not at all good for the ankle,” Russell says. “But the pointe shoe is not going to go away. It would alter the art of the ballerina far too much. So what we can do is help dancers dance to the best of their ability within the confines of ballet and not be sidelined by injury.”10
It’s a radical objective—and also a tricky one. Ballet dancers are slow to give up past practices; their art form is rooted in tradition. Ballet history is passed down from one generation of dancer to another, thereby maintaining its classical lineage. But there is an unforeseen problem with older-generation dancers teaching their successors how to perform ballet as they once practiced it; their instruction often comes encased in bad habits that help perpetuate ballet as an injury-prone profession.
“There’s an old-school line of thinking that physical training will ruin the ballet aesthetic,” Russell says. “In terms of generations, we’re still in a situation where the ones teaching the younger dancers are those who came through a system where there wasn’t much being offered in the way of physical training or even healthy dance practices. In their day, you just did what you did, and if you got hurt, tough. It really comes down to you teach what you know, and if that includes suffering for your art then that’s what’s also being passed down. It will take a major paradigm shift for the average ballet teacher to want to teach ballet in a different way.”
In other words, what often needs fixing most is a mindset. Besides dance teachers, Russell’s biggest challenge remains convincing dancers to set aside time for strengthening and conditioning exercises that will help lessen the number of injuries they sustain in the course of their work. “There are only twenty-four hours in a day, and I understand that for a lot of dancers carving out time to do cross-t
raining isn’t a priority. The typical dancer is going to spend the bulk of that day perfecting the craft.”
But reducing the amount of time given over to technical training in favor of core physical training actually does result in making dancers better artists. Heightened technical achievement in dancers can now be proven to be directly related to a stronger physical foundation. But that’s just the tip of the pointe shoe, so to speak. Russell says more needs to be done to help ballerinas of the future become even stronger as artists and more gifted as athletes. “We’re about twenty years behind sports medicine,” Russell says. “In terms of research, we’re still a number of years away from saying this is what we think is useful. And it will still be a difficult thing to get across to people used to working in the old way, especially because ballet has traditionally not been an area attended to by science. So it’s tough. But I’m going to stick with it. It’s my calling. I do see that I am making a difference. I think I am helping the ballerinas of the future.”
It is a clarion call also to companies to make it their mandate to safeguard the art of ballet for future generations. It starts with a shift in perception, seeing the ballerina not as a slave to her art but as a valuable employee within the juggernaut of the professional ballet company. Such is the thinking of an enlightened troupe like the Australian Ballet. There, ballerinas are perceived as elite athletes and are treated as such.
In 2007, the Australian Ballet implemented a company-wide Injury Management and Prevention Programme aimed directly at dancers’ health. The program came about as a result of ballet culture as a whole becoming more aware of medico-legal and liability issues.11 According to the company’s published mission statement, the aim is to do away with the days when ballerinas would bleed into their pointe shoes and no one would care, replacing a culture known for its abuse and neglect of dancers with one that sincerely cares about their overall health and well-being: “The Australian Ballet is committed to the health (physical and psychological) and safety of its most precious asset, the dancers. This commitment stems from the Board and extends to all levels of the company. The Australian Ballet has facilitated a change in behavior over the years, which has directly influenced the culture from one that poses a high risk to health to one that embodies health and wellbeing. As a result, the company has experienced fewer injuries, dancers are recovering faster and morale has increased.”12 Management regularly counsels dancers that injuries are not to be swept under the carpet or ignored for fear of reprisals. This concern for dancers’ health is written into the company’s policy: “The Australian Ballet has demonstrated to the dancers that reporting injuries does not disadvantage them in any way; on the contrary, everything is done to ensure that dancers are not restricted from their pre-injury status.”13
But it’s a two-way relationship, says Australian Ballet artistic director David McAllister, a former principal dancer with the company: “I see it very much as a shared responsibility. We have tried to build a culture within the company where the dancers are proactive about injury prevention and report any niggles early so we can treat them and avoid long-term periods away from the stage,” he says. “We have also built a great collaboration between the medical and artistic teams so we have shared responsibility about workload for dancers, so that we can keep them dancing but modify their load to avoid progressing to a major injury. But you can only do this with dancers who present early and don’t hide injury. They also need to make sure they are doing all the strengthening and technical coaching work and take responsibility of their own bodies; otherwise you will only be able to patch up.”14
The Australian Ballet takes a multidisciplinary approach to injury prevention; in the wings, at the ready, is a kind of Team Ballet, composed of various physiotherapists, myotherapists, masseurs, sports doctors, rehabilitation facilitators, body conditioning specialists, psychologists, and alternative medicine practitioners doing needling and other forms of acupuncture, devoted to ensuring that all dancers are performing at peak condition. Addressing dancers’ needs extends also to ordering special pointe shoes for a ballerina whose feet might be vulnerable to tendinitis or stress fractures.15 Great care is taken to ensure that they have healthy and strong bodies, a balanced diet, and sound nutrition. Dancers are also encouraged to have open communication with management in discussing their needs and concerns.
Principal dancer Amber Scott credits the open-door policy and the access to pertinent scientific knowledge as enabling her to have a long and rewarding profession: “It’s a grand statement but I believe the medical team and body conditioning programs at the Australian Ballet have been paramount in keeping me dancing professionally for the past eleven years,” Scott says. “The combination of very specific treatment, body conditioning and coaching all unite in a way that educates the dancers to understand the capability of their bodies in a safe environment. The open channels of communication between all departments have been key for learning as much as possible from the medical team. This knowledge has taken away many of the fears I had about injuries. It has empowered me in my quest to maintain a long and healthy career.”16
But even with injury prevention programs in place, accidents do and will happen. Ballerinas can pirouette into the orchestra pit, be hit by falling scenery, be dropped by their partners, or, as was common in the past, catch fire. They can also injure themselves from overuse and as a result of poor training or unsafe choreography. Injuries are worrisome because they can terminate a career before a dancer feels ready to quit. Claire Vince, a member of the National Ballet of Canada’s corps de ballet from 1989 to 1992, had to stop dancing after only four years as a result of a deteriorating hip: “The cartilage on the right hip had worn out from repetitive use, “ says the Australian-born Vince, who trained at England’s Royal Ballet School. “Dancing was so painful for me at the end that I couldn’t do developpés.”17 After moving back to Australia, she had hip replacement surgery. But before that, while still in Toronto, she had what she calls “a big operation on both ankles,” to address os trigonum syndrome, a medical condition caused by repeated downward pointing of the toes, as is common in ballet. Surgeons had to remove excess bone from the back of Vince’s ankles: “Effectively, I had to have the ankles broken, the bones removed, then go in plaster for six weeks,” she says. It sounds horrific, but Vince is matter-of-fact about what she endured as a result of ballet, calling her injuries “a part of a dancer’s natural term.”18
Today pain free, Vince has a new career in public relations. But for most ballerinas, when the dancing stops, they often are at loose ends. They don’t know what to do next. The pain that lingers lies within. The celebrated Canadian ballerina Evelyn Hart, formerly the prima ballerina of the Royal Winnipeg Ballet, has described the abrupt conclusion of a dancing career as a loss of identity, a loss of expression: “I feel I have no voice left.”19
When Joysanne Sidimus stopped dancing in 1970, she plunged into a deep depression. “It was a terrible time,” she says. “I went home to my mother’s and went to bed for six months; I didn’t get out of bed because I didn’t have a reason: My whole life was falling apart.”20 Having experienced firsthand the pain and desperation endured by dancers forced to leave their professions because of illness, injury, or incompatibility with an artistic director, Sidimus soon inquired after some of her colleagues, to see how they were coping with the break from ballet. What she heard shocked her; fifteen of her former partners had committed suicide and another had been committed to the psychiatric ward at New York’s Bellevue Hospital: “I wanted to do something.”
In 1985, Sidimus founded the Dancer Transition Resource Centre, a forward-thinking facility in Toronto providing career counseling, legal and financial advice, grants, and other supports to dancers needing to regain their moorings after being cast adrift from the stage. Since its founding twenty-five years ago, the center has gone on to help more than ten thousand dancers move into second careers in academia, arts
administration, medicine, law, graphic design, engineering, public relations, and real estate. One dancer who went through the center became a commercial pilot.
When it first opened, the center was radical for its time. “When we began, the issue was taboo for most dancers,” Sidimus says. “To end a performing career was something most dancers feared and did not wish to discuss or face.”21
The physical demands are so tough on the body and injuries in ballet are part of the job description. To withstand the wear and tear, a dancer needs youth on his or her side. The average age of retirement for ballet dancers today is twenty-nine. For modern dancers it is forty.
“More than any other professional, with perhaps the exception of athletes,” Sidimus says, “dancers don’t have a choice. Early retirement is built into the profession, and there’s no way around it.”22 In general, Sidimus adds, dancers are forced to give up their careers at a time when most other professionals are just starting to take off in theirs: “As a psychologist who works with us at the Centre says, ‘Dance is a downwardly mobile profession in an upwardly mobile society.’ ”23
David Tucker is a psychologist who worked closely with retired professional hockey players through the Phil Esposito Foundation in Toronto and served as a consultant to Sidimus when she was first establishing the Dancer Transition Centre. “The problem with professional athletes and dancers is that for all their lives they have been so focused on their careers, they don’t know where to even begin looking for a new job,” said Dr. Tucker at the time. “Often they feel desperate and will grab the first thing that comes along. It’s important that they think these things through so as to save themselves perhaps even greater aggravation later on.”24
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