Recovering from an injury.

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I wrote an essay on the arduous rehabilitation process for an individual who uses their body as their professional instrument. I outlined some of the pitfalls and emotional turmoils one goes through.

Submitted: November 12, 2011

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Submitted: November 12, 2011

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Virgil J. Angulo

Leap 11

HPER 109.10: Care & Prevention of Athletic Injuries

I was a professional dancer for 15 years who fortunately sustained only a few injuries. Over the years I have known many dancers who have suffered from varying degrees of injury and I have supported some of them through their recovery. I juried my back once, which still bothers me to this day, and I also pulled my calf muscles twice and torn my left shoulder rotator cuff. I will discuss a) some common causes of injuries, b) pitfalls one can encounter when not following a discipline routine, c) steps one can take to recover from an injury and d) the impact an injury has upon the individual’s life.

Some common causes of injuries.

There are many steps that one who uses their body as their professional tool can take to secure the physical well being of their instrument. Some of the same steps that facilitate recovery from injury are also instrumental in avoiding injuries before they occur. A healthy diet full of the daily recommended nutrients, proper rest, moderate alcohol consumption and a healthy lifestyle free of recreational drugs can help a professional maintain a healthy optimally functioning body. When I finally able to realize a career where I used my body as my professional tool it became vital that I put the health of that instrument first. As professional dancer I always tried to maintain a healthy diet and avoid excessive alcohol consumption during a performance season. At the time it appeared to me that taking extraordinary steps to insure the optimal functioning of my body was necessary to secure a professional career that utilized my body as my soul working instrument.

Tendonitis of the connective tissues within the body’s joints can manifest from overuse so it is imperative that an individual get proper amounts of rest to minimize risk of injury. One should allow their body time to restore to its optimal functioning level before resuming a physically strenuous routine. During my career I noticed that the dancers who respected and cared for their bodies as a professional tool sustained few injuries giving their careers more longevity. These individuals went home to get the sleep necessary to make it through the next day’s demands of performances and/or rehearsals. With ample amount of time to recuperate from the previous day’s bout of physical exertion their bodies were then able to withstand the unrelenting demands that professional dancers ask of their bodies during a work day. If one does not allow their body adequate recovery time the constant stress begins to wear down the bodies’ nature defenses resulting in injury. I learned this lesson the hard way when I injured my lower back I returned to work before my body had completely healed. If I had taken the appropriate measures of an adequate recuperation period perhaps I might have been able to avoid a reinjure of my back which is still prone pain from inflammation and irritation. I was told that the cushion between two of my lower back vertebrae is extremely compressed usually seen in patients much older than myself.

To ward off injuries and insure maximal efficient performance an individual partaking in physically strenuous exercise should always warm up their muscles sufficiently before starting. Warming the muscles brings blood and other bodily fluids into the area that will be performing the strenuous exercise. With joints fully lubricated the muscles are more malleable and elastic readying them to absorb the force of impact required during strenuous exertion. A properly warmed muscle also has more physical endurance with the ability to work more efficiently facilitating long term use. A cold muscle may appear tight and rigidly stiff being unresponsive and hesitant to react. In such a situation a muscle is more prove to tearing. Until I am completely warm I feel as those I am not in control of my instrument as though someone else is calling all the shots of instructing my body. During my third year as a professional dancer with a ballet company I had just such an occasion which resulted in me pulling one of my calf muscles. I was landing out of a jump when my calf torn resulting in a bruised swollen where the muscle attaches to the Achilles tendon. Once I recovered I was always sure to completely warm my muscles either on my own or in class before working them.

Professionals who use their bodies as their tool are often required to use that body in activity that the human body was not originally intended. Stretching the muscles creates supple agile muscles that are less prone to injury. Limber muscles facilitate the ability to handle yielding to the extreme demands of being pushed to the farther limits of abnormally hyper extensions. During strenuous use as the muscle fatigues it tightens creating a situation for a muscle to be injured. Every time I pulled a muscle it was because that muscle had become tight and enlarged during a rehearsal or performance. I learned to continue stretching my muscles during strenuous use to maintain their suppleness to keep the muscles from stiffening or cramping during long rehearsals. After many years of Yoga and Pilate classes I have implemented a personal regimen that I created in which I continue to my muscles stretch on my own in a corner of the studio during rehearsals.

 The body works as a cohesive unit so another tactic for maintaining the health of an individual’s body is to partake in physical activity that has cross training reciprocal benefits.  One should try to institute a personal regimen that utilizes exercises that have the mutual attributes of amassing muscle in area that are not routinely used in their chosen profession. There can be inadequacies in a training program that is too narrowly focused on program specific designed for a given profession weaknesses within one’s instrument can be over looked. Yet it was an accepted requirement of my profession to partner and lift other dancers. I realized that the injury to the rotator cuff of my shoulder was contributed to the fact that I neglected this area of my body with my traditional dance training. I used resistance weight training to build additional beneficial muscle on my upper body which working as a professional dancer was often neglected by the traditional practices of dance. I needed to take upon myself to seek out training that would create a well rounded instrument with the capacity to meet all the demands of a male professional dancer. One can also benefit from endurance and stamina enhancing exercises that build cardio and pulmonary performance abilities. I now realize that one should seek out a personal regime with the potential to fill in or augment their training specific to their profession.

Techniques like Yoga, Pilates and Feldenkrais not only assists in maintaining the flexibility of muscles but also helps keep the body healthy by reducing stress which has the potential of aiding the immune system. With a relaxed mind cleared of all outside distractions the individual is now able to devote all their concentration on their work duties minimizing their exposure to taking misstep. I go to a corner of the studio where I can a little solitude to focus my attention. I now use yoga poses to continue keeping my muscles malleable and pliable to avoid tearing a muscle. My continued practicing of these disciplines also aids my immune system by keeping me focused which centers me through relaxation.

Often the individual may have existing muscular deficiencies that they are not aware of until they sustain an injury. A professional dancer may find during the rehabilitative physical therapy process that they have been more prone to injury than they had realized because of hidden compromises to their physical muscular structure. After seeking the advice of a trained experienced professional who can evaluate the dancer’s weaknesses together they can then consider the steps to take to eradicate any potential risks for injury. I only became aware of hidden weaknesses with my body during a physical therapist examination to ascertain the extent of an injury I had sustained. Consequently I found that I had more work to recuperation than I had previously thought before the injury. Armed with this new valuable information they can then set up a training program that will benefit the professional with their work going forward.

 Pitfalls one can encounter when not following a discipline routine.

Although one may adhere to a disciplined lifestyle this does not insure an injury free career all risks of injury never eliminate. The mere fact that one uses their body as their professional tool will brings about times when they put their body at risk of injury.  The professional walks a thin line between challenging themselves and pushing their body too far. Given that many professional dancers being their careers quite young they may feel that their bodies are indestructible. Every time I injured myself was on occasions when I felt that I was living a healthy lifestyle and content that I was at the top of my abilities. Perhaps this feeling of indestructibility instilled me with a false sense of security that instigated me into pushing myself that bit too far ending in injury. At the time my youthful naiveté lead me to working under the belief that my body could take on forms of punishment I meted out.

Everyone finds themselves at times straying from their life of self imposed restrictions. For many individuals who choose to use their body as their professional instrument living a life of monastic restraint can become trying. There were times that I needed to cut loose and stray from my regime to alleviate the confines that began to feel suffocating. This break from one’s routine of restraint can result in loss of sleep that may contribute to a misstep or landing out of a jump into a wrong position bringing about an injury. The difference between executing a safe finish from a jump can be very narrow. The break from my routine caused me to be fatigued which facilitated the straying of my mind’s concentration while I was working. I now know that one must continue to follow their plan of self discipline when their body is their sole work instrument.

The body requires a healthy balanced diet to repair torn tissues and mend broken bones so a proper diet full of essential nutrients is imperative for full body repair. Without a proper diet injuries will not fully rehabilitate to optimal functioning ability. Many dancers eat a sparse diet as an everyday habit believing that over consuming food will lead to a thick body. For a group of professionals who already obsesses over their weight being inactive may prompt some to manipulate their diet out of fear of gaining weight during a sedentary convalesces. Unfortunately an improper diet may have contributed to their injury in the first place. Now they may be jeopardizing their recovery by continuing to eat an insufficient diet. I often ate just enough to keep myself functioning consequently when I became inactive due to an injury I ate even less. I played a game with myself everyday trying to see how little I could eat and still keep functioning. This game can have dire ramifications with an individual’s health halting recover altogether. Fortunately I recovered completely but many young dancers are not always so lucky. I came to realize that my full recovery and a speedy return to work were dependent upon consuming a proper diet.

An individual may take every precaution to guard against injury strictly avoiding unsafe activities outside of work unfortunately mistakes are an inevitable human frailty that even those who use unrelenting precaution still sustain. I often avoided activities that I felt put my body’s health at risk and jeopardized my professional life by taking extraordinary precautions outside of work. Many professional dancers go beyond what most people would consider necessary to safeguard against injury. I took every precaution I felt necessary only to sustain injuries during the duties of my professional career as a professional dancer. In fact the only times that I sustained any injury was while executing the requirements of my work. I came to realize that one can never remove all potential of injury they were simply a hazard of the profession.

Steps one can take to recover from an Injury.

After an injury the individual must take the appropriate amount of time to allow for their injury to fully recover before engaging in any rehabilitative or strenuous exercise. The obvious route to recovery from injury would be to follow the doctor’s instructions but many dancers may be eager to return to work as soon as possible. Sitting sedately while waiting for injuries to rehabilitate can become tedious for professionals who are accustom to daily physical activity. They may be instigated to return to work by the need to continue what they worked hard to achieve, boredom or even a misguided desire to please their boss. All of these dynamics can have detrimental effects on a dancer’s body causing an early end to their career. I am still experiencing the repercussions of lingering tendinitis from returning to work early. I now realize that the possibility of enduring lifelong complications warrants a patient convalescence. I never should have pushed through the pain which should have been interpreted as a signal to heed instead I took pills to quell my body’s warning signs. I learned to listen to my body when I am felling tired out or sorts to stop before I become injured.

Attempting to hasten their recovery many professionals may seek out any rehabilitation therapy that they feel will benefit them. There is no shortage of alternative therapies everyone will have advice to give with stories of their personal success when using untraditional approaches to their recovery. They may feel stymied by traditional medicine’s wait and see approach to recovery. When I pulled my calf muscle I felt uncomfortable lying immobilized in my apartment waiting to heal while others in my company progressed along. Feeling left behind I craved a quicker solution than waiting the six weeks that traditional medicine prescribed so I tried any and all modalities suggested to me in hopes of moving along my recuperation. With acupuncture my calf muscle released immediately allowing me to begin the process of pursuing my recovery. Before I discovered acupuncture I felt lost because my calf muscle was a completely nonfunctioning hard inflexible ball. I was relieved to find that there are alternative forms of medicine available which can hasten an individual’s restoration.

An ample night’s rest coupled with a healthy diet is essential to facilitating a complete recovery from an injury. Given that the body works as a coordinating interactive unit getting a full night’s sleep also facilitates recovery from injury. Losing sleep drains the immune system of vital resources necessary for the body’s full recovery. The body does most of its repairing during sleeping hours so it is imperative that an individual get a good night’s sleep. As someone who suffers from insomnia I always felt more sore the next day on those nights that I did not get a full night’s sleep. On many occasions I spent a restless night trying to get a full night’s sleep without success only to go to rehearsal or class the next morning with my body feeling rigid and stiff. Looking back it seems that in order for the body to function properly it needs an ample night’s rest. I realized that loss of sleep set me up for injury during rehearsal. After this episode I was always more conscientious about getting a good night’s sleep.

Allowing muscles to take appeal time to fully heal also prevents further injury. Pushing the body can have disastrous consequences. Many dancers fearful that their position within the hierarchy within their company is tenuous may try pushing their bodies by creating exercises they hope will facilitate a rapid recovery. I allowed myself to be coerced into participating in an eminent tour of Russia. Instigated by fear of losing my position within the company ranks I felt an urgency to return to work quickly. I tried to force my body into performing more rapidly even though I was advised by my doctor to give my body a longer recovery period. This concern for an accelerated recuperation time prompted me to hasten my recovery by starting exercises using a theraband on my calves. I now have Achilles tendinitis in both my calves which hastened my earlier retirement from dancing professionally.  

The Impact an Injury has upon the Individual’s life.

Injuries are an inevitable result that every person who uses their body as their professional tool must reconcile. With all the endless possibilities of youth being injured for the first time may come as a rude awakening for many young dancers. Before sustaining an injury they may have functioned under the false belief that injuries only happen to other people. I have heard many young dancers say after an injury, “I never thought this could happen to me.” After sustaining an injury they may find themselves spiraling down into a deep abyss of self doubt. Bodies heal but one’s sense of well being suffers from lack of a secure foundation. Forced to face the frailties of their body they may start considering what might become of them after they finish with their dance career. All their life choices may now seem ridiculous for not taking into consideration the long term well being of their personal and financial security. They now must acknowledge that the day will come when they will have to move on with another new facet of their lives. Like many who must start a physical career while still quite young I did not finish my college experience before embarking on my professional path as a dancer. Years later the physical restraints of age have expedited my retirement from dance. I realized that I needed to further my education in order to migrate into another profession.

The pressures of maintaining a career while still discovering one’s self value without having developed healthy survival skills can often distort a young dancer’s priorities. Careers that require one to use their body as their professional tool often have professionals who start their careers quite young. Many may have undeveloped insecure fragile egos. Having been forced into self reliance at an early age without a healthy support system may cause many to look externally for validation. The often highly disposable nature of these competitive professions coupled with a need to please for validation can be a catalyst for many under matured youngsters into developing odd coping tactics. Whenever I became injured I wanted desperately to return to working with the company I had been benched from. Desperate to prove that they warrant professional status many young dancers may be determined not to be left behind. I felt that I would be shirking my responsibilities by letting down my colleagues who I had been working hard with preparing for a tour when I found myself injured. I was eager to please my boss and believed that going on tour would establish my credibility to work for that particular company. Looking back I realize that this urgency to return to work was an unhealthy drive to please others fostered by a lack of a secure self esteem which contributed to my need for external validation. Hastening a speedy recovery has left me with linger physical ailments that continue to limit my physical abilities years after having left the dance world.

A dancer may fear that they will be seen as a liability prompting the selection of another dancer that is less injury prone. They may see promotions which they worked hard to receive being given to others while they watch from the sidelines. The dancer may begin to believe that they will find themselves being passed over so they may push pain through keeping injuries them to themselves. I pulled a muscle in my shoulder during a performance while executing an over head lift that still gives my trouble to this day. At the time of the injury I just kept dancing the role never complaining about the injury because I felt that I would be replaced. They may not contemplate the long term impact of hiding an injury will have on their life. It never occurred to me that years later I would still be experiencing limited range of motion with intermittent pain from a torn muscle in my shoulder fifteen years later. I learned that a professional must immediately address all injuries or suffer irrevocable consequences.

An injury can have a lifelong impact upon the individual not only expediting an early end to their career but residual pain that limits physical abilities in later careers. Years later I still experience the loss of strength do to a low threshold for stamina in my calves while taking ballet class or any high endurance exercise. The tendinitis I developed over years of “pushing through the pain” sets off dormancy in my calf which like a machine appears to run out of gas stalling during use. Literally nothing happens when I attempt to push off the floor to become air borne while ascending into a jump. My calf simply stops responding. Obviously not knowing if my body would react to my commands became extremely nerve wracking when I was still working as a dancer. Out of frustration I simply retired rather than continue risking farther damage to my body and sanity. I often have experience moments fear of when I am considering the job requirements of a new job. I wonder if I will encounter any limitations caused by an old injury that may impede my job performance. 

As a dancer ages injuries become a liability within the culture of a dance company. Injuries become a more prevalent element of the professional’s working life. After many years of persistent injuries the only choice for many dancers becomes how many more injuries before they finally decide to retire? I finally decided to stop dancing because of the tendonitis I developed in my Achilles Tendons which caused me great pain every time I danced. Beyond the pain, loss of strength and stamina I could no longer endure the anxiety of gauging my body’s reactions on that given day. Many times I would be coming out of a jump landing with a thud struggling not to off flat on my face. My legs gradually lost their ability to rebound from a landing after coming out of a jump. My only option was to change the choreography literally while I was dancing by transposing all the remaining choreography to the opposite foot. This uncertainty had a very stressful affect upon me as I prepared to go on stage waiting in the wings I would worry about whether I would be able to finish a performance. This fear developed into panic attacks until I became over wrought with worry backstage in the wings as I waited for my entrance. Finally I chose to retire from dance because the lifestyle became too nerve-racking.

 Much of the professional’s energies are spent on maintaining their instrument in top condition. The constant demand to constantly incorporate new strengthening exercises into the professional’s training program can become a dauntingly never ending endeavor. But this consistent reevaluating and challenging of the physical instrument is necessary to keep the body functioning at its optimal abilities. It can become tiresome after years of making one’s body their main focus. Toward the end of my professional career I was dedicating many additional hours on a personally crafted stretching and strengthening regime before and after company classes and rehearsals. I set aside private time in the mornings and evenings that I felt was necessary to maintain my peak professional competitive edge. Many people I had been in romantic relationships with found this unrelenting dedication to my body annoying. I would warn them that I had to go home early to my stretches as well as getting the necessary rest to start again the next morning the process of ready my body for a day’s work of dancing. I often felt like chucking it all aside to stay out late or sleeping longer in the morning. But I realize that my profession demanded that I approach my work with a healthy body.  

An injury can halt the ambitions of a young dancer’s progress within a company. The career of a professional who uses their body as their tool is short lived so they may feel that all their hard work will be lost if they are taken out of the performance schedule for a lengthy recuperation period. From the dancer’s perspective valuable time needed to establish their hierarchy within the company ranks is lost while recovering from an injury. Even though it may be for their own good the slow pace of recovery for many people accustom to activity can often cause anxiety from the boredom of an enforced sedentary lifestyle. Looking back the threat of and recovery from injury took up a major portion of one’s careers.

After years of striving toward an anticipated goal one can lose direction in their professional life with the fruition and finally the ultimate termination of that objective. The loss of one’s life purpose can send many into a deep depression. After enduring the arduous rehabilitative process they will have to reevaluate their life goals if they not able to continue with their chosen career. When one has worked a lifetime striving towards achieving a goal having it end abruptly once realized can wreak havoc with that individual’s purpose for accomplishing an aim. My ambition to excel my drive to continue pushing forward took a beating once my end resolution was taken away. Given that a dance’s career is quite ephemeral they will need to consider what they will do with the rest of their life once they stop dancing. It can be disheartening to finally reach a dream one has held for years only to have it end relatively quick.

Conclusion:

One must always be responsible for their personal wellbeing by taking the necessary steps to ensure their body’s health. The professional who enters into a career which requires the use of their body as their tool must make choices to preserve the health of their instrument everyday of their professional life. Young professionals who use their body as their tool often over estimate their physical fortitude. Unfortunately that false sense of security is soon proved a fallacy when they are surprisingly struck with a debilitating injury. Weaknesses that previously the professional had no knowledge existed are often only revealed after sustaining an injury during the rehabilitation process. Dancers are often asked to use their body in ways that go beyond the original intention of normal human activity. It is imperative that the muscles be adequately warmed to facilitate flexibility to sustain hard rigorous use.

 Although one may adhere to a disciplined lifestyle this does not insure an injury free career. Injuries that involve the body are an unavoidable fact of a professional dancer’s work activities. For a professional whose body is trained for constant motion the prospect of being completely immobile bed ridden for possibly weeks can be devastating to their ego. Professionals prompted by a desire for a full speedy recovery may try all forms of therapy available hoping to return their sole working tool back to full functioning capacity as quickly as possible. The first time a young professional experiences an injury they are forced to face the realization that they are not indestructible and must consider what they might do if they were not able to dance. The revelation that they cannot dance forever often sends many young dancers into a phase of questioning the life choices that brought them to become a dancer. They may also worry that being benched for a long recovery time could be interpreted as troublesome by decisions makers within a company. Having held a goal for many years of one’s life only to have it evaporate once reached at a relatively young age can make life seem fleetingly random.


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